Millennium Development Goals Linkages with Early Child Development and Nutrition DR. S.K CHATURVEDI...
Transcript of Millennium Development Goals Linkages with Early Child Development and Nutrition DR. S.K CHATURVEDI...
Millennium Development GoalsLinkages with Early Child Development and Nutrition
DR. S.K CHATURVEDIMD,MNAMS,FIAPSM,FIPHA
UNICEF State Representative for NE/NW statesNew Delhi
The Challenge in India
1. Genesis of Millennium Development Goals
2. Conceptual Framework
3. The Link with Integrated Early Child Development & Nutrition
4. Millennium Development Goals
5. India – Challenges & Opportunities
6. Moving Forward
The Genesis
Millennium summit of UN - September 2000Commitment to reduce global deprivation and promote sustainable human development
Millennium Development Goals/ Country Plan Goals• Quantifiable targets for 2015• Some 10th Plan Goals more ambitious than the MDGs
A Rights Perspective• Children’s & women’s rights fundamental to human rights • UN Convention on the Rights of the Child• Convention on Elimination of all forms of Discrimination Against
Women
Creating a World Fit For Children• UN General Assembly Special Session on Children - Sept 2002• Placing children first on the development agenda
Millennium Development Goals
1. Eradicate Poverty & Extreme Hunger
2. Achieve Universal Primary Education
3. Promote Gender Equality & Empower Women
4. Reduce Child Mortality
5. Improve Maternal Health
6. Combat HIV/AIDS, Malaria & Other diseases
7. Ensure Environment Sustainability
8. Develop Global Partnership for development
Civil Society /State
Natural Resource Base & Environment
Efficient resource use & control Natural /Human / Economic/Organization Resources
Education / Learning / Life skills / Information & Communication
Household Securities (eg Food,Water,Shelter)
Empowered Community & Change facilitators
Access to quality Services(Health, CDN, WES)
CAREHome Health Practices Home Hygiene Practices
Infant and Young Child FeedingPsychosocial Care
Care for Girls and Women
Well nourished and healthy child Secure & Active Learner
Fulfillment of the Rights of all children to survive grow and develop to their full potential without discrimination
BasicConditions
UnderlyingConditions
ImmediateConditions
Institutions and Governance
Political, Economic & Social Structures & Systems
Household/Community
Outcome
Young children on the Development Agenda
Child
Family
A conceptual Framework
Integrated Early Child Development & Nutrition
• Foundation for cumulative lifelong learning and human development
• Entry point for poverty reduction and human development strategy
• Early interventions most effective in addressing a life cycle of multiple deprivation - Poverty Gender Discrimination Malnutrition
• Sensitive proxy indicator of human development - % children 0-5 years underweight
Crucial for the achievement of first 6 MDGs
Halve, between 1990-2015, proportion of people…
Target 1 …whose income is less than $1 a day
Target 2 …who suffer from hunger
Goal 1 Eradicate Poverty & Extreme Hunger
Malnutrition erodes human capital, reduces learning abilities and productivity
For human capital formation, it is critical to prevent malnutrition, as early as possible
Early Care and Nurturing has a lasting impact on brain development- especially in the first 3 years
The first 3 years are crucial. They are forever…
Goal 2
Achieve Universal Primary EducationEnsure by 2015…
Target 3 Children everywhere, boys & girls alike, will be able to complete full course of primary schooling
10th Plan All children in school by 2003All children to complete 5 years of
schooling by 2007
Early Child Development interventions Result in increased cognitive and social skills Improve retention and learning outcomes in primary education Equality of opportunity for disadvantaged groups
Malnutrition reduces mental capacity & learning ability e.g. Micronutrient deficiencies such as Iodine (13 IQ points)Iron Deficiency Anemia (9 IQ points)
Goal 3
Promote Gender Equality & Empower WomenEliminate by 2005…
Target 4 …Gender disparity in primary & secondary education, & at all levels of education no later than 2015
Positive early child care practices and parent education help promote equal learning opportunities for girls and boys
Better nutriture and iron status of girls improves learning capacity, likely retention and future choices
Goal 4
Reduce Child Mortality
Reduce by 2/3 between 1990-2015Target 5 …Under 5 Mortality Rate10th Plan IMR to be 45 by 2007
IMR to be 28 by 2012
More than 50% of all child mortality is directly or indirectly associated with malnutrition
