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Breaking the cycle of poverty early: by Education & Nutrition

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Presentation on theme: "Breaking the cycle of poverty early: by Education & Nutrition"— Presentation transcript:

1 Breaking the cycle of poverty early: by Education & Nutrition
D.S Akram Hon. Chairperson Health Education & Literacy Program- Pakistan 19th July 2015 Washington-DC

2 Outline of Presentation
Insight into the issues related to nutrition and ECD in the developing world-Pakistan as an example UNICEF’s Conceptual Framework for malnutrition Possible solutions Scaling up Nutrition What will we gain • Nutritional deficiencies limit the intellectual and physical development and growth of the child » growth can be stunted » child does poorly at school. • Deficiencies in affection and psychosocial stimulation stunt emotional, physical and intellectual development with long term effects » limits potential in school » poor employment chances » lifelong disability » mental problems. • Nutritional and psychosocial deficiencies interact with short term and long term effects in learning, education and employability.

3 World Map based on Deaths from All Nutritional Deficiencies*
Nutritional deficiencies are due to inadequate amounts of particular categories of food and nutrients in what you have to eat and drink. All of the conditions here involve essential nutrients without which you cannot survive. You need large amounts of protein and carbohydrates, and small amounts of minerals and vitamins. Fats are essential to obtain some vitamins from food. Nutritional deficiencies are the sum of the following (with their contribution to the total nutritional deficiency deaths in 2002): Starvation [Protein-energy malnutrition], U054 Map 412, (54% of deaths). Iodine deficiency, U055 Map 413, (1% of deaths). Vitamin A deficiency, U056 Map 414, (5% of deaths). Iron-deficiency anaemia, U057 Map 415, (28% of deaths). Other nutritional disorders, U058 Map 416, (12% of deaths). Nutritional deficiencies caused 0.85% of all deaths worldwide in 2002, an average of 78 deaths per million people per year. The ten highest rates of death per million people in 2002 were in: Sao Tome and Principe, 845 Mali, 834 Sierra Leone, 713 Angola, 694 Liberia, 621  Haiti, 619 Afghanistan, 454 Guinea-Bissau, 422  Burkina Faso, 365 Lao People's Democratic Republic, 360 International Classification of Diseases (ICD) codes for all conditions included in category I-E Nutritional deficiencies U053 ICD-9 codes: 243, , , 285.9 ICD-10 codes: D50-D53,D64.9, E00-E02, E40-E46, E50-E64 * Deaths from protein-energy malnutrition, iodine, vitamin A, iron deficiency in 2002. ICD 10 codes: D50-D53, D64.9, E00-E02, E40-E46, E50-E64. Accessed at 8/4/08 3

4 What is causing malnutrition (Unicef’s analysis)

5 The “Window of Opportunity” for improving nutrition is very small…pre-pregnancy until months of age BRAIN DEVELOPMENT STARTS IN 1ST. Repositioning Nutrition, 2006 5

6 Over 162 million children <5 years are STUNTED
Maximum rates in South Asia are between 40-53% Proxy indicator for reduced physiological capacity, work output Decreased educational achievement Negative employability (Martorell R; Paper for WB) Stunting has been taken as a proxy to decreased performance based on lack of appropriate nutrition in the first 2 years of life

7 Pakistan

8 Mountains

9 Plains

10 Desert

11 Scarcity of water

12 Urban Slum

13 Mapping Nutrition

14 Ref: “Mapping of Nutrition Initiatives” DS Akram ,

15 Interventions that Affect Maternal and Child Under Nutrition
(Sufficient evidence for implementation in all 36 countries) Newborn babies Promotion of breastfeeding (individual and group counseling) Infants and children Promotion of breastfeeding (individual and group counseling). Behavior change communication for improved complementary feeding* Zinc supplementation Zinc in management of diarrhea Vitamin A fortification or supplementation Universal salt iodization Hand washing or hygiene interventions Treatment of severe acute malnutrition *Additional food supplements in food-insecure populations. Vol 371 February 2, 2008

16 Address Intermediate and underlying Causes
Possible Solutions Address Intermediate and underlying Causes Infant and Young Child Feeding Early Child stimulation Indigenous Hi density foods for children, PLW Address food insecurity Micro – Credit / cash transfers Empower Women – 43% reduction in malnutrition by educating women (Smith and Haddad, 2000) Land reforms – subsidized agriculture Alternate sources for power generation Employment POLITICAL AND SOCIAL SECURITY

17 Broadening the “nutrition lens”…
Financing envelope Health sector Narrow nutrition lens Multisectoral Education sector Agriculture sector Private sector Financial sector Trade and tax policies sector Transportation sector Multiple other sectors Increasing space for new sectors & new partners Environment sector Governance Gender Poverty alleviation 17

18 Scaling Up Nutrition (SUN) September 2010 Coordinated by U.N.
Based on evidence based nutrition strategies from “Lancet Series 2008” Public-Private Partnership of 102 government and non-government global partners Based on Three Principles: Should be Country Based and “Owned” Focus on “Window of Opportunity” priority to first 1000 days of life. Multi-Sectoral approach with integration of nutrition in related sectors.

19 Reaching the ‘Unreached’
Conventional methods: face to face, interactive radio, television Peer counselors and child to child, child to parent teaching Using technology: alternate sources of power in schools and health centers Utilizing mHealth, voice messaging and visuals Using skype for virtual classes and group counseling CSOs partnering with governments

20 School in Tharparker & Solar Plant

21 What will we Gain? Investment in Nutrition of children will results in : Decreased mortality (save 1 million deaths per year or 30 million life years). Decreased morbidity. Improved physical & mental growth. Contribution to achieving ALL MDGs goals. Increase in lifetime earnings. Very high rates of return among the top 10 development investments.

22 Convention of the Rights of the Child.
Adopted by UN General Assembly on 20th Nov, 1989. Total of 10. Principles. Principle No 4: The child shall enjoy the benefits of social security. He shall be entitled to grow and develop in health, to this end, special care and protection shall be provided both to him and to his mother, including adequate pre-natal and post-natal care. The child shall have the right to adequate nutrition, housing, recreation and medical services.

23 Our Right – Food Security Good Governance

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