Nearly Half of Nepali Children Still Malnourished

Mother’s group in Accham feed home-cooked meal to their
children. Credit: MARTY LOGAN

By Sonia Awale
KATHMANDU, Nov 8 2019 (IPS)

For the first two decades after 1990, Nepal took great strides
in reducing malnutrition. But progress has stalled.

Nepal registered one of the most dramatic reductions in
undernourishment among children and women after the government and
international agencies took action in recent decades to reverse
shocking statistics that showed half
of under-5 mortality in the country was due to insufficient
nourishment
.

“Nepal is the best country to showcase how political will can
implement a multisectoral nutrition program,” says Brenda Kellen,
director of Scaling Up Nutrition (SUN), which is holding a global
nutrition conference in Kathmandu this week.

“From being one of the countries with the highest malnutrition
in the 1990s, with stunting at 57%, to have reduced it to 36% —
Nepal can offer lessons for the rest of the world and its model can
be replicated elsewhere,” says Kellen, who added that holding the
fifth SUN global gathering in Kathmandu was recognition of this
achievement.

Over 1,000 delegates from 61 countries are attending the
conference to discuss the progress, challenges and priorities ahead
to ending malnutrition by 2030, a target set by the United
Nations’ World Health Assembly.

However despite initial progress, figures for stunting, wasting
and anaemia in Nepal have plateaued. UNICEF’s report, State of
the World’s Children 2019, released last month, stated that 43%
of children under five in Nepal were malnourished.

“Malnutrition is still very much prevalent in Nepal, mainly
among young children, adolescents and new mothers. We are not
satisfied with the progress and there is still much to do,” says
Anirudra Sharma at UNICEF Nepal.

 

 

According to the 2016 Demographic and Health Survey (DHS)
wasting (low weight for age) among Nepali children under 5 still
hovers at 10% — a mere 1% decrease from 8 years ago. The UN’s
Sustainable Development Goals (SDGs) require Nepal to reduce
wasting to less than 5% by 2030.
Stunting
needs to be well below 15% in 10 years to meet the
global target — it is about 36% now.

Says Swarnim Waglé, former vice-chair of the National Planning
Commission who helped draw up Nepal’s Multi-Sectoral Nutrition
Plan: “While a 20% reduction of chronic malnutrition in two
decades is quite impressive, 36% stunting is still very high and
unacceptable in this day and age. Conventional approaches will not
help achieve targets.”

 

 

Anaemia among Nepali women has always been very high, but
instead of declining it actually increased from 35% to 41% between
2011 and 2016. Anaemia in children below 5 rose dangerously in that
period: from 46% to 53%.

Exclusive breastfeeding in the first 6 months also declined, and
is now 65% against a target of greater than 90%. There has been no
significant change in low birth weight either, which declined only
2%, to 27%, in five years. The SDG target is below 5%.

“Improvements in nutrition levels are stagnant because we have
not reached the most vulnerable communities such as
Dalits
and people in remote far western Nepal,” says
public health expert Aruna Uprety
. “I see no reason to boast
about our past achievements when the present level of chronic
malnutrition is so serious.”

Nutrition levels are affected not just by food intake, but
access to safe drinking water and education about the right
selection of food. Underweight children in cities and the rise in
obesity are a result of the
proliferation of junk food
replacing traditional nutrient-rich
grains. Childhood obesity has decreased from 1.4% in 2011 to 1.2%
but the figure needs to drop below 1% to meet the target.

 

 


An article in The Journal of Nutrition
earlier this year found
that infants in Kathmandu were getting 25% of their calories from
junk food and instead of being fat, those who consumed the most
junk food were on average shorter than their peers.

Brenda Kellen agrees that while there is a lot of concern about
hunger and food security, there is not as much awareness about
whether food is nourishing or not.

“Let’s look at all the tools available to reduce
malnutrition. Fortifying foods can mean that people get
micronutrients but it should go hand in hand with promotion of
locally produced foods,” Kellen says.

