1. DOH STRATEGIC DIRECTION: MALNUTRITION DR YOGAN PILLAY DEPARTMENT OF HEALTH 27 MARCH 2015

2. MALNUTRITION A GLOBAL CHALLENGE “...around the world, roughly half of all child deaths can be attributed to malnutrition, with 3.1 million young children dying every year from related causes. Another nearly 200 million are chronically malnourished and suffer from serious, often irreversible, physical and cognitive damage. And all of this is preventable ”. (World Food Program http://wfpusa.org/what-wfp-does/1000-days)

3. NOT ONLY A SOUTH AFRICAN ISSUE! "Focusing on nutrition means bringing partners together to invest in the future of mothers and children. We hope all Americans will join us in ensuring that for every child, the first 1,000 days mark the beginning of a life full of promise.“ Rick Leach, CEO World Food Program USA

4. Countries With High Burden of Malnutrition 4 These 34 countries account for 90% of the global burden of malnutrition

7. WHAT NEEDS TO BE DONE? Save the Children has high lighted six low-cost nutrition interventions which if scaled up globally could prevent more than 2 million mother and child deaths each year. The lifesaving six are: – iron folate, breastfeeding – complementary feeding, vitamin A, zinc and hygiene Nearly 1 million lives could be saved by breastfeeding alone. This package can be delivered at a cost of less than $20 per child for the first 1,000 days.

8. Key Countdown Interventions 8

11. 2013 - 2017 Code Regulation

12. WHAT IS THE DOH DOING? Programme review (led by UNICEF) on MNCH&N Already implementing the 6 high impact priorities (STC) Implementation of the Breast feeding Summit Declaration (small increases in breastfeeding rates seen, significant in NC) Strengthened programme on contraception and family planning (to amongst others to reduce teenage pregnancies and unwanted pregnancies)

13. MNCH&N PROG REVIEW RECOMMENDATIONS: NUTRITION Update the current Severe Acute Malnutrition in-patient guidelines with the latest WHO, 2013 Technical update Build the capacity of all health workers on the promotion and support for the continuum of Breastfeeding from 0-2 years Develop a policy and implementation plan for Overweight and Obesity across the continuum Develop an HR structure for nutrition programming with an accountability framework especially in view of the current DOH/HPCSA deliberations on mid-level workers for Nutrition Review the relevance of Vitamin A Supplementation in the context of food fortification programmes

14. WHAT IS THE DOH DOING? Momconnect (330 000 pregnant women receiving messages) Focus on SAM – given its high rate (with in- hospital and upstream interventions) Piloting “three feet plans” to strengthen implementation of interventions at local level Partnership with NGOs with donor funding (RMCH/DFID; Windows of Opportunity/Path; World Vision; AMREF; HST; UNICEF) Commencing work on an investment case for MNCH&N

15. FOOD AND NUTRITION SECURITY: DRAFT POLICY IMPLEMENTATION PLAN The Department of Agriculture, Forestry and Fisheries (DAFF) is accepting written submissions on government’s latest plan to address until 27 March.

16. IN CONCLUSION Concerned about high rates of malnutrition in SA Need a more robust intersectoral approach: connect the DOTS We know what needs to be done (globally and locally) DOH committed to strengthening programming around nutrition, especially maternal and child nutrition Partnerships key to reduce malnutrition and strengthening health in the first 1000 days

17. I THANK YOU FOR YOUR ATTENTION!