1. WHO REGIONAL NUTRITION STRATEGY
Dr Kunal Bagchi
Regional Adviser – Nutrition & Food Safety
Healthy Ageing
WHO SEARO
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

2. NUTRITION FOOD & NUTRITION SECURITY FOR ALL
From K.Tontisirin,INMU-2007
FOOD
NUTRITION
HEALTH
Agriculture
Food Supply
Service
Promotion
Protection
Treatment
NUTRITION IS A LINK BETWEEN FOOD AND HEALTH:
FULFILLMENT OF NUTRIENT AND NON-NUTRIENT REQUIREMENTS FROM FOOD IN HUMAN LIFE-CYCLE
FOOD & NUTRITION SECURITY FOR ALL
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

3. Food Security
Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy lifestyle
- World Food Summit, 2009
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

4. Nutrition Challenges
Child malnutrition remains high, especially in rural areas
Wide prevalence of vitamin and mineral deficiencies
Changes in lifestyle-related behaviours, including lack of physical activity, tobacco and alcohol consumption and poor dietary habits
Aggressive marketing of food: shift in food preferences towards convenient and cheap but of poor nutrition quality foods
Overweight, obesity and nutritionally-related chronic diseases (NCD) have increased rapidly
Increasing reliance on imported food
Decline in local food production and impact of climate change
Increase in food prices
Lack of multi-sectoral collaboration
Double burden of malnutrition
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

5. Dietary Energy Consumption [kilocalories / person / day]
Between 1990 and 2007, overall increase in per capita energy consumption
FAO STAT 2010
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

6. Components of dietary energy (%): SEARO Member States (2005- 2007)
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011
FAO STAT 2010

7. Agricultural Produce Prices [US Dollars / Tonne] : WHEAT
Agricultural Produce Prices [US Dollars / Tonne] : RICE
FAO STAT 2010
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

8. Trends in the prevalence of UNDERWEIGHT(<- 2SD W/A) in children 0 – 5 years
[ ]
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

9. STUNTING (<- 2SD H/A) in children 0 – 5 years : Trends in the prevalence
[ ]
WASTING (<- 2SD W/H) in children 0 – 5 years : Trends in the prevalence
[ ]

10. Anemia SEARO Member States 65.5 % 115.3
Country estimates of prevalence in pre-school age children
Anemia
Proportion of population with Hb < 110 g/L
Country
Age group (years)
Estimate (%)
Public health problem
Bangladesh
0.5 – 4.99
47.0 [42.9 – 51.1]
Severe
Bhutan
0.50 – 5.07
80.6 [ 67.3 – 89.3]
DPR Korea
0.50 – 6.99
31.7 [28.7 – 34.8]
Moderate
India
0.5 – 2.99
74.3 [73.4 – 75.1]
Indonesia
Not available
44.5 [15.6 – 77.6]
Maldives
NS – 4.99
81.5 [78.9 – 83.8]
Myanmar
63.2 [28.1 – 88.3]
Nepal
78.0 [76.1 – 79.8]
Sri Lanka
29.9 [27.0 – 33.0]
Thailand
0.00 – 5.99
25.2 [23.2 – 27.4]
Timor Leste
0.00 – 4.99
31.5 [29.7 – 33.3]
Prevalence of anemia and number of individuals affected in pre-school age children: South- East Asia
Prevalence (%)
Number affected (in millions)
SEARO Member States
65.5 %
115.3
[61.0 – 70.0]
[107.3 – 123.2]
Worldwide prevalence of anemia 1993 – 2005: WHO Global database on anemia (2008)
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

11. Source: Global status report on noncommunicable diseases (2010), World Health Organization
Trends in proportion of overweight (> +2SD) in children 0-5 years age [ ]
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

12. Adults: prevalence of overweight & obesity in SEARO Member States
Source: Global status report on noncommunicable diseases (2010)
World Health Organization
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

13. Double burden of malnutrition
Adapted from 33rd Annual Session-UN-SCN, 2006
Double burden of malnutrition
Millions of adults and young are suffering from undernutrition and micronutrient deficiencies (especially of iron, vitamin A, iodine and zinc)
At the same time, overweight / obesity is becoming a recognized problem even in low income countries - more than a billion adults worldwide are overweight, of which 300 million are obese
Although these issues are still perceived to be separate, in reality both co-exist in communities, and even the same households, in many countries

14. Key nutrition intervention areas in SEARO Member States
Source: WHO Global Review of Nutrition Policies (Draft) 2010
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

