Download - Multi-Sector Nutrition Plan
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Multi-Sector Nutrition Plan
Approved by the Cabinet Meeting of the Government of Nepal on 19 November 2017
(2018–2022)
Government of NepalNational Planning Commission
Government of NepalNational Planning Commission
Singha Durbar, Kathmandu, Nepal2017
Government of NepalNational Planning Commission
Singha Durbar, Kathmandu, Nepal2017
Multi-Sector Nutrition Plan-II
Unofficial Translation
(2018–2022)
Approved by the Cabinet Meeting of the Government of Nepal on 19 November 2017
Multi-Sector Nutrition Plan-II2018–2022
Published byGovernment of NepalNational Planning CommissionSingha Durbar, Kathmandu Tel: (+977)-014211136, 4211158Fax: (+977)-014211700 Email: [email protected]: www.npc.gov.np
Year published: 2017Copyright: National Planning Commission
Photos: © UNICEF Nepal
Recommended citation: NPC (2017). Multi-Sector Nutrition Plan: 2018–2022. Kathmandu: National Planning Commission.
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Throughout the world, ending malnutrition is taken as a basis for achieving social, economic and human development as well as the Sustainable Development Goals. Studies have shown that the health issues caused by malnutrition are serious, long lasting and irreparable. Approximately 36 percent of Nepalese children suffer from stunting and 10 percent from wasting. Therefore, addi-tional efforts from all relevant stakeholders are es-sential to achieve the social and human develop-ment commitments Nepal has made at regional and international forums.
In this context, under the leadership of the Na-tional Planning Commission, and with coor-dinated support from relevant ministries and development partners, the Multi-Sector Nutri-tion Plan (MSNP, 2013–2017) has been imple-mented. It is essential to launch additional efforts targeted to reduce malnutrition in pregnant and lactating mothers, children under the age of two and adolescent girls. Similarly, as a continuation of the current plan, with participation from seven relevant ministries, development partners and other stakeholders, MSNP-II (2018–2022) has been formulated for the upcoming five years. This plan needs to be implemented with priority following the federal structure at all levels – fed-eral, provincial and local, so as to reduce malnu-trition which adversely affects social, economic and human development.
The plan has the target of minimizing the adverse effects on human capital and social and economic development by reducing chronic malnutrition
Message from the Prime Minister
from the current 36 percent to 28 percent in the upcoming five years. As per the World Health As-sembly global targets, malnutrition needs to be reduced to 24 percent of under-fives by the end of 2025. Similarly, the Sustainable Development Goals target is to reduce the percentage to 15 per-cent by 2030. In line with this, the plan attempts to build capacity at all levels of government agen-cies and relevant stakeholders by implementing promotional, preventive and therapeutic mea-sures to reduce the problem of malnutrition in women, children and adolescent girls.
It is essential, with our collective efforts, to re-duce malnutrition among women, children and adolescent girls. For this, our additional commit-ments are essential to achieve the neccessary addi-tional progress while sustaining the achievements made at all levels across the various sectors.
Jay Nepal!Mangsir, 2074
Sher Bahadur DeubaPrime Minister and ChairpersonNational Planning Commission
KATHMANDUNEPALTHE PRIME MINISTER
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Message from the vice Chair
Malnutrition causes 45 percent of all deaths of under 5-year-olds worldwide. Undernutrition hampers their physical, mental and emotional development which in turn adversely affects the overall social, economic and human development of countries.
Approximately 36 percent of Nepal’s children suffer from stunting, 10 percent from wasting and almost 53 percent from anaemia. Forty-one percent of women of reproductive age suffer from anaemia and 17 percent from long term energy deficits. These statistics differ by geographical re-gion and social group.
Studies have shown that malnutrition cannot be addressed by the efforts of the nutrition sec-tor alone and hence the first Multi-Sector Nu-trition Plan (2013–2017) was formulated and implemented in an integrated and coordinated way between nutrition specific and nutrition sensitive sectors. Taking stock of the achieve-ments under MSNP (2013–17) pointed to the necessity of continuing these efforts and thus MSNP-II (2018-2022) has been conceptualized. This new plan aims to make a crucial contribu-tion to achieve the Sustainable Development Goals related to health and nutrition and to help reap the benefits of the demographic dividend by strengthening the future economically productive population.
To ensure its effective implementation, MSNP-II was formulated by all the concerned ministries and development partners including the minis-tries of health; agricultural development; live-stock development; education; water supply and sanitation; women, children and social welfare; and federal affairs and local development, plus development partner agencies and other stake-holders. The National Planning Commission played the coordinating role.
Strong leadership is needed at the local level, as successful implementation at this level will de-termine the achievement of the plan’s outcomes. In this context, various federal, provincial, local and ward level structures are being established to effectively undertake the plan’s programmes and activities.
The NPC will extend various kinds of support, coordination and facilitation to ensure the imple-mentation of this plan at all levels. I expect uni-fied and consolidated support from all relevant stakeholders including all relevant ministries, local governments, development partners, civil society and the private sector.
Swarnim WagleVice ChairNational Planning Commission
GOVERNMENT OF NEPAL
National Planning CommissionSINGHA DURBAR, KATHMANDU, NEPALVICE-CHAIRMAN
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Both undernutrition and overnutrition persist among Nepalese women and children although undernutri-tion is more common. The problem of undernutri-tion is specially seen in women of reproductive age and children under the age of five. The main causes of undernutrition are inadequate access to nutritious and diverse food, the poor use of available foods, infectious diseases due to unsafe water and poor hygiene, untimely treatment of diseases, poor use of health services, heavy workloads and poor aware-ness. Stunting, wasting, under-weight, and maternal and child anaemia are the major problems caused by undernutrition. These problems are found in vary-ing degrees among different social groups, classes and communities, and geographical regions.
From the perspective of nutrition, the period from conception until a child’s second birthday are cru-cial — it is known as the “golden thousand days”. During this period, the foods eaten by pregnant women, new mothers and newborns and childcare play a crucial role in growth and development of children. Scientific studies indicate that the prob-lems of undernutrition, such as the breastfeeding of newborns and children, supplementary food, caring habits and behaviour, sanitation, cleanliness, and food security, can be resolved only if programmes are formulated and implemented in a consolidated way with a collective approach.
Under the leadership and coordination of the Na-tional Planning Commission (NPC), the ministries of health; agricultural development; livestock devel-opment; water and sanitation; education; women, children and social welfare; federal affairs and local development, as well as national and international agencies working on nutrition are applying collab-orative efforts through the multisectoral approach to address the problems of malnutrition.
The Sustainable Development Goals for Nepal have targets to reduce stunting to 25 percent, wasting to 4 percent, and anaemia to 10 percent among children under five by the year 2030. Similarly, the government has set a target to reduce anaemia in women of reproductive age to 10 percent on the same timeline.
Considering the research and study findings indicat-ing the need of multisectoral efforts to address mal-nutrition, the government formulated and imple-mented the Multi-Sector Nutrition Plan (MSNP) 2013-2017. As the continuation of this plan, MS-NP-II (2018-2022) has been formulated and will be expanded throughout the country.
The Multi-Sector Nutrition Plan-II (2018-2022) will be implemented at all three levels of govern-ment: federal, provincial and local, with active par-ticipation from the relevant sectors with the local level playing a vital role. In this context, in order to identify various activities under the plan and de-vise a detailed work plan and effectively implement it requires the participation of nutrition and food security committees at state, district, municipality, rural municipality and ward levels. This also requires the technical and financial contribution from devel-opment partners.
To conclude, I would like to express my sincere gratitude to the High Level Committee for Nutri-tion and Food Security formed under the chair-manship of NPC vice-chair for their direction and suggestions in formulating MSNP-II. I would also like to thank the members of the National Nutri-tion and Food Security Coordination Committee (NNFSCC) for their help and suggestions. I also appreciate the contribution of the ministries, donor agencies and development partners for their contri-butions to formulating the Multi-Sector Nutrition Plan-II. I also thank all the staff of the National Planning Commission Secretariat, National Nutri-tion and Food Security Secretariat for helping to produce this new plan.
Prof. Dr. Geeta Bhakta JoshiMemberNational Planning Commission
GOVERNMENT OF NEPAL
National Planning CommissionSINGHA DURBAR, KATHMANDU, NEPALMEMBER
Message from NPC Member
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Message from the Prime Minister iiiMessage from the Vice Chair vMessage from the NPC Member viiAbbreviations xExecutive Summary xiii
1 Review of Multi-Sector Nutrition Plan (2013–17) 3
1.1 Background 31.2 Introduction 31.3 Global Nutrition Initiatives 41.4 Initiatives to Improve Nutrition in Nepal 51.5 Situation of Nutrition in Nepal 61.6 Progress of Nutrition Programmes 81.7 Analysis of Causes of Malnutrition in Nepal 101.8 Analysis of Other Issues that Affect Nutrition 131.9 Achievements of Multi-Sector Nutrition Plan (2013–17) 151.10 Analysis of Estimated Costs and Expenditure of Multi-Sector Nutrition Plan (2013–17) 181.11 Key Problems and Challenges 181.12 Lessons Learned Implementing MSNP (2013–17) 191.13 The Rationale for MSNP-II 20
2 Multi-Sector Nutrition Plan-II (2018–2022) 25
2.1 Vision 252.2 Goal 252.3 Objectives 252.4 Strategies 252.5 Policy-level Principles and Approaches 252.6 Theory of Change 262.7 Results Framework of MSNP-II (2018–22) 33
3 Implementation of MSNP-II (2018–2022) 43
3.1 Implementation Arrangements 433.2 Target Groups and Prioritization 433.3 Financial Management 443.4 Estimated Costs 443.5 Duration of MSNP-II 463.6 MSNP Committees 463.7 Power to Frame Guidelines 483.8 National Nutrition and Food Security Secretariat 483.9 Responsibilities of Private, Non-government and Academic Sectors 483.10 Capacity Development 503.11 Review, Monitoring and Evaluation 503.12 Documentation and Reporting 50
Contents
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Annex 1: Multi-Sector Nutrition Plan-II (2018-2022) Results Framework 53Annex 2: MSNP (2013–17) Related Programmes and Projects Supported by Development Partners 81Annex 3: Commitments for Implementing MSNP 82Annex 4: Contributors to Multisector Nutrition Plan II (2018-2022) 84
References 88
TABLES
Table A: Goal, Outcomes and Outputs of MSNP-II xviTable 1.1: Nepal’s Status Against Global Nutrition Targets 6Table 1.2: Status of MSNP (2013–17) Nutrition Specific Indicators 16Table 1.3: Budget Allocated to Nutrition by Government of Nepal (GoN) and Development Partners
in MSNP (2013–17) Period 18Table 3.1: Estimated NPC and Sectoral Ministry Costs of Implementing MNSP-II (NPR million) 45Table 3.2: Estimated Nutrition-Specific and Nutrition-Sensitive Costs of Implementing MNSP-2 (NPR million) 45Table 3.3: Estimated Costs of MSNP-II by Sources of funds 45Table 3.4: Composition of High Level Nutrition and Food Security Steering Committee (HLNFSSC) 47Table 3.5: Composition of National Nutrition and Food Security Coordination Committee (NNFSCC) 47Table 3.6: Composition of Provincial Nutrition and Food Security Steering Committees (PLNFSSC) 47Table 3.7: Composition of Local Government Nutrition and Food Security Steering Committees 49Table 3.8: Composition of Ward-level Nutrition and Food Security Steering Committees 49
FIGURES
Figure 1.1: Nepal’s progress on World Health Assembly target 1 (40% reduction in number of stunted under 5-year-olds) 7Figure 1.2: Severity of stunting in Nepal’s provinces by WHO categories 8Figure 1.3: Disparities in Stunting Prevalence Among Under-5s in Nepal in 2016 9Figure 1.4: Coverage Progress of Nepal’s Nutrition Specific Interventions in MSNP (2013–17) period 10Figure 1.5: Coverage Progress of Nepal’s Nutrition Sensitive Interventions in MSNP (2013–17) period 11Figure 1.6: Timelines of Preparation of MSNP-II 21Figure 2.1: MSNP-II’s Theory of Change 27Figure 2.2: MSNP-II Results Structure — Outcome 1 on Nutrition Specific Services 29Figure 2.3: MSNP-II Results Structure — Outcome 2 on Nutrition Sensitive Services 30Figure 2.4: MSNP-II Results Structure — Outcome 3 on the Enabling Environment 32
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AARR Average Annual Rate of Reduction ABPMDD Agribusiness Promotion and Marketing Development DirectorateANC Antenatal CareAWPB Annual Workplan and BudgetBMI Body Mass IndexCLC Community Learning CentreCMAM Community-Based Management of Acute Malnutrition DFID Department for International Development (UK Aid)DFTQC Department of Food Technology and Quality ControlDoCR Department of Civil Registration DoE Department of EducationDoHS Department of Health ServicesDoLS Department of Livestock ServicesDWC Department of Women and ChildrenECED Early Childhood Education and DevelopmentEMIS Education Management Information SystemFAO Food and Agriculture OrganizationFCHV Female Community Health VolunteerGoN Government of NepalHLNFSSC High Level Nutrition and Food Security Steering CommitteeHMIS Health Information Management SystemIMAM Integrated Management of Acute MalnutritionIMNCI Integrated Management of Neonatal and Childhood IllnessITC Inpatient Therapeutic CareIYCF Infant and Young Child FeedingJMP Joint Monitoring ProgrammeMIYC Maternal, Infant and Young ChildMIYCN Maternal, Infant and Young Child Nutrition MIYCU Maternal, Infant and Young Child UndernutritionMNP Multiple Micronutrient PowderMoAD Ministry of Agriculture DevelopmentMoF Ministry of FinanceMoFALD Ministry of Federal Affairs and Local DevelopmentMoH Ministry of Health MoLD Ministry of Livestock DevelopmentMoWCSW Ministry of Women, Children and Social WelfareMoWSS Ministry of Water Supply and SanitationMSNP Multi-Sector Nutrition PlanNA Not Available NDHS Nepal Demographic and Health Survey
abbreviations
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NFC Nepal Food CorporationNLSS Nepal Living Standards SurveyNMICS Nepal Multiple Indicator Cluster SurveyNMIP-DWSS National Management Information Project of the Department of
Water Supply and Sewerage NNFSS National Nutrition and Food Security SecretariatNPC National Planning CommissionNPR Nepali RupeesNRH Nutrition Rehabilitation HomeO&M Organisation and ManagementODF Open Defecation FreeOPD Outpatient DepartmentORS Oral Rehydration SolutionOTC Outpatient Therapeutic CarePHC-ORC Primary Health Care Outreach ClinicsPNC Post-Natal CarePPE Pre-Primary EducationReSoMal Rehydration Solution for MalnutritionRUTF Ready to Use Therapeutic FoodSAM Severe Acute MalnutritionSDG Sustainable Development GoalSUN Scaling Up NutritionToT Training of TrainersTWG Technical Working GroupUNICEF United Nations Children’s FundUSAID United States Agency for International DevelopmentWASH Water, Sanitation and HygieneWCF Ward Citizens ForumWFP World Food ProgrammeWHA World Health AssemblyWHO World Health OrganisationWRA Women of Reproductive Age
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Nepal has made strong efforts to address the problem of malnutrition. The Government of Nepal has recognized the need of multi-sectoral efforts to improve the nutrition of its citizens. It developed the first Multi-Sector Nutrition Plan, which was implemented from 2013 led by the National Planning Commission. The second Multi-sector Nutrition Plan (2018/19–2022/23) has been designed as a continuation of MSNP (2013–17).
Nepal has made remarkable progress in the field of nutrition. According to the regular Nepal de-mographic health surveys (NDHSs), stunting among under-five years children has reduced from 57 percent in 2001 to 35.8 percent in 2016. The process of stunting starts at concep-tion, accelerates until two years of age, and is then irreversible. Therefore, nutrition needs to be improved among mothers and potential moth-ers (i.e. during adolescence and pregnancy) and when children are under two years of age.
Overweight and obesity is an emerging problem due to excessive intake of high amounts of fat, sugar and salt and inactive lifestyles. This is lead-ing to a growing incidence of high blood pressure, diabetes and other non-communicable diseases.
The undernutrition problems of stunting, wast-ing and low weight in children contribute to 52 percent of child mortality in Nepal. And those who survive usually have limited intellectual growth and cognitive development that affects their education.
The World Bank estimates that undernutrition causes losses of up to 3 percent of economic de-velopment. Thus, improving nutrition is a pre-condition to break the cycle of poverty and for sustainable economic development.
Major causes of chronic malnutrition in Nepal are poor feeding and care practices, insufficient nutrient intake, and high rates of infection and
teenage pregnancy. The Nepal Demographic Health Survey, 2016 reported that only 50 percent of babies were breastfed within one hour of birth. Although, the exclusive breastfeeding rate of newborns up to six months of age is 66 percent, only 17 percent of 6–8 months old babies were found receiving minimum acceptable diets while only 35 percent of children aged 6-23 months received minimum acceptable diets. Despite improvements in complementary feeding, families and fathers play little part in promoting this.
According to the Nepal Multiple Indicator Clus-ter Survey, 2014, 20 percent of children under 5 years of age had recently suffered from fever and 12 percent from diarrhoeal disease. These infec-tions lead to malnourishment and the death of young children. According to the 2016 NDHS, 17 percent of women of reproductive age and 30 percent of adolescent girls had chronic energy de-ficiency (BMI less than 18.5kg/m2), while 44 per-cent of adolescent girls were anaemic. Pregnancy in these conditions results in low birth weight babies, a cycle that repeats from mother to child and onwards. Maternal and infant infections are also common problems as are intestinal parasites. Other problems that contribute to malnutrition are that 13 percent of women of reproductive age smoke, while 40 forty percent of women suffer from indirect smoking, and 75 percent are ex-posed to smoke pollution from solid fuel cooking stoves.
According to the Nepal Multiple Indicator Clus-ter Survey, 2014, 48 percent of women aged 20-49 years were first married or in union before age 20 and so teenage pregnancies are common. And 16 percent of women delivered a baby before their eighteenth birthdays. In such cases, maternal care practices tend to be poor. The heavy workloads of many women after delivery is another problem.
Access to and the use of health services has im-proved. The 2016 NDHS reported 53 percent of married women aged 15-49 years using modern
Executive Summary
According to the regular Nepal demographic health surveys (NDHSs), stunting among under-five years children has reduced from 57 percent in 2001 to 35.8 percent in 2016. The process of stunting starts at conception, accelerates until two years of age, and is then irreversible.
Multi-Sector Nutrition Plan-II (2018–2022)
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family planning methods. Maternal care practices have also improved with 84 percent of pregnant women having at least one antenatal or postnatal checkup. Fifty-eight percent of pregnant women used the services of a skilled birth attendant for their deliveries.
According to the Nepal Multiple Indicator Clus-ter Survey, 2014, 93 percent of households used a source of safe drinking water. However only half of the population used toilet facilities while less care was taken for the safe management of cow dung and manure, which creates a polluting en-vironment and spreads disease and parasites. This indicates that personal hygiene and sanitation is still poor in many households.
Although the literacy rate among young women has reached more than 88.6 percent, women’s voices are not adequately heard and they play little part in decision-making. Gender discrimi-nation and social exclusion persist, although they are being addressed in many programmes of the government and its development partners.
The underlying causes of malnutrition have di-minished. Now, only 21.6 percent of the popu-lation live below the poverty line. It however remains challenging to provide enough food in food deficit districts year-round to attain the SDG of zero poverty and hunger. But at the basic level of causality there have been overwhelming improvements in infrastructure including roads, schools and health facilities.
According to the Global Nutrition Report, 2016, scaling up nutrition investments is a high-impact, high-return proposition, with a benefit-cost ratio of 16:1 and a compound rate of return of more than 10 percent. The costs of neglecting nutrition are high, causing economic losses of around 10 percent of gross domestic product.
The design of this Multi-Sector Nutrition Plan-II (2018/19–2022/23) addresses the achievement of the World Health Assembly global targets for 2025, the Sustainable Development Goals for 2030 and nutrition deprivation and causal-ity analysis in Nepal. This plan addresses lessons
The underlying causes of
malnutrition have diminished. Now,
only 21.6 percent of the population live
below the poverty line. It however
remains challenging to provide enough
food in food deficit districts year-round
to attain the SDG of zero poverty and
hunger.
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The implementation of MSNP (2013–17) started in 2013 with the aim of enhancing nutrition to remove it as an impeding factor for human development and for overall socioeconomic development. The new plan continues the MSNP (2013–17) interventions.
learned from MSNP (2013–17). Nutrition re-lated cultural trends, habits, weaknesses in the nutrition sector, gaps and the problems of under-nutrition and over-nutrition have also been anal-ysed. The plan’s logical framework leads on from its theory of change. This plan covers concepts and experiences shared by the related sectoral ministries.
This final draft of MSNP-II was discussed in the National Nutrition and Food Security Coordi-nation Committee and then submitted to the High Level Nutrition and Food Security Steer-ing Committee for endorsement. The endorsed document from the HLNFSSC was approved by the Council of Ministers in November 2017.
The implementation of MSNP (2013–17) start-ed with the aim of enhancing nutrition to remove it as an impeding factor for human development and for overall socioeconomic development.
The new plan continues the MSNP (2013–17) interventions. The goal for the next five years is “Improved maternal, adolescents and child nutri-tion’” which will be achieved by taking to scale nutrition specific and sensitive interventions and by improving the nutrition enabling environ-ment.
The nutrition specific interventions will be large-ly delivered through the health sector, and the nutrition sensitive interventions mainly by the education, agriculture, livestock, water and sani-tation, women and children sectors in collabora-tion with local governments. All these interven-tions will aim to improve the status of nutritional as measured against the incidence of stunting and wasting among under 5-year-olds and low birth weight babies. The plan also aims to reduce chronic energy deficiency among women. The expectation is also to reduce the proportion of mothes and children who are overweight.
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Table A: Goal, outcomes and outputs of MSNP-II
Goal: Improved maternal, adolescent and child nutrition by scaling up essential nutrition-specific and sensitive interventions and creating an enabling environment for nutrition
OUTCOME 1: IMPROVED ACCESS TO AND EQUITABLE USE OF NUTRITION-SPECIFIC SERVICES
Output 1.1: Enhanced nutrition status of women of reproductive age including adolescentsOutput 1.2: Improved infant and young child nutrition and care practicesOutput 1.3: Improved maternal, infant and young child micronutrient statusOutput 1.4: Improved management of severe and moderate acute malnutritionOutput 1.5: Enhanced preparedness for nutrition in emergency responsesOutput 1.6: Capacity built of nutrition-specific sectors
OUTCOME 2: IMPROVED ACCESS TO AND THE EQUITABLE USE OF NUTRITION-SENSITIVE SER-
VICES AND IMPROVED HEALTHY HABITS AND PRACTICES
Output 2.1: Increased availability and consumption of safe and nutritious foodOutput 2.2: Increased physical and economic access to diverse types of foodOutput 2.3: Increased access to safe drinking waterOutput 2.4: Increased access to safe and sustainable sanitation servicesOutput 2.5: Improved knowledge of children and mothers and caretakers of under 5-year-old
children on health and hygiene Output 2.6: Targeted groups have access to resources and opportunities that make them self-reliantOutput 2.7: Nutrition component incorporated in women, adolescent girls and child development
training packagesOutput 2.8: Women, children and out-of-school adolescent girls reached with health and nutrition
care practicesOutput 2.9: Child care homes comply with minimum standards of nutrition careOutput 2.10: Communities empowered to prevent harmful practices (menstrual seclusion [chhau-
padi], food taboos)Output 2.11: Enhanced enrolment of children in basic educationOutput 2.12: Increased adolescent girls’ awareness and improved behaviour on nutritionOutput 2.13: Enhanced access to health and reproductive health services
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OUTCOME 3: IMPROVED POLICIES, PLANS AND MULTI-SECTORAL COORDINATION AT FEDERAL,
PROVINCIAL AND LOCAL GOVERNMENT LEVELS TO ENHANCE THE NUTRITION
STATUS OF ALL POPULATION GROUPS
Output 3.1: MSNP-II included in local, provincial and federal government policies and plansOutput 3.2: MSNP governance mechanism instituted and strengthened at federal, provincial, and
local levelsOutput 3.3: MSNP institutional mechanisms established and functional at federal government levelOutput 3.4: Functional updated information system across all MSNP sectorsOutput 3.5: Enhanced capacity of federal, provincial and local level government to plan and imple-
ment nutrition programmes
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REVIEW OF MULTI-SECTOR NUTRITION PLAN, 2013–17
Chapter 1
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1.1 BackgroundThe Government of Nepal and its development partners are committed to addressing the com-plex problem of malnutrition. The government’s development objectives are outlined in the Con-stitution of Nepal, the Fourteenth Development Plan and the Sustainable Development Goals (SDGs). Economic growth, employment promo-tion, poverty alleviation, post-conflict reconstruc-tion, social transformation and human resource development are the government’s development priorities.
Improving the nutritional status of its citizens is a major priority of the government. Improving nu-trition involves interventions in health and other sectors; thus policies, strategies and plans of the health, agriculture, livestock, water and sanita-tion sectors emphasise good nutrition and food security.
The government is addressing the complex causes of malnutrition through a multi-sectoral approach. Its first Multi-Sector Nutrition Plan (MSNP, 2013-2017) had the following out-comes:1. Improved maternal, infant and young child
feeding.2. Increased maternal, infant and young child
micro-nutrient status.3. Improved management of malnutrition in
children.
MSNP (2013–17) was implemented through the following nutrition-specific and nutrition-sensi-tive programmes:• The ‘direct’ nutrition-specific interventions
targeted individuals and included micronu-trient supplements to under 5-year-olds and adolescents and women during pregnancy and lactation, micronutrient fortification (salt iodization and flour fortification), awareness raising and behaviour change communication
on optimal infant and young child feeding, and the management of severe acute malnu-trition.
• The ‘indirect’ nutrition-sensitive interventions targeted families and communities including on hygiene and sanitation, with cash and in-kind transfers (including child cash grants), nutritious food and diets, school feeding pro-grammes and parental education.
These programmes (most of which are ongoing) were implemented by government line minis-tries, principally the Ministry of Health (MoH), Ministry of Agricultural Development (MoAD), Ministry of Livestock Development (MoLD), Ministry of Education (MoE), Ministry of Wa-ter Supply and Sanitation (MoWSS), Ministry of Federal Affairs and Local Development (Mo-FALD), and the Ministry of Women, Children and Social Welfare (MoWCSW). In addition to funding the regular cross-sectoral nutrition pro-grammes nationwide, the government provided additional funding to implement MSNP (2013–17) in 28 priority districts from its own resources and development partner support.
1.2 IntroductionPeople are malnourished if their diet provides in-adequate nutrients for growth and good health or if they are unable to fully use the food they con-sume due to illness. They are also malnourished if they consume too many calories (overnutrition) (UNICEF 2012).
Malnutrition is caused by poor health, diet, edu-cation, access to resources, empowerment and other factors. Good nutrition, i.e. an adequate well-balanced diet, and regular physical activity are the cornerstones of good health. Poor nutri-tion can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development and reduced productivity.
Nutritional deficiencies among young children
1. Review of Multi-Sector Nutrition Plan (2013–17)
Chapter 1
The government is addressing the complex causes of malnutrition through a multi-sectoral approach.
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and mothers has large economic costs that mani-fest later in an increased burden of disease and losses of human capital and economic productiv-ity. Undernourished children suffer irreparable intellectual impairment and stunted physical growth. Hungry children make poor and less productive students and often make unhealthy workers. All this results in impoverished families and communities and an overburdened health care system.
Undernourished mothers usually give birth to un-derweight babies, thus transferring disadvantages to the next generation. From the perspective of nutrition, a young child’s first 1,000 days (from conception to the second birthday) are critical. Nutrition interventions can have a huge benefit during this period. Subsequent interventions can make a difference, but cannot undo damage re-lated to malnutrition from the first 1,000 days.
Children’s nutrition outcomes are closely related with maternal nutrition. Healthy, well-nourished mothers are more likely to give birth to and nur-ture healthy children. Accordingly, it is important that adolescent girls, pregnant women and lactat-ing mothers receive the range of nutrition-related services and information they need to support their good nutrition.
1.3 Global Nutrition InitiativesThe main initiatives that guide and promote im-proved nutrition at the global level are the Scal-ing Up Nutrition (SUN) Framework, the SDGs and the World Health Assembly’s global nutrition targets (2012).
The momentum to improve nutrition accelerated at the global level from 2009 with the initiation of a global collaborative process, the Scaling Up Nu-trition (SUN) Framework (scalingupnutrition.org). The SUN framework has been endorsed by over 100 international development institutions working in the field of nutrition including UNI-CEF, WFP, FAO, WHO, USAID, DFID, DFAT and the World Bank, and by the governments of 59 countries (the movement). The SUN Move-ment works to build an enabling social, eco-nomic and political environment that ensures all children can reach their full potential. The SUN Movement Strategy and Roadmap (2016-2020) (SUN Movement 2016) calls for the following:
1. Expanding and sustaining an enabling politi-cal environment.
2. Prioritizing and institutionalizing effective ac-tions that contribute to good nutrition.
3. Implementing effective actions aligned with common results frameworks.
4. Effectively using and significantly increasing financial resources for nutrition.
The SUN framework calls for multi-sectoral ap-proaches to improving nutrition, arguing that the essential complementary approaches of nutrition-specific activities and nutrition-sensitive activities both need scaling up.
Almost all countries signed up to the 2030 Agen-da for Sustainable Development committing to comprehensive, integrated and universal trans-formations, including ending hunger and malnu-trition. The agenda focuses on achieving the 17 Sustainable Development Goals by 2030. SDG 2 calls for “Ending hunger, achieving food security and improving nutrition and promoting sustain-able agriculture.” At least 12 of the 17 SDGs have indicators that are relevant to good nutrition with SDGs 1, 2, 3 and 6 closely related to nutrition. Nepal’s enactment of its new 2015 Constitution coincided with the beginning of the SDG period providing the opportunity for the new system of governance to focus on achieving the SDGs.
In 2012, the World Health Assembly (WHA) agreed on the following six global nutrition tar-gets by 2025 (WHO 2012): • 40 percent reduction in the number of chil-
dren under-5 who are stunted• 50 percent reduction of anaemia in women of
reproductive age• 30 percent reduction in low birth weight ba-
bies• no increase in childhood overweight• increase the rate of exclusive breastfeeding in
the first 6 months up to at least 50 percent• reduce and maintain childhood wasting to less
than 5 percent.
The following are other important global com-mitments signed up to by Nepal:• In 2013, the World Health Assembly agreed
to halt the rise in diabetes and obesity as part
From the perspective of
nutrition, a young child’s
first 1,000 days (from conception
to the second birthday) are
critical. Nutrition interventions
can have a huge benefit during this
period. Subsequent interventions can
make a difference, but cannot undo
damage related to malnutrition from
the first 1,000 days.
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of the adoption of the comprehensive global monitoring framework for the prevention and control of non-communicable diseases WHO 2013).
• Many countries, including Nepal, endorsed the World Health Organisation’s Compre-hensive Implementation Plan on Maternal, Infant and Young Child Nutrition (MIYCN) in 2012 (WHO 2014).
1.4 Initiatives to Improve Nutrition in NepalThe government has instituted a number of nu-trition-related policies and plans:
The National Nutrition Policy and Strategy, 2004 (CHD 2004) guides nutrition programmes and activities in the health sector. Other relevant policies and plans include the National Health Policy 2015, the Nepal Health Sector Strategy Action Plan (2016-2022) and the Food and Nu-trition Security Plan of Action (2014-2024).
The Agriculture Development Strategy, 2015–2035 (MoAD 2015) calls for reducing food-re-lated poverty from 27.6 percent in 2016 to 13 percent in 2026 and 6 percent in 2036. Food and Nutrition Security is one of the strategy’s flagship programs.
The Nepal Health Sector Strategy, 2016-2021 (MoHP 2015) recognises nutrition as a multi-sectoral issue and includes related programmes and activities under the following three action areas:• Maintain comprehensive extension and use
of services — These programmes include dis-tributing Vitamin A capsules to under 5-year-olds and deworming tablets to 1–5 year olds, the distribution and use of zinc tablets for diarrhoea treatment, the distribution of iron folic acid tablets, deworming tablets and vita-min A capsules to pregnant mothers, and the use of iodised salt.
• Programmes to scale up — These pro-grammes include exclusive breastfeeding af-ter birth, complementary feeding (including breastfeeding after 6 months), providing Baal-vita micronutrient powders to 2–23 month olds, handwashing at critical times, the in-tegrated management of severe malnutrition and the production of fortified flour.
• Programmes to assess and revise — These programmes include maternal and child nu-trition improvement related activities, mixing micronutrients in fortified wheat flour and the treatment of child malnutrition.
The Nepal Water Supply, Sanitation and Hy-giene Sector Development Plan, 2016-2030 (MSWW 2016) calls for actions that enhance nutrition including frequent handwashing with soap, safe disposal of faeces, the safe handling and treatment of drinking water and regular nail cut-ting, bathing, and tooth brushing.
And above all, Nepal’s new 2015 Constitution grants all citizens the fundamental right to food and basic health care (GoN 2015).
MSNP (2013-17) calls for nutrition-specific and nutrition-sensitive programmes to address under-nutrition. The health, education, water and sani-tation, agriculture and livestock, local governance and women, children and social welfare sectors have a leading role to play in improving nutri-tion in Nepal. The interventions implemented by these six sectors in Nepal under MSNP (2013–17) are summarised below. • Health — The wide range of health sector nu-
trition interventions included maternal infant and young child nutrition, maternal health care, micronutrient supplementation and the fortification of foodstuffs.
• Education — Education has a large role to play in improving the nutritional knowledge and behaviour of the future generation. Ma-jor MoE nutrition programmes under MSNP (2013–17) were the provision of midday meals in schools, improving water, sanitation and hygiene (WASH) facilities in schools and the inclusion of nutrition topics in curricula.
• Water and sanitation — The water and sani-tation sector is involved in nutrition by pro-moting safe drinking water and sanitation, es-pecially as diarrhoea is a major cause of child mortality. The interventions run in the MSNP (2013–17) period were mainly for safe water supplies and improving hygiene and sanita-tion.
• Agriculture and livestock — The develop-ment of agriculture and livestock production is crucial for improving nutrition. Interven-tions were run under MSNP (2013–17) to en-
MSNP (2013-17) called for nutrition-specific and nutrition-sensitive programmes to address undernutrition. The health, education, water and sanitation, agriculture and livestock, local governance and women children and social welfare sectors have a leading role to play in improving nutrition in Nepal.
