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  • GOVERNMENT OF NEPAL National Planning Commission

    Multi-sectoral Nutrition Plan For Accelerating the Reduction of Maternal and

    Child Under-nutrition in Nepal

    Volume I

    April , 2012 Kathmandu

  • TABLE OF CONTENTS

    Preface ................................................................................................................................................................................... 1

    Declaration of Commitments ....................................................................................................................................... 2

    Abbreviations ..................................................................................................................................................................... 4

    Executive Summary ......................................................................................................................................................... 6

    1 Introduction ........................................................................................................................................................... 12

    1.1 Background ................................................................................................................................................... 12

    1.2 Current Situation and Analysis of Casualty ..................................................................................... 13

    1.3 Policy Context .............................................................................................................................................. 15

    1.4 Global Initiatives on Nutrition .............................................................................................................. 16

    1.5 Summary of Sector Reviews .................................................................................................................. 17

    1.6 Key Chalenges and Constraints ............................................................................................................ 20

    1.7 Capacity Gaps and Opportunities ........................................................................................................ 21

    1.8 Multi-sectoral Nutrition Plan Preparatioin in Nepal ................................................................... 22

    1.9 Rationale for Multi-sectoral Approach .............................................................................................. 24

    2 Multi-sectoral Nutrition Plan .......................................................................................................................... 26

    2.1 Background ................................................................................................................................................... 26

    2.2 Goal .................................................................................................................................................................. 26

    2.3 Purpose ........................................................................................................................................................... 27

    2.4 Key Principles and Approaches ............................................................................................................ 27

    2.5 Major Outcomes, Outputs and Interventions ................................................................................. 28

    2.6 Risks and Assumptions ............................................................................................................................ 43

    2.7 Rolling out MSNP and Scaling up ......................................................................................................... 43

    2.8 Target Groups and Prioritization......................................................................................................... 44

    2.9 Duration of the MSNP ............................................................................................................................... 45

    2.10 Impact Overview ........................................................................................................................................ 46

    3 Management Structure ...................................................................................................................................... 47

    3.1 National Level .............................................................................................................................................. 47

    3.2 Sub-national Level ..................................................................................................................................... 49

    3.3 Private/Social Sector ................................................................................................................................ 51

    4 Implementation, Financing, Monitoring and Evaluation ..................................................................... 52

    4.1 Delivery Agencies ....................................................................................................................................... 52

    4.2 Financial Management ............................................................................................................................. 52

    4.3 Funds Flow .................................................................................................................................................... 54

    4.4 Budget ............................................................................................................................................................. 55

    4.5 Capacity Development Strategy ........................................................................................................... 57

    4.6 Advocacy and Communication Strategy ........................................................................................... 58

  • 4.7 Monitoring and Evaluation Strategy .................................................................................................. 58

    Annex I: Consolidated MSNP Logical Framework and Action Plan .......................................................... 63

    Annex II: Nutrition Focal Persons, Consultants, and Reference Group Members .............................. 94

  • Page | 1

    PREFACE

    Addressing chronic malnutrition is recognized as the foundation of social and economic

    development, and accelerated achievement of all the Millennium Development Goals (MDGs).

    Nutrition is the best indicator of quality of human capital of a country. In Nepal, 41 per cent of

    children suffer from stunting or low height for age. Four out of ten children under five years of

    age are less likely to survive their fifth birthday, and those who survive cannot achieve their

    physical growth and mental and cognitive development potential. The consequences are

    serious, life-long and irreversible. Chronic malnutrition accounts for at least one third of deaths

    in children aged under-five. The affected children are at increased risk of morbidity and

    decreased cognitive function resulting in lower academic performance, low economic

    productivity and increased risk of degenerative diseases like diabetes and obesity, later in life.

    Besides the high cost for the country, the high incidence of chronic malnutrition affects the

    reach of many international commitments to socio-economic development in Nepal.

    Chronic malnutrition is caused by malnutrition of the mother before and during pregnancy and

    lactation, and the child during the first two years of life. Therefore, efforts should be

    concentrated to reduce it in the following target groups: adolescent girls, pregnant and lactating

    women and children from 0-24 months of age.

    The Government of Nepal recognizes that chronic malnutrition is a major nutrition problem in

    the country. As highlighted in the National Nutrition Seminar held in October 2010, due to its

    potential negative impact on economic development and human population, it must be urgently

    addressed nationally towards its significant reduction. It must be considered a priority in the

    government's plans.

    This National Multi-sectoral Nutrition Plan for improving maternal and child nutrition and

    reducing chronic malnutrition, has been prepared by five key government sectors, under the

    lead of the National Planning Commission (NPC), in collaboration with their development

    partners. It offers a package of activities/interventions with priority strategic objectives by

    sector that, over a period of five years, should contribute to a reduction by one third the current

    prevalence rates of chronic malnutrition, and embark the country well on the way towards

    significantly reducing this problem within the next ten years to ensure that malnutrition no

    longer becomes an impeding factor for enhancing Nepal’s human capital and socio-economic

    development.

    The plan is not limited to addressing the problem of chronic malnutrition and measures for its

    prevention, but also considers the factors that limit the capacity of government institutions to

    implement it. The Plan includes actions to enhance inter-sectoral collaboration and

    coordination, strengthening multi-sectoral monitoring and evalu