Nutritionists believe that Nepal is on the right track, but it
needs to make nutrition a
political priority
, scale up its programs throughout the
country and
target groups susceptible to malnutrition
.

UNICEF’s Sharma says: “Nutrition should be universal,
households should not be left behind. The government has to
increase national investment on raising nutrition standards.”

 

Private sector for nutrition?

Do the private sector and nonprofits have a role in reducing
malnutrition? Does their involvement allow the government to shirk
its responsibility of ensuring equitable nutrition?

Brenda Kellen of the Scaling Up Nutrition Movement

The issue arose this week at a global conference on nutrition in
Kathmandu. Among the 1,000 delegates attending the global gathering
are representatives of Scaling Up Nutrition (SUN)
Business Network, which tries to build strong
alliances between the private sector and government
to reduce
malnutrition.

“There are many small scale enterprises that are looking for
opportunities to provide local solutions to nutrition-related
challenges,” says Brenda Kellen (pictured left) of the
Scaling Up Nutrition Movement, which is behind the global gathering
in Kathmandu, 4-7 November.

In fact, Nepal’s Multi-Sectoral Nutrition Plan 2018-2022
underlines the need for government to partner with business.
Experts say that while it makes sense to involve food manufacturers
and traders to improve nutrition, there is an inherent
contradiction between businesses that are out to maximise profits
and the need to ensure nutrition for communities that cannot afford
adequate food.

Nutrition
activist Aruna Uprety
is against private sector involvement in
ensuring proper nutrition for all. “If you involve businesses
they will look first for profit, not adequate nourishment. It is
100% the government’s job to reduce malnutrition.”

Uprety says last week she left the Baliyo Nepal Nutrition
Initiative, which is supported by the
Bill and Melinda Gates Foundation (BMFG)
, because it would
mobilise Nepal’s private sector food companies to raise nutrition
levels among Nepalis. Baliyo Nepal was launched by President Bidya
Devi Bhandari on 1 November (pictured below).

 

Nearly half of Nepali children still malnourished Progress in reducing malnutrition has stalled. What can be done to ensure enough of the right food for all?

 

MALNUTRITION TERMS

Malnutrition: lack of nutrition, either due to not
having enough to eat or not eating enough of the right foods

Stunting (also known as chronic malnutrition): a
child who is too short for his/her age

Wasting: low weight for height

Anaemia: deficiency of red blood cells or
haemoglobin in the blood

Low birth weight: an infant born weighing 2,500
grams or less

Childhood obesity: children above the average
weight for their age and height

Exclusive breastfeeding: feeding an infant breast
milk only (in this case until the first 6 months or 1000 days)

Baliyo Nepal’s Chair
Swarnim Waglé
, former vice-chair of the National Planning
Commission, says the organisation is not trying to take the place
of the government but complement its efforts precisely because of
the persistence of chronic malnutrition in the country.

Baliyo Nepal was dragged into controversy recently after one of
its backers, the Chaudhary Foundation, told the media that BMFG
funding would be used to fortify its popular instant noodle brand
Wai Wai.
BMFG did test instant noodle fortification
, but Waglé says the
initiative was not taken any further.

He told Nepali Times: “We are not touching any junk food. We
want to make nutrition affordable for all Nepalis and collaborate
with companies to meet the demand. We are creating a sustainable
and independent approach to meet malnutrition targets.”

Some experts argue that nutrient fortification of food brands
has been successful in Nepal in the past. Iodisation
of the Ayo Noon
brand of salt helped eradicate goitre and
cretinism in Nepal in the 1990s.

Whatever the merits of involving the private sector in ensuring
nutrition for all, the real scandal is one in three Nepali children
are still malnourished.

 

This story was originally
published
 by The Nepali Times

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Nearly Half of Nepali Children Still Malnourished
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Excerpt:

Progress in reducing malnutrition has stalled. What can be done
to ensure enough of the right food for all?

The post
Nearly Half of Nepali Children Still Malnourished
appeared
first on Inter Press
Service
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Source: FS – All – Food and Nutrition Blogs
Nearly Half of Nepali Children Still Malnourished