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hance homestead food and livestock produc-tion, to increase the incomes of poor women through credit incentives, and to increase the consumption of micronutrient-rich foods.
• Women children and social welfare — Dur-ing MSNP (2013–17) MoWCSW helped increase the knowledge of children and the mothers and caretakers of young children on hygienic behaviour and empowered commu-nities to address harmful traditional practices such as menstrual seclusion and food taboos.
• Local governance— Local governments have a major role to play in improving nutrition including through social mobilization and the administration of cash transfers and social protection. The contributions to improved nutrition by MoFALD and the local bodies under the previous constitution focussed on the 28 MSNP (2013–17) districts. The new federal units of local governance — provinces and the four levels of local government (met-ropolitan cities, sub-metropolitan cities, ur-ban municipalities and rural municipalities) plus their wards have an important role to play in improving nutrition.
Alongside these sectors, the Nepal Food Corpo-ration and Salt Trading Corporation (under the Ministry of Supplies) supply food to remote dis-tricts and distribute iodised salt and are therefore important MSNP-II stakeholders.
1.5 Situation of Nutrition in NepalAlthough there have been significant improve-ments across the different types of malnutrition (stunting, wasting, underweight, low body mass
index, micronutrient deficiency, overweight and obesity), malnutrition continues to constrain hu-man lives and Nepal’s socioeconomic develop-ment. Malnutrition contributes to more than a third of child mortality in Nepal, and children who survive often lead diminished lives due to impaired cognitive development, reduced eco-nomic productivity and the increased risk of mal-nutrition-related chronic diseases. Overweight and obesity are emerging amongst certain groups.
Nepal made mixed progress on the achievement of the World Health Assembly’s global nutrition targets for 2025 between the base year of 2011 and 2016. It must be noted though that Nepal has made great progress on these indicators over the last two decades.
There were small improvements in stunting (WHA target 1), childhood overweight (WHA 4), exclusive breastfeeding (WHA 5) and child-hood wasting (WHA 6) (Table 1.1). There was a worsening in the situation of anaemia among women and children and a doubling in the preva-lence of low birth weight (although the latter was probably due to the increased number of institu-tional deliveries meaning it was detected more). The childhood overweight and breastfeeding tar-gets have been achieved and efforts need acceler-ating to achieve the other targets.
Note that although overweight is only a minor problem amongst children it has become a seri-ous concern among adults with the 2016 NDHS finding that 22.2 percent of women and 17.1 percent of men were overweight (MoH, New ERA and ICF 2017). The highest incidence was in the highest wealth quintile where 45 percent
TABLE 1.1: NEPAL’S STATUS AGAINST GLOBAL NUTRITION TARGETS
Global nutrition targets for 2025 and 2030Base year situation
ProgressNepal's
WHA targetNepal’s SDG
targets
2011 2016 2025 2030
1 Achieve 40% reduction in the number of children under-5 who are stunted 40.5% 35.8% 25% 15%
2a Achieve a 50% reduction of anaemia in women of reproductive age 35% 40.8% 18% 10%
2b Achieve a 50% reduction of anaemia in children 46.2% 52.7% 23.1% 10%
3 Achieve a 30% reduction in low birth weight 12.1% 24.2%* 8% –
4 Ensure no increase in childhood overweight 1.4% 1.2% ≤1.4% –
5 Increase rate of exclusive breastfeeding in first 6 months to at least 50% 69.6% 66.1% >50% –
6 Reduce and maintain childhood wasting to less than 5% 10.9% 9.7% 5% 4%
There has been a large reduction in
childhood stunting (short height for
age) in Nepal in recent years;
reducing from 57 percent of under
5-year-olds in 2001 to 35.8 percent of
them in 2016.
Source of information: MoH, New ERA and ICF (2017) and *CBS 2015
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Note: AARR = average annual rate of reduction
FIGURE 1.1: NEPAL’S PROGRESS ON WORLD HEALTH ASSEMBLY TARGET 1 (40% REDUCTION IN NUMBER OF STUNTED UNDER 5-YEAR-OLDS)
2001
2003
2005
2007
2009
2011
2013
2015
2017
2019
2021
2023
2025
2027
2029
2031
2033
60
55
50
45
40
35
30
25
20
15
49.3
57.3
40.537.4 35.8
29.424.7
24.319.5
Existing (AARR 0.031)Required (AARR 0.043)
of women and a third of men were overweight or obese in 2016.
There has been a large reduction in childhood stunting (short height for age) in Nepal in recent years; reducing from 57 percent of under 5-year-olds in 2001 to 35.8 percent of them in 2016 (MoH, New ERA and ICF 2017). Note that the stunting of under 5-year-olds is recognised as the main indicator of malnutrition and so receives the most coverage here.
However, Nepal has fallen behind on the average annual rate of reduction needed to achieve WHA target 1 of a 40% reduction by 2025 in the num-ber of stunted under 5 year-olds (Figure 1.1). The prevalence of stunting in this age group in the 2011 WHA base year was 40.5 percent, amount-ing to 1,108,573 stunted children (CBS popula-tion projection 2011). To reduce the prevalence by 40 percent entails reaching 24.3 percent by 2025, which means having 661,860 fewer stunt-ed children. The average annual rate of reduction between 2001 and 2016 was 3.09 percent. To reach the WHA target of 24.2 percent therefore requires an average annual rate of reduction from 2016 onwards of 4.26 percent.
Note that the same kind of trend and disparity analysis was carried out for all six WHA indica-tors as background analysis for MSNP-II. Only the stunting analysis is included here.
The 2016 NDHS found that 35.8 percent of under-5-year-olds were stunted, although there were considerable variations, as illustrated in Fig-ure 1.2:• 40.2 percent of children stunted in rural areas
compared to only 32.0 percent in urban areas• Children from the poorest wealth quintile
were three times more likely to be stunted (49.2%) than children from the richest quin-tile (16.5%)
• Children of mothers who were not educated were twice as likely to be stunted (45.7%) as children of educated mothers (22.7%)
• Children below 18 months old were less stunted than older children
• 46.8 percent of children in mountain areas were stunted compared to 36.7 percent in the Tarai plains and 32.3 percent in the hills
• Provinces 2, 5, 6 and 7 had above national average rates of stunting with a very high
However, Nepal has fallen behind on the average annual rate of reduction needed to achieve WHA target 1 of a 40% reduction by 2025.
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1 The dataset used for this paragraph includes NDHS 2016, Nepal Multiple Indicator Cluster Survey (NMICS) 2014, Annual Reports of the Department of Health Services for 2012/2013 and 2014/2015, Nepal Health Facility Survey (NHFS) 2015 and other statistics from government ministries.
The prevalence of wasting (low
weight for height) has fluctuated in
recent years in Nepal from 9.6
percent of under 5-year-olds in 2001
to 11.4 percent in 2014 and 9.7 percent in 2016
FIGURE 1.2: SEVERITY OF STUNTING IN NEPAL’S PROVINCES BY WHO CATEGORIES
.
Creation Date:Map data source(s):
10 April 2017Nepal Gazette (10 March 2017)DoS, GoN
07 51 5037.5 KM
Province 7(35.9%)
Province 6(54.5%)
Province 4(28.9%)
Province 3(29.4%)
Province 1(32.6%)
Province 2(37.0%)
Province 5(38.5%)
Source: Nepal Demographic Health Survey, 2016
Legend
Very high: => 40 percentHigh: 30-39 percentMedium: 20-29 percentLow: <20 percent
Disclaimers: The map is based on The Constitution of Nepal Published by Government of Nepal, Ministry of Law, Justice and Parliamentary Affairs. Law Book Management Board The boundaries are derived using spatial operation in GIS environment on old ward level administrative data from DoS.
prevalence in Province 6 (mid-western Nepal) (54.5%), almost double that in Province 4 (28.9%) (Figure 1.3).
The prevalence of wasting (low weight for height) has fluctuated in recent years in Nepal from 9.6 percent of under 5-year-olds in 2001 to 11.4 percent in 2014 and 9.7 percent in 2016 (MoH, New ERA and ICF 2017). Wasting is a measure of acute undernutrition and represents the failure to receive adequate nutrition in the period im-mediately before the survey.
There was little difference in the rate of wasting between boys (9.5%) and girls (9.8%) in 2016 and only a small difference by residence with 10.2 percent of under 5-year-olds wasted in rural ar-eas versus 9.2 percent in urban areas. Children in the Tarai had the highest prevalence of wasting (12%) compared to children in the hills (6.4%)
and mountains (6.1%). And the prevalence of wasting among infants aged 0-23 months was al-most twice (ranging from 15.2% to 21.3%) that among 48-59 month old infants (6.2%).1
1.6 Progress of Nutrition ProgrammesIn 2017 UNICEF analysed the coverage trends of nutrition specific and sensitive interventions from the MSNP (2013–17) period (and in some cases earlier). This analysis was carried out using sectoral ministry data. Sufficient data was not available to do this analysis for enabling environ-ment interventions. Figures 1.4 and 1.5 show the results of this analysis, with:• the level of coverage of target groups along the
horizontal axis (up to maximum 100% cover-age) and associated recommendations
• the progress of coverage of along the vertical
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FIGURE 1.3: DISPARITIES IN STUNTING PREVALENCE AMONG UNDER-5S IN NEPAL IN 2016
Source: MoH, New ERA and ICF 2017
PREV
ALE
NCE
%
Male
Female Urban
Rural
Lowest
No Education
24-35m
18-23m
36-47m
12-17m
9-11m
6-8m
≤6m
48-59m
Primary
Mountain
Province 6
Province 5
Province 2
Province 7
Province 1
Province 3
Province 4
Terai
HillsSecondary
Higher
Middle
Fourth
Highest
Second
40.236.0
35.7
49.2
45.7
44.5
41.9
38.5
32.632.3
20.0
36.7
22.7
32.0
35.7
38.7
32.4
16.5
31.5
40.0
39.8
31.9
17.6
13.5
46.8
36.7
29.4
28.9
35.9
37.0
54.560
55
50
45
40
35
30
25
20
15
10
5
0Gender Area of
ResidenceWealth Quintile
MaternalEducation
Age Groups in Months
EcologicalZones
FederalProvinces
NationalAverage
35.8
axis ranging from programmes that have ex-panded significantly to ones that have shrunk.
The recommendations for the interventions in both graphs for the three levels of coverage are:• Need scaling up, strengthening or sustaining
for positive coverage trend interventions.• Need attention, reversing negative trend or
sustaining for negative trend coverage.
Based on the limited data available for this exer-cise, Figure 1.4 shows a mixed trend of progress of the nutrition-specific interventions during the MSNP (2013–17) period, with:• flour fortification being unchanged at 100
percent targeted coverage• the coverage of the treatment of diarrhoea
cases increased by 250 percent, but still only covers about 20 percent of cases
• the proportion of households using iodised salt increased by 50 percent to reach about 80 percent targeted coverage
• exclusive breastfeeding declined to about 56 percent of babies
• the needed financial resources for improving nutrition increased by about 40 percent.
The UNICEF Nepal analysis of the progress of nutrition-sensitive interventions found that 11 of the major selected nutrition sensitive indicators increased their coverage in the MSNP (2013–17) period (Figure 1.5). Only the two married-before-age-18-years indicators had a negative trend. The increases in coverage were for secondary school enrolment, disposal of child faeces, handwashing, and and access to improved sanitation. The most remains to be done on reducing early marriage and installing well-functioning water supply sys-tems, with less than a third of targeted coverage achieved.
Children in the Tarai had the highest prevalence of wasting (12%) compared to children in the hills (6.4%) and mountains (6.1%).
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1.7 Analysis of Causes of Malnutrition in NepalThe following text discusses the main health-re-lated causes of malnutrition in Nepal. 1) Causes — Nepal’s population faces a range of
nutritional problems from deficits in energy intake to imbalances in the consumption of macro and micronutrients. The causes include imbalanced diets; inadequate family care; poor quality water, sanitation and hygiene; in-adequate access to health services; child mar-riage; women’s heavy workloads; women’s lack of access to economic resources; gender-based violence and cultural taboos. The problem of excess intake is also surfacing as changing dietary patterns and lifestyles result in over-weight and obesity.
2) Causes of stunting — The underlying causes of stunting in Nepal are inadequate mater-nal, infant and young child feeding practices, untreated episodes of acute malnutrition, in-fections, and micronutrient deficiencies. Ex-
clusive breastfeeding is sufficient for the first six months after birth while the timely intro-duction of appropriate complementary foods with breastfeeding is essential after six months of age.
Nepal achieved the World Health Assembly target of exclusive breastfeeding of 50 per-cent of infants in early 2015. However, fur-ther efforts are needed to reach the target of the National Infant Young Child Feeding Strategy (CHD 2014) of 80 percent exclusive breastfeeding in the first six months of life by 2020 as in 2016 only 66% of this age group were exclusively breastfed (MoH, New ERA and ICF 2017). The 2016 NDHS found major disparities around this average figure with only 48.6 of female infants exclusively breastfed compared to 63.8 percent of male infants and only 48.3 percent of lowest wealth quintile infants compared to 70.8 percent of infants in the second wealth quintile (MoH, New ERA and ICF 2017).
The underlying causes of stunting
in Nepal are inadequate
maternal, infant and young child
feeding practices, untreated
episodes of acute malnutrition,
infections, and micronutrient
deficiencies.
FIGURE 1.4: COVERAGE PROGRESS OF NEPAL’S NUTRITION SPECIFIC INTERVENTIONS IN MSNP (2013–17) PERIOD
Posi
tive
Tren
dN
egat
ive
Tren
d
Source: DHS MICS 2014, NDHS 2011, NDHS 2006 and MoHP Annual Reports 2009/2010, 2010/2011 and 2014/2015
PP Vit-ASupplementation
Coverage
MNP all
0 25% 50% 75% 100% 125%
350
300
250
200
150
100
50
0
-50
Treatment of Diarrhea(Zinc+ORS)
45-days PP IFA
Feeding during Illness
Financial Resourcesfor Nutrition
MNP Districts MDDCMAM Districts
180+IFA (PW)
IFA (WRA)
Any IFA (PA)
HH Iodized SaltVit-A (6-59m)
Flour Fortification
ExclusiveBreast Feeding
ANC
MMF
MNP 1st
Early Initiation of BF
SAM Cure Rate
Deworming (12-59
Vit-A(6-11m)
Introduction to CF
Deworming (PW)Any IFA (PLW)
Attention and scale-up Reverse negative trend & strengthen Sustain
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in 2016, only 17 percent of children aged 6–8 months and only 35 percent of children aged 6–23 months had minimum acceptable diets.
In terms of the introduction of appropriate complementary foods after six months of age:• in 2016, only 17 percent of children aged
6–8 months and only 35 percent of chil-dren aged 6–23 months had minimum acceptable diets (MoH, New ERA and ICF 2017)
• in 2014, only 17 percent of children aged 6-23 months in the mid-western Ta-rai had minimum acceptable diet (CBS 2015)
• only 23.5 percent of young children from the middle wealth quintile had at least the minimum acceptable diet compared to 50.2 percent from the richest quintile (CBS 2015).
3) Disease — In Nepal, maternal and infant infections are common and intestinal para-sites are a major public health problem. The 2014 Nepal Multiple Indicator Cluster Survey (NMICS) found that 20.1 percent of under 5-year-olds had suffered fever in the previous two weeks while 12 percent had suffered diar-
rhoea and 7 percent acute respiratory infec-tions in the same period (CBS 2015). These diseases cause malnutrition and can cause the deaths of young children. A major cause of acute respiratory infection is exposure to in-door air pollution — principally smoke from cooking with firewood and other solid fuels. And, although the prevalence of diarrhoea in young children has decreased over the last decade, only 47 percent of children sought advice and treatment from a health facility or provider (CBS 2015).
4) Immunisation — In 2016, only 87 per-cent of children aged 12–23 months had re-ceived all the vaccinations as per the national schedule by their first birthday (MoH, New ERA and ICF 2017). The percentage of non-immunised children reduced to 1 percent in 2016 from 3 percent in 2011.
5) Adolescent nutrition — The NDHS 2016 found that many adolescents, and especially adolescent girls, were malnourished, with 30 percent of 15 to 19 year old girls being under-weight, while 44 percent of them were anae-
FIGURE 1.5: COVERAGE PROGRESS OF NEPAL’S NUTRITION SENSITIVE INTERVENTIONS IN MSNP (2013–17) PERIOD
Attention &scale-up
SustainReverse negativetrend & strengthen
20-24 Womenmarried before
15 years
20-24 Womenmarried before
18 years
25-29 Womenmarried
before 15Well-functioning
water supply scheme
Child faecesdisposed
safely
Access to Improved Sanitation
Literacy rate (15-24 years)
Cash grants
Net EnrolmentPrimary Education
Improved Drinking Water Source
Secondary school set enrolment prevalence
Coverage25%0% 50% 75% 100%
Hand washingsoap + water
25-29 Womenmarried before
18 years
150
100
50
0
-50
Posi
tive
Tren
dN
egat
ive
Tren
d
Recommendations:
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Although the poverty level
reduced from 49 percent in 1992 to 21.6 percent in 2016 (NPC
2016a), certain areas of the
country are food insecure and suffer
food deficits. The affordability,
consumption and absorption of local
food is a problem in the Tarai,
Mid-West and Far Western regions.
mic (MoH, New ERA and ICF 2017). This means they are poorly prepared for the rigours of motherhood, which often translates into them having low birth weight babies.
6) Harmful practices — Maternal and child care is still beset by too frequent pregnancies, inadequate awareness of health services, unse-cured deliveries, inappropriate care of babies, and the lack of qualified health workers’ in ru-ral areas.
The other factors that compromise health and nutrition are as follows:7) Food security — Although the poverty lev-
el reduced from 49 percent in 1992 to 21.6 percent in 2016 (NPC 2016a), certain areas of the country continue to be food insecure and suffer food deficits. The affordability, con-sumption and absorption of local food is a problem in the Tarai, Mid-West and Far West-ern regions.
8) Early marriage — Teenage marriage is com-mon in Nepal with 48 percent of women aged 20-49 years having first married or been in a union before age 18 years (CBS 2015). This results in almost a quarter of mothers (16 per-cent) having a live birth before the age of eigh-
teen (CBS 2015). And maternal care practices are often poor with only 57 percent of women having received a health check following de-livery or a post-natal care visit within two days of delivery of their most recent live birth (CBS 2015).
9) Smoke — The 2016 NDHS found that 13 percent of women smoked while far more were exposed to domestic smoke pollution from the use of solid fuel for cooking inside homes (MoHP, New ERA and ICF 2012).
10) WASH — The lack of proper sanitation threatens the health of many people. About half the population still defecate in the open, 27.5 percent of households lack a specific place for hand washing (CBS 2015) and cow manure and dung is often carelessly managed, creating a polluting environment that spreads disease and parasites such as worms.
11) Traditional harmful practices — Tradi-tional practices that are harmful to health per-sist in certain areas and among certain caste groups. This includes adolescent girls and women not being allowed to consume milk, yoghurt or ghee during menstruation. Men-strual seclusion (chhaupadi) is still practised in the Mid-West and Far West. And inadequate
12
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Nepal has seen impressive improvements in recent years on human development, infrastructure, transport networks, communication, social services, the expansion of cooperatives and self-initiated local development. These provide the foundation for many kinds of improvements including for improved nutrition.
menstrual hygiene is commonplace leading to infection and disease, sometimes triggering anaemia, resulting in undernutrition.
12) Natural disasters — Nepal’s vulnerability to natural disasters was demonstrated by the impact of the 2015 earthquakes that displaced many people from their homes, destroyed crops and disrupted healthy nutrition in thou-sands of households.
13) Education and infrastructure — Large im-provements in education and infrastructure have ameliorated major causes of malnutri-tion. The literacy rate among young women (15-24 years) now stands at 88.6 percent meaning they are more educated and aware about health and nutrition issues. The large improvements in Nepal’s road network makes it easier to transport foodstuffs around the country.
1.8 Analysis of Other Issues that Affect NutritionNepal’s current situation provides many oppor-tunities and significant challenges to improve nu-trition as a key driver of socioeconomic growth. Nepal has seen impressive improvements in re-cent years on human development, infrastruc-ture, transport networks, communication, social services, the expansion of cooperatives and self-initiated local development. These provide the foundation for many kinds of improvements including for improved nutrition. The major development challenges faced by Nepal include the lack of jobs, reliance on remittance incomes, deep-rooted discrimination, the underdevelop-ment of agriculture and unplanned urban growth.
1.8.1 ECONOMIC
In 2015, Nepal adopted the ambitious aims of graduating from least developed country status (LDC) to developing country status by 2022, and middle-income country status by 2030 (NPC 2015). To become a developing country Nepal needs to achieve a certain human asset index score. This score is calculated based on (i) per-centage of population undernourished; (ii) mor-tality rate of children under 5-years of age; (iii) gross secondary school enrolment ratio; and (iv) adult literacy rate. These are all affected by nu-tritional status meaning that good nutrition is a precondition for Nepal to graduate to developing
and middle income status. This ambition is a spur for improved nutrition.
The third Nepal Living Standards Survey (NLSS 3) reported a shrinking income gap between the poor and the rich (CBS 2011).
Although the annual income of the poorest 20 percent of the population had increased consider-ably, poverty persists among a fifth of the popula-tion. The rate of joblessness remains high, par-ticularly among women and young people, with youth unemployment being the major cause of the high rate of migration of young people from rural to urban areas and to work abroad. In 2011, 55 percent of households were receiving remit-tance incomes with an average of $773 per year (CBS 2011). And the trend has increased with remittances accounting for 29.2 percent of gross domestic product in 2014/15.
NLSS 3 found that agricultural development was neglected with the percentage of irrigated land remaining stagnant at 54 percent compared to NLSS 2 in 2003/04 while the percentage of farmers holding less than 0.5 hectares of land had increased.
1.8.2 SOCIAL
NLSS-3 found that people’s access to basic fa-cilities had improved. It found that 95 percent of households could reach a primary school and 74 percent a health centre within 30 minutes’ travel. It also reported improved access to banking, mar-ket centres, paved roads and safe drinking water. The 2016 NDHS found that the use of health services had increased:• The proportion of married women (15-49
years) using any modern method of contra-ception increased from 48 percent in 2011 to 53 percent in 2016.
• The proportion of pregnant women receiv-ing at least one antenatal check-up by skilled health personnel increased from 58 percent in 2011 to 84 percent in 2016 with 69 percent of women having received the recommended four antenatal check-ups.
• The percentage of women delivering their ba-bies in a health facility increased from 36 per-cent in 2011 to 58 percent in 2016 (MoHP, New ERA and ICF 2016).
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Job creation and other development efforts are hindered by persistent discriminatory socio-cul-tural practices that cause the social and economic exclusion of women and people from marginal-ized groups. The development-related results of gender discrimination and social exclusion vary between Nepal’s urban and rural areas and be-tween its regions/provinces. For example, the Mid and Far-western regions ranked the lowest on the Gender Empowerment Measure and the Gen-der-related Development Index (GDI) (UNDP 2015). It is likely that deep-rooted exclusionary practices will remain in the near future.
1.8.3 POLITICAL
Nepal is instituting a federal system of gover-nance under its 2015 constitution with a three-tiered structure that devolves executive and legis-lative powers to provincial and local governments (metropolitan cities, sub-metropolitan cities, ur-ban municipalities and rural municipalities). This involves restructuring the civil service and laws to protect and empower women and other tradi-tionally marginalized people. This system of de-volved governance provides many opportunities for improving the health and nutritional status of Nepal’s people.
1.8.4 DEMOGRAPHY
Nepal has a young population. It is estimated that 44 percent of its 28.4 million people are under 19-years-old. Given current trends, Ne-pal should be able to benefit from its youth-based demographic dividend until at least 2050 (UNCT Nepal 2017). The rapid demographic changes are due to declining birth and death rates and improved life expectancy. Nepal needs to prepare itself for these changes and invest in today’s children so they become more productive on entering the workforce. There is a finite win-dow of opportunity until the proportion of the working-age population starts to decrease. Dur-ing this time, the proportion of working-age peo-ple is high compared to dependent young and old people, which provides favourable conditions for socioeconomic development. This highlights the urgency of investing in children to ensure they are more productive when they enter the work-force. At the same time investments need making to reduce malnutrition and develop human capi-tal focusing on children under-5 and adolescents.
Eighteen percent of Nepal’s population live in urban and peri-urban areas with an estimated ur-ban growth rate of 3 percent per year (in 2014)
Nepal is instituting a federal system
of governance under its 2015
constitution with a three-
tiered structure that devolves
executive and legislative powers to provincial and
local governments.
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2 Achham, Baitadi, Bajhang, Bajura, Bara, Bardiya, Dadeldhura, Dailekh, Dhanusha, Dolpa, Doti, Humla, Jajarkot, Jumla, Kalikot, Kapilvastu, Khotang, Mahottari, Mugu, Nawalparasi, Panchthar, Parsa, Rautahat, Rolpa, Rukum, Saptari, Sarlahi and Udayapur
(Bakrania 2015). However, much of this popula-tion growth is amongst the urban poor, who live in unsanitary, overcrowded and unhealthy condi-tions that especially put mothers and children at risk (HEART 2013).
1.9 Achievements of Multi-Sector Nutrition Plan (2013–17)MSNP (2013-2017) was implemented from 2014 in 28 districts.2 It was also partially im-plemented in other districts with the support of non-government organisations. Its main aim was to reduce chronic malnutrition (stunting) by achieving the following three outcomes that broadly match the nutrition specific, nutrition sensitive and enabling environment outcomes of MSNP-II (see Section 2.1):1. Improved maternal, infant and young child
feeding.2. Increased maternal, infant and young child
micro-nutrient status.
3. Improved management of malnutrition in children.
A) LONG-TERM IMPACT
During the MSNP (2013–17) period chronic malnutrition (stunting) reduced by 12 percent from 40.5 percent in 2011 to 35.8 percent in 2016, which is a great achievement. This achieve-ment was greatly facilitated by the Fourteenth Plan prioritising improved nutrition (NPC 2016b) with a tripling of the budget for nutrition programmes from NPR 5,220 million spent in FY 2013/14 to NPR 19,260 million allocated in 2017/18.
However, much remains to be done as 27 per-cent of under 5-year-olds remain moderately or severely underweight and 5.4 percent severely un-derweight. Ten percent are moderately or severely wasted or too thin for their height and 2 percent are severely wasted (MoH, New ERA and ICF 2017).
During the MSNP (2013–17) period chronic malnutrition (stunting) reduced by 12% from 40.5% in 2011 to 35.8% in 2016.
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TABLE 1.2: STATUS OF MSNP (2013–17) NUTRITION SPECIFIC INDICATORS
IndicatorBaseline
Progress Status
MSNP target
2012 2016 2017
Outcome 1: Improved maternal, infant and young child feeding
1.1. % of children born in last 24 months who were put to the breast within one hour of birth 44.5 55 56
1.2. % of infants 0–5 months of age who received only breast milk during the previous day 70 66 88
1.3. % of infants registered for growth monitoring who reached 6 months in the last month who were exclusively breastfed for the first 6 months NA 28.5 36
1.4. % of infants registered for growth monitoring who reached 6 months in the last month who were timely initiated complementary feeding at 6 months of age NA 27.5 34
1.5. % of infants 6–8 months of age surveyed who received solid, semi-solid or soft foods in the previous day 70 73.5 88
1.6. % of children 6-23 months of age who were receiving a minimum acceptable diet (apart from breast milk) 24 36 42
Outcome 2: Increased maternal, infant and young child micro-nutrient status
2.1. % of children under 5-69 months with anaemia 46 52.7 69
2.2. % of women aged 15-49 years with anaemia 35 40.8 53
2.3. % of women who delivered in previous 6 months who reported consuming all 180 iron folic acid tablets during pregnancy 49.8 42 75
2.4. % of women surveyed who delivered in previous 6 months who reported consuming anthelminthics during pregnancy 55.1 70 83
2.5. % of women who delivered in previous 6 months who reported consuming all 45 tablets of iron folic acid postpartum 55.6 45 83
2.6. No. of students in grades 1-10 in private and public schools who received deworming tablets in previous six months (1,000s) 1,919 1,636 2,581
2.7. % of households where adequately iodized (>15ppm) salt was present 80 95 >95
2.8. % of children aged 6-23 months surveyed who consumed multiple micronutrient powder (MNP) in previous 7 days NA 78.8 80
2.9. % of children under-5 who had diarrhoea in two weeks preceding the survey 14 8 7
2.10. % of children under-5 who had symptoms of acute respiratory infections in two weeks preceding the survey 5 6.7 3
2.11. % of children aged 6-59 months who received vitamin A supplements in previous six months 90.4 90.3 >95
2.12. % of children aged 12-59 months who received antihelminthics in previous six months 83.7 79 >95
2.13. % of women reporting receiving vitamin A supplementation within 6 weeks following a live birth in previous three years 40.3 49.1 60
Outcome 3: Improved management of malnutrition in children
3.1. % of cases of severe acute malnutrition discharged who recovered 89 84 >75
3.2. % of cases of severe acute malnutrition discharged who defaulted 4.8 9 <15
3.3. % of cases of severe acute malnutrition discharged who died 1.3 0 <10
3.4 % of children aged 0-23 months underweight among those registered for growth monitoring 3 3.3 12
3.5. No. of children under-5 with severe acute malnutrition registered 6,646 11,517 8,308
Source: MoH, New ERA and ICF 2017; DoHS 2016
Note: All Outcome 1 and Outcome 2.1 to 2.5 targets were based on the WHA targets (2012–2025). Since 2017 is about midway to 2025, it was assumed that the target for 2017 would be half the WHA target for most of the indicators. The outcome 3 targets were based on the minimum standard in humanitar-ian response (SPHERE Standard).
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Most programmes implemented under MSNP (2013–17) addressed the causes of malnutrition and contributed to improving the nutritional status of all Nepal’s women and children.
B) PROGRESS AGAINST NUTRITION SPECIFIC
OUTCOME
Although good progress was made against many of the MSNP (2013–17) targets, only the follow-ing five had been achieved or almost achieved by 2016: immediate breastfeeding (target 1.1), the presence of adequately iodized salt (2.7), the con-sumption of MNP (2.8), children who suffered diarrhoea (2.9) and deaths among discharged se-vere acute malnutrition cases (3.3) (Table 1.2).
There has been progress on mitigating micro-nutrient deficiencies (vitamin A, iron and iodine) of essential dietary components (USAID nd), al-though a below average proportion of households use iodized salts, vitamin A supplementation and iron supplementation in the hills and mountain regions of the Mid-west (CBS 2015). In 2014, 81.5 percent of households nationwide were us-ing adequately iodized salt (15 parts per million), which is less than the targeted 90 percent (CBS 2015).
Maternal care has improved with increased access to antenatal care with 6% of pregnant women having at least one session with a skilled health worker and 59.5% at least four sessions by any provider (MoH, New ERA and ICF 2017). In 2014, 58 percent of mothers had a post-natal health check-up (CBS 2015).
Two major concerns are the management of di-arrhoea and anaemia in children, with the rate of anaemia among 15-59 month olds increasing between 2011 and 2016 (MoH, New ERA and ICF 2017). The recently conducted Nepal Mi-cronutrient Survey hopes to identify the cause of this. Also, see Figure 1.5 for progress of nutrition-sensitive interventions.
C) PROGRESS AGAINST NUTRITION SENSI-
TIVE OUTCOME
Most programmes implemented under MSNP (2013–17) addressed the causes of malnutrition and contributed to improving the nutritional sta-tus of all Nepal’s women and children. Among the achievements, the 2016 NDHS found that:• 72.5 percentage of households had specific
places for hand washing where water and soap or another cleansing agent was present
• 53 percent of married women of 15-49 years were using family planning methods.
The agriculture sector has added nutrition indi-cators into its management information system (NEKSAP), which further strengthen monitor-ing and evaluation. And with support from UNI-CEF, bottom-up planning has been started in both nutrition specific and nutrition sensitive ar-eas. Also, See Figure 1.5 for progress of nutrition-sensitive interventions.
D) PROGRESS AGAINST ENABLING ENVIRON-
MENT OUTCOME
MSNP (2013–17) activities strengthened the enabling environment for nutrition. An MSNP institutional mechanism is now in place with the lead role taken by the National Planning Com-mission (NPC). A High-Level Nutrition and Food Security Steering Committee and a Na-tional Nutrition and Food Security Coordination Committee were formed in 2011. District level nutrition and food security steering committees were formed in most districts over the course of MSNP. External development partners are sup-porting the National Nutrition and Food Securi-ty Secretariat (NNFSS), which helps NPC man-age nutrition-related issues.
The sectoral ministries responsible for health; ag-riculture; livestock; water and sanitation; educa-tion; women, children and social welfare; and lo-cal governance implemented MSNP (2013–17). Three technical working groups were formed in 2011/12 to support i) advocacy and communi-cation, ii) capacity development, and iii) moni-toring, evaluation and information management. The six sectoral ministries have all included nutri-tion and food security in their working policies. An M&E framework was used to measure the progress of MSNP.
The programmes under MSNP (2013–17) were implemented in the 28 districts through the Ministry of Health, MoFALD and the other sec-toral ministries in coordination with NPC. The government allocated budget to the district level for implementing the plan, which was reflected in district development committees’ annual pro-grammes. These funds were spent by sectoral line agencies according to the decisions of district nu-trition and food security steering committees.
A range of development partners provided tech-nical and financial support to the government to formulate and implement MSNP (2013–17).
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From 2013, the partners implemented MSNP activities through their projects and programmes. Some worked in the same districts and deciding in which areas they would work. The govern-ment and its development partners implemented MSNP in a total of 60 districts. A summary of MSNP (2013–17) programmes and projects sup-ported by donors is given in Annex 2.
1.10 Analysis of Estimated Costs and Expenditure of Multi-Sector Nutrition Plan (2013–17)The amount allocated for nutrition by the gov-ernment and its development partners almost tripled over the course of MSNP (2013–17) from NPR 7,210 million ($69 million) in 2013 to NPR 19,241 million ($184.9 million) in 2017. The proportion provided by the government and its development partners varied from year to year with the government overall contributing 46 per-cent and development partners 54 percent.
