Ramping up the fight against child malnutrition

Nepal is boosting efforts to tackle child malnutrition, which is so widespread that every other child under five has been found to be malnourished.

Alarmed by the situation, officials say plans are afoot which will see combined action across a range of ministries in addition to activities by the Health Ministry, traditionally responsible for the issue.

“Multi-sectoral nutrition action has been planned. This was endorsed by several ministries recently, and for the first time they will be working together actively,” Rajkumar Pokhrel, a nutritionist and head of the government’s nutrition programme at the Department of Health Services, told IRIN.

The plans, which will include the ministries for women, local development, agriculture and education, will be scaled up this year amid an increase in support from aid agencies, according to department officials.

An expansion of feeding programmes for infants, young children and women in food-deficit areas is envisaged.

There will also be increased coverage of the government’s micronutrient programme aimed at pregnant women, mothers and their infants, which will include more dosing with Vitamin A and iron to prevent anaemia.

Iron deficiency anaemia is a major public health issue in Nepal, where 36 percent of women aged 15-49, and nearly half (48 percent) of children aged 6-59 months, are anaemic, according to the Health Ministry.

"This will drastically reduce anaemia among women and children," said Pokhrel.

Malnutrition widespread

A report from the Department of Health and the UN Children’s Fund (UNICEF) released earlier this month found that 50 percent of Nepali children under five are malnourished, 49 percent are stunted and nearly 2 percent are severely malnourished.

Photo: Naresh Newar/IRIN
A young boy with malnutrition being treated for diarrhoea at a health camp in western Nepal

The problem is particularly pronounced in underdeveloped food-deficit areas of the far- and mid-west regions where more than 27 percent of children are acutely malnourished, Pokhrel said.

“In such areas, there is a need to provide food rations which include fortified super flour also for the mothers,” he said.

Health experts say poor maternal health among Nepali women is directly contributing to child malnutrition; nearly a quarter of the country’s estimated 14.5 million women are malnourished, afflicted particularly by a low body mass index.

Meanwhile, nutrition workers from NGOs say the government has not done enough to educate women and health workers about nutrition at a local level, especially in the most remote areas.

“The government has not done anything vital. It has even failed to raise awareness about basic education about nutrition,” Som Paneru, a nutrition expert and executive director of health and education NGO, the Nepalese Youth Opportunity Foundation (NYOF), told IRIN.

Agency support

Officials say the World Bank, UNICEF and the United States Agency for International Development (USAID) recently completed a nutritional gap analysis to assess child and maternal nutrition needs.

The findings are to be integrated into the Nepal Health Sector Programme, which aims to expand access to and the use of essential health care services, and is supported by the World Bank and the UK Department for International Development (DFID).

The first phase of the programme will expire in July this year and the Ministry of Health and Population is drawing up plans for its implementation over the next five years.

“The World Bank now is bringing significant funding which hasn’t been previously specifically for nutrition within the national health sector plan. So we know the interventions that will work,” Gillian Mellsop, UNICEF country representative in Nepal, told IRIN.

However, officials say they have yet to sort out how efforts will be coordinated across the relevant ministries, while challenges lie ahead in implementing programmes at the local level.

“We still do not have specific planning for community-level programmes and we have not been able to make targeted area-focused programmes,” said Pokhrel.