15. Key maternal, infant and young child related interventions in SEARO Member States
Source: WHO Global Review of Nutrition Policies (Draft) 2010
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

16. Policies and actions related to the “Global strategy on infant and young child feeding” in SEARO Member States
Source: WHO Global Review of Nutrition Policies (Draft) 2010
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

17. Sectors involved in the coordination of nutrition policies & programmes in SEARO Member States
Source: WHO Global Review of Nutrition Policies (Draft) 2010
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

18. Regional Nutrition Strategy:
Addressing malnutrition and micronutrient deficiencies
Rationale for the Strategy
70% of the world’s malnourished children are in this Region
Double burden of malnutrition
Universal coverage of all available nutrition interventions can reduce a substantial proportion of childhood malnutrition
Need for multi-sectoral approach
Need for adequate monitoring and surveillance of interventions
The Regional Strategy is intended to assist Member States in developing a multisectoral approach and identifying and prioritizing nutrition action in their countries in all relevant sectors
Timeframe
Five years [2011 – 2015]
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

19. Addressing obesity and dietary prevention of chronic diseases
GOAL
To encourage Member States to initiate, develop and sustain a multisectoral approach and measures for the promotion of nutrition among all population groups following a life-course approach
Strategic Elements
Developing a country-driven, outcome-oriented integrated multisectoral nutrition policy and plan of action
Addressing malnutrition and micronutrient deficiencies through a multisectoral approach and involvement of all relevant sectors
Addressing obesity and dietary prevention of chronic diseases
Developing effective and functional nutrition surveillance systems
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

20. Addressing obesity and dietary prevention of chronic diseases
Developing a country-driven, outcome-oriented integrated, multisectoral nutrition policy and plan of action
Assist Member States in the formulation of their national nutrition policies and plans of action by adopting an integrated & intersectoral approach
Promoting Maternal and Child Nutrition with focus on the ‘window of opportunity’
Effective control and prevention of micronutrient deficiencies
Ensuring appropriate nutrition for elderly persons
Addressing macro- and micronutrient deficiencies through a multisectoral approach and involvement of all relevant sectors
Addressing obesity and dietary prevention of chronic diseases
Undertake interventions aimed at the prevention and management of overnutrition
Prevent the predicted sharp escalation in noncommunicable diseases
Developing effective and functional nutrition surveillance systems
To assist Member States in the strengthening and expansion of the national nutrition monitoring and surveillance systems
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

21. Multisectoral Approach and Partnerships
Member States, involving all relevant ministries, e.g. health, agriculture, fisheries, transport, regulatory bodies
Civil Society, NGOs, Consumer Forums & Professional Associations
Food Industry
Media
United Nations Specialized Agencies and other international organizations
Multisectoral Approach and Partnerships
Improving the health and nutrition status of the population will need a multi-sectoral approach involving all relevant sectors
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

22. Indicators Documented national nutrition policy /plan of action
Improvement in the prevalence of underweight / stunting / wasting in children < 5 yrs
Formulation of national food-based dietary guidelines
Increase in the rate of exclusive breastfeeding
Establishment of National Nutrition Surveillance Systems
Elimination of Iodine deficiency disorders as a public health problem
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

23. SAARC Declaration on Food Security
South Asian Association for Regional Cooperation, 2008
SAARC Declaration on Food Security
Adopted by the Extraordinary Session of the Agriculture Ministers,
New Delhi, November 2008
Commit to share best practices for enhancing agricultural production
Cooperate and collaborate to promote strategies to mitigate the risks associated with climate change
Develop a harmonized network for safe movement of agricultural commodities in the region
Cooperate and collaborate in training, human resource development and capacity building in the areas of:
integrated pest management
pest-risk analysis
integrated nutrient management
post harvest technologies
bio-technology & bio-resource management
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

24. National Nutrition Strategy
Source: National Nutrition Policy and Strategy, Dec Nutrition Section, Ministry of Health & Population, Nepal.
Nepal
National Nutrition Strategy
Strategic Approaches:
Reducing undernutrition and micronutrient deficiencies in infants, children below five-years, women of child-bearing age and pregnant women;
Preventing and controlling infectious diseases to improve nutrition and reduce mortality
Improving household food security;
Promoting good dietary habits and related life-style practices;
Promoting school health and nutrition programmes;
Reducing risk of malnutrition during difficult circumstances and disaster situations;
Improving monitoring and evaluation programme;
Increasing community participation
Effective coordination and collaboration with all partners.
Meeting of South-East Asia Regional Programme Managers on Child Health, Kathmandu, Nepal, 15 – 18 November 2011

25. Thank You