GoN Development partners Total 2013
Budget (NPR million) 3,408 3,802 7,210
Proportion 47% 53% 100%
2014
Budget (NPR million) 3,889 27,094 30,983
Proportion 13% 87% 100%
2015
Budget (NPR million) 12,717 6,056 18,773
Proportion 68% 32% 100%
2016
Budget (NPR million) 6,627 5,653 12,281
Proportion 54% 46% 100
2017
Budget (NPR million) 13,773 5,469 19,241
Proportion 72% 28% 100
Total (2013–2017)
Budget (NPR million) 40,414 48,074 88,488
Proportion 46% 54% 100%
TABLE 1.3: BUDGET ALLOCATED TO NUTRITION BY GOVERNMENT OF NEPAL AND DEVELOPMENT PARTNERS IN MSNP (2013–17) PERIOD
Source: NPC, Annual Development Programme, Part 1:
Including on and off-budget figures two-thirds of MSNP (2013–17) expenditure came from development partner support. These local bud-gets were planned by the district nutrition and food security steering committees and were spent through sectoral line agencies to reach the various target groups.
1.11 Key Problems and ChallengesThe following were the main issues that hindered the implementation of MSNP (2013–17): 1. Disparities — The large disparities in access
to adequate nutrition and good quality health care between people living in urban and rural areas and between the wealthiest and poorest people make it difficult for poor rural dwellers to improve their nutritional status.
2. Quality of services — Poor quality health care sometimes impedes the delivery of health services to the populations who are most vul-nerable to undernutrition.
The amount allocated for
nutrition by the government and its development partners almost tripled over the
course of MSNP (2013–17) from
NPR 7,210 million ($69 million)
in 2013 to NPR 19,241 million
($184.9 million) in 2017.
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3. Traditional practices — Erroneous food and social practices in more conservative commu-nities impede the correct intake of nutrients for mothers and children and their care.
4. Inadequate data — Inadequate data on the nutritional status of women and children af-fected the adoption of evidence based plan-ning.
5. Budgets — The insufficient and late release of budgets led to inadequate health services and made it difficult to run local nutrition and awareness programmes. This was a cause of the limited progress on increasing awareness and protection for mothers and their children, and ending child marriage and harmful food practices during menstruation and pregnancy.
6. Assessment of financial investments — It was difficult to assess the financial invest-ments by the different sectors as their budget and programme codes differed.
7. Weak institutional structure — Inadequate
personnel, institutional and individual capac-ity gaps, and rapid staff turnover hindered the implementation of MSNP (2013–17). Existing institutional structures and human resources were not fully mobilised to improve nutrition and food security and there was, in some cases, inadequate coordination between higher and lower authorities. Also, sectoral ministries gave a low priority to nutrition.
1.12 Lessons Learned Implementing MSNP (2013–17)• More convergence and complementarity are
needed while implementing MSNP interven-tions.
• Improved information management and the sharing of information is needed for the suc-cess of the multi-sectoral nutrition approach.
• The MSNP key sectors need to improve own-ership, the assignment of roles and respon-sibilities and the commitment of time and
More convergence and complementarity are needed while implementing MSNP interventions.
19
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resources to nutrition as competing priorities and workloads delayed MSNP (2013–17) in-terventions.
• There needs to be more technical assistance and capacity building support to all MSNP sectors at community and institutional levels.
1.13 The Rationale for MSNP-IIThis introductory chapter concludes with a sum-mary of the main reasons for producing the fol-low-on MSNP-II:• Impact of stunting — In Nepal, one out of
three children still suffer from stunting. Stunt-ed children under-5-years-old are less likely to survive their fifth birthdays, and those who survive are unlikely to achieve adequate physi-cal growth and mental and cognitive develop-ment. The stunting process occurs from con-ception to two years of age and is irreversible.
• Micronutrient deficiency — Many Nepalis, and especially the most vulnerable and wom-
en and children, are affected by micronutrient deficiencies. This increases the risk of mortali-ty in infancy and childhood, impairs cognitive functions and hinders national socioeconomic development.
• Build on MSNP (2013–17) — Most of the proposed MSNP-II activities will build on the achievements of MSNP (2013–17)
• Graduation from LDC status — The gradu-ation of Nepal from LDC status by 2022 is contingent on improving nutrition. All the criteria needed to graduate (income, human assets index and economy vulnerability index) demand nutrition programmes for children and women in one way or another.
• Reaping the demographic dividend — The demographic window of opportunity for Ne-pal began around 1992 and will start to close around 2047. During this time the number and proportion of working-age population will be high providing very favourable condi-
The graduation of Nepal from LDC status by
2022 is contingent on improving
nutrition.
20
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June 2016-May 2017 :Desk review of imple-mentation of MSNP-I (2013-2017)
9 September 2016 :Malnutrition causality analysis workshop
31 August 2016 :Nutrition deprivation analysis workshop
21-22 February 2017 : MSNP-II theory of change workshop
April-May 2017 :Draft MSNP-II shared for feedback and inputs
August 2017 :Costing of MSNP-II
19 November 2017 :MSNP-II approved by Cabinet
30 March 2017 :MSNP-II results framework work-shop
May-September 2017 : MSNP-I review by NPC
October 2017 :Endorsement of MSNP-II by NPC (Coordination Comittee, Steering Comit-tee and NPC Board)
FIGURE 1.6: TIMELINE OF PREPARATION OF MSNP-II
tions for socioeconomic development. To reap this dividend the government must invest in early childhood development, health, nutri-tion, education, water, sanitation and hygiene, child protection, adolescents’ development and social protection.
• Global development imperatives — Malnu-trition is a major issue to be addressed under the SDGs (2016-2030). These new develop-ment goals provide a massive opportunity for the national and international community to upscale nutrition initiatives and secure good nutrition for all. And the Lancet causality framework for maternal and child undernutri-tion (The Lancet 2013) and the Global Scal-ing Up Nutrition (SUN) Movement remain key driving forces for improvements worl-wide.
Set against this strong rationale, in 2016/17 the National Planning Commission (NPC) formu-lated the second MSNP (MSNP-II) with support from its development partners to outline a set of core values that reflect the country’s social and economic priorities. The plan is based on consul-tations with a wide range of public and private stakeholders and on the analysis of nutrition de-privations, causality, disparities, inequities, bot-tlenecks, a desk review, recommendations from the Lancet 2013 series on maternal and child nu-trition (The Lancet 2013) and other global and national priorities. Figure 1.6 shows the process undertaken to prepare MSNP-II beginning in June 2016 and concluding with the plan’s ap-proval by the Cabinet in November 2017.
Malnutrition is a major issue to be addressed under the SDGs (2016-2030).
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MULTI-SECTOR NUTRITION PLAN-II (2018–2022)
Chapter 2
23
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2.1 VisionTo reduce malnutrition so that it no longer im-pedes people’s potential and performance towards enhanced human capital and overall socioeco-nomic development.
2.2 GoalImproved maternal, adolescent and child nutri-tion by scaling up essential nutrition-specific and sensitive interventions and creating an enabling environment for nutrition.
2.3 ObjectivesThe three objectives (that are directly related to MSNP-II’s three outcomes):• To increase the number of service delivery in-
stitutions to improve access to and the use of nutrition-specific services.
• To increase access to and the use of nutrition sensitive services including improving health-related behaviour.
• To improve policies, plans and multi-sectoral coordination at federal, provincial and local government levels to create an enabling envi-ronment to improve nutrition.
2.4 StrategiesMSNP-II will take the following strategies:1. Scale up multisector nutrition programmes
across Nepal to ensure qualitative, equitable and gender-informed nutrition services for all.
2. Develop positive nutrition behaviour by run-ning advocacy, communication and participa-tion campaigns and through public engage-ment programmes.
3. Foster cooperation, partnership, coordination and the sharing of lessons learned and best practices on improving nutrition.
4. Promote and use innovative technologies and initiatives for improving nutrition.
5. Internalise and implement nutrition interven-
tions in federal, provincial and local govern-ment policies and plans.
6. Strengthen monitoring, evaluation, study and research for evidence-based planning, decision making and implementation.
2.5 Policy-level Principles and Approaches• Prevailing government policies and per-
spective plans — MSNP-II will be the basis for the implementation of the parts of the Fourteenth Plan (2016/17–2018/19) (NPC 2016b) on improving nutrition. MSNP-II has been designed and will be implemented in compliance with the Constitution of Nepal, 2015 (GoN 2015) and with related regula-tions.
• Inclusiveness and gender equity — Inter-ventions under MSNP-II will promote social inclusion and gender equity especially in the hills and mountains of the Mid-West and Far West and in the central Tarai. MSNP-II will support the socially inclusive, gender sensitive and child-friendly continuum of care.
• Affirmative action — Affirmative action poli-cies will be introduced in favour of poor peo-ple, women and disadvantaged communities to maximise their participation in, and ben-efits from, MSNP-II’s interventions. The lead-ership and management skills of women and disadvantaged communities (Dalit, Janajatis [ethnic groups] and others) will be improved. The plan will seek to ensure that their voices are heard in local decision-making processes, including by mainstreaming and institution-alizing their participation in local institutions.
• Flexible and process-oriented approach — MSNP-II will translate the government’s commitments on improving nutrition, state restructuring and the engagement of line agencies with communities to improve the de-livery of public goods and services. The sup-
2. Multi-Sector Nutrition Plan-ii (2018–2022)
Chapter 2
Improved maternal, adolescent and child nutrition by scaling up essential nutrition-specific and sensitive interventions and creating an enabling environment for nutrition.
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26
port provided to line agencies and local gov-ernments will be flexible and process-oriented and will include innovative and context-spe-cific approaches for responsive, inclusive, and accountable governance through participatory development. Procedures for working with communities and targeting the poorest and most disadvantaged people will be rationalised and harmonised.
• Transparency and accountability — MSNP-II will be transparent in its operations, budgets, decision making, communications, coordination among line agencies and non-state agencies and in reaching remote areas. It will delineate the roles and responsibilities of all actors and take a systemic approach to increase accountability at all levels.
• Information and communication — Behav-iour change communication will be organised to raise civic awareness about chronic malnutri-tion and actions needed to improve maternal and child nutrition, focussing on reaching the most marginalized, poorest segments and tak-
ing into account gender related factors. Civil society organisations, parliamentarians, other elected representatives, and decision makers will be mobilised with advocacy activities.
2.6 Theory of ChangeTheories of change explain how activities are understood to produce results that contribute to achieving intended impacts. Using this tool sharpens the focus on what needs to be addressed and the changes needed at government, commu-nity, family, and individual levels to reduce mal-nutrition.
MSNP-II’s theory of change (Figure 2.1) helps the different sectors to see their roles in imple-menting MSNP-II. It shows the desired impact of MSNP-II to address the main nutrition-relat-ed problems, which range from stunting of under 5-year olds to childhood wasting. Below are the three outcomes of MSNP-II and the intervention areas (outputs) that the five sectors, plus NPC and local governance, need to carry out under to achieve the desired impact.
MSNP-II’s theory of change helps the
different sectors to see their roles in implementing
MSNP-II.
26
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FIG
URE
2.1
: M
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eder
al, p
rovi
ncia
l and
loca
l lev
els
3.
Dev
elop
pol
icy
fram
ewor
k fo
r exp
licit
budg
et in
vestm
ent a
rtic
ulat
ion
on n
utrit
ion
at fe
dera
l, pr
ovin
cial
and
loca
l lev
els
4. A
ppoi
nt a
nd p
rovi
de le
ader
ship
trai
ning
to lo
cal n
utrit
ion
cham
pion
s to
coor
dina
te lo
cal i
mpl
emen
tatio
n
1.
Redu
ce M
IYC
& im
prov
e ado
lesc
ent
mic
ronu
trie
nt s
tatu
s to
red
uce
anae
-m
ia &
oth
er d
efici
enci
es2.
Im
prov
e IY
C f
eedi
ng p
ract
ices
and
th
e di
etar
y di
vers
ity o
f WR
A3.
En
hanc
e pr
epar
edne
ss f
or n
utrit
ion
in e
mer
genc
ies
4.
Incr
ease
cov
erag
e of
dise
ase
prev
en-
tion
and
man
agem
ent
5.
Appr
opria
tely
tre
at a
nd m
anag
e se
-ve
rely
mal
nour
ished
and
sic
k ch
il-dr
en6.
Im
prov
e co
vera
ge
and
qual
ity
of
heal
th a
nd n
utrit
ion
serv
ices
, inc
lud-
ing
fam
ily p
lann
ing
and
repr
oduc
tive
heal
th se
rvic
es.
1.
Impr
ove
early
ch
ildho
od
deve
lopm
ent f
or a
ll ch
ildre
n 36
-59
mon
ths.
2.
Ensu
re t
hat
all
girls
com
plet
e se
cond
ary
educ
atio
n.3.
Im
prov
e lif
e sk
ills a
nd n
utrit
iona
l sta
tus f
or a
ll ad
oles
cent
girl
stu-
dent
s.
1.
Ensu
re th
e ec
onom
ic a
nd s
ocia
l em
pow
erm
ent o
f wom
en2.
St
reng
then
chi
ld p
rote
ctio
n an
d de
velo
pmen
t3.
St
reng
then
soci
al p
rote
ctio
n se
r-vi
ces
4.
Elim
inat
e ch
ild
mar
riage
an
d ot
her
harm
ful
trad
ition
al p
rac-
tices
5.
Impr
ove
the
avai
labi
lity
of a
nd
acce
ss to
mat
erna
l men
tal h
ealth
se
rvic
es
1.
Incr
ease
ac
cess
to
sa
fe
drin
king
wat
er2.
In
crea
se a
cces
s to
impr
oved
sa
nita
tion
3.
Impr
ove
hygie
ne b
ehav
iour
pr
actic
es a
nd t
heir
man
-ag
emen
t
1.
Impr
ove
the
avai
labi
lity
of,
phys
ical
and
ec
onom
ic a
cces
s to
,and
the
cons
umpt
ion
of, d
iver
sified
fo
od g
roup
s, es
peci
ally
in
dige
nous
loca
l fo
od (c
erea
ls,
legu
mes
and
oi
lseed
s) a
nd
fruits
and
ve
geta
bles
.
1.
Impr
ove
the
avai
labi
lity
of, p
hysic
al
and
econ
omic
ac
cess
to,
and
the
cons
umpt
ion
of d
iver
sified
fo
od g
roup
s, es
peci
ally
fles
h m
eat,
dairy
pr
oduc
ts an
d eg
gs
Hea
lth
Wom
en, C
hil
dren
an
d So
cial
W
elfa
reW
ater
Su
pp
ly, S
anit
a-ti
on a
nd
Hyg
ien
eA
gric
ult
ura
lD
evel
opm
ent
Liv
esto
ck
Dev
elop
men
tE
duca
tion
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
2828
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
29
GO
AL:
IM
PR
OV
ED
MAT
ER
NA
L, A
DO
LESC
EN
T A
ND
CH
ILD
NU
TR
ITIO
N B
Y SC
ALI
NG
UP
ESS
EN
TIA
L N
UT
RIT
ION
-SPE
CIF
IC
AN
D S
EN
SIT
IVE
INT
ER
VE
NT
ION
S A
ND
CR
EAT
ING
AN
EN
AB
LIN
G E
NV
IRO
NM
EN
T F
OR
NU
TR
ITIO
N
Out
com
e 1:
Impr
oved
acc
ess t
o an
d eq
uita
ble
use
of n
utrit
ion-
spec
ific
Out
put 1
.1 E
nhan
ced
nutr
ition
stat
us o
f W
RA
incl
udin
g ad
oles
cent
s
Out
put 1
.2:
Impr
oved
infa
nt a
nd
youn
g ch
ild n
utrit
ion
and
care
pra
ctic
es
Out
put 1
.4:
Impr
oved
man
agem
ent
of se
vere
and
mod
erat
e ac
ute
mal
nutr
ition
Out
put 1
.5:
Enha
nced
pre
pare
dnes
s fo
r nut
ritio
n in
emer
genc
y. re
spon
ses
Out
put 1
.6:
Cap
acity
bui
lt of
nutr
ition
spec
ific
sect
ors
Out
put 1
.3: I
mpr
oved
MIY
C m
icro
nutr
ient
sta
tus
1.1.
1 O
rgan
ize a
nd
impl
emen
t ful
ly-
nour
ished
vill
ages
/w
ards
incl
udin
g G
1000
D c
omm
u-ni
catio
n ca
mpa
ign
1.1.
2 Re
vita
lize
Scho
ol
Hea
lth a
nd N
utri-
tion
Prog
ram
me
in-
clud
ing
prom
otio
n of
hea
lthy
diet
ary
habi
ts an
d ph
ysic
al
activ
ities
1.1.
3 R
aise
aw
aren
ess a
nd
serv
ices
for h
ealth
y tim
ing
and
spac
ing
of p
regn
ancy
1.1.
4 C
ondu
ct b
ar-
rier a
naly
sis fo
r in
crea
sed
ANC
se
rvic
e ut
iliza
tion
1.1.
5 In
tegr
ate
and
expa
nd a
dole
scen
t-fri
endl
y he
alth
and
nu
triti
on se
rvic
es
1.2.
1 C
ondu
ct M
IYC
N c
oun-
selli
ng a
t all
heal
th se
ctor
pl
atfo
rms v
iz. h
ealth
m
othe
r’s g
roup
mee
tings
, im
mun
izatio
n, A
NC
, PN
C, G
MP,
PHC
-ORC
, IM
NC
I & O
PD se
rvic
es1.
2.2
Con
duct
regu
lar g
row
th
mon
itorin
g co
unse
lling
at
PHC
-ORC
s and
hea
lth
faci
litie
s1.
2.3
Diss
emin
ate
IEC
& B
CC
m
ater
ials
thro
ugh
heal
th
faci
litie
s, &
FC
HV
s to
com
mun
ities
& h
ouse
-ho
lds r
egul
arly
1.2.
4 C
ondu
ct fo
od p
repa
ratio
n &
coo
king
dem
onstr
a-tio
ns to
pre
pare
loca
l nu
triti
ous f
oods
(e.g
. nu
triti
ous fl
our/
porr
idge
(li
to),
jaul
o/kh
icha
di u
s-in
g lo
cal f
oods
tuffs
1.2.
5 En
gage
med
ia fo
r do
cum
enta
tion
and
dis-
sem
inat
ion
of M
IYC
N
prog
ram
me
1.2.
6 R
aise
aw
aren
ess o
n nu
tri-
tion
incl
udin
g es
sent
ial
new
born
car
e
1.3.
1 M
aint
ain
and
susta
in ro
utin
e di
strib
utio
n of
V
itam
in A
cap
sule
and
dew
orm
ing
tabl
ets t
o ch
ildre
n un
der 5
yea
rs1.
3.2
Incr
ease
cov
erag
e an
d co
mpl
ianc
e of
iron
folic
ac
id a
nd d
ewor
min
g am
ong
preg
nanc
y an
d po
st-pa
rtum
wom
en1.
3.3
Scal
e-up
hom
e fo
od fo
rtifi
catio
n w
ith M
NP
in ta
rget
ed a
rea
1.3.
4 R
aise
aw
aren
ess t
o pr
omot
e ho
useh
old
use
of
two-
child
-logo
iodi
zed
salt
1.3.
5 R
aise
aw
aren
ess t
o pr
omot
e co
nsum
ptio
n of
ro
ller-
mill
pro
duce
d fo
rtifi
ed fl
our a
nd ri
ce1.
3.6
Initi
ate
rice
fort
ifica
tion
in g
over
nmen
t (N
FC) a
nd se
lect
ed la
rge
rice
mill
s.1.
3.7
Con
duct
rese
arch
to im
prov
e co
mpl
ianc
e of
IF
A su
pple
men
tatio
n1.
3.8
Con
duct
bar
rier a
naly
sis o
n lo
w c
over
age/
com
plia
nce
of M
NP
1.3.
9 Pr
ocur
e an
d su
pply
nut
ritio
n co
mm
oditi
es fo
r re
gula
r and
em
erge
ncy
prog
ram
mes
(Vita
min
A,
IFA,
dew
orm
ing
tabl
ets,
MN
P, RU
TF,
th
erap
eutic
milk
, ReS
oMal
) 1.
3.10
Sca
le-u
p fo
rtifi
ed su
per c
erea
l flou
r dist
ri-bu
tion
in d
istric
ts w
ith h
igh
prev
alen
ce o
f ac
ute
mal
nutr
ition
to p
regn
ant a
nd la
ctat
ing
wom
en a
nd 6
-23
mon
ths c
hild
ren
unde
r M
CH
N p
rogr
amm
e
1.4.
1 Ex
pand
and
es
tabl
ish O
TC
an
d IT
C c
entre
s fo
r man
agem
ent
of se
vere
acu
te
mal
nutr
ition
in
child
ren
unde
r 5
1.4.
2 Sc
ale-
up N
RH
in
50+
bed
ho
spita
ls1.
4.3
Con
duct
per
i-od
ic n
utrit
ion
asse
ssm
ents
and
coun
selli
ng a
t co
mm
unity
leve
ls1.
4.4
Con
duct
bar
-rie
r ana
lysis
on
serv
ices
rela
ted
to
SAM
man
age-
men
t1.
4.5
Scal
e-up
and
str
engt
hen
IMN
-C
I pro
gram
me
1.4.
6 Es
tabl
ish a
nd
stren
gthe
n nu
tri-
tion
info
rmat
ion
and
surv
eilla
nce
syste
m in
nor
mal
an
d hu
man
itar-
ian
situa
tions
1.5.
1 Es
tabl
ish
loca
l lev
el
nutr
ition
cl
uste
rs a
nd
cond
uct
quar
terly
co
ordi
natio
n m
eetin
g 1.
5.2
Upd
ate
an
d de
velo
p nu
triti
on in
em
erge
ncy
prep
ared
-ne
ss fo
r re
spon
se a
nd
cont
inge
ncy
plan
ning
at
loca
l lev
els.
1.6.
1 Re
fresh
er
trai
ning
for
HW
s &
FCH
Vs a
t all
leve
l on
MI-
YCN
pac
kage
1.6.
2 O
rgan
ize
basic
trai
ning
on
MIY
CN
pa
ckag
e to
ne
wly
recr
uit-
ed n
utrit
ion
supe
rviso
rs
and
nutr
ition
offi
cers
1.6.
3 O
rgan
ize
nutr
ition
ch
ampi
on
lead
ersh
ip
deve
lopm
ent
even
ts1.
6.4
Con
duct
ro
utin
e da
ta q
ualit
y as
sess
men
ts (R
DQ
A) u
s-in
g nu
triti
on
prog
ram
me
rela
ted
HM
IS
tool
s
FIG
URE
2.2
: M
SNP-
II R
ESU
LTS
STRU
CTU
RE
— O
UTC
OM
E 1 O
N N
UTR
ITIO
N S
PEC
IFIC
SER
VIC
ES
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
30
Out
com
e 2:
Impr
oved
acc
ess t
o an
d th
e eq
uita
ble
use
of n
utrit
ion-
sens
itive
serv
ices
and
impr
oved
hea
lthy
habi
ts an
d pr
actic
es
Out
put 2
.1:
Incr
ease
d av
aila
bilit
y an
d co
nsum
p -tio
n of
safe
an
d nu
triti
ous
food
s
Out
put 2
.2:
Incr
ease
d ph
ysic
al a
nd
econ
omic
ac-
cess
to d
iver
se
type
s of f
ood
Out
put 2
.3:
Incr
ease
d ac
cess
to sa
fe
drin
king
w
ater
Out
put 2
.4:
Incr
ease
d ac
cess
to sa
fe
and
susta
in-
able
sani
tatio
n se
rvic
es
Out
put 2
.5:
Impr
oved
kno
wle
dge
of ch
ildre
n an
d m
othe
rsan
d ca
reta
kers
of u
nder
5
child
ren
on h
ealth
an
d hy
gien
e
Out
put 2
.6: T
ar-
gete
d gr
oups
hav
e ac
cess
to re
sour
ces
and
oppo
rtun
ities
th
at m
ake
them
se
lf-re
liant
Out
put 2
.7: N
utri-
tion
com
pone
nt in
-co
rpor
ated
in w
omen
, ad
oles
cent
girl
s and
ch
ild d
evel
opm
ent
trai
ning
pac
kage
s
2.1.
1
Mak
e av
aila
ble
agric
ultu
re a
nd li
vesto
ck
inpu
ts (i.
e. se
eds,
fert
ilize
rs, b
reed
s) a
t ho
useh
old
and
com
mun
ity le
vels
2.1.
2
Prov
ide
tech
nica
l sup
port
(tra
inin
g,
dem
onstr
atio
n) to
pro
mot
e pr
oduc
tion
of
fruits
, veg
etab
les,
nutr
itiou
s roo
ts, c
erea
ls an
d pu
lses t
o in
crea
se c
onsu
mpt
ion
of
dive
rsifi
ed fo
ods i
n ho
useh
olds
2.1.
3
Incr
ease
pro
duct
ion
and
prom
ote
con-
sum
ptio
n of
fres
h fru
its a
nd g
reen
leaf
y ve
geta
bles
2.1.
4
Build
cap
acity
of l
ives
tock
farm
ers a
nd
entre
pren
eurs
to in
crea
se m
ilk, m
eat a
nd
egg
prod
uctio
n2.
1.5
Te
chni
cal s
uppo
rt fo
r mic
ro a
nd a
ltern
ativ
e sm
all i
rrig
atio
n to
pro
duce
div
ersifi
ed a
nd
mic
ronu
trie
nt ri
ch fo
ods
2.1.
6
Supp
ort f
ood
prod
ucin
g in
dustr
ies t
o ad
opt
good
man
ufac
turin
g pr
actic
es (G
MP)
and
re
late
d sy
stem
s2.
1.7
Tr
ain
agric
ultu
re a
nd li
vesto
ck e
xten
sion
office
rs a
nd st
aff o
n fo
od sa
fety
, foo
d pr
o-ce
ssin
g an
d nu
triti
on2.
1.8
Tr
ain
farm
ers o
n fo
od sa
fety
, foo
d pr
oces
s-in
g an
d nu
triti
on
2.1.
9
Stud
y an
d im
prov
e lo
cal f
ood
reci
pes
2.1.
10 U
pdat
e an
d di
ssem
inat
e fo
od c
ompo
sitio
n ta
bles
2.1.
11 D
issem
inat
e fo
od b
ased
die
tary
gui
delin
es
to lo
cal g
over
nmen
ts2.
1.12
Dev
elop
and
mul
tiply
BC
C m
ater
ials
incl
udin
g au
dio
visu
als o
n fo
od sa
fety
, foo
d pr
oces
sing
and
nutr
ition
2.2.
1 En
hanc
e ac
cess
and
ut
iliza
tion
of
anim
al so
urce
fo
ods
2.2.
2 Pr
omot
e an
d su
ppor
t pr
oduc
-tio
n an
d co
nsum
ptio
n of
fish
incl
ud-
ing
supp
ort
to e
stabl
ish
com
mun
ity
pond
s for
pr
oduc
tion
and
loca
l co
nsum
ptio
n
2.5.
1 C
onstr
uct,
esta
blish
and
pr
omot
e us
er fr
iend
ly
hand
was
hing
fa
cilit
ies i
n ho
useh
olds
an
d in
stitu
-tio
ns2.
5.2
Rai
se a
war
e-ne
ss o
n ha
nd
was
hing
at
criti
cal t
imes
in
com
mun
ities
, sc
hool
chi
ldre
n an
d he
alth
w
orke
rs.
2.5.
3 R
aise
aw
are-
ness
on
men
-str
ual h
ygie
ne
man
agem
ent
in c
omm
u-ni
ties a
nd
scho
ols.
2.5.
4 R
aise
aw
are-
ness
abo
ut
food
hyg
iene
in
com
mun
i-tie
s
2.3.
1 C
onstr
uct
and
repa
ir w
ater
supp
ly
sche
mes
in
com
mun
i-tie
s and
in
stitu
tions
th
roug
h w
ater
safe
ty
plan
s and
pr
ojec
ts2.
3.1
Prom
ote
alte
rna-
tive
and
inno
vativ
e te
chno
logi
es
for s
uppl
y w
ater
2.3.
3 Pr
omot
e ho
useh
old
wat
er
treat
men
t op
tions
2.6.
1 Su
ppor
t com
mun
ity
seed
ban
ks.
2.6.
2 Su
ppor
t wom
en a
nd
disa
dvan
tage
d gr
oups
to
pro
duce
and
con
-su
me
anim
al li
vesto
ck
prod
ucts.
2.6.
3 Pr
ovid
e sta
rt-u
p en
tre-
pren
eurs
hip
gran
ts to
w
omen
coo
pera
tives
fo
r soc
ial a
nd e
co-
nom
ic e
mpo
wer
men
t 2.
6.4
Prov
ide
start
-up
entre
pren
eurs
hip
gran
ts to
wom
en
grou
p m
embe
rs fo
r so
cial
and
eco
nom
ic
empo
wer
men
t.2.
6.5
Trai
ning
and
orie
nta-
tions
for i
ncom
e ge
n-er
atio
n an
d bu
sines
s pr
omot
ion
(veg
etab
le
& fr
uit p
rodu
ctio
n,
anim
al h
usba
ndry
, liv
esto
ck, t
ailo
ring
)2.
6.6
Link
the
distr
ibut
ion
of c
hild
pro
tect
ion
gran
ts to
nut
ritio
n in
al
l dist
ricts.
2.6.
7 In
clud
e nu
triti
on
as a
maj
or o
bjec
tive
of so
cial
pro
tect
ion
prog
ram
mes
2.4.
1 Sen
sitize
com
-m
uniti
es to
ra
ise a
war
enes
s fo
r con
struc
-tio
n, m
ain-
tena
nce
and
hygi
enic
use
of
impr
oved
ho
useh
old
toi-
lets
incl
udin
g sa
fe d
ispos
al o
f ch
ild fa
eces
2.4.
2 Sup
port
and
str
engt
hen
WAS
H
coor
dina
tion
com
mitt
ees
and
loca
l gov
-er
nmen
t to
ac-
cele
rate
OD
F ca
mpa
igns
.2.
4.3 S
uppo
rt
cons
truc
tion
and
man
age-
men
t of c
hild
, ge
nder
and
dif-
fere
ntly
abl
ed
frien
dly
toile
ts in
clud
ing
men
-str
ual h
ygie
ne
man
agem
ent
faci
litie
s at
insti
tutio
ns
2.7.
1 In
tegr
ate
nutr
ition
m
odul
es
in tr
aini
ng
pack
ages
in
clud
ing
GBV
pre
-ve
ntio
n
and
resp
onse
tr
aini
ng,
lead
ersh
ip,
com
mun
ity
prot
ectio
n,
busin
ess
deve
lop-
men
t and
lif
e sk
ills
trai
ning
.
FIG
URE
2.3
: M
SNP-
II R
ESU
LTS
STRU
CTU
RE
— O
UTC
OM
E 2 O
N N
UTR
ITIO
N S
ENSI
TIV
E SE
RV
ICES
GO
AL:
IM
PR
OV
ED
MAT
ER
NA
L, A
DO
LESC
EN
T A
ND
CH
ILD
NU
TR
ITIO
N B
Y SC
ALI
NG
UP
ESS
EN
TIA
L N
UT
RIT
ION
-SPE
CIF
IC
AN
D S
EN
SIT
IVE
INT
ER
VE
NT
ION
S A
ND
CR
EAT
ING
AN
EN
AB
LIN
G E
NV
IRO
NM
EN
T F
OR
NU
TR
ITIO
N
30
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
31
Out
put 2
:8: W
omen
, ch
ildre
n an
d ou
t-of
-sch
ool a
dole
scen
t gi
rls re
ache
d w
ith
heal
th a
nd n
utrit
ion
care
pra
ctic
es
Out
put 2
.10:
C
omm
uniti
es e
mpo
w-
ered
to p
reve
nt h
arm
ful
prac
tices
(men
strua
l se
clus
ion
[chh
aupa
di],
food
tabo
os)
Out
put 2
.12:
In
crea
sed
adol
esce
nt
girls
’ aw
aren
ess a
nd
impr
oved
beh
avio
ur
on n
utrit
ion
Out
put 2
.9:
Chi
ld c
are
hom
es c
ompl
y w
ith m
inim
um
stand
ards
of
nutr
ition
car
e
Out
put 2
.11:
En
hanc
ed
enro
lmen
t of
child
ren
in
basic
edu
catio
n
Out
put 2
.13:
En
hanc
ed a
cces
s to
hea
lth a
nd
repr
oduc
tive
heal
th se
rvic
es
2.8.
1 O
rgan
ize tr
aini
ngs f
or
mem
bers
of w
omen
co
oper
ativ
es a
nd c
hild
cl
ubs o
n nu
triti
on
sens
itive
serv
ices
.
2.8.
2 L
ife sk
ill d
evel
opm
ent
prog
ram
mes
for o
ut-
of-s
choo
l ado
lesc
ent
girls
2.9.
1 M
onito
r chi
ld
care
hom
es
com
plia
nce
with
min
imum
sta
ndar
ds o
f pr
ovisi
on o
f nu-
triti
on se
nsiti
ve
serv
ices
.
2.9.
2 P
rom
ote
nutr
i-tio
n se
nsiti
ve
serv
ices
at c
hild
ca
re h
omes
.
2.9.
3 In
tegr
ate
nutr
i-tio
n co
mpo
-ne
nt in
chi
ld
prot
ectio
n ca
se
man
agem
ent
trai
ning
and
se
rvic
es.
2.9.
4 D
epriv
ed
(Bip
anna
) inf
ant
nutr
ition
pro
-gr
amm
e (N
PR
50,0
00 g
rant
for
wom
en c
oope
ra-
tive)
2.10
.1 R
un b
ehav
-io
ural
cha
nge
com
mun
icat
ion
activ
ities
to
prev
ent h
arm
-fu
l tra
ditio
nal
prac
tices
.
2.10
.2 R
un c
ampa
igns
to
pre
vent
mar
-ria
ge u
ntil
age
20 (3
50 a
dole
s-ce
nts,
390
stake
-ho
lder
s, 84
0 dh
ami-j
hakr
i in
39 in
tera
ctio
n pr
ogra
mm
es.
2.10
.3 C
arry
out
pro
-gr
amm
es to
shift
so
cial
nor
ms
and
harm
ful
prac
tices
on
food
tabo
os
that
pre
vent
m
enstr
ual h
y-gi
ene,
ade
quat
e nu
triti
on fo
r ad
oles
cent
s, et
c.
2.11
.1 R
un w
elco
me
to
scho
ol c
ampa
igns
for
basic
edu
catio
n.2.