Around 25 % of young child mortality can be prevented through nutrition and early child care interventions
Goal 5
Improve Maternal Health
Reduce by 75% between 1990-2015Target 6 …Maternal Mortality ratio
Maternal health is compromised by inadequate care and nutrition of girls and women
Malnutrition, including anemia, is associated with most major risk factors for maternal mortality
Severe anemia is a major cause of maternal deaths – around 20 % globally
Goal 6
Combat HIV/AIDS, Malaria & Other diseasesHave halted by 2015…
Target 7 …and begin to reverse the spread of HIV/AIDS
Malnutrition Hastens onset of AIDS among HIV-positive Weakens resistance to infections and reduces malaria survival rates
Infant & Young Child FeedingInformed choice important for prevention of mother to child transmission of HIV/ AIDS
Linking Nutrition & Development Mechanisms and Instruments
More effective poverty reduction• Nutrition key to addressing inter-generational cycle of poverty• Helps targeting the most vulnerable and at risk• Proxy indicator for multi-sectoral interventions
Strengthened health sector reform• Inclusion of early child care and nutrition increases efficiency and
quality of health services• Using nutrition tools and methods
e.g. Mother Child Care Counseling Package
Improved Governance• Community based care interventions promote participatory
processes and capacity
The Challenge in India
• Every fifth young child in the world lives in India
• Every second young child in India is malnourished
• Three out of four young children in India are anemic
• Every second newborn in India is at risk of reduced learning capacity due to iodine deficiency
• Vitamin A a public health issue• Malnutrition limits development potential
and active learning capacity of the child
0
20
40
60
80
100
120
14019
80
1984
1988
1992
1996
2000
2002
Rural Total Urban
6964
40
Source : SRS Bulletins - RGI
IMR Reduction needs acceleration…
51.5%47.1%
19.3%15.5%
45.5%47.0%
Underweight Stunted Wasted
NFHS 1 (1992-93) NFHS 2 (1998-99)
Children 0- 3 years
Promoting early child development is crucial
Addressing Malnutrition…
% children 0-3 years below -2 SD Weight-for-Age, NCHS
Source : NFHS II, 1998-99
50 %40-49 %30-39%20-29%Data NA
Jammu & Kashmir
Himachal Pradesh
Uttaranchal
Uttar Pradesh
Bihar
Arunachal Pradesh
Nagaland
Manipur
MizoramTripura
WestBengal
Orissa
J
Andhra Pradesh
Tamil Nadu
Kerala
Karnataka
Goa
Maharashtra (49.6%)
Madhya PradeshGujarat
Rajasthan
HaryanaDelhi
Punjab
Sikkim
Assam
Meghalaya
Andaman & Nicobar Islands
Lakshadweep
Pondicherry
Karaikal (Pondicherry)
Dadar & Nagar
Haveli
Daman
Diu
Jharkhand
Chattisgarh
The boundaries and names shown in this map do not imply official endorsement or acceptance by the UN
Prevalence of Underweight Children…(0-3 years)
Improve Infant and Young Child Feeding PracticesIncrease early initiation (colostrum feeding) : 16% to 50% Increase exclusive breastfeeding 0-6 mths : 55% to 80%
(0-3 mths) (0-6 mths)
Increase complementary feeding (6-9 mths) : 34% to 75%
Reduce the prevalence of Underweight (Children Under-3 years) from 47% to 40%Reduce prevalence of severe under-nutrition in children in the 0-6 years age group by 50%
Reduce prevalence of anaemia by 25% and that of moderate/ severe anaemia by 50%
Eliminate Vitamin-A deficiency
Reduce prevalence of IDD to less than 10% by 2010
10th Plan Goals…
Achieving the 10th Plan Goals…
• It is possible to achieve these through relatively simple interventions
• Improved family community care behaviours, focusing on children Under-3 years of age– Infant and Young Child Feeding– Psychosocial Care– Care for girls and women– Hygiene– Health
• Positive evidence from community based care projects - even in challenging states
Preventable Under-5 deaths - India
0 4 8 12 16
Antimalarial I PT in Pregnancy
Insecticide treated materials
Nivirapine & replacement feeding
Measles vaccine
Antibiotics for PRM
Tetanus Toxoid
Newborn temprature management
Antinatal streoids
Vitamin A
Zinc
Clean water, sanitation & hygiene
HiB Vaccine
Clean Delivery
Complementary Feeding
Breast Feeding
Through universal coverage with individual interventions (2000)
Source : Lancet Series
• Build upon innovative state-specific early child care approaches
• Enhance quality improvement initiatives in ICDS
• Increase emphasis on improving family/community early child care practices for younger children Under-3 years in RCH-II & ICDS e.g. Infant and Young Child Feeding
• Strengthen partnerships for WCD Panchayati Raj InstitutionsWomen’s Self Help Groups and community groups
• National Nutrition Mission
Moving Forward…