Nutrition fhs iihmr_prof_barun_kanjilal
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Transcript of Nutrition fhs iihmr_prof_barun_kanjilal
1
State Level ConsultationOn
Child Nutrition – Innovations andChallenges
Inaugural Presentation
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Consultation on multisectorchild nutrition initiatives
Background
Barun KanjilalFuture Health Systems Programme
Purpose of the workshop
Bring the stakeholders from various sectors on one platform
Stress the importance of integrated systems rather than simple technical fixes to combat malnutrition.
Set a stage for cross learning Reinforce the policy dialogue on this issue
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Partner organizers
Future Health Systems (FHS), IIHMR
Welthungerhilfe (WHH) UNICEF DRCSC And several non-government
agencies
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Future Health Systems (FHS)
A multi-country research consortium funded by DFID and led by Johns Hopkins University
In India, it is implemented by IIHMR University
Working in Sundarban with the aim of improving child health care system through knowledge intervention
Working closely with the NGOs, development partners, government agencies, and other related stakeholders to build a network and trigger actions for improving child health
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FHS Research Objective
What would be the most feasible & sustainable strategy to reach the excluded children with quality appropriate basic health and nutrition care package?
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Nutrition – through a multi-sector lens
7Source: Levinson & Balarajan (2013)
Nutrition-sensitive strategies increase the impact ofspecific actions for nutrition
Strategies
Nutrition-specific
Feeding practices
& behaviours
Food fortificatio
n
Micronutrient
supplement
Treat-ment of acute
malnutr-ition
Nutrition-sensitive
Agriculture Water & sanitation
Education &
employment
Health care
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ROOTED IN
PovertyDisempowerment
of womenPolitical & Cultural
Environment
Insufficient access to affordable, nutritious
FOODthroughout the year
Lack of good
CAREfor mothers &
children & support for mothers on
appropriate child feeding practices
Inadequateaccess to
HEALTHsanitation & clean
water services
The causes of malnutrition are interconnected
Some evidence from FHS research
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FHS evidence (2009): Level of chronic child malnutrition in Sundarbans
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52%
23%
45%
18%
48%
24%
0%
10%
20%
30%
40%
50%
60%
Stunted Severely stunted
Estimated percentage of stunted children (<5 years) in the Sundarbans, West Bengal (NFHS-3), and India (NFHS-3)
Sunderban West Bengal India
FHS Evidence (2012): Open defecation and malnutrition
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44.5
13
43.9
14.1
32.8
11.2
36.6
11.2
<-2sd <-3sd <-2sd <-3sd
Stunted Underweight
Malnutrition and Household level Open Defecation Practice
Open Defacation Not Open Defecation
FHS evidence (2012): livelihood and malnutrition
43.8
33.6
44.237.5
Food insecured Others
% of children with adequate foodStunted Underweight
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Evidence on inequity
A little more than one-third of the children are chronically malnourished. However, the prevalence is astoundingly high, almost 60%, for the girls of 1-3 years belonging to the poorer households.
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41.5
34.3
24.5
0
5
10
15
20
25
30
35
40
45
<18.5 18.6 - 24.99 >25
% o
f ch
ild
ren
Mothers’ BMI
FHS evidence (2012) : Nutritional chord between mothers and their children
% of children underweight
Convergent / integrated approach: lessons learned
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Few lessons from case studies (Levinson & Balarajan, 2013)
Nutrition-sensitive strategies increase the impact of nutrition-specific actions.
It is not necessary that ALL sectors should be equally explicit in nutrition-sensitivity.
‘Plan multisectorally, implement sectorally, and review multisectorally’ seems to be the most effective mechanism for convergence.
Convergence does not necessarily require complex interaction among the actors
Targeting is necessary
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MDG-F programme: An example from Bangladesh
Implemented in one division (Barishal) – the division with highest poverty and malnutrition rates - with support from several global aid agencies
The intervention basket includes: Targeting acute malnutrition by CMAM through NGO – GO
combination Improving food security through agriculture, homestead
food production and nutrition training School feeding and school gardening Blanket iron supplementation to children 6-23 months
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Proposed format for the consultation
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Thematic sessions
Three separate sessions on (1) Health and nutrition, (2) WASH and nutrition, and (3) Livelihoods, rights and nutrition
Presentations and discussions in each session will primarily focus on the gaps and solutions
The moderator in each session will summarize and present the key points to all after the session.
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Panel discussion
The concluding session will be an open panel discussions on “Multi sectoralapproach in addressing child nutrition” led by a team of eminent experts.
The outputs from the thematic sessions and the panel discussion will be documented and shared with all policy actors for necessary actions.
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Thank you!
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