11.2
Pro
vide
ade
quat
e re
-so
urce
s to
all s
choo
ls to
hav
e EC
ED/P
PE.
2.11
.3 P
rovi
de d
iver
sified
an
d nu
triti
ous m
id-
day
mea
ls to
chi
ldre
n in
bas
ic e
duca
tion.
2.11
.4 E
CED
faci
litat
ors,
com
mun
ity le
arni
ng
cent
res (
CLC
) fac
ili-
tato
rs, f
ocal
teac
her
and
heal
th te
ache
rs
and
food
man
age-
men
t com
mitt
ees i
n co
ordi
natio
n w
ith
FCH
Vs e
ngag
e pa
rent
s to
impr
ove
thei
r kno
wle
dge
on
heal
th, h
ygie
ne a
nd
nutr
ition
.2.
11.5
Nut
ritio
n m
onito
ring
of b
asic
edu
catio
n stu
dent
s.2.
11.6
Bui
ld n
utrit
ion
capa
city
of E
CD
fa
cilit
ator
s, C
LC
faci
litat
ors,
heal
th
teac
hers
and
food
m
anag
emen
t com
-m
ittee
in sc
hool
s
2.12
.1 R
un c
ampa
igns
for g
irls’
educ
atio
n to
incr
ease
en
rolm
ent i
n sc
hool
s in
targ
eted
are
a. (G
ende
r Pa
rity
Inde
x in
NER
1:
00 (1
-8).
2.12
.2 C
reat
e pr
iorit
y m
inim
um
enab
ling
cond
ition
s (c
lass
room
s, te
ache
rs,
text
boo
ks, W
ASH
, boo
k co
rner
s) in
scho
ols.
2.12
.3 B
uild
sepa
rate
func
tiona
l to
ilets
with
gro
up h
and
was
h fa
cilit
ies,
espe
cial
ly
for g
irls i
n sc
hool
s.2.
12.4
Pro
vide
safe
drin
king
w
ater
in sc
hool
s.2.
12.5
Pro
mot
e he
alth
y be
hav-
iour
thro
ugh
skill
s-ba
sed
heal
th e
duca
tion
in
scho
ols.
2.12
. 6 R
evise
hea
lth a
nd n
utri-
tion
curr
icul
um.
2.12
.7 E
stabl
ish fo
od m
anag
e-m
ent c
omm
ittee
s in
all
scho
ols p
rovi
ding
mid
-da
y m
eals.
2.12
.8 D
evel
op a
set o
f edu
ca-
tiona
l tra
inin
g pa
ckag
es
on d
isaste
r risk
redu
ctio
n (D
RR
) for
stud
ents,
te
ache
rs a
nd sc
hool
man
-ag
emen
t com
mitt
ees.
2.13
.1 P
rovi
de re
prod
uc-
tive
heal
th in
for-
mat
ion
serv
ices
in
scho
ols a
nd
heal
th fa
cilit
ies
for b
oys a
nd
girls
.
2.13
.2 P
rovi
de k
now
l-ed
ge o
n im
por-
tanc
e of
del
ayed
fir
st pr
egna
ncy
afte
r mar
riage
.
2.13
.3 P
rovi
de in
form
a-tio
n to
scho
ol
stude
nts o
n be
nefit
s of u
se o
f fa
mily
pla
nnin
g m
etho
ds.
2.13
.4 B
ehav
iour
cha
nge
com
mun
icat
ion
for i
ncre
asin
g up
take
of r
outin
e m
easle
s and
ru
bella
imm
uni-
zatio
n.
31
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
32
3.1.
1 In
corp
orat
e MSN
P-II
in fe
dera
l plan
s an
d po
lices
3.1.
2 In
corp
orat
e MSN
P-II
in p
rovi
ncia
l lev
el pl
ans a
nd p
olic
ies
3.1.
3 In
corp
orat
e M
SNP-
II in
loca
l go
vern
men
t plan
s an
d pl
anni
ng
proc
esse
s
3.1.
4 O
rgan
ize jo
int
annu
al re
view
m
eetin
gs am
ong
MSN
P-II
sect
or
min
istrie
s at f
eder
al
level
3.1.
5 Ad
voca
cy m
eetin
gs
for i
ncre
asin
g nu
tritio
n bu
dget
(a
t lea
st 3.
5% o
f to
tal)
at fe
dera
l and
pr
ovin
ce le
vels
3.1.
6 D
evelo
p nu
tritio
n bu
dget
code
3.5.
1 D
evel
op n
atio
nal
capa
city
bui
ldin
g m
aste
r pla
n fo
r M
SNP-
II.
3.5.
2 Im
plem
ent c
apac
ity
deve
lopm
ent m
aste
r pl
an a
t all
leve
ls.
Out
com
e 3:
Impr
oved
pol
icie
s, pl
ans a
nd m
ulti-
sect
oral
coo
rdin
atio
n at
fede
ral,
prov
inci
al a
nd lo
cal
gove
rnm
ent l
evel
s to
enha
nce
the
nutr
ition
stat
us o
f all
popu
latio
n gr
oups
.
Out
put 3
.1 M
SNP-
II in
-cl
uded
in lo
cal,
prov
inci
al
and
fede
ral g
over
nmen
t po
licie
s and
pla
ns
3.2.
1 O
rgan
ise H
igh
Leve
l N
utrit
ion
and
Food
Sec
u-rit
y St
eerin
g C
omm
ittee
(H
LNFS
S) m
eetin
gs tw
ice
a ye
ar.
3.2.
2 O
rgan
ise N
atio
nal N
utri-
tion
and
Food
Sec
urity
C
oord
inat
ion
Com
mitt
ee
mee
tings
qua
rter
ly.
3.2.
3 Se
nd c
ircul
ar a
nd fa
cilit
ate
form
atio
n of
nut
ritio
n an
d fo
od se
curit
y ste
erin
g co
m-
mitt
ee in
pro
vinc
es.
3.2.
4 Fo
rm n
utrit
ion
and
food
se
curit
y ste
erin
g co
mm
it-te
es a
t pro
vinc
e le
vel
3.3.
1 St
reng
then
Nat
iona
l Nut
ritio
n an
d Fo
od
Secu
rity
Secr
etar
iat a
t NPC
.3.
3.2
Car
ry o
ut o
rgan
izatio
n &
man
agem
ent
surv
ey o
n in
clud
ing
NN
FSS
in N
PC.
3.3.
3 Fa
cilit
ate
endo
rsem
ent o
f the
O&
M
surv
ey re
port
.3.
3.4
Recr
uit s
taff
for N
FSS
as p
er a
ppro
ved
orga
nogr
am.
3.2.
5 O
rgan
ise n
utrit
ion
and
food
secu
rity
steer
ing
com
mitt
ee m
eetin
gs tw
ice
a ye
ar a
t pro
vinc
e le
vel.
3.2.
6 Fo
rm n
utrit
ion
and
food
secu
rity
coor
di-
natio
n co
mm
ittee
s at p
rovi
nce
leve
l.3.
2.7
Org
anise
nut
ritio
n an
d fo
od se
curit
y co
ordi
natio
n co
mm
ittee
mee
tings
qua
r-te
rly a
t pro
vinc
e le
vel.
3.2.
8 Ap
poin
t nut
ritio
n fo
cal p
erso
ns fo
r all
sect
oral
min
istrie
s at p
rovi
nce
leve
l.3.
2.9
Org
anise
them
atic
tech
nica
l wor
king
gr
oup
mee
tings
at f
eder
al le
vel q
uart
erly.
3.2.
10 F
orm
nut
ritio
n an
d fo
od st
eerin
g co
m-
mitt
ees a
t loc
al g
over
nmen
ts le
vel a
nd
mee
t reg
ular
ly.3.
2.11
For
m n
utrit
ion
and
food
stee
ring
com
mitt
ee a
nd re
gula
r mee
tings
at w
ard
leve
l in
MSN
P lo
cal g
over
nmen
ts.3.
2.12
Fac
ilita
te to
ass
ign
coor
dina
tors
(e
xisti
ng st
aff o
r out
sour
ced)
at l
ocal
go
vern
men
ts to
ove
rsee
MSN
P-II
in
terv
entio
ns.
3.4.
1 U
pdat
e M
SNP
info
rma-
tion
port
al a
nd m
ake
it fu
nctio
nal.
3.4.
2 Li
nk a
nd u
pdat
e nu
triti
on
info
rmat
ion
at c
entr
al le
v-el
(HM
IS, E
MIS
, WAS
H,
agric
ultu
re, l
ives
tock
and
lo
cal g
over
nanc
e).
3.4.
3 Pr
ovid
e tr
aini
ng o
n w
eb-
base
d M
SNP
repo
rtin
g sy
stem
at f
eder
al a
nd
prov
ince
leve
l.3.
4.4
Doc
umen
t & d
issem
inat
e go
od p
ract
ices
, les
sons
le
arne
d an
d ca
se st
udie
s.3.
4.5
Dev
elop
and
revi
ew m
oni-
torin
g an
d ev
alua
tion
fram
ewor
k fo
r all
MSN
P se
ctor
s at f
eder
al le
vel.
3.4.
6 D
evel
op a
nd re
view
mon
i-to
ring
and
eval
uatio
n fra
mew
ork
for a
ll M
SNP
sect
ors a
t pro
vinc
e le
vel.
3.4.
7 En
sure
dev
elop
men
t of
mon
itorin
g an
d ev
alu-
atio
n fra
mew
ork
for a
ll M
SNP
sect
ors a
t loc
al
leve
l.
Out
put 3
.2: M
SNP
gove
r-na
nce
mec
hani
sm st
reng
th-
ened
at f
eder
al, p
rovi
ncia
l, an
d lo
cal l
evel
s
Out
put 3
.3:
MSN
P-II
in
stitu
tiona
l mec
hani
sms
func
tiona
l at f
eder
algo
vern
men
t lev
el
Out
put 3
.4: F
unct
iona
l up
date
d in
form
atio
nm
anag
emen
t sys
tem
acr
oss a
ll M
SNP-
II se
ctor
s
Out
put 3
.5: E
nhan
ced
capa
city
of
fede
ral,
prov
inci
al a
nd lo
cal g
over
n-m
ent t
o pl
an &
impl
emen
t nut
ritio
n pr
ogra
mm
es
FIG
URE
2.4
: M
SNP-
II R
ESU
LTS
STRU
CTU
RE
— O
UTC
OM
E 3 O
N T
HE
ENA
BLIN
G E
NV
IRO
NM
ENT
GO
AL:
IM
PR
OV
ED
MAT
ER
NA
L, A
DO
LESC
EN
T A
ND
CH
ILD
NU
TR
ITIO
N B
Y SC
ALI
NG
UP
ESS
EN
TIA
L N
UT
RIT
ION
-SPE
CIF
IC
AN
D S
EN
SIT
IVE
INT
ER
VE
NT
ION
S A
ND
CR
EAT
ING
AN
EN
AB
LIN
G E
NV
IRO
NM
EN
T F
OR
NU
TR
ITIO
N
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
33
2.7 Results Framework of MSNP-II (2018–22)Based on the theory of change, MSNP-II aims to achieve the following three outcomes:
1. Improved access to and the equitable use of nutrition-specific services.
2. Improved access to and the equitable use of nutrition-sensitive services and improved healthy habits and practices.
3. Improved policies, plans and multi-sectoral coordination at federal, provincial and lo-cal government levels to enhance the nutri-tion status of all population groups.
Outcome 1: Improved equitable utilization of nutrition specific services.The outputs under this outcome address the im-mediate causes of malnutrition. The health sec-tor is responsible for achieving the following six outputs and implementing the associated 33 key activities (see Figure 2.2):
OUTPUT 1.1: ENHANCED NUTRITION STATUS
OF WRA INCLUDING ADOLESCENTS
Key interventions: 1.1.1 Organize and implement fully-nourished
village/ward including Golden 1000 Days communication campaign.
1.1.2 Revitalize School Health and Nutrition/Weekly Iron Folic Acid Supplementation programme including promoting healthy dietary habits and physical activities.
1.1.3 Raise awareness and services for healthy timing and spacing of pregnancy and in-crease access to and utilisation of family planning tools.
1.1.4 Conduct barrier analysis for increased ANC services utilization.
1.1.5 Integrate and expand adolescent-friendly health and nutrition services.
OUTPUT 1.2: IMPROVED INFANT AND
YOUNG CHILD NUTRITION AND CARE
PRACTICES
Key interventions: 1.2.1 Conduct maternal, infant, young child
and newborn (MIYCN) counselling at all
health sector platforms viz. health moth-er’s group meetings, immunization, ANC, PNC, growth monitoring, PHC-ORC, IMNCI and OPD services.
1.2.2 Conduct regular growth monitoring coun-selling at PHC-ORCs and health facilities.
1.2.3 Disseminate IEC and BCC materials through health facilities and FCHVs to communities and households regularly.
1.2.4 Conduct food preparation and cooking demonstrations on preparing local nutri-tious foods (e.g. nutritious flour/porridge (lito), jaulo/khichadi using locally avail-able food products.
1.2.5 Engage media for documentation and dis-semination of MIYCN programme.
1.2.6 Raise awareness on nutrition including on essential newborn care.
OUTPUT 1.3: IMPROVED MIYC
MICRONUTRIENT STATUS
Key interventions: 1.3.1 Maintain and sustain routine distribution
of Vitamin A capsules to children under 5 years and deworming tablets to children of 1-5 years.
1.3.2 Increase coverage and compliance of iron folic acid and de-worming among women during pregnancy and post-partum.
1.3.3 Scale-up home fortification with MNP in targeted areas.
1.3.4 Raise awareness to promote household use of two-child-logo iodized salt.
1.3.5 Raise awareness to promote consumption of national roller-mill produced fortified flour.
1.3.6 Initiate fortification process in production of national roller mills and in foods sup-plied by Nepal Food Corporation.
1.3.7 Conduct qualitative study for improved compliance of IFA supplementation.
1.3.8 Conduct barrier analysis for low coverage and compliance of MNP.
1.3.9 Procure and supply nutrition commodities for regular and emergency programmes (VAC, IFA, deworming tablets, MNPs, RUTF, therapeutic milk, ReSoMal).
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OUTPUT 1.4: IMPROVED MANAGEMENT OF
SEVERE AND MODERATE ACUTE MALNUTRI-
TION
Key interventions: 1.4.1 Expand and establish OTC and ITC to
manage severe acute malnutrition in chil-dren under 5 years.
1.4.2 Scale-up nutrition rehabilitation homes (NRHs) in 50+ bed hospitals.
1.4.3 Conduct periodic nutrition assessments and counselling at community level.
1.4.4 Conduct barrier analysis to identify barri-ers to seek services related to SAM man-agement.
1.4.5 Scale-up and strengthen IMNCI pro-gramme.
1.4.6 Establish and strengthen nutrition infor-mation and surveillance system in normal and humanitarian situations.
OUTPUT 1.5: ENHANCED PREPAREDNESS FOR
NUTRITION IN EMERGENCY RESPONSES
Key interventions: 1.5.1 Establish local nutrition clusters and con-
duct quarterly coordination meetings at local levels.
1.5.2 Update and develop nutrition in emergen-cy preparedness for response and contin-gency plans at local levels.
OUTPUT 1.6: BUILT CAPACITY OF NUTRITION
SPECIFIC SECTORS
The aim of this output is to implement the ca-pacity development measures recommended in the capacity development plan that will be implemented by the nutrition specific sector. Key activities: 1.6.1 Conduct refresher training for health work-
ers and FCHVs at all level on the MIYCN package.
1.6.2 Organize basic training on the MIYCN package to newly recruited nutrition super-visors and nutrition officers.
1.6.3 Organize nutrition champion leadership development events.
1.6.4 Conduct routine data quality assessment (RDQA) for nutrition programme related HMIS tools.
Outcome 2: Improved access to and equitable utilisation of nutrition sensitive services and improved healthy habits-practices.The outputs under this outcome address the basic causes of malnutrition. These outputs are clus-tered under nutrition sensitive elements. Health, agriculture, livestock, WASH, education women and children, and local governance will be re-sponsible to attain this outcome. There are 13 outputs and 59 key activities under this outcome (see Figure 2.3).
OUTPUT 2.1: INCREASED AVAILABILITY AND
CONSUMPTION OF SAFE AND NUTRITIOUS
FOODS
The following key interventions will be imple-mented by the agriculture and livestock sector: 2.1.1 Make available agriculture and livestock
inputs (i.e. seeds, fertilizers, breeds) in-cluding at households and community levels.
2.1.2 Provide technical support (training, dem-onstrations) to promote the production of fruits, vegetables, nutritious roots, cereals and pulses to improve the consumption of diversified foods at household level.
2.1.3 Increase production and promote con-sumption of fresh fruits and green leafy vegetables.
2.1.4 Build capacity of livestock farmers and en-trepreneurs to increase milk, meat and egg production.
2.1.5 Provide technical support for micro and alternative small irrigation to produce di-versified and micronutrient rich foods.
2.1.6 Technical support to food processing in-dustries on good manufacturing practices and quality promotion measures through training, workshops and observation.
2.1.7 Training on food safety, food processing and nutrition to farmers.
2.1.8 Study and improve local food recipes.2.1.9 Update the food composition table.2.1.10 Update and disseminate the food compo-
sition table.
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2.1.11 Update and disseminate food-based di-etary guidelines in local governments.
2.1.12 Develop and multiply BCC materials in-cluding audiovisuals on food safety, food processing and nutrition.
OUTPUT 2.2: INCREASED PHYSICAL AND
ECONOMIC ACCESS TO DIVERSIFIED FOOD
The following key interventions will implement-ed by the agriculture and livestock sector:
2.2.1 Enhance access to and use of animal prod-uct foods.
a) Establish livestock and food markets.b) Distribute chilling vats to dairies.
c) Raise awareness about consumption of livestock related foodstuff.
2.2.2 Promote and support production and con-sumption of fish including support for establish-ing community ponds.
OUTPUT 2.3: INCREASED ACCESS TO SAFE
DRINKING WATER
The following key interventions will be imple-mented by the water and sanitation sector:2.3.1 Construct and repair water supply schemes
in communities and institutions ensuring water safety plan.
2.3.2 Promote alternative and innovative tech-nologies for providing water supplies.
2.3.3 Promote household water treatment op-tions.
OUTPUT 2.4: INCREASED ACCESS TO SAFE
AND SUSTAINABLE SANITATION SERVICES
The following key interventions will be imple-mented by the water and sanitation sector:2.4.1 Sensitize communities to raise awareness
for construction, maintenance and hygien-ic use of improved household toilet includ-ing the safe disposal of child faeces.
2.4.2 Support and strengthen WASH coordina-tion committees, and local government to accelerate ODF campaigns.
2.4.3 Support for construction and management of CGD friendly toilet facilities including menstrual hygiene management facilities at institutions.
2.4.4 Support to construct safe food hygiene fa-cilities (silauta covers, dish drying racks).
OUTPUT 2.5: IMPROVED KNOWLEDGE ON
HYGIENIC BEHAVIOUR OF CHILDREN AND
MOTHER AND CARETAKERS OF UNDER 5
CHILDREN
The water and sanitation sector is responsible for implementing the following key activities.2.5.1 Construct, establish and promote user-
friendly hand washing facilities in house-holds and institutions.
2.5.2 Raise awareness on hand washing at criti-cal times to communities, school children and health workers.
2.5.3 Raise awareness on menstrual hygiene management in communities and schools.
2.5.4 Raise awareness to promote safe food hy-giene at community level.
OUTPUT 2.6: TARGETED GROUPS HAVE AC-
CESS TO RESOURCES AND OPPORTUNITIES
THAT ARE ESSENTIAL FOR MAKING THEM
SELF-RELIANT
All the plan’s sectors will be responsible to attain this results, particularly the women and children, agriculture and livestock sectors. The key inter-ventions under this output are the following:
2.6.1 Support community seed banks.2.6.2 Support women and disadvantaged group
participation in producing and marketing safe and nutritious food. Raise awareness to increase consumption of these foods.
2.6.3 Provide start-up entrepreneurship grants to women group members for social and economic empowerment.
2.6.4 Provide basic entrepreneurship training to women entrepreneurs groups for the socio-economic empowerment of women.
2.6.5 Provide training and orientation for IGA and business promotion (vegetable, fruits, production, animal husbandry, livestock lining with agricultural sector, tailoring).
2.6.6 Link child protection grants to child nu-trition in all districts (including distribu-tion).
2.6.7 Include nutrition as a major objective of the Social Protection Programme.
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OUTPUT 2.7: NUTRITION COMPONENT
INCORPORATED IN WOMEN, ADOLESCENT
GIRLS AND CHILD DEVELOPMENT TRAINING
PACKAGES
The women and children sector will be respon-sible to coordinate and attain this result and carry out the following activity: 2.7.1 Integrate nutrition module in existing
training packages: Gender based violence prevention and response training, leader-ship, community protection, business de-velopment and life skills training.
OUTPUT 2.8: WOMEN, CHILDREN AND OUT
OF SCHOOL ADOLESCENT GIRLS REACHED
WITH HEALTH AND NUTRITION CARE PRAC-
TICES
The women and children sector is responsible to coordinate and attain this result and carry out the following activities: 2.8.1 Training members of women cooperatives
and child clubs on nutrition sensitive ser-vices:a) Leadership developmentb) Gender based violence managementc) Social protectiond) Entrepreneurship developmente) Reproductive healthf ) Gender based violence management
(male and female participation).2.8.2 Life skill development programmes to ado-
lescent girls in and out of school:a) Menstrual hygiene managementb) Gender violence management, women
trafficking orientation to adolescent girls.
c) Life skill development training to ado-lescent girls.
d) Nutrition and child care related train-ing to child club and village child pro-tection committees.
OUTPUT 2.9: CHILD CARE HOMES COMPLY
WITH MINIMUM STANDARDS OF NUTRITION
CARE SERVICES
The women and children sector will be respon-sible to coordinate and attain this result and carry out the following activities: 2.9.1 Monitor child care homes for compliance
with minimum standards of nutrition sen-sitive services.
2.9.2 Promote nutrition sensitive services at child care homes.
2.9.3 Integrate nutrition component in child protection case management training and services.
2.9.4 Deprived (bipanna) infant nutrition pro-gramme grant for women cooperatives.
OUTPUT 2.10: COMMUNITIES EMPOWERED
TO ADDRESS HARMFUL PRACTICES
The women and children sector will be respon-sible to coordinate and carry out the following activities: 2.10.1 Conduct behavioural change communi-
cation activities to prevent harmful tradi-tional practices.
2.10.2 Run campaigns to prevent child mar-riage.
2.10.3 Carry out programmes to shift social norms and harmful practices on food taboos preventing adequate nutrition for adolescents, menstrual seclusion, etc.
OUTPUT 2.11: ENHANCED ENROLMENT OF
CHILDREN IN BASIC EDUCATION
The education sector will be responsible to attain this result and carry out the following activities:2.11.1 Run welcome to school campaigns for
basic education students.2.11.2 Provide adequate resources to all schools
to have ECED/pre-primary education (PPE).
2.11.3 Provide diversified and nutritious mid-day meals and other nutrition services to children in basic education.
2.11.4 Increase knowledge of ECED facilita-tors, community learning centre (CLC) facilitators, focal teacher, health teach-ers and food management committees in coordination with FCHVs to activate them on health, hygiene and nutrition.
2.11.5 Carry out nutrition monitoring of basic education children.
2.11.6 Build nutrition capacity of ECD facili-tators, CLC facilitators, health teachers and food management committees.
2.11.7 Prepare study materials and demonstrate them to CLC facilitators, focal teachers, health teachers and food management committees on regular dietary (food, vegetable and fruits) calendar.
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OUTPUT 2.12: INCREASED ADOLESCENT
GIRLS’ AWARENESS AND BEHAVIOURS IN
NUTRITION
The education sector will be responsible to carry out the following activities.2.12.1 Run campaigns for girls education to in-
crease their enrolment in schools in tar-geted areas.
2.12.2 Create priority minimum enabling con-ditions (class room, teacher, text book, WASH, book corners) in schools.
2.12.3 Construct separate toilets with group hand wash facility especially for girls in schools.
2.12.4 Provide safe drinking water in schools.2.12.5 Promote healthy behaviours through
skills-based health education in schools.2.12.6 Revise health and nutrition curriculum.2.12.7 Establish food management committees
in all schools providing midday meals.2.12.8 Develop educational training packages
on DRR for students, teachers and school management committees (SMCs).
OUTPUT 2.13 PROMOTE ACCESS TO HEALTH
AND REPRODUCTIVE HEALTH SERVICES
The health sector will be responsible to acarry out the following activities:2.13.1 Provide reproductive health and nutri-
tion information services at schools and health facilities to provide access to boys and girls.
2.13.2 Provide knowledge on the importance of delayed first pregnancy after marriage (if married before 20 years).
2.13.3 Raise knowledge of students at commu-nity schools on benefits of family plan-ning methods.
2.13.4 Run behaviour change communication programmes for improving routine mea-sles and rubella immunization.
Outcome 3: Improved policies, plans and multi-sectoral coordination at federal, provincial and local government levels to create enabling environment to improve nutrition statusOutcome 3 is the enabling environment out-
come. This outcome aims to increase multi-sec-toral commitment and resources for nutrition, strengthen nutritional information management and data analysis and establish protocol for nu-trition profiles (as the basis for planning) at fed-eral, provincial and local government levels. The NPC, NPC, MoFALD and other sector minis-tries will be responsible for the accomplishment of the following 5 outputs and 31 key activities (see Figure 2.4).
OUTPUT 3.1: MSNP INCLUDED IN LOCAL,
PROVINCIAL AND FEDERAL GOVERNMENTS’
POLICIES AND PLANS
The NPC, MoFALD, MoF and other sectoral ministries will be responsible for the accomplish-ment of the following key activities:3.1.1 Incorporate MSNP-II in federal sectoral
plans and polices. a) Update MSNP in the policy, long-term
plan and strategies of federal level sector ministries in line with MSNP-II.
b) Provide guidelines from NPC to incor-porate MSNP-II activities in the annual programme and budget of sectoral minis-tries.
c) Monitor to ensure incorporation of MSNP -II activities in the annual pro-grammes and budgets of sectoral minis-tries.
3.1.2 Incorporate MSNP-II in province level plans and policies.a) Organise workshops at provincial level
to provide advocacy and counselling on MSNP-II.
b) Send circular to all provicncial govern-ments to incorporate nutrition in their relevant policies, long-term plans and strategies in line with MSNP-II.
3.1.3 Incorporate MSNP-II in local govern-ments’ plans and planning processes.
3.1.4 Organize joint annual review meeting among MSNP-II sectoral ministries at fed-eral level.
3.1.5 Advocacy meeting for budget increment at federal, province and local government level.a) Conduct advocacy meetings with fed-
eral and provincial level parliamentar-ians to arrange resources and allocation of adequate budget for the implementa-tion of MSNP-II.
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b) Conduct advocacy meetings with MoF at federal and provincial levels to ar-range resources and allocation of ade-quate budget for implementing MSNP-II.
c) Conduct advocacy and counselling with educational agencies, private sec-tor, entrepreneurs etc. to arrange ade-quate resources for the implementation of MSNP-II.
d) Conduct advocacy and counselling with NGOs and civil society organisa-tions to arrange adequate resources for the implementation of MSNP-II.
3.1.6 Develop a nutrition budget code.
OUTPUT 3.2: MSNP GOVERNANCE MECHA-
NISM STRENGTHENED AT FEDERAL, PROVIN-
CIAL, AND LOCAL LEVEL
The NPC, MoFALD and other sectoral min-istries will be responsible for implementing the folllowing activities:3.2.1 Organise High Level Nutrition and Food
Security Steering Committee (HLNFSS) meeting twice a year.
3.2.2 Organise Nutrition and Food Security Coordination Committee meetings in every trimester.
3.2.3 Send circular and facilitate formation of nutrition and food security steering com-mittees at province level.
3.2.4 Form nutrition and food security steering committees at provincial level.
3.2.5 Organise nutrition and food security steering committee meetings at provin-cial level twice a year.
3.2.6 Form nutrition and food security coordi-nation committee at provincial level.
3.2.7 Organise nutrition and food security co-ordination committee meetings in every trimester.
3.2.8 Assign a focal person for MSNP-II in provincial level sectoral ministries.
3.2.9 Organise thematic technical working group meetings at federal level each quar-ter.
3.2.10 Ensure formation of nutrition and food security steering committees and their
regular meetings at local government level.
3.2.11 Ensure formation of nutrition and food security steering committees and regular meeting at ward level in MSNP imple-mented local government areas.
3.2.12 Assign coordinators (from existing staff or outsourced) in local governments.
OUTPUT 3.3: MSNP INSTITUTIONAL MECHA-
NISMS FUNCTIONAL AT FEDERAL GOVERN-
MENT LEVEL.
NPC will be responsible to attain this result and carry out the following activities:3.3.1 Strengthen the National Nutrition and
Food Security Secretariat at NPC.3.3.2 Conduct O&M survey to establish
NNFSSC within NPC.3.3.3 Establish NNFSSC within NPC and re-
cruit staff as per approved organogram.
OUTPUT 3.4: STRENGTHENED INTEGRATED
INFORMATION MANAGEMENT SYSTEM
ACROSS THE SECTORS IN LINE WITH MSNP-II.
NPC, MoFALD and other sector ministries will be responsible to attain this result and carry out the following activities:3.4.1 Update the MSNP information portal
(www.nnfssp.gov.np) and all relevant sec-tor ministries information on the portal.
3.4.2 Link and update the nutrition information management system of sectoral ministries with the MSNP information portal at the central level.
3.4.3 Provide training on web-based MSNP re-porting system to MSNP related staff at federal and province levels.
3.4.4 Document and disseminate good practic-es, lessons learned and case studies through the MSNP portal.
3.4.5 Update the existing MSNP M&E frame-work used at federal level.
3.4.6 Facilitate preparation of MSNP M&E framework development and implementa-tion at the provincial level.
3.4.7 Facilitate MSNP M&E framework devel-opment at local level and ensure its imple-mentation.
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OUTPUT 3.5: ENHANCED CAPACITY OF FED-
ERAL, PROVINCE AND LOCAL LEVEL GOVERN-
MENT TO PLAN AND IMPLEMENT NUTRITION
PROGRAMME.
NPC and all MSNP-II sectors will be responsible to attain this output and carry out the following activities:3.5.1 Develop capacity building master plan for
the implementation of MSNP-II3.5.2 Build capacity of relevant staff at federal,
provincial and local government level as per the capacity development master plan.
a) Prepare training manual for the imple-mentation of MSNP-II.
b) Provide ToT to implement MSNP-II at federal level.
The full MSNP-II results framework is given in Annex 1 including the goal and outcome level in-dicators with annual targets for 2018 to 2022, the means of verification and the responsible sectors; the output level indicators and the key activities. The outcomes, outputs and key activities are also presented graphically in Figures 2.2, 2.3 and 2.4.
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IMPLEMENTATION OF MSNP-II (2018–2022)
Chapter 3
41
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3.1 Implementation ArrangementsThe key sectors for implementing MSNP-II are health, education, agriculture, livestock, water and sanitation, women, children and social wel-fare and federal affairs and local development. The finance, communication, commerce and supply sectors are also partners. NPC will lead the coordination with and between these sectors and facilitate the implementation of MSNP-II.
MSNP-II will be scaled up across the country to address malnutrition and will be rolled out to all local governments. It will initially be rolled out in the areas of greatest need — the remote and severe food deficit areas in the Mid-West and Far Western hills and mountains and in the mid-Tarai. The Local Government Operation Act, 2074 (GoN 2017) gives additional guidelines on implementing this plan at the local level.
The arrangements for implementing MSNP-II will be as follows: a) Planning and budgeting — MSNP-II will be
incorporated in provincial and local govern-ment policies and plans. Annual programmes and budget will be prepared in line with MSNP-II in all seven provinces and all local governments. Budgetary arrangements will be ensured for this purpose.
b) Institutional strengthening and human re-sources management — Necessary human resources will be assigned for managing nu-trition programmes at all levels of involved ministries and focal persons will be assigned at all levels to strengthen institutional, organ-isational and human resource capacities for implementing the plan at all levels and sectors linked to nutrition. The capacity of these of-ficials will be developed.
c) Coordination and management — The co-ordination and management of MSNP-II will
be the responsibility of NPC at the federal level and the entities responsible for planning at provincial and municipality levels. Com-mittees will be formed and made functional to give technical guidance on MSNP-II related functions (see Section 3.6). These commit-tees will coordinate vertically and horizontally with the line agencies to implement MSNP-II.
d) Information and Communication — Be-haviour change communication will be organ-ised to raise civic awareness about the major problem of chronic malnutrition and the ac-tions needed to improve maternal and child nutrition, thus ensuring equity, and facilitat-ing access to information, to promoting be-haviour change, with a focus on reaching the most marginalized and poorest segments of the population, and taking into account gen-der related factors. The mobilization of civil society organisations, parliamentarians, other elected representatives, and decision making authorities for advocacy activities will acceler-ate this process.
3.2 Target Groups and PrioritizationAs already mentioned, MSNP-II will initially be rolled out in the areas of greatest need — the remote and severe food deficit areas in the Mid-West and Far Western hills and mountains and in the mid-Tarai.
Although MSNP-II will benefit a wide range of people, it’s main focus will be on the following two groups:• Nutritional investments are most effective and
yield the greatest returns in the window of opportunity of the 1,000 days from concep-tion. Therefore, women of reproductive age, adolescent girls and under-3-year olds will re-ceive greater attention. Mothers, adolescents, infants’ grandmothers and husbands of preg-nant women will also be targeted.
3. implementation of MSNP-ii (2018–2022)
Chapter 3
MSNP-II will be scaled up across the country to address malnutrition and will be rolled out to all local governments.MSNP-II will initially be rolled out in the areas of greatest need.
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• Pocket areas and communities that suffer higher levels of deprivation or are vulnerable to undernutrition will be prioritised. As many of the causes of undernutrition are related with feeding and care practices and socio-cultural traditions, MSNP-II will address the needs of all citizens including males and fe-males of all ages, castes, ethnicities, religions and geographical areas.
Information, communication and education pro-grammes will target all people nationwide. Other interventions will gradually be geared up to meet the needs of all citizens.
3.3 Financial ManagementAt the beginning of MSNP-II, in coordination with the Ministry of Finance, the NPC will de-velop a programme and financial planning frame-work with well-defined budget lines. The NPC will coordinate, facilitate, guide and monitor implementation.
