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The World Health Organization (WHO) and other global nutrition and health agencies recommend nutrition actions throughout the life-course to address malnutrition in all its forms. In this report, we examined how Pakistan’s nutrition policies and programs addressed recommended nutrition actions, nutrition outcomes, and the determinants of these outcomes. We reviewed population-based surveys and administrative data systems to assess the availability of data on nutrition actions and on indicators of determinants and outcomes. Our policy review identified a total of 53 recommended evidence-based nutrition actions, of which 51 were applicable to Pakistan; of those, 47 were addressed in nutrition policies and programs. Nutrition actions not included in current policies and programs were: daily iron and folic acid (IFA) supplementation and deworming during preconception; and food supplementation for complementary feeding, and daily IFA supplementation during early childhood. The Pakistan Multi-Sectoral Nutrition Strategy (PMNS) (2018–2025) was found to recognize and address all the key determinants of nutrition; it also expressed an intent to address all the Sustainable Development Goal (SDG) nutrition targets for maternal, infant, and young child nutrition. Targets for noncommunicable diseases (NCDs) were not currently set in the national strategies. Our data review found that, out of 47 actions that policies and programs addressed, population-based surveys contained data on 26 actions and administrative data sources contained data on 22 actions. Neither surveys nor administrative sources contained data on any actions aimed at adolescence, on energy and protein dietary supplements, on various types of counseling, on birth preparedness during pregnancy, or on optimal timing (delayed) of umbilical cord clamping; they also did not contain data on indicators related to newborn care, IFA supplementation around delivery and in the postpartum period, or counseling after growth monitoring during early childhood. The data gaps in population-based surveys on nutrition actions during early childhood were compensated for by the data on these nutrition actions that was available from administrative sources. Neither of the population-based surveys contained data on nutrition actions during early childhood such as breastfeeding counseling, counseling on appropriate complementary feeding, growth monitoring, and identification and management of severe acute malnutrition (SAM), or management of moderate acute malnutrition (MAM); administrative data sources, however, contained data on these actions. Population-based surveys contained data on most of the indicators on immediate and underlying determinants of undernutrition, but administrative data sources lacked data on indicators of immediate determinants. Population-based surveys contained data on all outcome indicators. In conclusion, Pakistan’s policy landscape for nutrition is robust, but there is limited consideration of targets for NCDs. The gaps in data availability for tracking progress on nutrition are much greater than are the gaps in policies and programs for addressing the recommended actions. Future population-based surveys and future modifications of other data systems should aim to fill the identified data gaps for nutrition actions.
The World Health Organization (WHO) and other global nutrition and health agencies recommend nutrition actions across the life-course to address malnutrition in all its forms. In this report, we examined how Maldives’ nutrition policies and programs addressed recommended nutrition actions, determinants, and outcomes. We reviewed population-based surveys and assess the availability of data on nutrition actions, nutrition outcomes, and the determinants of these outcomes. Our policy review identified a total of 53 recommended evidence-based nutrition actions; of these, 49 nutrition actions were applicable in Maldives and 31 were addressed in the country’s nutrition policies and programs. The Maldives nutrition plan (the Integrated National Nutrition Strategic Plan, or INNSP) recognized and addressed all key determinants of nutrition except women’s status (appropriate age of marriage/childbirth) and infectious diseases; the country’s nutrition plan aimed to track progress on all nutrition outcome indicators. Our data review found that of 31 actions addressed by policies and programs, population-based surveys contained data on only 22 actions. Neither of the population-based surveys contained data on a range of actions, including advice on consuming iron and folic acid (IFA) during pregnancy, support for early initiation of breastfeeding and immediate skin-to-skin contact, optimal feeding of low-birth-weight infants, counseling of mothers of low-birth-weight infants on kangaroo mother care (KMC) during delivery and postpartum period, counseling on infant and young child feeding (IYCF), growth monitoring, and counseling after growth monitoring during early childhood. The population-based surveys contained data on most of the indicators for immediate and underlying determinants; indicators that were not available included maternal dietary diversity during pregnancy, household food insecurity, and coverage under social protection schemes. With the exception of anemia among non-pregnant women, data on all nutrition outcomes was available in population-based surveys. In conclusion, Maldives should consider updating its national policies and programs to address existing gaps in recommended nutrition actions; in addition, future population-based surveys may also need to be revised to fill identified data gaps around nutrition actions and determinants.
