breaking the cycle of poverty early: by education & nutrition d.s akram hon. chairperson health...
TRANSCRIPT
Breaking the cycle of poverty early: by Education & Nutrition
D.S AkramHon. Chairperson
Health Education & Literacy Program- Pakistan19th July 2015
Washington-DC
Outline of Presentation
• Insight into the issues related to nutrition and ECD in the developing world-Pakistan as an
example• UNICEF’s Conceptual Framework for
malnutrition• Possible solutions
• Scaling up Nutrition• What will we gain
World Map based onDeaths from All Nutritional Deficiencies*
Accessed at http://www.worldmapper.org/display_extra.php?selected=412 8/4/08
* Deaths from protein-energy malnutrition, iodine, vitamin A, iron deficiency in 2002. ICD 10 codes: D50-D53, D64.9, E00-E02, E40-E46, E50-E64.
What is causing malnutrition (Unicef’s analysis)
The “Window of Opportunity” for improving nutrition is very small…pre-pregnancy until 18-24 months of age
-2.00
-1.75
-1.50
-1.25
-1.00
-0.75
-0.50
-0.25
0.00
0.25
0.50
0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60
Age (months)
Weig
ht
for
ag
e Z
-sco
re (
NC
HS
)
Latin America and Caribbean
Africa
Asia
Repositioning Nutrition, 2006
• Over 162 million children <5 years are STUNTED• Maximum rates in South Asia are between 40-53%• Proxy indicator for reduced physiological capacity, work
output• Decreased educational achievement• Negative employability (Martorell R; 1996. Paper for WB)
Pakistan
Mountains
Plains
Desert
Scarcity of water
Urban Slum
Mapping Nutrition
Ref: “Mapping of Nutrition Initiatives” DS Akram ,et.al.TRF2013
Interventions that Affect Maternal and Child Under Nutrition
Newborn babies• Promotion of breastfeeding (individual and group counseling)
Infants and children• Promotion of breastfeeding (individual and group counseling).
• Behavior change communication for improved complementary feeding*
• Zinc supplementation
• Zinc in management of diarrhea
• Vitamin A fortification or supplementation
• Universal salt iodization
• Hand washing or hygiene interventions
• Treatment of severe acute malnutrition
*Additional food supplements in food-insecure populations.
(Sufficient evidence for implementation in all 36 countries)
www.thelancet.com Vol 371 February 2, 2008
Possible Solutions
Address Intermediate and underlying Causes
Infant and Young Child Feeding Early Child stimulation Indigenous Hi density foods for children, PLW Address food insecurity Micro – Credit / cash transfers Empower Women – 43% reduction in malnutrition
by educating women (Smith and Haddad, 2000) Land reforms – subsidized agriculture Alternate sources for power generation Employment POLITICAL AND SOCIAL SECURITY
Financing envelope
Health sector
Narrow nutrition lens
Multisectoral nutrition lens
Education sector
Agriculture sector
Private sector
Financial sector
Trade and tax policies sector
Transportation sector
Multiple other sectors
Incre
as
ing
spa
ce fo
r ne
w
sec
tors
& n
ew
pa
rtners
Environment sector
Go
ve
rnan
ce
Ge
nd
er
Broadening the “nutrition lens”…
Po
vert
y a
llev
iati
on
Scaling Up Nutrition (SUN)September 2010
Coordinated by U.N.
• Based on evidence based nutrition strategies from “Lancet Series 2008”
• Public-Private Partnership of 102 government and non-government global partners
Based on Three Principles:• Should be Country Based and “Owned”• Focus on “Window of Opportunity” priority to first
1000 days of life.• Multi-Sectoral approach with integration of nutrition
in related sectors.
Reaching the ‘Unreached’
• Conventional methods: face to face, interactive radio, television
• Peer counselors and child to child, child to parent teaching
• Using technology: alternate sources of power in schools and health centers
• Utilizing mHealth, voice messaging and visuals• Using skype for virtual classes and group counseling• CSOs partnering with governments
School in Tharparker & Solar Plant
What will we Gain?
• Investment in Nutrition of children will results in :– Decreased mortality (save 1 million deaths per year or 30
million life years).– Decreased morbidity.– Improved physical & mental growth.– Contribution to achieving ALL MDGs goals.– Increase in lifetime earnings.– Very high rates of return among the top 10 development
investments.
Convention of the Rights of the Child.
• Adopted by UN General Assembly on 20th Nov, 1989.• Total of 10. Principles.• Principle No 4: The child shall enjoy the benefits of social security. He shall be
entitled to grow and develop in health, to this end, special care and protection shall be provided both to him and to his mother, including adequate pre-natal and post-natal care. The child shall have the right to adequate nutrition, housing, recreation and medical services.
-Our Right – Food Security Good Governance