The huge amount needed to scale up nutrition programmes nationally will be provided by the government and development partners. Imple-mentation will follow the financial administra-tion rules and regulations with auditing carried out by the Office of the Auditor General. The Ministry of Finance will maintain updated re-cords of off-budget grants received from develop-ment partners.
Donors and international agencies who wish to channel their support through development partners should first get endorsement from the HLNFSSC. Donors should submit proposals to the NPC stating total amounts, budget code and mode (lump sum or instalments).
All support received to implement MSNP-II, in-cluding from the government, foreign grants and the private sector will be entered into the govern-ment’s Budget Management Information System and Financial Management Information System.
MSNP-II grants will be allocated to local gov-ernments based on fixed criteria including per-centage of children with malnutrition, causes of malnutrition, status of nutrition and food secu-rity, geographical remoteness and availability of local resources. Nutrition analysis in local govern-
ments will also cover the nutrition status of preg-nant women, mothers and adolescents.
Also, provincial and local governments will con-tribute at least 15 percent of their internal re-sources (revenue) and grants for improving the nutrition of women and children.
NPC will assess the funds spent on implement-ing MSNP-II separately for nutrition specific, nutrition sensitive and enabling environment activities. It will coordinate the ratio of expendi-ture and issue guidance and directives for needed changes.
Various government ministries and agencies and non-government agencies were involved in im-plementing MSNP (2013–17). It was difficult to assess the financial investments made as budget and programme codes differed. The NPC will thus coordinate with the Ministry of Finance to implement a separate nutrition budget code. This will help in the preparation of the Medium Term Expenditure Framework, and the monitoring and evaluation of expenditure on nutrition in-cluding the allocation of budgets for MSNP-II’s programme, and budget preparation by provinces and local governments.
3.4 Estimated CostsThe estimated cost of implementing MSNP-II is NPR 48,901 million ($470 million at exchange rate of NPR 104.04). The budget is segregated thus:• By seven sectors plus NPC ,with the Ministry
of Education needing the most funds (35% of total) followed by the Ministry of Health (25%) (Table 3.1).
• By nutrition specific and nutrition sensitive programming with nutrition sensitive pro-gramming accounting for 76 percent of esti-mated costs (Table 3.2).
• The proportion of funding provided by the government is planned to increase from 47 percent in 2018 to 69 percent in the final year of MSNP-II, with the government providing 59 percent of funds and development partners 41 percent (Table 3.3).
These estimates are based on 2017/18 fixed cost prices, the present or past unit cost of planned activities, existing fixed rates of the government,
The huge amount needed to scale
up nutrition programmes
nationally will be provided by
the government and development
partners.
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TABLE 3.1: ESTIMATED NPC AND SECTORAL MINISTRY COSTS OF IMPLEMENTING MNSP-II (NPR MILLION)
NPC/sectoral ministries 2018 2019 2020 2021 2022 Total %
Health 2,223 2,403 2,615 2,497 2,464 12,202 25%
Education 3,428 3,434 3,444 3,455 3,467 17,228 35%
Agricultural development 1,652 1,728 1,812 1,900 2,006 9,098 19
Livestock development 101 87 108 96 118 510 1%
Drinking water and sanitation 568 1,021 1,865 2151 2,431 8,036 16%
Women, children and social welfare 188 196 211 223 235 1,053 2%
Local governance 42 78 91 97 104 412 1%
NPC 55 76 75 79 77 362 1%
Total 6,937 7,704 8,900 9,178 9,559 48,901 100%
TABLE 3.2: ESTIMATED NUTRITION-SPECIFIC AND NUTRITION-SENSITIVE COSTS OF IMPLEMENTING MNSP-2 (NPR MILLION)
Programmes 2018 2019 2020 2021 2022 Total
Nutrition sensitive 6,111 6,709 7,717 8,122 8,562 37,211 76%
Nutrition specific 2,146 2,314 2,504 2,376 2,340 11,680 24%
Total 8,256 9,023 10,221 10,498 10,902 48,901 100%
TABLE 3.3: ESTIMATED COSTS OF MSNP-II BY SOURCES OF FUNDS
GoN Development partners Total
2018
Budget (NPR million) 3,260 3,677 6,937
Percentage 47% 53% 100%
2019
Budget (NPR million) 4,409 4,119 8,528
Percentage 52% 48% 100%
2020
Budget (NPR million) 6,032 4,514 10,546
Percentage 57% 43% 100%
2021
Budget (NPR million) 6,973 4,148 11,121
Percentage 63% 37% 100%
2022
Budget (NPR million) 8,156 3,613 11,769
Percentage 69% 31% 100%
Total
Budget (NPR million) 28,830 20,071 48,901
Percentage 59% 41% 100%
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national and international costs and discussions with the concerned line ministries.
The annual financial tracking of nutrition-related expenditure carried out by the NPC covers all of the nutrition-related programmes in the govern-ment’s AWPB. The programmes proposed under MSNP-II do not necessarily cover all nutrition-related programmes and therefore the proposed above budget is less than the figures in NPC’s an-nual financial tracking exercises.
3.5 Duration of MSNP-IIMSNP-II will be implemented from Nepali FY 2075/76 to 2079/80 (mid-July 2018 to mid-July 2022).
3.6 MSNP CommitteesTwo existing high-level committees will govern the implementation of MSNP-II at the national level. The High Level Nutrition and Food Secu-rity Steering Committee (HLNFSSC) (see com-position in Table 3.4) is the highest level govern-ing body and will provide high level guidance and endorse policies and programmes. Its roles and responsibilities are as follows: a) Formulate and endorse macro level policies
and strategies on nutrition and food security.b) Ensure necessary resources for MSNP-II.c) Make policy decisions on foreign grant needs
and development partner support for MSNP-II.
d) Advocate and counsel on nutrition and food security related issues at national and interna-tional conferences, workshops, and meetings on behalf of the country.
e) Review MSNP-II’s progress and evaluate its performance and effects.
f ) Coordinate about MSNP-II with sectoral ministries at federal level.
g) Provide guidelines and directives to the Fed-eral Level Nutrition and Food Security Steer-ing Committee.
The National Nutrition and Food Security Co-ordination Committee (NNFSCC) (Table 3.5) will be responsible for national level coordination of the implementation of MSNP-II. Its roles and responsibilities oare as follows:a) Implement MSNP-II related national policies
and strategies
b) Arrange budget for federal level sectoral min-istries to implement MSNP-II.
c) Implement decisions of the HLNFSSC.d) Provide guidelines and directives to provincial
level NFSSCs.e) Facilitate the formation and operation of pro-
vincial and local government nutrition and food security steering committees.
f ) Form federal level technical groups and deter-mine their roles and responsibilities for imple-menting MSNP-II.
g) Review progress of MSNP-II at province and local government levels.
h) Form technical working groups for MSNP-II at the federal level.
i) Coordinate and perform other functions to implement, monitor, review and evaluate MS-NP-II at the federal level.
j) Provide guidelines to NNFSS and responsible NPC divisions.
New committees will be formed as the main bod-ies for overseeing the implementation of MSNP-II in provinces, local governments and wards. District coordination committees will also be formed.
Provincial nutrition and food security steering committees (PLNFSSC) (Table 3.6) will have the following responsibilities:a) Formulate provincial level policies and strate-
gies on nutrition and food security that com-ply with HLNFSSC and NNFSCC federal level policies.
b) Identify available resources for MSNP-II and ensure necessary resources for its implementa-tion at provincial and local government levels.
c) Advocate and guide on nutrition and food security at national level conferences, work-shops and meetings on behalf of provinces
d) Review MSNP-II progress and evaluate its performances and effects at the local level.
e) Provide guidelines and directives to provin-cial level sectoral ministries and agencies on implementing MSNP-II.
f ) Facilitate the formation and operation of local government nutrition and food security steer-ing committees.
g) Review performance of local nutrition and food security steering committees.
MSNP-II will be implemented from
Nepali FY 2075/76 to 2079/80 (mid-July 2018 to mid-
July 2022).
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
47
TABLE 3.4: COMPOSITION OF HIGH LEVEL NUTRITION AND FOOD SECURITY STEERING COMMITTEE (HLNFSSC)
Office holders Position on committee
Hon. Vice Chairman, National Planning Commission (NPC) Chairperson
Hon. Member, Health and Nutrition, NPC Co-chair
Hon. members NPC (agriculture, livestock development, WASH, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies)
Members
Secretaries of federal ministries of health, agriculture development, livestock development, drinking water and sanitation, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies
Members
Nutrition and food security experts (4, nominated by the Chair) Members
Member Secretary, National Planning Commission Member Secretary
Joint Secretary, Social Development Division, NPC Joint Member Secretary
TABLE 3.5: COMPOSITION OF NATIONAL NUTRITION AND FOOD SECURITY COORDINATION COMMITTEE (NNFSCC)
Office holders Position on committee
Hon. Member, Health and Nutrition Sector, NPC Coordinator
Hon. NPC members responsible for health, agriculture, livestock, WASH, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies. Members
Chiefs of the Policy Planning and International Cooperation Division, the Budget and Programme Division and Nutrition Division from the federal ministries of health, agriculture, livestock, drinking water and sanitation, women, children and social welfare, education, federal affairs and local development, communication, commerce and supplies.
Members
Director generals of federal departments of health, agriculture development, livestock development, drinking water and sanitation, women, children and social welfare, education, federal affairs and local development
Members
Executive Director, Nepal Health Research Council Member
Two nutrition and food security experts (nominated by the Coordinator) Members
Representative of civil society network working on nutrition and food security Member
Representative responsible for health and nutrition from FNCCI or other representative body Member
Joint Secretary, Social Development Division, NPC Member Secretary
TABLE 3.6: COMPOSITION OF PROVINCIAL NUTRITION AND FOOD SECURITY STEERING COMMITTEES (PLNFSSC)
Office holders Position on committee
Chief of body responsible for provincial level planning Chair
Chief of agencies responsible for health, agriculture development, livestock development, drinking water and sanitation, women children and social welfare, education, federal affairs and local development, finance, communication, commerce and supplies in the province
Members
Two local nutrition and food security experts Members
Development partners working in the nutrition and food security sector in the province. Can be invited to meetings as per need
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
48
h) Regularly submit MSNP progress report to National Nutrition and Food Security Coor-dination Committee.
District coordination committees will carry out monitoring and coordination within provinces by carrying out the following responsibilities: a) Conduct MSNP-II monitoring in local gov-
ernments where it is implemented.b) Coordinate with provinces and between local
governments.c) Facilitate the incorporation of MSNP-II in lo-
cal governments’ long-term, periodic and an-nual programmes.
d) Advocacy and guidance on nutrition and food security at local conferences, workshops, and meetings on behalf of provincial governments.
e) Review MSNP-II progress and evaluate its performance and effects at the local level.
Local government nutrition and food security steering committees will be formed in metropoli-tan cities, sub-metropolitan cities, urban munici-palities and rural municipalities (Table 3.7). They will have the following responsibilities:a) Formulate local government policies and
strategies on nutrition and food security that comply with federal and provincial policies.
b) Identify resources for MSNP-II and ensure necessary resources for its implementation.
c) Incorporate MSNP-II activities in long-term, periodic and annual programmes of local gov-ernments.
d) Advocate and counsel on nutrition and food security at national conferences, workshops, and meetings.
e) Facilitate the formation of ward level nutri-tion and food security steering committees, review their progress and provide guidelines and directives.
f ) Review MSNP-II related performance of ward level nutrition and food security steer-ing committees and provide directions for im-provement.
g) Regularly submit MSNP-II progress reports to district coordination committee and prov-ince level nutrition and food security coordi-nation committees.
Ward-level nutrition and food security steering committees (Table 3.8) will have the following responsibilities:
a) Identify nutrition programmes in a participa-tory way and submit for support to local gov-ernment councils.
b) Identify local nutrition deficient communities.c) Assess needs of nutrition deficient communi-
ties and support prioritization of programmes for them with their participation.
d) Mobilise communities to run nutrition spe-cific and sensitive campaigns.
e) Assign NGOs and other agencies to monitor local nutrition programmes and report find-ings to the committee.
3.7 Power to Frame Guidelines The NPC may frame guidelines and issue direc-tives to provincial and local levels to implement MSNP-II.
3.8 National Nutrition and Food Security Secretariat A National Nutrition and Food Security Secre-tariat (NNFSS) will be established under the NPC Secretariat to provide technical and mana-gerial support to the national committees (HL-NFSSC and NNFSCC) for the smooth operation of MSNP-II. The organogram and staffing of the secretariat will be as assigned by NPC.
3.9 Responsibilities of Private, Non-government and Academic SectorsMSNP-II will be implemented by government agencies, national and international NGOs, pri-vate sector agencies and community and civil so-ciety organisations. The plan will be implemented through the coordinated efforts of national and international agencies, professional bodies, civil society and academia. At the local level, the range of stakeholders will be involved in formulating policies, and planning, implementing and moni-toring nutrition and food security programmes.
Civil society organisations, the private sector and other stakeholders will participate in nutrition and food security-related advocacy and commu-nication. Their cooperation will also be sought for the organisation of nutrition-related public hearings and grievance handling. Public-private-partnerships will help implement MSNP-II with NPC responsible for coordinating this process.
MSNP-II will be implemented
by government agencies, national and international
NGOs, private sector agencies
and community and civil society
organisations.
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
49
TABLE 3.7: COMPOSITION OF LOCAL GOVERNMENT NUTRITION AND FOOD SECURITY STEERING COMMITTEES
Office holders Position on committee
Chief of local government authority Chair
Deputy chief of local government Deputy chair
All ward chairpersons of local government Members
Woman member of local government designated by the chair Member
Dalit woman member of local government designated by the chair Member
Coordinator designated for planning and implementation of nutrition and food security programmes Member
Section chiefs of health, agriculture, livestock development, WASH, women, children and social welfare, education, federal affairs and local development, communication, finance, commerce and supplies and documentation and information section of local government
Members
Programme officer of social development section of local government Member
President of local chambers of commerce and industry Member
President of local NGO federation Member
Executive officer of local government or a designated officer Member Secretary
Executive member who looks after the social sector or executive woman member Coordinator
Nutrition and food security experts from local government and development partners. Can be invited as per need
TABLE 3.8: COMPOSITION OF WARD-LEVEL NUTRITION AND FOOD SECURITY STEERING COMMITTEES
Office holders Position on committee
Ward chair Chair
Female ward member Member
Unit chiefs of health, agriculture, livestock development, WASH, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies unit in the ward (if any)
Members
Local female teacher Member
Representative of an NGO working in the ward Member
Coordinator of ward citizens forum Member
One local female community health volunteer (FCHV) Member
Representative of a local school management committee Member
Representative of a local health service management committee Member
Ward secretary Member Secretary
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
50
3.10 Capacity Development The capacity of staff and officials involved in implementing MSNP-II will be developed in-cluding their knowledge and skills on nutrition and food security, documentation and reporting, information dissemination and training skills.
3.11 Review, Monitoring and EvaluationA) NEED AND PROCESS
The review, monitoring and evaluation of MSNP-II will assess progress of MSNP-II pro-grammes principally in terms of the attainment of outcomes and outputs and impact on target groups. Annex 1 lists the indicators for measuring progress against the annual targets.
A monitoring and evaluation framework will be prepared as per the National Monitoring and Evaluation Guidelines to measure programme delivery and sectoral performance. Information will be collected on all indicators. The capacity of stakeholders will be developed at all levels to monitor the achievement of results.
Nutrition improvements will indirectly help to achieve all 17 SDGs, particularly SDGs 2 and 3.
B) REGULAR MONITORING AND REVIEW
Much of the data for measuring the indicators will come from regular national surveys including the Nepal Demographic and Health Survey, the Nepal Multiple Indicators Cluster Survey, and Nepal Living Standards Surveys. The periodic reports of government agencies will be another important source of information and means of verification. Further surveys may be carried out to gather data not available from existing surveys. Capacity will be built to carry out monitoring.
C) STUDIES, RESEARCH AND EVALUATION
Applied and action research will be carried out to identify and address bottlenecks to implementing MSNP-II.
Status and progress information will be regu-larly posted on the nutrition and food security web portal (http://www.nnfsp.gov.np). Relevant policy making-related information will also be posted here.
Consultations will be held with NPC’s Monitor-ing and Evaluation Division to guide decisions on monitoring, review and evaluation. A Tech-nical Working Group for monitoring and evalu-ating MSNP-II will be formed under the joint secretary of NPC’s Social Development Division to supervise MSNP-II’s management informa-tion system. Each involved sectoral ministry will nominate an M&E focal person to this TWG who will be responsible for updating their min-istry’s progress.
3.12 Documentation and ReportingLocal governments will be responsible for report-ing on the physical and financial progress of MS-NP-II to district coordination committees, pro-vincial level and federal level sectoral ministries. Local governments will submit four monthly and annual physical progress reports and statements of expenditure to their district coordination com-mittees and sectoral ministries at provincial and national levels. The sectoral ministries will pre-pare integrated reports for submission to NPC and will document the implementation status of MSNP-II and update physical and financial progress reports in the prescribed format.
Status and progress information will be regularly posted on
the nutrition and food security
web portal (http://www.nnfsp.
gov.np)
50
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
51
Annexes
51
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
5252
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
53
ann
ex 1
: Mul
ti-se
ctor
Nut
ritio
n Pl
an-ii
(20
18-2
022)
Re
sults
Fra
mew
ork
Resu
lts
chai
nRe
sult
indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
Goa
l (Im
pact
)
Impr
oved
m
ater
nal,
adol
esce
nt a
nd
child
nut
ritio
n by
sc
alin
g up
ess
entia
l nu
triti
on-s
peci
fic
and
sens
itive
in
terv
entio
ns
and
crea
ting
an e
nabl
ing
envi
ronm
ent f
or
nutr
ition
1. P
reva
lenc
e of
stu
ntin
g am
ong
unde
r 5 y
ears
chi
ldre
n re
duce
d 35
.8
ND
HS
2016
3431
3129
28N
DH
S, N
MIC
SH
ealth
2. P
reva
lenc
e of
was
ting
amon
g un
der
5-ye
ar-o
ld c
hild
ren
redu
ced
9.7
N
DH
S 20
169.
58
87
7N
DH
S, N
MIC
SH
ealth
3. P
reva
lenc
e of
low
birt
h w
eigh
t re
duce
d24
N
MIC
S 20
1420
1713
1110
ND
HS,
NM
ICS
Hea
lth
4. %
redu
ctio
n in
chi
ldre
n un
der-
5 w
ith o
verw
eigh
t and
obe
sity
2.1
N
DH
S 20
162
1.9
1.7
1.6
1.4
ND
HS,
NM
ICS
Hea
lth
5. %
redu
ctio
n in
ove
rwei
ght a
nd
obes
e w
omen
of r
epro
duct
ive
age
(WRA
)
22
ND
HSS
201
622
2120
1918
ND
HS,
NM
ICS
Hea
lth
6. %
of w
omen
with
chr
onic
ene
rgy
defic
ienc
y (m
easu
red
as b
ody
mas
s in
dex)
redu
ced
17
ND
HS
2016
12N
DH
S, N
MIC
SH
ealth
Out
com
es
1: N
utri
tion
spe
cific
out
com
e
Out
com
e 1:
Im
prov
ed a
cces
s to
and
equ
itabl
e us
e of
nut
ritio
n-sp
ecifi
c se
rvic
es
1.1.
Incr
ease
d %
of c
hild
ren
aged
6-
23 m
onth
s hav
ing
min
imum
ac
cept
able
die
t
35
ND
HS
2016
4045
5055
60N
DH
S, N
MIC
SH
ealth
1.2.
Incr
ease
d %
of c
hild
ren
unde
r 6
mon
ths
with
exc
lusi
ve
brea
stfe
edin
g
66
ND
HS
2016
6870
7477
80N
DH
S, N
MIC
SH
ealth
1.3.
Red
uced
% o
f ana
emia
am
ong
child
ren
aged
6-5
9 m
onth
s 52
.7
ND
HS
2016
4037
3330
28N
DH
S, N
MIC
SH
ealth
1.4.
Red
uced
% o
f ana
emia
am
ong
adol
esce
nt g
irls
(10-
19 y
ears
)39
N
DH
S 20
1620
25N
DH
S, N
MIC
SH
ealth
Goa
l and
Out
com
e in
dica
tors
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
54
Resu
lts
chai
nRe
sult
indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
Out
com
e 1:
Im
prov
ed a
cces
s to
and
equ
itabl
e us
e of
nut
ritio
n-sp
ecifi
c se
rvic
es
1.5.
Red
uced
% o
f ana
emia
am
ong
WRA
(15-
49 y
ears
)40
.8
ND
HS
2016
2624
ND
HS,
NM
ICS
Hea
lth
1.6.
Red
uced
pre
vale
nce
of u
nder
5-
year
s ol
d ch
ildre
n w
ith d
iarr
hoea
in
last
two
wee
ks
14%
N
DH
S 20
1610
%7%
ND
HS,
NM
ICS
Hea
lth
1.7.
Mea
n di
etar
y di
vers
ity s
core
am
ong
WRA
(15-
49 y
ears
) TB
D
ND
HS
2016
TBD
ND
HS,
NM
ICS
Hea
lth
2: N
utri
tion
-sen
siti
ve o
utco
me
Out
com
e 2:
Im
prov
ed a
cces
s to
an
d th
e eq
uita
ble
use
of n
utrit
ion-
sens
itive
ser
vice
s an
d im
prov
ed
heal
thy
habi
ts a
nd
prac
tices
2.1.
Red
uced
pro
port
ion
of p
opul
atio
n be
low
min
imum
leve
l of d
ieta
ry
ener
gy c
onsu
mpt
ion
22.8
N
MIC
S 20
14
1715
.514
12.5
11SD
G s
tatu
s re
port
s, N
MIC
SAg
ricul
ture
an
d liv
esto
ck
2.2.
Incr
ease
d %
peo
ple
usin
g sa
fe
drin
king
wat
er
15
JMP
2017
33.7
38.4
43.1
47.8
52.5
Join
t Mon
itorin
g Pr
ogra
mm
e (J
MP)
WA
SH
2.3.
Incr
ease
d %
peo
ple
usin
g im
prov
ed s
anita
tion
faci
litie
s th
at
are
not s
hare
d
92.6
to
ilet
cove
rage
: 20
17
NM
IP-D
WSS
, 20
17
9598
100
100
100
NM
ICS
& N
MIP
-D
WSS
W
ater
and
sa
nita
tion
2.4.
Incr
ease
d %
of p
eopl
e pr
actis
ing
hand
was
hing
with
soa
p an
d w
ater
be
fore
feed
ing
baby
(0-2
yrs
) and
af
ter c
lean
ing
babi
es’ b
otto
ms
Know
ledg
e 6
and
5.5
NM
ICS
2014
1520
3040
50
NM
ICS
Wat
er a
nd
sani
tatio
n
2.5.
Per
cent
age
of w
omen
age
d 20
-24
year
s w
ho w
ere
mar
ried
or in
un
ion
befo
re a
ge 1
8
40.7
%
ND
HS
2011
5% re
duct
ion
per y
ear
ND
HS
Wom
en,
Child
ren
and
Soci
al W
elfa
re
and
Hea
lth
2.6.
Incr
ease
d gr
oss
enro
lmen
t rat
e (G
ER) (
boys
and
girl
s) in
ear
ly
child
edu
catio
n an
d de
velo
pmen
t (E
CED
)/pr
e-pr
imar
y ed
ucat
ion
(PPE
)
81
(81.
2, 8
0.9)
82.6
(8
2.8,
82.
5)84
.3
(84.
5, 8
4.2)
86
(86.
2, 8
5.9)
87.7
(8
7.9,
87.
6)89
.4
(89.
4, 8
9.5)
Educ
atio
n M
anag
emen
t In
form
atio
n Sy
stem
(EM
IS)
Educ
atio
n
2.7.
Dec
reas
ed %
of o
ut-o
f-sch
ool
child
ren
(boy
s an
d gi
rls) i
n ba
sic
educ
atio
n
10.6
(1
0.8,
10.
4)
9.06
(9
.2, 9
.8)
7.5
(7.6
, 7.3
)6.
0 (6
.1, 5
.8)
4.5
(4
.6, 4
.6)
3.0
(3.1
, 2.0
)EM
ISEd
ucat
ion
2.8.
Incr
ease
d ba
sic
educ
atio
n cy
cle
com
plet
ion
rate
(boy
s an
d gi
rls)
69.6
(6
8.8,
70.
5)72
.4
(71.
6,73
.4)
75.4
(7
4.5,
76.
4)78
.5
(77.
6, 7
9.5)
81.7
(80.
8,
82.8
)85
.0
(84.
1, 8
6.1)
EMIS
Educ
atio
n
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
55
Resu
lts
chai
nRe
sult
indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
3: E
nabl
ing
envi
ronm
ent o
utco
me
Out
com
e 3:
Im
prov
ed
polic
ies,
plan
s an
d m
ulti-
sect
oral
co
ordi
natio
n at
fe
dera
l, pr
ovin
cial
an
d lo
cal
gove
rnm
ent l
evel
s to
enh
ance
the
nutr
ition
sta
tus
of a
ll po
pula
tion
grou
ps
3.1.
% o
f far
m la
nd o
wne
d by
wom
en
or in
join
t ow
ners
hip
10
(201
0)12
1315
1821
AD
SAg
ricul
ture
an
d Li
vest
ock
3.2.
No.
of l
ocal
, pro
vinc
ial a
nd fe
dera
l go
vern
men
t pla
ns th
at in
clud
e nu
triti
on a
nd fo
od s
ecur
ity
prog
ram
s in
line
with
MSN
P-II
30 d
istr
icts
29
9 lo
cal
gove
rnm
ents
60 d
istr
icts
75
3 lo
cal
gove
rnm
ents
753
loca
l go
vern
men
ts75
3 lo
cal
gove
rnm
ents
Gov
ernm
ent
plan
s an
d M
SNP-
II an
nual
pr
ogre
ss re
port
s
Loca
l G
over
nanc
e
3.3.
Ava
ilabi
lity
of n
atio
nal M
SNP-
II do
cum
ent
MSN
P-I
1-
--
-M
SNP-
II do
cN
PC
3.4.
Ava
ilabi
lity
of n
atio
nal b
udge
t co
de fo
r nut
ritio
n an
d fo
od
secu
rity
01
--
--
MoF
bud
get
code
NPC
, MoF
3.5.
Nat
iona
l Cap
acity
Dev
elop
men
t M
aste
r Pla
n fo
r im
plem
enta
tion
of
MSN
P-II
Prod
uced
01
--
--
Capa
city
D
evel
opm
ent
Plan
NPC
, all
sect
ors
3.6.
Mul
ti-se
ctor
com
mitm
ent a
nd
reso
urce
s fo
r nut
ritio
n in
crea
se to
at
leas
t 3.5
% o
f tot
al g
over
nmen
t bu
dget
1.08
1.5
22.
53
3.5
MoF
red
Book
NPC
3.7.
Fin
anci
al re
sour
ce tr
acki
ng in
pla
ce1
11
11
1Fi
nanc
ial
reso
urce
tr
acki
ng to
ols
NPC
, MoF
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
56
Out
put
indi
cato
rsRe
sult
sIn
dica
tors
Base
line
Targ
ets
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
2018
2019
2020
2021
2022
Nut
riti
on s
peci
fic o
utpu
ts
Out
com
e 1:
Impr
oved
acc
ess
to a
nd e
quit
able
use
of n
utri
tion
-spe
cific
ser
vice
s
Out
put 1
.1:
Enha
nced
nut
ritio
n st
atus
of W
RA
incl
udin
g ad
oles
cent
s
Med
ian
age
at fi
rst b
irth
amon
g W
RA (1
5-49
yea
rs)
17
ND
HS
2016
20
ND
HS
Hea
lth
% o
f ins
titut
iona
l del
iver
y 57
N
DH
S 20
1665
70N
DH
S, N
MIC
SH
ealth
% g
ettin
g a
post
nata
l che
ck-u
p fo
r ess
entia
l new
born
car
e an
d se
rvic
es w
ithin
24
hour
s of
de
liver
y
57
ND
HS
2016
75N
DH
SH
ealth
Out
put 1
.2:
Impr
oved
infa
nt a
nd
youn
g ch
ild n
utrit
ion
and
care
pra
ctic
es
% o
f new
born
s in
itiat
ing
brea
stfe
edin
g w
ithin
one
hou
r of
birt
h
55
ND
HS
2016
80N
DH
S, N
MIC
SH
ealth
Prop
ortio
n of
infa
nts
6–8
mon
ths
of a
ge re
ceiv
ing
solid
, sem
i-sol
id
or s
oft f
oods
73.5
N
MIC
S 20
1495
ND
HS,
NM
ICS
Hea
lth
% o
f chi
ldre
n ag
ed 0
-59
mon
ths
who
rece
ived
mor
e fr
eque
nt
feed
ing
(bre
ast m
ilk a
nd
appr
opria
te fo
od) d
urin
g ep
isod
es
of d
iarr
hoea
29 N
DH
S 20
1650
ND
HS,
NM
ICS
Hea
lth
Out
put 1
.3:
Impr
oved
mat
erna
l, in
fant
and
you
ng c
hild
(M
IYC)
mic
ronu
trie
nt
stat
us
% o
f chi
ldre
n ag
ed 6
–59
mon
ths
who
rece
ived
Vita
min
A c
apsu
le in
la
st s
ix m
onth
s
86
ND
HS
2016
95N
DH
S, N
MIC
SH
ealth
% o
f chi
ldre
n ag
ed 1
2-59
mon
ths
who
rece
ived
dew
orm
ing
tabl
et
in la
st s
ix m
onth
s
83
ND
HS
2016
90N
DH
S, N
MIC
SH
ealth
% o
f pre
gnan
t and
lact
atin
g w
omen
who
took
180
+ IF
A
tabl
ets
42
ND
HS
2016
65>8
0N
DH
S, N
MIC
SH
ealth
% o
f pre
gnan
t wom
en w
ho
rece
ived
dew
orm
ing
tabl
ets
55
ND
HS
2016
80N
DH
SH
MIS
Hea
lth
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
57
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
% o
f sch
ool a
ge c
hild
ren
who
re
ceiv
ed d
ewor
min
g ta
blet
in
crea
sed
65
HM
IS80
HM
ISH
ealth
% o
f hou
seho
lds u
sing
ade
quat
ely
iodi
zed
salt
82
NM
ICS
2014
>90
ND
HS,
NM
ICS
Hea
lth
% o
f ado
lesc
ent g
irls
(10-
19 y
ears
) w
ho re
ceiv
ed w
eekl
y IF
A ta
blet
su
pple
men
ts
550
HM
ISH
ealth
% o
f chi
ldre
n ag
ed 6
-23
mon
ths
who
rece
ived
mic
ronu
trie
nt
pow
der (
MN
P)
5
HM
IS20
HM
ISH
ealth
% o
f chi
ldre
n w
ho re
ceiv
ed O
RS
and
zinc
dur
ing
diar
rhoe
a 18
N
MIC
S 20
1450
ND
HS,
NM
ICS
Hea
lth
Out
put 1
.4:
Impr
oved
m
anag
emen
t of
seve
re a
nd m
oder
ate
acut
e m
alnu
triti
on
No.
of l
ocal
gov
ernm
ents
with
in
tegr
ated
man
agem
ent o
f acu
te
malnu
trition
(IM
AM
) pro
gram
me
35 d
istr
icts
520
loca
l go
vern
men
tsH
MIS
Hea
lth
Perc
enta
ge o
f chi
ldre
n ag
ed 6
-59
mon
ths
iden
tified
with
sev
ere
acut
e m
alnu
triti
on (S
AM
) aga
inst
to
tal e
stim
atio
n of
SA
M
NA
>90
ND
HS
Hea
lth
% o
f chi
ldre
n ag
ed 6
-59
mon
ths
with
acu
te m
alnu
triti
on tr
eate
d am
ong
iden
tified
cas
es
70
90H
MIS
Hea
lth
No.
of l
ocal
gov
ernm
ent
bodi
es w
ith IM
NCI
pro
gram
me
impl
emen
ted
55 d
istr
icts
753
loca
l go
vern
men
ts
HM
ISH
ealth
Out
put 1
.5:
Enha
nced
pr
epar
edne
ss
for n
utrit
ion
in
emer
genc
y re
spon
ses
No.
of l
ocal
gov
ernm
ents
w
ith n
utrit
ion
emer
genc
y pr
epar
edne
ss a
nd re
spon
se o
r co
ntin
genc
y pl
an
5050
0 lo
cal
gove
rnm
ents
Cont
inge
ncy
plan
s an
d pr
epar
edne
ss
plan
Hea
lth
Out
put 1
.6:
Capa
city
bui
lt of
nu
triti
on s
peci
fic
sect
ors
No.