The World Health Organization (WHO) and other global nutrition and health agencies recommend nutrition actions throughout the life-course to address malnutrition in all its forms. In this report, we examined how Nepal’s nutrition policies and programs addressed recommended nutrition actions, nutrition outcomes, and the determinants of these outcomes. We reviewed population-based surveys and administrative data systems in order to assess the data availability on nutrition actions, and on the indicators of determinants and outcomes. Our policy review identified a total of 53 recommended evidence-based nutrition actions, of which 50 nutrition actions were applicable in Nepal. Of these, 45 were addressed in the country’s nutrition policies and programs and some of the actions were only available in some districts. Nutrition actions that were not included in current policies and programs included calcium supplementation and advice on consuming calcium during pregnancy, and daily iron and folic acid (IFA) supplementation during childhood. Current policies addressed daily or intermittent IFA supplementation during preconception and food supplementation for malnourished lactating women during the postnatal period; however, there was no program to implement these actions. Nepal’s Multi-Sector Nutrition Plan (MSNP) recognized and addressed all key determinants of nutrition; it also expressed an intent to address all SDG nutrition targets for maternal, infant, and young child nutrition. Noncommunicable diseases (NCDs), however, were addressed separately by a multisectoral plan for NCDs. Our data review found that out of 45 actions that policies and programs addressed, population-based surveys contained data on only 27 actions and administrative data systems contained data on only 25 actions. Population-based surveys and administrative data sources contained no data on: food supplementation during adolescence; weight monitoring and various types of counseling during pregnancy; optimal timing (delayed) of umbilical cord clamping, support for breastfeeding and immediate skin-to-skin contact, optimal feeding of low-birth-weight infants and counseling of mothers of low-birth-weight infants on kangaroo mother care (KMC) during delivery and in the postpartum period; breastfeeding counseling, counseling on appropriate complementary feeding, counseling after growth monitoring, and inpatient management of severe acute malnutrition (SAM) during early childhood. Population-based surveys contained data on most of the indicators of immediate and underlying determinants, while administrative data systems did not have data on all indicators of immediate determinants. Data on all indicators of nutrition outcomes were available from population-based surveys. In conclusion, Nepal’s policy and program landscape for nutrition is robust, however the gaps in data availability for tracking progress on nutrition actions are much larger than the gap in policies and programs for addressing recommended actions. Future population-based surveys and modifications of administrative data systems should aim to fill the identified data gaps for nutrition actions.
The World Health Organization (WHO) and other global nutrition and health agencies recommend nutrition actions throughout the life-course to address malnutrition in all its forms. As global recommendations are updated based on available evidence, it is anticipated that governments and stakeholders will, in turn, build on these recommendations to update national policies and programs. Little is known in the South Asia region about policy coherence with globally recommended actions. Even less is known about the degree to which countries are able to track their progress on nutrition actions. To address the gap, this brief summarizes the policy and program gaps in addressing nutrition actions, along with data gaps in population-based surveys in all the countries in the South Asia region, including Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka.
At the 2013 Nutrition for Growth Summit in London, 96 signatories (governments, civil society organizations, donors, United Nations’ agencies, and businesses) agreed to support the creation of an annual report on global nutrition that would be authored by an independent expert group, in partnership with a large number of contributors. The first edition of this report, the Global Nutrition Report 2014, puts a spotlight on worldwide progress by the 193 member countries of the United Nations in improving their nutrition status, identifies bottlenecks to change, highlights opportunities for action, and contributes to strengthened nutrition accountability on country and global levels.
Few challenges facing the global community today match the scale of malnutrition, a condition that directly affects 1 in 3 people. Malnutrition manifests itself in many different ways: as poor child growth and development; as individuals who are skin and bone or prone to infection; as those who are carrying too much weight or whose blood contains too much sugar, salt, fat, or cholesterol; or those who are deficient in important vitamins or minerals. Malnutrition and diet are by far the biggest risk factors for the global burden of disease: every country is facing a serious public health challenge from malnutrition. The economic consequences represent losses of 11 percent of gross domestic product (GDP) every year in Africa and Asia, whereas preventing malnutrion delivers $16 in returns on investment for every $1 spent. The world’s countries have agreed on targets for nutrition, but despite some progress in recent years the world is off track to reach those targets. This third stocktaking of the state of the world’s nutrition points to ways to reverse this trend and end all forms of malnutrition by 2030.
The concept of food and nutrition security has evolved and risen to the top of the international policy agenda over the last decade. Yet it is a complex and multi-faceted issue, requiring a broad and inter-disciplinary perspective for full understanding. This Handbook represents the most comprehensive compilation of our current knowledge of food and nutrition security from a global perspective. It is organized to reflect the wide scope of the contents, its four sections corresponding to the accepted current definitional frameworks prevailing in the work of multilateral agencies and mainstream scholarship. The first section addresses the struggles and progression of ideas and debates about the subject in recent years. The other sections focus on three key themes: how food has been, is and should be made available, including by improvements in agricultural productivity; the ways in which politico-economic and social arenas have shaped access to food; and the effects of food and nutrition systems in addressing human health, known as food utilisation. Overall, the volume synthesizes a vast field of information drawn from agriculture, soil science, climatology, economics, sociology, human and physical geography, the nutrition and health sciences, environmental science and development studies.
Since the group of least developed countries (LDCs) was identified in 1971, only five countries have graduated from the group, all of which are characterised by small size or population. The projections are that the next decade will see a rapid increase in the pace of graduation, with Bangladesh in particular poised to be one of the largest countries, in terms of its economy and population, yet to leave the group. While previously many LDCs viewed the prospect of graduation with some apprehension, fearing significant erosion of international support, increasingly, the move is being seen as a more positive landmark. This book aims to articulate appropriate strategies and initiatives to help Bangladesh to maintain its developmental momentum and to prepare for a sustainable graduation in 2024. In doing so, the book explores themes such as key analytical issues of the LDC graduation paradigm, smooth transition and structural transformation, and post-graduation challenges and opportunities. Further, against the backdrop of Gross National Income per capita, the Human Assets Index and Economic Vulnerability Index goals required for graduation, the Sustainable Development Goals (SDGs) set by the 2030 Agenda will also be in the process of implementation. Whilst some feel that the two agendas might be in conflict, the book teases out some of the important synergies which can be drawn when LDCs are undertaking the journey of graduation in the era of the SDGs. The book also takes into cognisance the uncertain external environment and the emerging global scenario within which Bangladesh's graduation is to take place. Conceptual discourse around LDC graduation and the particular narrative around Bangladesh's journey towards LDC graduation will be of interest not only to scholars of Bangladesh, but also to researchers and policymakers with an interest in LDC graduation for other countries facing similar challenges.