The report card was launched on March 4, 2010, at a high-level meet attended by government agencies and major external donor partners in Kathmandu, along with UNICEF’s global report, “Tracking Progress on Child and Maternal Nutrition,” that includes profiles of 24 countries in which 80% of the world’s stunted children live.[break]
Nepal is the first country, of all those that participated in the data collection scheme, where the government has pledged to highlight nutrition in its development agenda. Nutrition is expected to be a prominent aspect of the next Health Sector Program’s five-year implementation plan. Improvements in overall nutrition is essential for realizing Nepal’s commitments to achieving the Millennium Development Goals by 2015, and is a significant element of the Convention on the Rights of the Child, of which Nepal is a signatory.
Nutrition is an interdisciplinary problem that involves a wide range of sectors, from agriculture to education to rural development and poverty. Till date, focus has emphasized the direct causes of malnutrition. However, at the meeting, over 200 public and private stakeholders pledged their support for nutrition initiatives, speaking with a common voice in underlining nutrition not just as a health problem.
“Malnutrition is a multi-factorial problem. It is an outcome of two common interrelated causes: inadequate food intake and disease load. This in turn is caused by inappropriate feeding practices, inadequate access to food, insufficient maternal/child care, and inadequate health care and hygiene practices,” states the report.
“Even if mothers know that they need to feed their babies five times a day, they may not be able to do so because they have to go to work in the field, or because there isn’t sufficient food,” explains Pragya Mathema, Nutrition Specialist at UNICEF.
According to the report, stunting has reduced from 57% in 2001 to 49% in 2006 – when the last national Nepal Demographic and Health Survey was carried out – at an annual rate of reduction of 0.8%. Compared to its neighbors, Nepal doesn’t fare much worse, with stunting at 49% in Afghanistan, 48% in India, 48% in Bhutan, and 42% in Pakistan.
Regarding other indicators of general malnutrition in Nepal, 39% of under-fives are underweight, 11% are severely underweight, 13% are wasted, and three percent are severely wasted. The disparity across societal brackets has also been measured: 36% stunting in urban children under five, compared to 51% in rural areas; 31% in the highest wealth quintile compared to 62% in the lowest wealth quintile; and an even distribution of 49% in males compared to 50% in females.
Nepal has made considerable progress in tackling micronutrient deficiencies, and is set to be one of the few countries in the world on track to reaching all three of its micronutrient World Fit for Children goals by 2010. Vitamin A deficiency is no longer considered a public health problem, 80% of households now use adequately iodized salt, and the prevalence of anemia in preschool children has reduced from 78 to 48%. However, when it comes to general malnutrition, advancements have been slow.
“Stunting is the best indicator for economic productivity,” says Pragya Mathema, which means that by tackling nutrition, Nepal will also be boosting the physical and mental capacity of its children, thereby contributing to economic development. Children, who face chronic under-nutrition during their formative years, may perform less well in school, be at higher risks of acquiring diseases, be less productive as adults, and earn less. The value of the recent exercise, as described in the report itself, therefore, “lies in its argument for nutrition to be established as a core pillar of human development.”
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