of c
apac
ity d
evel
opm
ent
mea
sure
s re
com
men
ded
in
the
capa
city
dev
elop
men
t pla
n im
plem
ente
d by
nut
ritio
n sp
ecifi
c se
ctor
NA
>90
HM
ISH
ealth
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
58
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
NU
TRIT
ION
SEN
SITI
VE
OU
TPU
TS
Out
com
e 2:
Impr
oved
acc
ess
to a
nd th
e eq
uita
ble
use
of n
utri
tion
-sen
siti
ve s
ervi
ces
and
impr
oved
hea
lthy
hab
its
and
prac
tice
s
Agr
icul
ture
and
live
stoc
k
Out
put 2
.1:
Incr
ease
d av
aila
bilit
y an
d co
nsum
ptio
n of
sa
fe a
nd n
utrit
ious
fo
ods
% o
f pro
duct
ion
and
prod
uctiv
ity
of c
rops
and
live
stoc
k:
1. C
erea
ls: a
rea
(1,0
00 h
a)33
06
3405
3371
3303
3270
3188
Ann
ual r
epor
t of
MoA
D
Agric
ultu
re
2. C
erea
ls: p
rodu
ctio
n (1
,000
to
nnes
)86
1495
1597
5094
1496
9799
87Ag
ricul
ture
3. P
ulse
s: a
rea
(1,0
00 h
a)34
234
935
335
636
036
3Ag
ricul
ture
4. P
ulse
s: p
rodu
ctio
n (1
,000
to
nnes
)31
632
933
534
234
935
6Ag
ricul
ture
5. V
eget
able
s: a
rea
(1,0
00 h
a)28
031
532
834
135
436
9Ag
ricul
ture
6. V
eget
able
s : p
rodu
ctio
n (1
,000
to
nnes
)38
1944
1346
7849
5952
5655
72Ag
ricul
ture
7. P
otat
oes:
are
a (1
,000
ha)
190
210
218
227
236
246
Agric
ultu
re
8. P
otat
o: p
rodu
ctio
n (1
,000
to
nnes
)25
5129
7632
1434
7137
4940
49Ag
ricul
ture
9. F
ish:
pro
duct
ion
(1,0
00 to
nnes
) 48
5760
6366
69Ag
ricul
ture
10. F
ruits
: pro
duct
ion
(1,0
00
tonn
es)
992
(2
014)
1181
1252
1327
1407
1492
Agric
ultu
re
Year
roun
d irr
igat
ion
(%)
18
(201
0)22
2530
3545
ADS
annu
al
repo
rtsAg
ricul
ture
Per c
apita
food
gra
in p
rodu
ctio
n (k
g)34
1
(201
4)38
139
140
141
142
2SD
G p
rogr
ess
repo
rtAg
ricul
ture
Dec
reas
ed in
cide
nce
of su
b-
stan
dard
food
in th
e m
arke
t (%
)12
D
FTQ
C11
109
87
Ann
ual r
epor
t of
DFT
QC
Agric
ultu
re
and
Live
stoc
k
Hou
seho
lds
with
min
imum
di
etar
y di
vers
ity (%
)10
.5
AHSI
II 201
4/15
1315
1820
23A
nnua
l ho
useh
old
surv
ey (C
BS)
Agric
ultu
re
and
Live
stoc
k
% o
f pro
duct
ion
and
prod
uctiv
ity
of c
rops
and
live
stoc
k:
Milk
(1,0
00 to
nnes
)1,
954
2031
2296
2594
2776
2942
Ann
ual r
epor
t of
MoL
D
Live
stoc
k
Mea
t (1,
000
tonn
es)
332
344
379
417
438
460
Live
stoc
k
Eggs
(1,0
00 to
nnes
)13
513
514
515
716
817
8Li
vest
ock
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
59
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
Out
put 2
.2:
Incr
ease
d ph
ysic
al a
nd
econ
omic
acc
ess
to
dive
rse
type
s of
food
s
Impr
oved
acc
ess
to u
pdat
ed
agric
ultu
re m
arke
ting
info
rmat
ion
ABP
MD
D re
port
Publ
ish
agric
ultu
re m
arke
ting
info
rmat
ion
bulle
tin1
11
11
1Ag
ricul
ture
Upd
ate
web
site
and
app
re
late
d to
agr
icul
ture
mar
ketin
g in
form
atio
n sy
stem
11
11
11
Agric
ultu
re
Hou
seho
lds
rais
ing
lives
tock
NA
Wat
er, S
uppl
y an
d Sa
nita
tion
Out
put 2
.3:
Incr
ease
d ac
cess
to
safe
drin
king
wat
er
% h
ouse
hold
s us
ing
impr
oved
dr
inki
ng w
ater
faci
litie
s93
.3N
MIP
201
795
9810
010
010
0N
MIP
-DW
SSW
ater
Su
pply
and
Sa
nita
tion
% h
ouse
hold
s w
ith p
iped
wat
er
supp
ly in
dw
ellin
g ya
rd26
NM
IP 2
017
2532
4045
50N
MIP
-DW
SSW
ater
Su
pply
and
Sa
nita
tion
% h
ouse
hold
s ad
opte
d w
ater
tr
eatm
ent o
ptio
n22
.4
NM
ICS
2014
3052
.15
58.1
64.0
570
NM
ICS
Wat
er
Supp
ly a
nd
Sani
tatio
n
% h
ouse
hold
s w
ith E
sche
richi
a co
li (E
. col
i) ris
k le
vel i
n ho
useh
old
wat
er o
f ≥ 1
col
ony
form
ing
unit
(cfu
)/10
0ml
82.2
N
MIP
201
760
5030
2010
NM
IP-D
WSS
Wat
er
Supp
ly a
nd
Sani
tatio
n
Out
put 2
.4:
Incr
ease
d ac
cess
to
safe
and
sus
tain
able
sa
nita
tion
serv
ices
% h
ouse
hold
s ha
ving
toile
ts
(san
itatio
n co
vera
ge)
87.2
7N
MIP
-DW
SS
2016
9899
100
100
100
NM
IP/D
WSS
Wat
er
Supp
ly a
nd
Sani
tatio
n
% o
f chi
ldre
n ag
ed 0
–2 y
ears
w
hose
last
sto
ols
wer
e di
spos
ed
of s
afel
y (u
se o
f toi
let,
or fa
eces
di
spos
ed in
toile
t)
48
NM
ICS
2014
5256
6266
70N
MIC
SW
ater
Su
pply
and
Sa
nita
tion
Num
ber o
f dis
tric
ts d
ecla
red
open
de
feca
tion
free
(OD
F)42
dis
tric
ts
NM
IP-2
017
6577
(7
53 lo
cal
gove
rnm
ents)
77
(753
loca
l go
vern
men
ts)
77
(753
loca
l go
vern
men
ts)
77
(753
loca
l go
vern
men
ts)
NM
IP-D
WSS
Wat
er
Supp
ly a
nd
Sani
tatio
n
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
60
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
Out
put 2
.5:
Impr
oved
kno
wle
dge
of c
hild
ren,
and
m
othe
rs a
nd
care
take
rs o
f und
er
5-ye
ar-o
lds
on h
ealth
an
d hy
gien
e
% o
f mot
hers
and
car
etak
ers
of u
nder
-5 y
ear-
old
child
ren
(hou
seho
lds)
with
kno
wle
dge
of
hand
was
hing
bef
ore
eatin
g
92.2
NM
ICS
2014
9596
9798
100
NM
ICS
Wat
er
Supp
ly a
nd
Sani
tatio
n
% o
f mot
hers
and
car
etak
ers
of u
nder
5-y
ear-
old
child
ren
(hou
seho
lds)
with
kno
wle
dge
of
hand
was
hing
bef
ore
prep
arin
g fo
od
22.2
NM
ICS
2014
3040
5060
70N
MIC
SW
ater
Su
pply
and
Sa
nita
tion
% o
f mot
hers
and
car
etak
ers o
f un
der-
5 ye
ar-o
lds (
hous
ehol
ds)
with
kno
wle
dge
of h
andw
ashi
ng
befo
re b
reas
tfeed
ing
or fe
edin
g ba
bies
6N
MIC
S 20
1420
3040
5060
NM
ICS
Wat
er
Supp
ly a
nd
Sani
tatio
n
% o
f mot
her a
nd c
aret
aker
s of
un
der 5
-yea
r-ol
ds (h
ouse
hold
s)
with
kno
wle
dge
of h
andw
ashi
ng
afte
r def
ecat
ion
and
urin
atin
g
86.6
NM
ICS
2014
8890
9396
99N
MIC
SW
ater
Su
pply
and
Sa
nita
tion
% o
f mot
hers
and
car
etak
ers
of
unde
r 5 y
ear-
olds
(hou
seho
lds)
w
ith k
now
ledg
e of
han
dwas
hing
af
ter c
lean
ing
child
ren’
s bo
ttom
s
5.5
NM
ICS
2014
1520
5070
90N
MIC
SW
ater
Su
pply
and
Sa
nita
tion
% o
f mot
hers
and
car
etak
ers
of
unde
r 5 y
ear-
olds
(hou
seho
lds)
w
ith k
now
ledg
e of
han
dwas
hing
af
ter c
lean
ing
toile
ts a
nd p
ottie
s (a
fter
man
agin
g w
aste
)
7.7
NM
ICS
2014
2030
4560
75N
MIC
SW
ater
Su
pply
and
Sa
nita
tion
% o
f peo
ple
who
was
h ra
w fo
od,
vege
tabl
es, c
over
s co
oked
food
an
d su
ffici
ently
hea
t sta
le fo
od
befo
re e
atin
g
NA
Soci
al P
rote
ctio
n
Out
put 2
.6:
Targ
eted
gro
ups
have
ac
cess
to re
sour
ces
and
oppo
rtun
ities
that
m
ake
them
sel
f-rel
iant
No.
of w
omen
gro
up c
oope
rativ
es
rece
ived
gra
nts
and
cred
it41
188
9010
011
012
0A
nnua
l rep
ort o
f D
ept o
f Wom
en
and
Child
ren
(DW
C)
Wom
en,
Child
ren
and
Soci
al W
elfa
re
No.
of c
omm
unity
leve
l aw
aren
ess
prog
ram
mes
hel
d on
redu
cing
ch
ild m
arria
ge
900
1,00
01,
050
1125
1,20
0A
nnua
l rep
ort o
f D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
No.
of w
omen
gro
up, c
omm
ittee
, co
oper
ativ
e m
embe
rs w
ith
esta
blis
hed
self-
entr
epre
neur
ship
(s
tart
-up
gran
ts)
49,3
8515
,000
12,0
0010
,000
15,0
0017
,000
Ann
ual
econ
omic
su
rvey
Wom
en,
Child
ren
and
Soci
al W
elfa
re
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
61
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
No.
of l
ocal
gov
ernm
ents
pr
ovid
ing
child
gra
nts
to c
hild
ren
unde
r 5-y
ears
-old
203
203
299
323
347
372
Repo
rt o
f D
ept o
f Civ
il Re
gist
ratio
n (D
oCR)
Loca
l G
over
nanc
e se
ctor
Mat
erna
l Hea
lth
and
Wom
en E
mpo
wer
men
t
Out
put 2
.7:
Nut
ritio
n co
mpo
nent
in
corp
orat
ed in
w
omen
, ado
lesc
ent
girls
and
chi
ld
deve
lopm
ent t
rain
ing
pack
ages
No.
of t
rain
ing
pack
ages
with
he
alth
and
nut
ritio
n m
odul
e in
tegr
ated
23
21
--
Ann
ual r
epor
ts
of D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
Out
put 2
:8:
Wom
en, c
hild
ren
and
out o
f sch
ool
adol
esce
nt g
irls
reac
hed
with
hea
lth
and
nutr
ition
car
e pr
actic
es
No.
of o
ut-o
f-sch
ool a
dole
scen
t gi
rls re
ache
d w
ith h
ealth
an
d nu
triti
on c
are
prac
tices
in
form
atio
n th
roug
h lif
e sk
ills
trai
ning
NA
3,70
03,
750
3,80
03,
825
3,90
0A
nnua
l rep
orts
of
DW
CW
omen
, Ch
ildre
n an
d So
cial
Wel
fare
No.
of w
omen
gro
up, c
omm
ittee
, co
oper
ativ
e m
embe
rs re
ache
d w
ith h
ealth
and
nut
ritio
n ca
re
info
rmat
ion
thro
ugh
wom
en
soci
al a
nd e
cono
mic
dev
elop
men
t tr
aini
ng
NA
15,0
0012
,000
10,0
0015
,000
17,0
00A
nnua
l rep
orts
of
DW
CW
omen
, Ch
ildre
n an
d So
cial
Wel
fare
Out
put 2
.9:
Child
car
e ho
mes
co
mpl
y w
ith m
inim
um
stan
dard
s of
nut
ritio
n ca
re
No.
of c
hild
car
e ho
mes
that
co
mpl
y w
ith m
inim
um n
utrit
ion
care
ser
vice
s
103
4725
3035
40A
nnua
l rep
orts
of
DW
CW
omen
, Ch
ildre
n an
d So
cial
Wel
fare
Out
put 2
.10:
Co
mm
uniti
es
empo
wer
ed to
pr
even
t har
mfu
l pr
actic
es
No.
of c
omm
uniti
es a
nd
rura
l mun
icip
aliti
es d
ecla
red
chha
upad
i fre
e
15 V
DCs
(d
ecla
red
as
men
stru
al
secl
usio
n sh
ed
[chh
aupa
di
goth
] fre
e)
67
89
10A
nnua
l rep
orts
of
DW
CW
omen
, Ch
ildre
n an
d So
cial
Wel
fare
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
62
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
Earl
y Ch
ildho
od D
evel
opm
ent a
nd C
lass
room
Edu
cati
on
Out
put 2
.11:
En
hanc
ed e
nrol
men
t of
chi
ldre
n in
bas
ic
educ
atio
n
Num
ber o
f chi
ldre
n in
bas
ic
educ
atio
n re
ceiv
ing
mid
day
mea
ls
612,
000
stud
ent
612,
000
612,
000
612,
000
612,
000
612,
000
EMIS
Educ
atio
n
Out
put 2
.12:
In
crea
sed
adol
esce
nt
girls
’ aw
aren
ess
and
impr
oved
beh
avio
ur
on n
utrit
ion
Num
ber o
f sch
ools
usi
ng
nutr
ition
-sen
sitiv
e lit
erac
y m
ater
ials
Ann
ual r
epor
t of
Dep
artm
ent o
f Ed
ucat
ion
(DoE
)
Educ
atio
n
Hea
lth
and
Fam
ily P
lann
ing
Serv
ices
Out
put 2
.13:
En
hanc
ed a
cces
s to
hea
lth a
nd
repr
oduc
tive
heal
th
serv
ices
Prop
ortio
n of
wom
en (1
5-49
ye
ars)
usi
ng a
ny c
ontr
acep
tive
met
hod
53
ND
HS
2016
60N
DH
SH
ealth
% o
f chi
ldre
n re
ceiv
ing
com
plet
e im
mun
izat
ion
with
in o
ne y
ear
78
ND
HS
2016
≥ 90
ND
HS,
NM
ICS
Hea
lth
Enab
ling
envi
ronm
ent o
utpu
ts
Out
com
e 3:
Im
prov
ed p
olic
ies,
pla
ns a
nd m
ulti
-sec
tora
l co
ordi
nati
on a
t fe
dera
l, pr
ovin
cial
and
loc
al g
over
nmen
t le
vels
to
enha
nce
the
nutr
itio
n st
atus
of
all
popu
lati
on g
roup
s
Out
put 3
.1:
MSN
P-II
incl
uded
in
loca
l, pr
ovin
cial
and
fe
dera
l gov
ernm
ent
polic
ies
and
plan
s
No.
of s
ecto
ral m
inis
trie
s’ pl
ans
that
incl
ude
nutr
ition
and
food
se
curit
y in
line
with
MSN
P-II
77
77
77
AWPB
of
Sect
oral
M
inis
trie
s
NPC
, Sec
tora
l M
inis
trie
s
No.
of p
rovi
ncia
l gov
ernm
ent’s
pl
ans
incl
udin
g nu
triti
on a
nd fo
od
secu
rity
in li
ne w
ith M
SNP-
II
Not
app
licab
le
77
77
7AW
PB o
f pr
ovin
ce
gove
rnm
ent
NPC
, Sec
tora
l M
inis
trie
s
No.
of l
ocal
gov
ernm
ents
in
corp
orat
ed n
utrit
ion
rela
ted
targ
ets
and
indi
cato
rs in
thei
r pl
ans
and
prog
ram
mes
30 d
istr
icts
(s
elec
ted
war
ds o
f 19
4 lo
cal
gove
rnm
ents
)
308
(30
dist
ricts
)30
8 (3
0 di
stric
ts)
332
(33
dist
ricts
356
(37
dist
ricts
)38
1 (3
9 di
stric
ts)
AWPB
s of
loca
l go
vern
men
tsLo
cal
Gov
erna
nce
No.
of p
rovi
nces
with
MSN
P-II
inst
itutio
nal a
rran
gem
ent s
et u
p an
d fu
nctio
nal
Not
app
licab
le
5 6
7 7
7M
eetin
g m
inut
esLo
cal
Gov
erna
nce
No.
of p
rovi
nces
allo
cate
d re
sour
ces
as re
quire
d fo
r MSN
P-II
Not
app
licab
le
77
77
7A
nnua
l bud
gets
an
d pl
ans
at
prov
ince
Loca
l G
over
nanc
e
No.
of l
ocal
gov
ernm
ents
al
loca
ted
reso
urce
s as
requ
ired
for
MSN
P-II
Not
app
licab
le
308
308
332
356
381
Ann
ual
budg
ets
and
plan
s of
loca
l go
vern
men
ts
Loca
l G
over
nanc
e
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
63
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
Out
put 3
.2:
MSN
P go
vern
ance
m
echa
nism
inst
itute
d an
d st
reng
then
ed a
t fe
dera
l, pr
ovin
cial
, and
lo
cal l
evel
s
No.
of m
eetin
gs o
f Hig
h Le
vel
Nut
ritio
n an
d Fo
od S
ecur
ity
Stee
ring
Com
mitt
ee c
ondu
cted
a
year
at f
eder
al le
vel
12
22
22
Mee
ting
min
utes
N
PC
No.
of q
uart
erly
Nut
ritio
n an
d Fo
od S
ecur
ity C
oord
inat
ion
Com
mitt
ee m
eetin
gs c
ondu
cted
at
fede
ral l
evel
14
44
44
Mee
ting
min
utes
N
PC
Nut
ritio
n an
d fo
od s
ecur
ity
stee
ring
com
mitt
ees
form
ed a
t pr
ovin
ce le
vel
Not
app
licab
le
7-
--
-M
eetin
g m
inut
es
NPC
, Loc
al
gove
rnan
ce
No.
pro
vinc
es h
oldi
ng n
utrit
ion
and
food
sec
urity
ste
erin
g co
mm
ittee
mee
tings
twic
e a
year
Not
app
licab
le
77
77
7M
eetin
g m
inut
es
NPC
, Loc
al
gove
rnan
ce
No.
pro
vinc
es fo
rmin
g nu
triti
on
and
food
sec
urity
coo
rdin
atio
n co
mm
ittee
s
Not
app
licab
le
7-
--
-M
eetin
g m
inut
es
NPC
, Loc
al
gove
rnan
ce
No.
of p
rovi
nces
con
duct
ed
nutr
ition
and
food
sec
urity
co
ordi
natio
n co
mm
ittee
mee
tings
qu
arte
rly
Not
app
licab
le
77
77
7M
eetin
g m
inut
es
NPC
, Loc
al
gove
rnan
ce
MSN
P-II
foca
l poi
nt/u
nit i
dent
ified
in
all
rele
vant
sec
tors
at p
rovi
nce
leve
l
Not
app
licab
le
77
77
7D
ecis
ion
lett
er
for M
SNP
foca
l po
int/
unit
Loca
l G
over
nanc
e
No.
of l
ocal
uni
ts (d
istr
icts
and
lo
cal g
over
nmen
ts) w
ith M
SNP
inst
itutio
nal a
rran
gem
ents
30 d
istr
icts
(3
08 lo
cal
gove
rnm
ents
)
308
loca
l go
vern
men
ts
(30
dist
ricts
)
308
(3
0 di
stric
ts
332
(33
dist
ricts
)35
6
(37
dist
ricts
)38
1 (3
9 di
stric
ts)
Mee
ting
min
utes
Loca
l G
over
nanc
e
No.
of l
ocal
gov
ernm
ents
co
nduc
ted
nutr
ition
and
food
se
curit
y st
eerin
g co
mm
ittee
m
eetin
g at
leas
t tw
ice
a ye
ar
30 d
istr
icts
(3
08 lo
cal
gove
rnm
ents
)
308
(30
dist
ricts
)30
8 (3
0 di
stric
ts)
332
(3
3 di
stric
ts)
356
(3
7 di
stric
ts)
381
(3
9 di
stric
ts)
30 d
istr
icts
(3
08 lo
cal
gove
rnm
ents
)
Loca
l G
over
nanc
e
No.
of l
ocal
gov
ernm
ents
ass
igne
d a
coor
dina
tor (
from
exi
stin
g st
aff
or o
utso
urce
d) to
ove
rsee
MSN
P-II
inte
rven
tions
30 d
istr
icts
(3
08 lo
cal
gove
rnm
ents
)
308
(30
dist
ricts
)30
8 (3
0 di
stric
ts)
332
(33
dist
ricts
)35
6 (3
7 di
stric
ts)
381
(3
9 di
stric
ts)
Lett
ers
Loca
l G
over
nanc
e
No.
of w
ards
with
war
d le
vel
nutr
ition
and
food
sec
urity
st
eerin
g co
mm
ittee
s
2,74
92,
749
2749
2,94
13,
133
3,51
4M
eetin
g m
inut
esLo
cal
Gov
ernm
ent
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
64
Resu
lts
Indi
cato
rsBa
selin
e Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
or20
1820
1920
2020
2120
22
No.
war
ds c
ondu
cted
war
d le
vel
nutr
ition
and
food
secu
rity
stee
ring
com
mitt
ee a
t lea
st tw
ice
a ye
ar
2,74
92,
749
2,74
92,
941
3,13
33,
514
Mee
ting
min
utes
Loca
l G
over
nmen
t
Out
put 3
.3:
MSN
P in
stitu
tiona
l m
echa
nism
s fu
nctio
nal a
t fed
eral
go
vern
men
t lev
el
Nat
iona
l Nut
ritio
n an
d Fo
od
Secu
rity
Secr
etar
iat (
NN
FSS)
in
stitu
tiona
lized
and
func
tiona
l at
NPC
11
11
11
FN
PC
Org
aniz
atio
n an
d m
anag
emen
t su
rvey
for N
NFS
S co
mpl
eted
and
ap
prov
ed b
y N
PC B
oard
01
--
--
NPC
or
gano
gram
NPC
Num
ber o
f san
ctio
ned
staff
po
sitio
ns fi
lled
at N
NFS
S1
(Ful
fille
d fr
om e
xter
nal
sour
ces)
-1
--
-Co
ntra
ct le
tter
sN
PC
Out
put 3
.4:
Func
tiona
l upd
ated
in
form
atio
n sy
stem
ac
ross
all
MSN
P-II
sect
ors
MSN
P-II
M&
E fr
amew
ork
deve
lope
d or
upd
ated
for a
ll se
ctor
s an
d im
plem
ente
d at
fe
dera
l, pr
ovin
cial
and
loca
l lev
els
11
11
11
M&
E fr
amew
ork
for M
SNP-
IIN
PC, s
ecto
rs,
Loca
l G
over
nanc
e
Web
-bas
ed re
port
ing
syst
em
linke
d w
ith M
SNP-
II M
&E
plan
at
all l
evel
s
7 se
ctor
s7
77
77
NPC
’s w
eb
base
d sy
stem
NPC
& s
ecto
rs
NN
FSS
port
al u
pdat
ed e
ach
quar
ter
44
44
44
NN
FSS
port
al
NPC
No.
of s
ecto
ral r
epor
ts u
pdat
ed
on N
NFS
S po
rtal
as
per M
&E
plan
ea
ch q
uart
er
04
44
44
NN
FSS
port
alN
PC, a
ll se
ctor
s
Out
put 3
.5:
Enha
nced
cap
acity
of
fede
ral,
prov
inci
al a
nd
loca
l lev
el g
over
nmen
t to
pla
n an
d im
plem
ent
nutr
ition
pro
gram
mes
Nat
iona
l Cap
acity
Dev
elop
men
t M
aste
r Pla
n fo
r im
plem
enta
tion
of
MSN
P-II
deve
lope
d
01
11
11
Capa
city
de
velo
pmen
t pl
an
NPC
, all
sect
ors
MSN
P-II
Capa
city
Dev
elop
men
t M
aste
r Pla
n im
plem
ente
d at
fe
dera
l lev
el
01
11
11
Sect
oral
trai
ning
re
port
sN
PC, a
ll se
ctor
s
MSN
P-II
Capa
city
Dev
elop
men
t M
aste
r Pla
n im
plem
ente
d at
pr
ovin
cial
leve
l
07
77
77
Sect
oral
trai
ning
re
port
sN
PC, a
ll se
ctor
s
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
65
Key
act
iviti
es
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
OU
TPU
T 1
Nut
riti
on s
ensi
tive
act
ivit
ies
Out
put 1
.1: E
nhan
ced
nutr
itio
n st
atus
of W
RA in
clud
ing
adol
esce
nts
1.1.
1 O
rgan
ize
and
impl
emen
t ful
ly-n
ouris
hed
villa
ges/
war
ds in
clud
ing
Gol
den
1000
D
ays
com
mun
icat
ion
cam
paig
n
Villa
geN
A
300
villa
ges
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.1.
2 Re
vita
lize
Scho
ol H
ealth
and
Nut
ritio
n Pr
ogra
mm
e in
clud
ing
prom
otio
n of
he
alth
y di
etar
y ha
bits
and
phy
sica
l act
ivity
Loca
l go
vern
men
ts77
dis
tric
ts
350
loca
l go
vern
men
ts
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.1.
3 Ra
ise
awar
enes
s an
d se
rvic
es fo
r hea
lthy
timin
g an
d sp
acin
g of
pre
gnan
cy.
Loca
l go
vern
men
ts77
dis
tric
ts75
3 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.1.
4 Co
nduc
t bar
rier a
naly
sis
for i
ncre
asin
g A
NC
serv
ice
utili
zatio
nPr
ovin
ceN
A7
(1 in
eac
h pr
ovin
ce)
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.1.
5 In
tegr
ate
and
expa
nd a
dole
scen
t-fr
iend
ly
heal
th a
nd n
utrit
ion
serv
ices
Loca
l go
vern
men
tsN
A37
2 lo
cal
gove
rnm
ents
A
nnua
l rep
orts
of
DoH
SH
ealth
Out
put 1
.2: I
mpr
oved
mat
erna
l, in
fant
and
you
ng c
hild
nut
riti
on a
nd c
are
prac
tice
s
1.2.
1 Co
nduc
t mat
erna
l, in
fant
and
you
ng
child
nut
ritio
n (M
IYCN
) cou
nsel
ling
on a
ll he
alth
sec
tor p
latf
orm
s vi
z. h
ealth
mot
her’s
gr
oup
mee
tings
, im
mun
izat
ion,
AN
C, P
NC,
gr
owth
mon
itorin
g (G
MP)
, PH
C-O
RC, I
MN
CI
and
OPD
Loca
l go
vern
men
tsN
A37
2 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.2.
2 Co
nduc
t reg
ular
gro
wth
mon
itorin
g co
unse
lling
at P
HC-
ORC
s an
d he
alth
fa
cilit
ies
Loca
l go
vern
men
tsN
A37
2 lo
cal
gove
rnm
ents
Ann
ual r
epor
t of
DoH
SH
ealth
1.2.
3 D
isse
min
ate
IEC
and
BCC
mat
eria
ls in
lin
e w
ith F
ood
Base
d D
ieta
ry G
uide
lines
th
roug
h he
alth
faci
litie
s, FC
HVs
to
com
mun
ities
and
hou
seho
lds
regu
larly
.
Loca
l go
vern
men
tsN
A75
3 lo
cal
gove
rnm
ents
A
nnua
l rep
ort
of D
oHS
Hea
lth
1.2.
4 Co
nduc
t foo
d pr
epar
atio
n an
d co
okin
g de
mon
stra
tions
to p
repa
re lo
cal n
utrit
ious
fo
ods
(e.g
. nut
ritio
us fl
our/
porr
idge
(lito
), ja
ulo
and
khic
hadi
usi
ng lo
cal f
oods
tuffs
Loca
l go
vern
men
ts N
A75
3 lo
cal
gove
rnm
ents
Ann
ual r
epor
t of
DoH
SH
ealth
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
66
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
1.2.
5 En
gage
med
ia fo
r doc
umen
tatio
n an
d di
ssem
inat
ion
of M
IYCN
pro
gram
me
Even
tN
A7
(1 in
all
7)A
nnua
l rep
ort
of D
oHS
Hea
lth
1.2.
6 Ra
ise
awar
enes
s on
nut
ritio
n in
clud
ing
esse
ntia
l new
born
car
eLo
cal
gove
rnm
ents
NA
753
loca
l go
vern
men
tsA
nnua
l rep
ort
of D
oHS
Hea
lth
Out
put 1
.3: I
mpr
oved
MIY
C m
icro
nutr
ient
sta
tus
1.3.
1 M
aint
ain
and
sust
ain
rout
ine
dist
ribut
ion
of V
itam
in A
cap
sule
s an
d de
wor
min
g ta
blet
s to
chi
ldre
n un
der 5
Loca
l go
vern
men
ts77
dis
tric
ts75
3 lo
cal
gove
rnm
ents
Ann
ual r
epor
t of
DoH
SH
ealth
1.3.
2 In
crea
se c
over
age
and
com
plia
nce
of ir
on
folic
aci
d an
d de
wor
min
g am
ong
preg
nant
and
po
st-p
artu
m w
omen
Loca
l go
vern
men
ts77
dis
tric
ts75
3 lo
cal
gove
rnm
ents
Ann
ual r
epor
t of
DoH
SH
ealth
1.3.
3 Sc
ale-
up h
ome
food
fort
ifica
tion
with
m
ultip
le m
icro
nutr
ient
pow
der (
MN
P) in
ta
rget
ed a
reas
Loca
l go
vern
men
ts30
dis
tric
ts34
di
stric
ts45
di
stric
ts55
di
stric
ts75
3 lo
cal
gove
rnm
ents
753
loca
l go
vern
men
tsA
nnua
l rep
orts
of
DoH
SH
ealth
1.3.
4 Ra
ise
awar
enes
s to
pro
mot
e ho
useh
old
use
of tw
o-ch
ild-lo
go io
dize
d sa
ltLo
cal
gove
rnm
ents
77 d
istr
icts
753
loca
l go
vern
men
tsA
nnua
l rep
orts
of
DoH
SH
ealth
1.3.
5 Ra
ise
awar
enes
s to
pro
mot
e co
nsum
ptio
n of
nat
iona
l rol
ler-
mill
fort
ified
flou
r and
rice
Lo
cal
gove
rnm
ents
NA
372
loca
l go
vern
men
tsA
nnua
l rep
orts
of
DoH
SH
ealth
and
ag
ricul
ture
1.3.
6 In
itiat
e ric
e fo
rtifi
catio
n in
gov
ernm
ent
(NFC
) and
sel
ecte
d bi
g ric
e pr
oduc
ing
mill
sRo
ller m
ills
NA
1 2
22
Ann
ual r
epor
ts
of D
FTQ
CAg
ricul
ture
, he
alth
, su
pplie
s
1.3.
7 Co
nduc
t res
earc
h to
impr
ove
use
of ir
on-
folic
aci
d (IF
A) s
uppl
emen
tatio
nPr
ovin
ce7
Ann
ual r
epor
ts
1.3.
8 Co
nduc
t bar
rier a
naly
sis
on lo
w c
over
age/
com
plia
nce
of M
NP
Even
t per
pr
ovin
ceN
A7
(1 in
all
7 pr
ovin
ce)
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.3.
9 Pr
ocur
e an
d su
pply
nut
ritio
n co
mm
oditi
es
for r
egul
ar a
nd e
mer
genc
y pr
ogra
ms
(VAC
, IFA
, de
wor
min
g ta
blet
s, M
NPs
, RU
TF, t
hera
peut
ic
milk
, ReS
oMal
)
Perc
enta
ge10
010
0A
nnua
l rep
orts
of
DoH
SH
ealth
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
67
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
1.3.
10 S
cale
-up
fort
ified
sup
er c
erea
l flou
r di
strib
utio
n in
sel
ecte
d di
stric
ts w
ith h
igh
prev
alen
ce o
f acu
te m
alnu
triti
on to
pre
gnan
t an
d la
ctat
ing
wom
en a
nd 6
-23
mon
ths
child
ren
unde
r MCH
N p
rogr
amm
e
Dis
tric
ts6
66
89
9A
nnua
l rep
orts
of
DoH
SH
ealth
Out
put 1
.4: I
mpr
oved
man
agem
ent o
f sev
ere
and
mod
erat
e ac
ute
mal
nutr
itio
n
1.4.
1 Ex
pand
and
est
ablis
h O
TC a
nd IT
C ce
ntre
s fo
r man
agem
ent o
f sev
ere
acut
e m
alnu
triti
on
in c
hild
ren
unde
r 5 y
ears
Loca
l go
vern
men
ts32
dis
tric
ts75
3 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.4.
2 Sc
ale-
up n
utrit
ion
reha
bilit
atio
n ho
mes
(N
RH) i
n 50
+ be
d ho
spita
lsLo
cal
gove
rnm
ents
43
hosp
itals
37
2 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.4.
3 Co
nduc
t per
iodi
c nu
triti
on a
sses
smen
ts
and
coun
selli
ng a
t com
mun
ity le
vel
Loca
l go
vern
men
tsN
A37
2 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.4.
4 Co
nduc
t bar
rier a
naly
sis
on s
ervi
ces
rela
ted
to S
AM
man
agem
ent
Prov
ince
NA
7 pr
ovin
ce
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.4.
5 Sc
ale-
up a
nd s
tren
gthe
n IM
NCI
pr
ogra
mm
eLo
cal
gove
rnm
ents
77 d
istr
icts
753
loca
l go
vern
men
tsA
nnua
l rep
orts
of
DoH
SH
ealth
1.4.
6 Es
tabl
ish
and
stre
ngth
en n
utrit
ion
info
rmat
ion
and
surv
eilla
nce
syst
em in
nor
mal
an
d hu
man
itaria
n si
tuat
ions
Prov
ince
2
dist
ricts
7 pr
ovin
ces
Ann
ual r
epor
ts
of D
oHS
Hea
lth
Out
put 1
.5: E
nhan
ced
prep
ared
ness
for n
utri
tion
in e
mer
genc
y re
spon
ses
1.5.
1 Es
tabl
ish
loca
l nut
ritio
n cl
uste
rs a
nd
cond
uct q
uart
erly
coo
rdin
atio
n m
eetin
g at
lo
cal l
evel
s
Prov
ince
77 d
istr
icts
7 pr
ovin
ces
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.5.
2 U
pdat
e an
d de
velo
p nu
triti
on in
em
erge
ncy
prep
ared
ness
for r
espo
nse
and
cont
inge
ncy
plan
ning
at l
ocal
leve
ls
Prov
ince
s an
d lo
cal
gove
rnm
ents
77 d
istr
icts
7
prov
ince
s an
d 37
2 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
Out
put 1
.6: B
uilt
cap
acit
y of
nut
riti
on s
peci
fic s
ecto
r
1.6.
1 Co
nduc
t ref
resh
er tr
aini
ng to
hea
lth
wor
kers
and
FCH
Vs a
t all
leve
ls o
n M
IYCN
pa
ckag
e
Loca
l go
vern
men
ts77
dis
tric
ts
753
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.6.
2 O
rgan
ize
basi
c tr
aini
ng o
n M
IYCN
pac
kage
to
new
ly re
crui
ted
nutr
ition
sup
ervi
sors
and
nu
triti
on o
ffice
rs
Loca
l go
vern
men
tsN
A75
3 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
68
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
1.6.
3 O
rgan
ize
nutr
ition
cha
mpi
on le
ader
ship
de
velo
pmen
t eve
nts
Prov
ince
NA
7 pr
ovin
ces
Ann
ual r
epor
ts
of D
oHS
Hea
lth
1.6.
4 Co
nduc
t rou
tine
data
qua
lity
asse
ssm
ent
(RD
QA
) usi
ng n
utrit
ion
prog
ram
me-
rela
ted
HM
IS to
ols
Loca
l go
vern
men
tsN
A37
2 lo
cal
gove
rnm
ents
Ann
ual r
epor
ts
of D
oHS
Hea
lth
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
OU
TPU
T 2
Agr
icul
ture
and
Liv
esto
ck
Out
put 2
.1: I
ncre
ased
ava
ilabi
lity
and
cons
umpt
ion
of s
afe
and
nutr
itio
us fo
od
2.1.
1 M
ake
avai
labl
e ag
ricul
ture
and
live
stoc
k in
puts
(i.e
. see
ds, f
ertil
izer
s, br
eeds
) at
hous
ehol
d an
d co
mm
unity
leve
ls
Impr
oved
see
ds (i
ncre
ase
by 1
0%) (
in 1
,000
to
nnes
) 1,
000
tonn
es9,
540
(201
4)12
,698
13,9
6815
,364
16,9
0118
,591
MoA
D’s
annu
al
repo
rts
Agric
ultu
re
Fert
ilize
rs (i
ncre
ase
use
by 5
% a
nnua
lly) (
in
1,00
0 to
nnes
) 1,
000
tonn
es29
8,67
7
(201
4)34
5,75
636
3,04
438
1,19
640
0,25
642
0,26
9M
oAD
’s an
nual
re
port
sAg
ricul
ture
Bree
ds (n
o. o
f art
ifici
al in
sem
inat
ions
)Br
eeds
450,
000
500,
000
525,
000
550,
000
600,
000
650,
000
MoA
D’s
annu
al
repo
rts
Live
stoc
k
2.1.
2 Pr
ovid
e te
chni
cal s
uppo
rt (t
rain
ing,
de
mon
stra
tion)
to p
rom
ote
prod
uctio
n of
frui
ts,
vege
tabl
es, n
utrit
ious
root
s, ce
real
s an
d pu
lses
to
incr
ease
con
sum
ptio
n of
div
ersi
fied
food
s in
ho
useh
olds
Agric
ultu
re
Cere
als
(1,0
00 to
nnes
)1,
000
tonn
es8,
614
(201
4)9,
515
9,70
59,
414
9,69
79,
987
MoA
D’s
annu
al
repo
rts
Puls
es (1
,000
tonn
es)
1,00
0 to
nnes
316
(201
4)32
933
534
234
935
6
Frui
ts (1
,000
tonn
es)
1,00
0 to
nnes
992
(201
4)11
811,
252
1,32
71,
407
1,49
2
Vege
tabl
es (1
,000
tonn
es)
1,00
0 to
nnes
3,81
9 (2
014)
4413
4,67
84,
959
5,25
65,
572
Pota
to (1
,000
tonn
es)
1,00
0 to
nnes
190
210
218
227
236
246
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
69
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
2.1.
3 In
crea
se p
rodu
ctio
n an
d pr
omot
e co
nsum
ptio
n of
fres
h fr
uits
and
gre
en le
afy
vege
tabl
es
Refe
r to
c.
and
d. o
f ac
tivity
2.1
.2
MoA
D’s
annu
al
repo
rts
Agric
ultu
re
2.1.
4 Bu
ild c
apac
ity o
f liv
esto
ck fa
rmer
s an
d en
trep
rene
urs
to in
crea
se m
ilk, m
eat a
nd e
gg
prod
uctio
n
Pers
on13
,000
15,0
0017
,000
19,0
0022
,000
25,0
00A
nnua
l rep
orts
of
MoL
D
Live
stoc
k
2.1.
5 Te
chni
cal s
uppo
rt fo
r mic
ro a
nd a
ltern
ativ
e sm
all i
rrig
atio
n to
pro
duce
div
ersi
fied
and
mic
ronu
trie
nt ri
ch fo
ods
% o
f cro
p la
nd
in y
ear r
ound
irr
igat
ion
18
(201
0)22
2530
3545
AD
SAg
ricul
ture
2.1.
6 Su
ppor
t foo
d pr
oduc
ing
indu
strie
s to
ad
opt g
ood
man
ufac
turin
g pr
actic
es a
nd
rela
ted
syst
ems
Indu
stry
N
A
1010
1010
10Re
port
s of
D
FTQ
CAg
ricul
ture
and
Li
vest
ock
2.1.
7 Tr
ain
agric
ultu
re a
nd li
vest
ock
exte
nsio
n offi
cers
and
sta
ff on
food
saf
ety,
food
pro
cess
ing
and
nutr
ition
Even
tN
A
100
100
100
100
100
Repo
rts
of
DFT
QC
Agric
ultu
re a
nd
Live
stoc
k
2.1.
8 Tr
ain
farm
ers
on fo
od s
afet
y, fo
od
proc
essi
ng a
nd n
utrit
ion
Pers
onN
A1,
000
1,00
01,
000
1,00
01,
000
Repo
rts
of D
oA
& D
oLS
Agric
ultu
re a
nd
Live
stoc
k
.9 S
tudy
and
impr
ove
loca
l foo
d re
cipe
sEv
ent
NA
55
55
5Re
port
s of
D
FTQ
CAg
ricul
ture
and
Li
vest
ock
2.1.
10 U
pdat
e an
d di
ssem
inat
e fo
od
com
posi
tion
tabl
esa)
Ana
lyse
food
sam
ples
b) D
ata
com
pila
tion
and
publ
icat
ion
of
upda
ted
food
com
posi
tion
tabl
e
Piec
e Ex
istin
g 30
0 30
0 30
030
0 30
0Re
port
s of
D
FTQ
CAg
ricul
ture
and
Li
vest
ock
2.1.
11 D
isse
min
ate
food
bas
ed d
ieta
ry
guid
elin
es to
loca
l gov
ernm
ents
Piec
e N
A30
030
030
030
030
0Re
port
s of
D
FTQ
CAg
ricul
ture
and
Li
vest
ock
2.1.
12 D
evel
op a
nd m
ultip
ly B
CC m
ater
ials
in
clud
ing
audi
o vi
sual
s on
food
saf
ety,
food
pr
oces
sing
and
nut
ritio
n
Piec
e N
A5
55
55
Repo
rts
of
DFT
QC
Agric
ultu
re a
nd
Live
stoc
k
Out
put 2
.2: I
ncre
ased
phy
sica
l and
eco
nom
ic a
cces
s to
div
ersi
fied
food
2.2.
1 En
hanc
e ac
cess
and
util
izat
ion
of a
nim
al
sour
ce fo
ods
a) O
pen
mar
ket e
stab
lishm
ents
No.
of m
arke
ts3
56
77
7
Ann
ual r
epor
ts
of M
oLD
Live
stoc
k b)
Chi
lling
vat
dis
trib
utio
nN
umbe
r20
4060
7010
011
0
c) A
war
enes
s pr
ogra
mm
es to
use
saf
e an
imal
pr
oduc
ts (e
vent
s)Ev
ent
2040
5070
9012
0
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
70
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
2.2.
2 Pr
omot
e an
d su
ppor
t pro
duct
ion
and
cons
umpt
ion
of fi
sh in
clud
ing
supp
ort t
o es
tabl
ish
com
mun
ity p
onds
for p
rodu
ctio
n an
d lo
cal c
onsu
mpt
ion
1,00
0 to
nnes
48
5760
6366
69A
nnua
l rep
orts
of
MoA
D
Agric
ultu
re
Wat
er S
uppl
y an
d Sa
nita
tion
Out
put 2
.3: I
ncre
ased
acc
ess
to s
afe
drin
king
wat
er
2.3.
1 Co
nstr
uct a
nd re
pair
wat
er s
uppl
y sc
hem
es
in c
omm
uniti
es a
nd in
stitu
tions
thro
ugh
wat
er
safe
ty p
lans
and
pro
ject
s
Perc
enta
ge
610
0 D
WSS
Wat
er S
uppl
y an
d Sa
nita
tion
2.3.
1 Pr
omot
e al
tern
ativ
e an
d in
nova
tive
tech
nolo
gies
for s
uppl
y w
ater
Perc
enta
ge
0.4
2.5
NM
IP-D
WSS
Wat
er S
uppl
y an
d Sa
nita
tion
2.3.
3 Pr
omot
e ho
useh
old
wat
er tr
eatm
ent
optio
nsPe
rcen
tage
N
A25
NM
IP-D
WSS
Wat
er S
uppl
y an
d Sa
nita
tion
Out
put 2
.4: I
ncre
ased
acc
ess
to s
afe
and
sust
aina
ble
sani
tati
on s
ervi
ces
2.4.
1 Ra
ise
com
mun
ity a
war
enes
s on
co
nstr
uctio
n, m
aint
enan
ce a
nd h
ygie
nic
use
of im
prov
ed h
ouse
hold
toile
ts in
clud
ing
safe
di
spos
al o
f chi
ld fa
eces
Perc
enta
geN
A10
0N
MIP
-DW
SSW
ater
Sup
ply
and
Sani
tatio
n
2.4.
2 Su
ppor
t and
str
engt
hen
WA
SH
coor
dina
tion
com
mitt
ees
and
loca
l gov
ernm
ent
to a
ccel
erat
e O
DF
cam
paig
ns.
Perc
enta
ge
100
NM
IP-D
WSS
Wat
er S
uppl
y an
d Sa
nita
tion
2.4.
3 Su
ppor
t con
stru
ctio
n an
d m
anag
emen
t of
chi
ld, g
ende
r and
diff
eren
tly a
bled
fr
iend
ly to
ilets
incl
udin
g m
enst
rual
hyg
iene
m
anag
emen
t fac
ilitie
s at
inst
itutio
ns
Perc
enta
ge
NA
2035
WA
SH S
ecto
r D
evel
opm
ent
Plan
Wat
er S
uppl
y an
d Sa
nita
tion
22.4
.4 S
afe
and
hyge
nic
food
saf
ety
prac
tices
su
ch a
s co
verin
g st
one
mix
ture
, dry
ing
ut
ensi
ls e
tc
Perc
enta
ge
NA
2035
WA
SH S
ecto
r D
evel
opm
ent
Plan
Wat
er S
uppl
y an
d Sa
nita
tion
Out
put 2
.5: P
rom
oted
hyg
iene
beh
avio
ur p
ract
ices
and
its
man
agem
ent
2.5.
1 Co
nstr
uct,
esta
blis
h an
d pr
omot
e us
er
frie
ndly
han
d w
ashi
ng fa
cilit
ies
in h
ouse
hold
s an
d in
stitu
tions
Perc
enta
geN
A10
0D
WSS
Wat
er S
uppl
y an
d Sa
nita
tion
2.5.
2 Ra
ise
awar
enes
s on
han
d w
ashi
ng a
t cr
itica
l tim
es in
com
mun
ities
, sch
ool c
hild
ren
and
heal
th w
orke
rs
NA
Dat
a fr
om D
oE
and
DoH
SW
ater
Sup
ply
and
Sani
tatio
n
2.5.
3 Ra
ise
awar
enes
s on
men
stru
al h
ygie
ne
man
agem
ent i
n co
mm
uniti
es a
nd s
choo
lsPe
rcen
tage
NA
100
DW
SSW
ater
Sup
ply
and
Sani
tatio
n
2.5.
4 Ra
ise
awar
enes
s ab
out f
ood
hygi
ene
in
com
mun
ities
NA
DW
SSW
ater
Sup
ply
and
Sani
tatio
n
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
71
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
Soci
al P
rote
ctio
n
Out
put 2
.6: T
arge
ted
grou
ps h
ave
acce
ss to
reso
urce
s an
d op
port
unit
ies
that
are
ess
enti
al fo
r mak
ing
them
sel
f-re
liant
.
2.6.
1 Su
ppor
t com
mun
ity s
eed
bank
sSe
ed b
ank
15
(201
6)17
1921
2325
Ann
ual r
epor
t of
MoA
DAg
ricul
ture
2.6.
2 Su
ppor
t wom
en a
nd d
isad
vant
aged
gr
oups
to p
rodu
ce a
nd c
onsu
me
anim
al
lives
tock
pro
duct
s
Dis
tric
t N
A20
2530
3235
Ann
ual r
epor
t of
MoL
DLi
vest
ock
2.6.
3 Pr
ovid
e st
art-
up e
ntre
pren
eurs
hip
gran
ts
to w
omen
coo
pera
tives
for s
ocia
l and
eco
nom
ic
empo
wer
men
t (N
PR 1
50,0
00 to
450
,000
)
Wom
en
coop
erat
ive
411
8890
100
110
120
Ann
ual r
epor
ts
of D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
2.6.
4 Pr
ovid
e st
art-
up e
ntre
pren
eurs
hip
gran
ts
to w
omen
gro
up m
embe
rs fo
r soc
ial a
nd
econ
omic
em
pow
erm
ent (
NPR
350
0–75
00)
Mem
bers
of
wom
en
coop
erat
ives
49,3
85
15,0
0012
,000
10,0
0015
,000
17,0
00D
raft
73/
74
Ann
ual
Econ
omic
Su
rvey
Wom
en,
Child
ren
and
Soci
al W
elfa
re
2.6.
5 Tr
aini
ng a
nd o
rient
atio
ns fo
r inc
ome
gene
ratio
n an
d bu
sine
ss p
rom
otio
n (v
eget
able
&
frui
t pro
duct
ion,
ani
mal
hus
band
ry, l
ives
tock
, ta
ilorin
g, e
tc.)
Pers
ons/
no. o
f tr
aini
ngs
163,
959
1,50
01,
600
1,75
01,
900
2,00
0A
nnua
l rep
orts
of
DW
CW
omen
, Ch
ildre
n an
d So
cial
Wel
fare
2.6.
6 Li
nk th
e di
strib
utio
n of
chi
ld p
rote
ctio
n gr
ants
to n
utrit
ion
in a
ll di
stric
tsLo
cal
gove
rnm
ents
203
loca
l go
vern
men
ts20
3 29
9 32
3 34
7 37
2 Re
port
s of
D
oCR
Loca
l G
over
nanc
e
2.6.
7 In
clud
e nu
triti
on a
s a
maj
or o
bjec
tive
of
soci
al p
rote
ctio
n pr
ogra
mm
esLo
cal
gove
rnm
ents
203
loca
l go
vern
men
ts20
3 29
9 32
3 34
7 37
2 Re
port
s of
D
oCR
Loca
l G
over
nanc
e
Mat
erna
l Hea
lth a
nd W
omen
Em
pow
erm
ent
Out
put 2
.7: N
utri
tion
com
pone
nt in
corp
orat
ed in
wom
en, a
dole
scen
t gir
ls a
nd c
hild
dev
elop
men
t tra
inin
g pa
ckag
es
2.7.
1 In
tegr
ate
nutr
ition
mod
ules
in tr
aini
ng
pack
ages
incl
udin
g ge
nder
bas
ed v
iole
nce
prev
entio
n an
d re
spon
se tr
aini
ng, l
eade
rshi
p,
com
mun
ity p
rote
ctio
n, b
usin
ess
deve
lopm
ent
and
life
skill
s tr
aini
ng
Mod
ule
2 3
21
00
Ann
ual r
epor
ts
of D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
72
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
Out
put 2
.8: W
omen
, chi
ldre
n an
d ou
t of s
choo
l ado
lesc
ent g
irls
reac
hed
wit
h he
alth
and
nut
riti
on c
are
prac
tice
s
2.8.
1 O
rgan
ize
trai
ning
s fo
r wom
en c
oope
rativ
es
and
child
clu
bs o
n nu
triti
on s
ensi
tive
serv
ices
:
Ann
ual r
epor
ts
of D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
Lead
ersh
ip tr
aini
ngPe
rson
37,6
323,
760
3,80
03,
825
3,85
03,
900
Gen
der b
ased
vio
lenc
e pr
even
tion
and
resp
onse
trai
ning
Coop
erat
ive
3640
4245
50
Com
mun
ity p
rote
ctio
n tr
aini
ngCo
oper
ativ
e32
4042
4550
Busi
ness
dev
elop
men
t tra
inin
gsPe
rson
48,3
00
28,3
0038
,200
51,6
0062
,000
73,0
00
Repr
oduc
tive
heal
th tr
aini
ngPe
rson
121,
513
1980
2,00
02,
050
2,15
02,
200
Gen
der d
evel
opm
ent t
rain
ing
(c
o-de
velo
pmen
t)Pe
rson
2,85
02,
900
2,95
03,
000
3,10
03,
200
2.8.
2 Li
fe s
kill
deve
lopm
ent p
rogr
amm
es fo
r ou
t-of
-sch
ool a
dole
scen
t girl
s:
Men
stru
al h
ygie
ne tr
aini
ng
Pers
on24
050
070
090
01,
000
Ann
ual r
epor
ts
of D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
Know
ledg
e an
d aw
aren
ess
rais
ing
initi
ativ
es
for a
dole
scen
t girl
s (v
ulne
rabl
e di
stric
ts fo
r ge
nder
-bas
ed v
iole
nce
and
girl
traffi
ckin
g)
Pers
on3,
700
3,85
04,
000
4,20
04,
500
Ann
ual r
epor
ts
of D
WC
Gen
eral
life
ski
ll de
velo
pmen
t tra
inin
gPe
rson
,5,
120
2,80
03,
000
3,20
03,
300
3,50
0A
nnua
l rep
orts
of
DW
C
Org
aniz
e tr
aini
ng to
chi
ld c
lubs
and
vill
age
child
pro
tect
ion
com
mitt
ees
(VCP
C) o
n nu
triti
on c
are
Ann
ual r
epor
ts
of D
WC
Out
put 2
.9: C
hild
car
e ho
mes
com
ply
wit
h m
inim
um s
tand
ards
of n
utri
tion
car
e se
rvic
es.
2.9.
1 M
onito
r chi
ld c
are
hom
es c
ompl
ianc
e w
ith
min
imum
sta
ndar
ds o
f pro
visi
on o
f nut
ritio
n se
nsiti
ve s
ervi
ces
Child
Car
e H
ome
103
4725
3540
45A
nnua
l rep
orts
of
DW
C
Wom
en,
Child
ren
and
Soci
al W
elfa
re
Child
Car
e H
ome
103
103
100
105
110
120
Ann
ual r
epor
t of
DW
C
2.9.
2 Pr
omot
e nu
triti
on s
ensi
tive
serv
ices
at
child
car
e ho
mes
Child
Car
e H
ome
NA
5010
010
010
010
0A
nnua
l rep
orts
of
DW
C
2.9.
3 In
tegr
ate
nutr
ition
com
pone
nt in
chi
ld
prot
ectio
n ca
se m
anag
emen
t tra
inin
g an
d se
rvic
es
Trai
ning
Pa
ckag
eN
A
1A
nnua
l rep
orts
of
DW
C
2.9.
4 D
epriv
ed (B
ipan
na) i
nfan
t nut
ritio
n pr
ogra
mm
e (N
PR 5
0,00
0 gr
ant f
or w
omen
co
oper
ativ
es)
Coop
erat
ive
3640
5055
6070
Ann
ual r
epor
ts
of D
WC
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
73
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
Out
put 2
.10:
Com
mun
itie
s em
pow
ered
to p
reve
nt h
arm
ful p
ract
ices
2.10
.1 R
un b
ehav
iour
cha
nge
com
mun
icat
ion
activ
ities
to e
nd h
arm
ful t
radi
tiona
l pra
ctic
esEv
ent
NA
90
01,
000
1,15
01,
200
1,50
0A
nnua
l rep
ort
of D
WC
Wom
en,
Child
ren
and
Soci
al W
elfa
re
2.10
.2 R
un c
ampa
igns
to p
reve
nt m
arria
ge u
ntil
age
20 (3
50 a
dole
scen
ts, 3
90 s
take
hold
ers,
840
dham
i-jha
kri i
n 39
inte
ract
ion
prog
ram
mes
)
Even
t5,
000
2750
3,00
03,
200
3,50
04,
000
Ann
ual r
epor
t of
DW
C
2.10
.3 P
rogr
amm
es to
shi
ft s
ocia
l nor
ms
and
harm
ful p
ract
ices
on
food
tabo
os th
at p
reve
nt
men
stru
al h
ygie
ne, a
dequ
ate
nutr
ition
for
adol
esce
nts,
etc.
Even
t30
030
040
045
050
055
0A
nnua
l rep
ort
of D
WC
Earl
y Ch
ildho
od D
evel
opm
ent a
nd C
lass
room
Edu
cati
on
Out
put 2
.11
Enha
nced
enr
olm
ent o
f chi
ldre
n in
bas
ic e
duca
tion
.
2.11
.1 R
un w
elco
me
to s
choo
l cam
paig
ns fo
r ba
sic
educ
atio
nSc
hool
29,2
07
29,3
0729
,407
29,5
0729
,607
29,7
07A
nnua
l rep
orts
of
DoE
Ed
ucat
ion
2.11
.2 P
rovi
de a
dequ
ate
reso
urce
s to
all
scho
ols
to h
ave
ECED
/PPE
Scho
ol25
,000
25
,500
26,0
0027
,000
28,0
0029
,000
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
2.11
.3 P
rovi
de d
iver
sifie
d an
d nu
triti
ous
mid
day
mea
ls to
chi
ldre
n in
bas
ic e
duca
tion
Stud
ent
612,
000
612,
000
612,
000
612,
000
612,
000
612,
000
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
2.11
.4 E
CED
faci
litat
ors,
com
mun
ity le
arni
ng
cent
res
(CLC
) fac
ilita
tors
, foc
al te
ache
r and
he
alth
teac
hers
and
food
man
agem
ent
com
mitt
ees
in c
oord
inat
ion
with
FCH
Vs e
ngag
e pa
rent
s to
impr
ove
thei
r kno
wle
dge
of h
ealth
, hy
gien
e an
d nu
triti
on
Dis
tric
t 12
12
1212
1212
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
2.11
.5 N
utrit
ion
mon
itorin
g of
bas
ic e
duca
tion
stud
ents
Dis
tric
t 12
57
5757
5757
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
2.11
.6 B
uild
nut
ritio
n ca
paci
ty o
f ECD
faci
litat
ors,
CLC
faci
litat
ors,
heal
th te
ache
rs a
nd fo
od
man
agem
ent c
omm
ittee
in s
choo
ls
Dis
tric
t 12
12
1212
1212
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
Out
put 2
.12:
Incr
ease
d ad
oles
cent
gir
ls’ a
war
enes
s an
d be
havi
ours
in n
utri
tion
2.12
.1 R
un c
ampa
igns
to in
crea
se g
irls’
enro
lmen
t in
scho
ols
in ta
rget
ed a
reas
Sc
hool
29,2
0729
,307
29,4
0729
,507
29,6
0729
,707
EMIS
Educ
atio
n
2.12
.2 C
reat
e pr
iorit
y m
inim
um e
nabl
ing
cond
ition
s (c
lass
room
s, te
ache
rs, t
ext b
ooks
, W
ASH
, boo
k co
rner
s) in
sch
ools
Scho
olN
A
All
scho
ols
All
scho
ols
All
scho
ols
All
scho
ols
All
scho
ols
EMIS
Educ
atio
n
2.12
.3 B
uild
sep
arat
e fu
nctio
nal t
oile
ts w
ith
grou
p ha
nd w
ash
faci
litie
s, es
peci
ally
for g
irls
in
scho
ols
Scho
ol67
7277
8287
92EM
ISEd
ucat
ion
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
74
Key
acti
viti
esU
nit
Situ
atio
n in
201
7Ta
rget
Mea
ns o
f ve
rific
atio
nRe
spon
sibl
e se
ctor
s20
1820
1920
2020
2120
22
2.12
.4 P
rovi
de s
afe
drin
king
wat
er in
sch
ools
Scho
ol80
8590
9510
010
0EM
ISEd
ucat
ion
2.12
.5 P
rom
ote
heal
thy
beha
viou
r thr
ough
sk
ills-
base
d he
alth
edu
catio
n in
sch
ools
Scho
olN
A
35,2
2235
,300
35,4
0035
,500
35,6
00EM
ISEd
ucat
ion
2.12
.6 R
evis
e he
alth
and
nut
ritio
n cu
rric
ulum
Clas
sN
A
Clas
s 1-
3Cl
asse
s 4-
5Cl
asse
s 6-
8Cl
asse
s 9-
10Cl
asse
s 11
-12
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
2.12
.7 E
stab
lish
food
man
agem
ent c
omm
ittee
s in
all
scho
ols
prov
idin
g m
idda
y m
eals
Dis
tric
t 12
57
5757
5757
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
2.12
.8 D
evel
op a
set
of e
duca
tiona
l tra
inin
g pa
ckag
es o
n di
sast
er ri
sk re
duct
ion
(DRR
) for
st
uden
ts, t
each
ers
and
scho
ol m
anag
emen
t co
mm
ittee
s
Trai
ning
pa
ckag
e N
A1
Ann
ual r
epor
ts
of D
oE
Educ
atio
n
Hea
lth
and
Fam
ily P
lann
ing
Serv
ices
Out
put 2
.13
Prom
ote
acce
ss to
hea
lth
and
repr
oduc
tive
hea
lth
serv
ices
.
2.13
.1 P
rovi
de re
prod
uctiv
e he
alth
info
rmat
ion
serv
ices
in s
choo
ls a
nd h
ealth
faci
litie
s fo
r boy
s an
d gi
rls
Publ
ic s
choo
l77
dis
tric
ts
>75%
of p
ublic
sc
hool
sA
nnua
l rep
orts
of
DoH
SH
ealth
2.13
.2 P
rovi
de k
now
ledg
e on
impo
rtan
ce o
f de
laye
d fir
st p
regn
ancy
aft
er m
arria
gePu
blic
sch
ool
77 d
istr
icts
>7
5% o
f pub
lic
scho
ols
Ann
ual r
epor
ts
of D
oHS
Hea
lth
2.13
.3 P
rovi
de in
form
atio
n to
sch
ool s
tude
nts
on b
enefi
ts o
f use
of f
amily
pla
nnin
g m
etho
ds
Publ
ic s
choo
l77
dis
tric
ts
>75%
of p
ublic
sc
hool
sA
nnua
l rep
orts
of
DoH
SH
ealth
2.13
.4 B
ehav
iour
cha
nge
com
mun
icat
ion
for
incr
easi
ng u
ptak
e of
rout
ine
mea
sles
and
ru
bella
imm
uniz
atio
n
Loca
l go
vern
men
ts
77 d
istr
icts
75
3 A
nnua
l rep
orts
of
DoH
SH
ealth
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
75
Key
acti
viti
esU
nit
Situ
atio
n in
20
17Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
ors
2018
2019
2020
2021
2022
OU
TPU
T 3
Enab
ling
envi
ronm
ent a
ctiv
itie
s
Out
put 3
.1:
MSN
P in
clud
ed in
loca
l, pr
ovin
cial
and
fede
ral g
over
nmen
t’s p
olic
ies
and
plan
s.3.
1.1
Inco
rpor
ate
MSN
P-II
in fe
dera
l pla
ns a
nd
polic
esSe
ctor
al
polic
ies
and
plan
s
NPC
, Sec
tors
a) D
evel
op a
nd u
pdat
e se
ctor
al p
olic
ies,
long
-te
rm p
lans
and
str
ateg
ies
at fe
dera
l lev
el
Min
istr
y7
77
77
7Se
ctor
al
polic
ies
and
plan
s
NPC
, Sec
tors
b) D
irect
ives
from
NPC
to s
ecto
rs a
t fed
eral
le
vel t
o in
corp
orat
e nu
triti
on s
peci
fic a
nd
sens
itive
act
iviti
es in
AW
PBs
in li
ne w
ith
MSN
P-II
Even
t 1
11
11
1D
irect
ives
NPC
c) E
nsur
e nu
triti
on s
peci
fic a
nd s
ensi
tive
activ
ities
are
inco
rpor
ated
in a
nnua
l wor
k pl
ans
and
budg
ets
of a
ll se
ctor
s at
fede
ral l
evel
in
line
with
MSN
P-II
Min
istr
y 7
77
77
7AW
PBs
of
sect
ors
NPC
3.1.
2 In
corp
orat
e M
SNP-
II in
pro
vinc
ial l
evel
pl
ans
and
polic
ies
a) A
dvoc
acy
wor
ksho
p on
MSN
P-II
in a
ll pr
ovin
ces
Even
tN
A7
77
77
Wor
ksho
p Re
port
sN
PC
b) S
end
circ
ular
to a
ll pr
ovin
cial
gov
ernm
ents
to
inco
rpor
ate
nutr
ition
in th
eir r
elev
ant
polic
ies,
long
-ter
m p
lans
and
str
ateg
ies
in li
ne
with
MSN
P
Even
tN
A1
11
11
Polic
es a
nd
plan
s of
pr
ovin
ces
NPC
, Loc
al
Gov
erna
nce,
Fi
nanc
e
c) C
oord
inat
e an
d fa
cilit
ate
with
loca
l go
vern
men
t sec
tor a
t fed
eral
leve
l (M
oFA
LD)
to d
evel
op M
SNP-
II po
licy,
long
-ter
m p
lan
and
stra
tegy
at l
ocal
leve
ls
Even
tN
A2
22
22
Coor
dina
tion
mee
tings
N
PC
3.1.
3 In
corp
orat
e M
SNP-
II in
loca
l gov
ernm
ent
plan
s an
d pl
anni
ng p
roce
sses
Loca
l go
vern
men
ts28
dis
tric
ts
(194
loca
l go
vern
men
ts)
203
299
323
347
372
AWPB
s of
loca
l go
vern
men
tsLo
cal
Gov
erna
nce
sect
or
3.1.
4 O
rgan
ize
join
t ann
ual r
evie
w m
eetin
gs
amon
g M
SNP-
II se
ctor
min
istr
ies
at fe
dera
l lev
elEv
ent
01
11
11
Repo
rts
of re
view
m
eetin
g
NPC
3.1.
5 Ad
voca
cy m
eetin
gs fo
r inc
reas
ing
nutr
ition
bu
dget
(at l
east
3.5
% o
f tot
al) a
t fed
eral
and
pr
ovin
ce le
vels
a) A
dvoc
acy
mee
tings
with
par
liam
enta
rian
at
fede
ral a
nd p
rovi
nce
leve
lsEv
ent
08
88
88
Mee
ting
repo
rts
NPC
, sec
tors
b) A
dvoc
acy
mee
tings
with
min
istr
y of
fin
ance
at f
eder
al a
nd p
rovi
nce
leve
lsEv
ent
02
22
22
Mee
ting
repo
rts
NPC
, sec
tors
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
76
Key
acti
viti
esU
nit
Situ
atio
n in
20
17Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
ors
2018
2019
2020
2021
2022
c) A
dvoc
acy
mee
tings
with
gro
ups,
educ
atio
nal i
nstit
utes
, priv
ate
sect
or a
nd
indu
strie
s
Even
t 0
22
22
2M
eetin
g re
port
sN
PC
d) A
dvoc
acy
mee
tings
with
civ
il so
ciet
y or
gani
zatio
ns a
nd N
GO
s Ev
ent
12
22
22
Mee
ting
repo
rts
NPC
3.1.
6 D
evel
op n
utrit
ion
budg
et c
ode
Even
t 0
1-
--
-Re
d bo
okN
PC, M
oF
Out
put 3
.2: M
SNP
gove
rnan
ce m
echa
nism
str
engt
hene
d at
fede
ral,
prov
inci
al a
nd lo
cal l
evel
3.2.
1 O
rgan
ise
Hig
h Le
vel N
utrit
ion
and
Food
Se
curit
y St
eerin
g Co
mm
ittee
(HLN
FSS)
mee
tings
tw
ice
a ye
ar
Even
t 2
22
22
2M
eetin
g m
inut
esN
PC
3.2.
2 O
rgan
ise
Nat
iona
l Nut
ritio
n an
d Fo
od
Secu
rity
Coor
dina
tion
Com
mitt
ee m
eetin
gs
quar
terly
Even
t 4
44
44
4M
eetin
g m
inut
esN
PC
3.2.
3 Se
nd c
ircul
ar a
nd fa
cilit
ate
form
atio
n of
nu
triti
on a
nd fo
od s
ecur
ity s
teer
ing
com
mitt
ee
in p
rovi
nces
Even
t N
A7
--
--
Mee
ting
min
utes
NPC
3.2.
4 Fo
rm n
utrit
ion
and
food
sec
urity
ste
erin
g co
mm
ittee
s at
pro
vinc
e le
vel
Prov
ince
N
A7
--
--
Mee
ting
min
utes
NPC
, Loc
al
Gov
erna
nce
3.2.
5 O
rgan
ise
nutr
ition
and
food
sec
urity
st
eerin
g co
mm
ittee
mee
tings
twic
e a
year
at
prov
ince
leve
l
Even
t N
A14
1414
1414
Mee
ting
min
utes
NPC
, Loc
al
Gov
erna
nce
3.2.
8 A
ppoi
nt n
utrit
ion
foca
l per
sons
for a
ll se
ctor
al m
inis
trie
s at
pro
vinc
e le
vel
Prov
ince
NA
7-
--
-D
ecis
ion
lett
ers
Loca
l G
over
nanc
e
3.2.
9 O
rgan
ise
them
atic
tech
nica
l wor
king
gr
oup
(TW
G) m
eetin
gs a
t fed
eral
leve
l qua
rter
ly.
Them
atic
gro
ups:
a)
Cap
acity
Bui
ldin
gb)
Adv
ocac
y an
d co
mm
unic
atio
nc)
M&
E
Even
t 3
TWG
s12
1212
1212
Mee
ting
min
utes
NPC
3.2.
10 F
orm
nut
ritio
n an
d fo
od s
teer
ing
com
mitt
ees
at lo
cal g
over
nmen
ts le
vel a
nd
mee
t reg
ular
ly
Loca
l go
vern
men
ts30
dis
tric
t 20
3 29
932
334
7 37
2Re
port
s fr
om lo
cal
gove
rnm
ents
Loca
l G
over
nanc
e
3.2.
11 F
orm
nut
ritio
n an
d fo
od s
teer
ing
com
mitt
ee a
nd re
gula
r mee
tings
at w
ard
leve
l in
MSN
P lo
cal g
over
nmen
ts
War
dsVD
C le
vel
091
413
5014
5016
00Re
port
fr
om lo
cal
gove
rnm
ents
Loca
l G
over
nanc
e
3.2.
12 F
acili
tate
to a
ssig
n co
ordi
nato
rs (e
xist
ing
staff
or o
utso
urce
d) a
t loc
al g
over
nmen
ts to
ov
erse
e M
SNP-
II in
terv
entio
ns
Loca
l go
vern
men
ts30
dis
tric
t20
3 29
9 32
3 34
7 37
2 Re
port
s fr
om lo
cal
gove
rnm
ents
Loca
l G
over
nanc
e
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
77
Key
acti
viti
esU
nit
Situ
atio
n in
20
17Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
ors
2018
2019
2020
2021
2022
Out
put 3
.3 M
SNP
inst
itut
iona
l mec
hani
sms
func
tion
al a
t fed
eral
gov
ernm
ent l
evel
3.3.
1 St
reng
then
Nat
iona
l Nut
ritio
n an
d Fo
od
Secu
rity
Secr
etar
iat a
t NPC
Ev
ent
11
11
11
NN
FSS
NPC
3.3.
2 Ca
rry
out o
rgan
izat
ion
and
man
agem
ent
surv
ey o
n in
clud
ing
NN
FSS
with
in N
PC
Even
t0
1O
&M
sur
vey
repo
rt
NPC
3.3.
3 Fa
cilit
ate
endo
rsem
ent o
f the
O&
M s
urve
y re
port
Even
t0
1N
PC
orga
nogr
am
NPC
3.3.
4 Re
crui
t sta
ff fo
r NFS
S as
per
app
rove
d or
gano
gram
Even
t0
01
11
1A
nnua
l rep
orts
NPC
Out
put 3
.4: F
unct
iona
l upd
ated
info
rmat
ion
syst
em a
cros
s th
e se
ctor
s.3.
4.1
Upd
ate
MSN
P in
form
atio
n po
rtal
and
mak
e it
func
tiona
lEv
ent
11
11
11
Acce
ss to
up
date
d M
SNP
port
al
NPC
3.4.
2 Li
nk a
nd u
pdat
e nu
triti
on in
form
atio
n at
ce
ntra
l lev
el (H
MIS
, EM
IS, W
ASH
, agr
icul
ture
, liv
esto
ck a
nd lo
cal g
over
nanc
e)
Even
t1
11
11
1Li
nkag
e of
nu
triti
on
info
rmat
ion
with
all
sect
ors
NPC
All
sect
ors
3.4.
3 Pr
ovid
e tr
aini
ng o
n w
eb-b
ased
MSN
P re
port
ing
syst
em a
t fed
eral
and
pro
vinc
e le
vel
Even
t0
-1
-U
se o
f web
-ba
sed
MSN
P re
port
ing
syst
em
NPC
3.4.
4 D
ocum
ent a
nd d
isse
min
ate
good
pr
actic
es, l
esso
ns le
arne
d an
d ca
se s
tudi
esEv
ent
11
11
11
Repo
rtLo
cal
Gov
erna
nce
3.4.
5 D
evel
op a
nd re
view
mon
itorin
g an
d ev
alua
tion
fram
ewor
k fo
r all
MSN
P se
ctor
s at
fe
dera
l lev
el
Even
t1
11
11
1M
SNP-
II M
&E
fram
ewor
kN
PC, s
ecto
rs
3.4.
6 D
evel
op a
nd re
view
mon
itorin
g an
d ev
alua
tion
fram
ewor
k fo
r all
MSN
P se
ctor
s at
pr
ovin
ce le
vel
Prov
ince
N
A7
77
77
MSN
P-II
M&
E fr
amew
ork
NPC
, sec
tors
3.4.
7 D
evel
op m
onito
ring
and
eval
uatio
n fr
amew
ork
for a
ll M
SNP
sect
ors
at lo
cal l
evel
Loca
l go
vern
men
ts30
dis
tric
ts20
329
932
334
737
2M
SNP-
II M
&E
fram
ewor
kN
PC, l
ocal
go
vern
ance
, se
ctor
s
Out
put 3
.5:
Enha
nced
cap
acit
y of
fede
ral,
prov
ince
and
loca
l lev
el g
over
nmen
t to
plan
and
impl
emen
t nut
riti
on p
rogr
am3.
5.1
Dev
elop
nat
iona
l cap
acity
bui
ldin
g m
aste
r pl
an fo
r MSN
P-II
Even
t0
1-
--
-Ca
paci
ty
deve
lopm
ent
mas
ter p
lan
docu
men
t
NPC
, Sec
tors
3.5.
2 Im
plem
ent c
apac
ity d
evel
opm
ent m
aste
r pl
an a
t all
leve
ls.
a) D
evel
op tr
aini
ng p
acka
ge
Even
t0
1-
--
-Tr
aini
ng
pack
age
NPC
, sec
tors
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
78
Key
acti
viti
esU
nit
Situ
atio
n in
20
17Ta
rget
sM
eans
of
veri
ficat
ion
Resp
onsi
ble
sect
ors
2018
2019
2020
2021
2022
b) C
ondu
ct m
aste
r tra
inin
g of
trai
ners
(MTo
T)
on M
SNP-
IIEv
ent
11
11
1M
ToT
repo
rt
NPC
3.5.
2 (c
ontin
ued)
: Cap
acity
dev
elop
men
t mea
sure
s fr
om s
ecto
rs
Agr
icul
ture
and
Liv
esto
ck D
evel
opm
ent
Capa
city
dev
elop
men
t tra
inin
g, in
tera
ctio
ns,
expo
sure
vis
its:
a) C
entr
al le
vel —
10
pers
ons
b) P
rovi
ncia
l lev
el —
35
pers
ons
c) L
ocal
leve
l — 1
,488
(agr
icul
ture
and
liv
esto
ck s
ecto
r hum
an re
sour
ces)
Pers
onN
A1,
523
-1,
523
-1,
523
Trai
ning
re
port
sAg
ricul
ture
an
d Li
vest
ock
Sect
or
d) C
ondu
ct tr
aini
ng a
nd d
emon
stra
tions
on
impr
oved
reci
pes
Even
tN
A7
77
77
Trai
ning
re
port
sAg
ricul
ture
an
d Li
vest
ock
Sect
or
e) E
stab
lish
and
stre
ngth
en fo
od p
roce
ssin
g,
food
saf
ety
and
nutr
ition
regu
latio
n an
d ex
tens
ion
serv
ices
at l
ocal
leve
l
Loca
l go
vern
men
tsN
A75
375
375
375
375
3A
nnua
l rep
ort
of M
oAD
Agric
ultu
re
and
Live
stoc
k Se
ctor
Loca
l Gov
erna
nce
a) B
uild
cap
acity
for i
n-se
rvic
e nu
triti
on
spec
ific
and
nutr
ition
sen
sitiv
e tr
aini
ng to
nu
triti
on s
take
hold
ers
at fe
dera
l, pr
ovin
cial
, vi
llage
cou
ncil,
loca
l gov
ernm
ent a
nd
com
mun
ity le
vels
Loca
l go
vern
men
ts30
Dis
tric
ts1
fede
ral,
5 pr
ovin
ce,
203
Loca
l go
vern
men
ts
1 fe
dera
l, 5
prov
ince
, 29
9 Lo
cal
gove
rnm
ents
1 fe
dera
l, 7
prov
ince
, 32
3 Lo
cal
gove
rnm
ents
1 fe
dera
l, 7
prov
ince
, 34
7 Lo
cal
gove
rnm
ents
1 fe
dera
l, 7
prov
ince
, 37
2 Lo
cal
gove
rnm
ents
Perio
dic
repo
rt o
f loc
al
gove
rnm
ents
Loca
l G
over
nanc
e
b) D
evel
op in
tegr
ated
pac
kage
for G
olde
n 10
00
days
hou
seho
lds
— o
rient
atio
n, tr
aini
ngEv
ent
NA
1N
PC, L
ocal
G
over
nanc
e
c) S
ensi
tize
stak
ehol
ders
on
MSN
P-II
Pers
onN
/A4,
500
8,97
09,
780
10,5
0011
,400
Perio
dic
repo
rts
of lo
cal
gove
rnm
ents
Loca
l G
over
nanc
e
NPC a)
Pre
pare
MSN
P-II
capa
city
dev
elop
men
t pla
nEv
ent
01
--
--
Capa
city
de
velo
pmen
t m
aste
r pla
n
NPC
, sec
tors
b) P
repa
re a
dvoc
acy
and
com
mun
icat
ion
stra
tegy
Even
t1
1St
rate
gy
docu
men
tSe
ctor
s
c) T
rain
M&
E fo
cal p
erso
n on
info
rmat
ion
syst
emEv
ent
11
11
1Tr
aini
ng
Repo
rtN
PC
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
7979
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
8080
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
81
MSNP (2013–17) Related Programmes and Projects Supported by Development Partners
ANNEX 2:
Nepal’s development partners implemented the following programmes and projects under MSNP (2013–17) with some of them carrying on into the MSNP-II period:
Period Project Description
October 2012 to March 2017
Sunaula Hazar Din (Golden Thousand Days)
This project was funded by the World Bank and implemented by the Ministry of Federal Affairs and Local Development (MoFALD). Programmes were conducted in 15 districts to prevent malnutrition in the crucial first 1,000 days from conception until children’s second birthday (= 270 days + 365 days + 365 days = 1,000 days).
2011 to 2016 (Suaahara-1)
2016 to 2021 (Suaahara-2)
Suaahara Project This integrated nutrition programme is implemented with USAID funding in partnership with stakeholders to improve the nutritional status of women and children in 40 districts. The project is a major initiative under MSNP (2013–17) and MSNP-II. The second phase is being rolled out in coordination with the National Planning Commission and relevant federal ministries; and will be rolled out in coordination with provincial planning units, provincial ministries and local governments once they are established. Its activities address the first thousand days from conception to two years of age focussing on infants and women and adolescent girls as the people mainly responsible for caring for infants. It integrates health, nutrition, WASH, agriculture and food security activities.
2013 to 2018 Agriculture and Food Security Project
This World Bank funded project is being implemented by the Ministry of Agricultural Development and the Ministry of Livestock Development in coordination with the Ministry of Health in 18 districts. It aims to improve the nutritional status and food security of targeted groups by increasing the productivity of agriculture and livestock production and improving the availability of and access to nutritional food and nutrition-related behaviour.
2013 to 2016 KISAN: Knowledge-based Integrated Sustainable Agriculture and Nutrition
The KISAN project was implemented by the ministries of agricultural and livestock development and the health ministry with funding from USAID. It ran in 16 districts of the Mid-West and Far Western regions –the areas most severely affected by food insecurity, hunger and inadequate nutrition. The project improved food security and increased incomes through integrated agriculture activities and was implemented as part of USAID’s Feed the Future initiative.
2014–2019 SABAL: Sustainable Action for Resilience and Food Security
This project is being implemented in 11 hill and mountain districts of the eastern and central regions with support from USAID. It is being implemented by the Ministry of Agricultural Development, the Ministry of Federal Affairs and Local Development, the Ministry of Health and local NGO partners.
2016–2019 Partnership for Improved Nutrition (Poshan Ko Laagi Haatemalo)
With financial aid from the European Union channelled via UNICEF, and additional funding from UNICEF, this project is conducting nutrition specific programmes through the Ministry of Health and nutrition sensitive programmes through MoFALD in 28 districts in coordination with relevant ministries following MSNP (2013–17) guidelines.
2014-2017 Food for Education Supported by the World Food Programme and implemented by the Ministry of Education, this programme is improving the nutritional status of students in 10 hill and mountain districts of Far Western and Mid-Western Nepal. It aims to bring quantitative and qualitative improvements in primary education, increase school admission rates for girls, and achieve sustainable improvements in the food security of marginalized community, especially women and children.
2013–2016 Multi-partner Trust Fund
Nepal received a Multi-partner Trust Fund grant from the SUN Movement Secretariat to expand the availability of nutrition-related services. The Civil Society Alliance of Nepal allocated funds to its members to run advocacy and capacity building activities that facilitated the implementation of MSNP (2013–17).
2013–2016 REACH:Renewed Efforts Against Child Hunger and Undernutrition
The REACH project helped establish the National Nutrition and Food Security Secretariat in the initial phase of MSNP (2013–17) to coordinate capacity building at central and district levels. This project has also helped to manage information related to nutrition and food security by developing the Nepal Nutrition and Food Security Portal.
81
82
September 2012 Kathmandu Declaration of Commitments
For an accelerated improvement in maternal and child nutrition in Nepal
ANNEX 3:
We, the Nepal Government, UN agencies, de-velopment partners and members of civil soci-ety and the private sector, meeting today, the 17 September 2012, in the National Nutrition and Food Security Coordination Meeting, whose ob-jective is to achieve a national consensus on the scaling up of the multi-sector action plan for the reduction of chronic malnutrition in Nepal,
Recognizing that chronic malnutrition is the main problem affecting the nutrition of Nepali children especially during the first 1,000 days of life (from conception up to two year of age) and that its reso-lution requires a multi-sector approach,
Concerned that malnutrition is responsible for more than a third of child mortality, and for derailing socio-economic development of the af-fected families, communities, and ultimately the country, and impacting negatively on achieve-ment of the all the Millennium Development Goals,
Recalling and reaffirming the commitment dur-ing the World Food Summit, held in Rome in 1996, to reduce the number of undernourished people by 50 per cent by the year 2015,
Recognizing that poverty reduction is a Gov-ernment priority and that there is a strong link between poverty reduction, food insecurity and nutrition and chronic malnutrition,
Taking into account the opportunities that pres-ent themselves, notably: the national political engagement, cost effective interventions based on scientific evidence, global initiatives on Scal-ing Up of Nutrition (SUN) and Renewed Ef-forts Against Child Hunger and Under-nutrition (REACH), with Nepal having made commit-ment to be an ‘early riser’ SUN country under the leadership of His Excellency the Prime Minister of
Nepal as a member of the SUN Lead Group, and to introduce REACH in the country with the in-volvement of national and international partners,
Recognizing that the right to adequate food and nutrition is a fundamental human right,
We commit ourselves and strive to:• Contribute to the implementation of actions
defined in multi-sector nutrition plan of ac-tion for the improvement of maternal and child nutrition and the reduction of chronic malnutrition;
• Develop advocacy, communication, and social mobilization actions to raise awareness of the various sectors and the general public, about the significant problem of chronic malnutri-tion and actions needed to improve maternal and child nutrition, accessible to everyone, especially during the first 1,000 days of life, ensuring equity, and facilitating access to in-formation, to promoting behaviour change, with a focus to reach the most marginalized, poorest segments of the population, and tak-ing into account gender related factors;
• Strengthen the institutional, organization and human resource capacity for the implementa-tion of the plan at all levels and in different sectors linked to nutrition;
• Support the inter-sector coordination body at all the key levels (national, district, and VDC) in all its dimension so that through functional coordination mechanisms are implemented and effective action to improve the nutri-tional status of women and children, ensuring complementarity and strengthening synergies between the different actors;
• Enhance the multi-sector nutrition informa-tion, knowledge management, surveillance systems, monitoring and evaluation of prog-
Commitments For implementing MSNP
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
83
______________________________Mr. Deependra Bahadur Kshetry
Hon. Vice Chair, National Planning Commission
______________________________Mr. Krishna Hari BaskotaSecretary, Ministry of Finance
______________________________Mr. Balananda PaudelSecretary, Ministry of Women, Children, & Social Welfare
______________________________Mr. Suresh Man ShresthaSecretary, Ministry of Education
______________________________Dr. Praveen MishraSecretary, Ministry of Health and Population
______________________________Ms. Hanaa Singer, Representative UNICEFOn Behalf of UN REACH Partners (FAO, UNICEF, WFP, WHO)
______________________________Mr. Suraj VaidyaChair, Federation of Nepalese Chambers of Commerce and Industries (FNCCI)
______________________________Prof. Dr. Shiba Kumar RaiHon. Member, National Planning Commission, Country SUN Focal Point - Nepal
______________________________Dr. Ganesh Raj JoshiSecretary, Ministry of Agriculture Development
______________________________Mr. Kishor ThapaSecretary, Ministry of Urban Development
______________________________Mr. Sheetal Babu RegmiSecretary, Ministry of Federal Affairs and Local Development
______________________________Mr. Robert PiperUN Resident Coordinator
______________________________Dr. Lin Aung, WHO Representative Chair, External Development Partners-Health
______________________________Mr. Deepak Raj Sapkota, Country Director, Karuna FoundationAs a Chair, Association of International NGOs in Nepal
ress with links to existing early warning sys-tems; and
• Mobilize support nationally and internation-ally to ensure the large-scale implementation of interventions and nutrition programs to address both the immediate, underlying and basic social and economic determinants of maternal and under-nutrition.
We, the Nepal Government, UN agencies, de-velopment partners and members of civil society and the private sector, by this we approve the contents of this “Declaration of Commitment for an Accelerated Improvement in Maternal and Child Nutrition in Nepal.”
Kathmandu, September 2012
(For)
(For)
(For)
(AI)
(For)
(For)
84
CONTRiBUTORS TO MULTiSECTOR NUTRiTiON PLaN-ii (2018-2022)
ANNEX 4:
Officials from Government of NepalS.N. Name Position Organization/ Institute
1 Dr. Min Bahadur Shrestha Hon’ble Vice- Chair National Planning Commission, Singhadurbar2 Dr. Swarnim Wagle Hon’ble Vice- Chair National Planning Commission, Singhadurbar3 Dr. Usha Jha Hon’ble Member National Planning Commission, Singhadurbar4 Mr. Min Bahadur Shahi Hon’ble Member National Planning Commission, Singhadurbar5 Prof. Dr. Geeta Bhakta Joshi Hon’ble Member National Planning Commission, Singhadurbar6 Prof. Dr. Ramesh Kant
AdhikariExpert Member, High Level Nutrition and Food Security Steering Committee
National Planning Commission, Singhadurbar/KIST
7 Prof. Dr. Madhu Dixit Devkota
Expert Member, High Level Nutrition and Food Security Steering Committee
National Planning Commission, Singhadurbar/IOM
8 Mr. Chandra Kumar Ghimire Member Secretary National Planning Commission, Singhadurbar9 Mr. Madhu Kumar Marasini Joint Secretary National Planning Commission, Singhadurbar10 Mr. Radhakrishna Pradhan Joint Secretary National Planning Commission, Singhadurbar11 Mr. Khomraj Koirala Joint Secretary National Planning Commission, Singhadurbar12 Dr. Tritharaj Dhakal Joint Secretary National Planning Commission, Singhadurbar13 Mr. Biju Kumar Shrestha Joint Secretary National Planning Commission, Singhadurbar14 Dr. Kiran Rupakhetee Programme Director National Planning Commission, Singhadurbar15 Mr. Prakash Prasad Kharel Programme Director National Planning Commission, Singhadurbar16 Ms. Lila Kumari KC Programme Director National Planning Commission, Singhadurbar17 Mr. Mahesh Kharel Programme Director National Planning Commission, Singhadurbar18 Mr. Krishna Murari Neupane Programme Director National Planning Commission, Singhadurbar19 Ms. Sita Devi Thapa Planning Officer National Planning Commission, Singhadurbar20 Mr. Chudamani Aryal Planning Officer National Planning Commission, Singhadurbar21 Ms. Sushila Kumari Panth Planning Officer National Planning Commission, Singhadurbar22 Ms. Gita Ghimire Planning Officer National Planning Commission, Singhadurbar23 Ms. Bandana Kumari KC Planning Officer National Planning Commission, Singhadurbar24 Mr. Purushottam Nepal Joint Secretary MoFALD25 Mr. Kedarnath Sharma Joint Secretary MoFALD26 Mr. Bijaya Raj Subedi Under Secretary MoFALD27 Mr. Dila Ram Panthi Under Secretary MoFALD28 Mr. Janak Raj Sharma Section Officer MoFALD29 Mr. Dhananjaya Poudyal Nutrition Expert MoFALD/G1000D30 Mr. Manoj Pant M & E Officer MoFALD31 Dr. Khem Pokharel MSNP Coordinator MoFALD//HERD32 Mr. Indra Bhujel Information Manager MoFALD/HERD33 Mr. Mahendra Prasad Shrestha Chief, PPICD Ministry of Health and Population34 Dr. Bikash Lamichhane Director Child Health Division, DoHS, MoHP35 Ms. Yashoda Aryal PHA, PPICD Ministry of Health and Population36 Mr. Giri Raj Subedi Chief, Nutrition Section Child Health Division, DoHS, MoHP37 Mr. Raj Kumar Pokharel Chief, Nutrition Section Child Health Division, DoHS, MoHP
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
85
38 Mr. Kapil Timalsena Chief, Planning Section Child Health Division, DoHS, MoHP39 Mr. Sharad Kumar Sr.Demo-Graph Family Health Division, DoHS, MoHP40 Mr. Harihar Sharma Sr Public Health Officer CHD, MoHP41 Ms. Basundhara Sharma PHO Child Health Division, DoHS, MoHP42 Mr. Shanker Pandey Sr. AHWO Child Health Division, DoHS, MoHP43 Mr. Uttam Acharaya Technical Coordinator-
NUTECChild Health Division, DoHS, MoHP
44 Mr. Mahesh Karki L.V.D. NHEICC, Ministry of Health and Population45 Dr. Rashmina Manandhar MO NHEICC, Ministry of Health and Population46 Mr. Kunja Prasad Joshi HEA NHEICC, Ministry of Health and Population47 Ms. Rajani Gyawali Technical Coordinator-
NUTECChild Health Division, DoHS, MoHP
48 Mr. Chetnath Sharma Deputy Director General Department of Education, Ministry of Education49 Mr. Bedahari Dahal Deputy Director Department of Education, Ministry of Education50 Mr. Bishnu Bhandari Deputy Director Food for Education, Ministry of Education51 Mr. Chetnath Aryal Deputy Director Department of Education, Ministry of Education52 Mr. Khem Nanda Bhushal Deputy Director Department of Education, Ministry of Education53 Mr. Narendra Raj Paudel Under Secretary Ministry of Education54 Mr. Nava Raj Khatiwada Under Secretary Ministry of Education55 Mr. Anil Sharma Mishra Under Secretary Ministry of Education56 Mr. Karan Bdr. Bhuwagi Under Secretary Ministry of Education57 Mr Sunil K. Das Deputy Director General Department of Water Supply & Sanitation58 Mr. Hari Prasad Timilsina SDE Ministry of Water Supply & Sanitation59 Mr. Shekhar Khanal Engineer Ministry of Water Supply & Sanitation60 Ms. Sushma Kafle Engineer Ministry of Water Supply & Sanitation61 Mr. Kamal Adhikari Sociologist Department of Water Supply & Sanitation62 Ms. Bishwa Maya Neupane WDO Ministry of Women, Children and Social Welfare63 Ms. Shobha Kharel Women Development
OfficerMinistry of Women, Children and Social Welfare
64 Ms. Sabriti Poudel Section Officer Dept. of Women and Childern, MoWCSW65 Dr. Y.K. Karki Joint Secretary Ministry of Agriculture Development66 Dr. Sita Ram Aryal Director NARC, Ministry of Agriculture Development67 Ms. Jyotsna Shrestha Food Research Officer Ministry of Agriculture Development68 Mr. Kalash Ram Chaudhary Sr.Agri Economist Ministry of Agriculture Development69 Mr. Jeevan Acharaya Hrt. Dev Officer Department of Agriculture Development70 Mr. Santosh Kr. Singh Fisheries Dev. Officer Department of Agriculture Development71 Mr. Kishor Bista Sr. Agri. Economist Department of Agriculture Development72 Mr. Ram Krishna Regmi Statistcian Ministry of Agriculture Development73 Mr. Kalash Ram Chaudhary Sr. Agri. Economist Ministry of Agriculture Development74 Mr. Shiva Sundar Ghimire Sr.Agri Economist Department of Agriculture, Food Security Nutrition
Section75 Mr. Dinesh Bhattarai S.S.O Ministry of Agriculture Development76 Mr. Purna Chandra Wasti Sr.Food Researcher Officer
(SFRO)DFTQC, Ministry of Agriculture
77 Dr. K.P Premy Joint Secretary Ministry of Livestock Development78 Dr. Barun k . Sharma Senior VET Officer Ministry of Livestock Development79 Dr. Pradeep Bhattarai Sr. Live Stock Dev. Officer Ministry of Livestock Development80 Mr. Rajeev Kumar Agri. Economist Ministry of Livestock Development81 Mr. Jay Mangal Prasad SFO Ministry of Livestock Development82 Dr. Tej Bahadur Rijal SLDO Dept of Livestock, Ministry of Livestock
Development83 Mr. Atmaram Pandey Former Secretary GoN84 Ms. Savita Malla Advocacy & Communication
SpecialistNNFSS/NPC/UNICEF
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
86
85 Mr. Bishnu Paudel Program and Policy Specialist NNFSS/NPC/Suaahara86 Mr. Min Raj Gyawali Nutrition Advisior NNFSS/NPC/UNICEF87 Ms. Rohita Gauchan Thakali M & E Officer NNFSS/NPC/UNICEF88 Ms. Manu Panthi Nutrition Officer NNFSS/NPC/UNICEF89 Ms. Shikha Basnet M & E and Documentation
ConsultantNNFSS/NPC/UNICEF
90 Mr. Sagar Shrestha Adim & Finance NNFSS/NPC/UNICEF
Contributors from Development PartnersS.N. Name Position Organization/ Institute
1 H.E. Rensje Teerink Ambassador/Head of Delegation
Delegation of the EU to Nepal
2 Mr. Andreas Roettger Head of the Programs Delegation of the EU to Nepal3 Mr. Robert Hynderick Program Manager Delegation of the EU to Nepal4 Mr. Mim Hamal Program Manager Delegation of the EU to Nepal5 Mr. Tomoo Hozumi Country Representative UNICEF Nepal6 Mr. Stanley Chitekwe Chief, Nutrition Section UNICEF Nepal7 Mr. Pradiumna Dahal Nutrition Specialist UNICEF Nepal8 Mr. Anirudra Sharma Nutrition Specialist UNICEF Nepal9 Mr. Gyan Bahadur Bhujel Nutrition Officer UNICEF Nepal10 Mr. Sanjay Rijal M&E Officer UNICEF Nepal11 Mr. Naveen Paudyal Nutrition Officer UNICEF Nepal12 Mr. Mukunda Nepal Communication Officer UNICEF Nepal13 Mr. Yadav KC Information Management
OfficerUNICEF Nepal
14 Mr. Phulgendra Singh Nutrition Officer UNICEF Nepal15 Mr. Rudra Khadka Nurtition Officer UNICEF Nepal16 Mr. Prakash Chandra Joshi Nutrition Officer UNICEF Nepal17 Ms. Meena Thapa H & N Officer UNICEF Nepal18 Ms. Alisha Pradhan Consultant UNICEF Nepal19 Mr. Babu Ram Acharaya Nutrition Officer UNICEF Nepal20 Mr. Binod Nepal Program Associate UNICEF Nepal21 Ms. Dibya Manadhar Consultant CHD, DOHS/UNICEF Nepal22 Dr. Rajendra Kumar BC Consultant CHD, DOHS/UNICEF Nepal23 Ms. Pragya Rimal Consultant CHD, DOHS/UNICEF Nepal24 Mr. Sher Singh Dahit IMAM Officer CHD, DOHS/UNICEF Nepal25 Ms. Sophiya Uprety Nutrition Officer UNICEF Nepal26 Ms. Sumi Maskey Nutrition Officer UNICEF Nepal27 Ms. Chahana Singh Rana Programme Officer UNICEF Nepal28 Mr. Chandan Deo IMO UNICEF Nepal29 Mr. Dipu Shakya ECD Specialist UNICEF Nepal30 Mr. Ernest Lecomte Intern UNICEF Nepal31 Mr. Kapil Ghimire Consultant UNICEF Nepal32 Mr. Lokendra Shansher Thapa Logistic Officer UNICEF Nepal33 Mr. Siddhi Shrestha WASH Specialist UNICEF Nepal34 Ms. Satya Tamatta Progs. Assistance UNICEF Nepal35 Ms. Sanju Bhattarai C4D UNICEF Nepal36 Mr. Sudip Pokharel Consultant UNICEF Nepal37 Mr. Ram Thapa Budget Asst. UNICEF Nepal38 Ms. Shanda Steimer Director USAID39 Mr. Debendra Adhikari Nutrition Specialist USAID40 Dr. Shilu Adhikari MNCH Advisor USAID41 Dr. Manav Bhattarai Health Specialist World Bank
M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )
87
42 Ms. Pooja Pandey Rana Deputy Chief of Party Suahaara II43 Ms. Bishow Raman Neupane Sr. Manager Suahaara II44 Mr. Harendra Chand M& E Co-ordinator Suahaara II45 Ms. Bhim Kumari Pun Sr. Program Manager Suahaara II46 Ms. Anita Shah Sr. Coordinator Suahaara II47 Mr. Bishnu Pd. Dulal Data Analysis Suahaara II48 Dr. Lonim Dixit National Professional Officer WHO49 Mr. Paridhi Pathak Programme Associate FAO50 Mr. Shrawan Adhikari Food Security Officer FAO51 Mr. Tej Bahadur Subedi Programme Director AFSP/FAO52 Mr. Kul Dip Ghimire Sr. Planning Officer AFSP/FAO53 Mr. Amrit Gurung Sr. Program Associate for
NutritionWFP
54 Ms. Mamta Gurung Head of Education WFP55 Mr. Puspa Shrestha NekSAP WFP56 Mr. Richard Nwandetar Nutrition WFP57 Mr.Nhukesh Maharjan Programme Associate WFP58 Mr. Umesh Chaudhary Programme Policy WFP59 Ms. Naomi Saville Nutrition Advisior WFP60 Mr. Chandra Br. Thapa VAM Officer WFP61 Mr. Sujay N Bhattacharaya Head Nutrition and Health ACF62 Mr. Deepak Paudel HoD Save the Children63 Ms. Nira Sharma Program Manager Save the Children64 Dr. Jaganath Sharma Sr. Tech. Manager Health &
NutritionSABAL Program
65 Mr. Jeeban Ghimire Sr. Programme Coordinator SABAL Program66 Mr. Santosh Ghimire Sr. Manager SABAL Program67 Mr. Govinda Acharaya Goverance &Coordination
AdvisorPAHAL Program
68 Mr. Buddhi Devkota Quality Control Officer Pahal/ NTAG69 Ms. Shanti Upadhyaya Nutrition Specialist Pahal/ Plan Nepal70 Ms. Richa Uprety Communication Specialist Care Nepal71 Ms. Asha Basnyet Deputy Country Director Helen Keller International72 Ms. Dale Davis Country Director Helen Keller International73 Mr. Madhukar Shrestha Consultant Helen Keller International74 Ms. Sabina Hora IEC & Nutrition Specialist Helen Keller International75 Dr. Sushil Baral Managing Director HERD International76 Hom Nath Subedi Sr. Programme Manager HERD77 Ms. Shophika Regmi Programme Manager HERD International78 Mr. Deepak Joshi Sr.RM &E Officer HERD 79 Mr. Alok Shrestha National Facilitator HELVETAS80 Mr. Sunil Shrestha Board Member CSANN81 Ms. Prativa AC Communication Officer CSANN82 Dr. Purushottam Mainali Nutrition Advisor KISAN83 Mr. Kuber Adhikari National Health Coordinator World Vision84 Mr. Pranab Rajbhandari Deputy Chief of Party HC385 Ms. Seema Luitel Programme Manger WHH Nepal86 Ms. Nira Joshi Research Officer New Era87 Prof. Dr. Uma Koirala Chairperson Civil Society Alliances for Nutrition 88 Dr. Marina Vaidya Shrestha Doctor Kathmandu Medical College
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Bakrania S. (2015). Urbanization and Urban Growth in Nepal. Governance and Social Development Resource Centre (GSDRC). Accessed November 2017 at http://www.gsdrc.org/wp-content/uploads/2015/11/HDQ1294.pdf
CBS (2011). Nepal - Nepal Living Standards Survey 2010-2011, NLSS Third. Kathmandu: Central Bureau of Statistics.
CBS (2015). Nepal Multiple Indicator Cluster Survey 2014, Final Report. Kathmandu: Central Bureau of Statistics and UNICEF Nepal.
CBS. (2011). National Population and Housing Census 2011 (National Report) (Vols. 01, NPHC 2011). Kathmandu, Nepal: Central Bureau of Statistics.
CHD (2004). National Nutrition Policy and Strategy, 2004. Kathmandu: Child Health Division, Department of health Services. Accessed 23 November 2017 at http://dohs.gov.np/wp-content/uploads/chd/Nutrition/Nutrition_Policy_and_Strategy_2004.pdf
CHD (2014). Strategy for Infant and Young Child Feeding: Nepal. Kathmandu: Child Health Division, Department of health Services. Accessed 23 November 2017 at https://www.humanitarianresponse.info/system/files/documents/files/iycf_strategy_final_draft_18th_sept_014_english.pdf
DoHS (2016). Annual Report of Department of Health Services: 2015/16. Kathmandu: Department of Health Services.
GoN (2015). The Constitution of Nepal. Kathmandu: Government of Nepal
GoN (2017). Local Government Operation Act, 2074 (2017). Katmandu: Government of Nepal.
HEART (2013). Nepal Health Sector Programme II (NHSP II) Mid-Term Review. Kathmandu: HEART.
IFPRI (2016). Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington DC: International Food Policy Research Institute.
MoAD (2015). Agriculture Development Strategy (ADS) 2015 to 2035. Kathmandu: Ministry of Agricultural Development
MoH, New ERA and ICF (2017). Nepal Demographic and Health Survey 2016. Kathmandu: Ministry of Health.
MoH, New ERA, NHSSP and ICF (2017). Nepal Health Facility Survey, 2015. Kathmandu: Ministry of Health, New ERA, Nepal Health Sector Support Programme and ICF.
MoH, New ERA and ORC Macro (2002). Nepal Demographic and Health Survey 2001. Calverton, Maryland, USA: Family Health Division, Ministry of Health; New ERA; and ORC Macro.
MoHP (2015b). Nepal Health Sector Strategy (NHSS) 2015-2020, 2015. Kathmandu: Ministry of Health and Population.
MoHP, New ERA and ICF (2012). Nepal Demographic and Health Survey 2011. Kathmandu: Ministry of Health and Population, New ERA, and ICF International.
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