Nutrition Forum - Maternal & Child Nutrition In Asia

From the 2nd regional consultation on maternal and child nutrition in asian countries – focusing on vitamin and mineral nutrition through a food based approach
jakarta, 22 september 2005

1. The consultative meeting had very important inputs from:

- ms. Sheila sisulu reminded the consultation that asian countries should start considering effective interventions in food security to meet the needs of mothers and children to prevent malnutrition.

- the coordinating minister of people’s welfare represented by Dr. Adang seiana discussed the need for strong commitment for managing nutrition problems from central government to local level in each country as well as international and regional collaboration. Besides, he emphasized the importance of networking between government and other sectors.

- prof. Soekirman stated food fortification is the preferred strategy to overcome micronutrient deficiencies. This strategy requires public and private partnerships. He stated that for implementing food fortification four main aspects should be considered: political, marketing, regulatory, and technological.

- dr. Sri mulyani emphasized that asian countries have been blessed with vast natural resources, and also have a long history of cultural achievement which includes self-help and concern for the poor. She stated that the most important assets in development efforts are the people themselves and thus governments should take into consideration improving their potentials in order to compete successfully in the world market. This means promoting individual rights, particularly for children and women

- dr. Peter katona emphasized the importance of the synergistic relationship between malnutrition and infection.

- dr. Ali mokdad stated the importance of nutritional assessment for timely and appropriate nutrition interventions.

- dr. Pattanee reminded the consultation that to properly address micronutrient deficiencies, it is essential to intervene in the pre-pregnancy period and when possible as early as adolescent girls.

- dr. Rhuksana haider underscored the importance of advocacy and using social marketing techniques in promoting nutrition.

- wfp and unicef are launching an initiative to end child hunger in asia that will contribute to achieving the first mdg goal. In the east asia region, wfp and unicef have initiated a strategy targeted at pre pregnant and pregnant women and infants and preschool-aged children that includes a package of essential services.

2. Together, we have shared and learnt from countries present in this meeting on issues of:

- the importance of promoting an integrated approach in nutrition strategies.

- the importance of advocacy for the inclusion of food and nutrition dimensions as a priority in government planning.

- the importance of already existing strategies to address maternal and child health, including food insecurity, protein-energy malnutrition and vitamin and mineral deficiency diseases.

- the importance of exploring and developing opportunities for regional cooperation regarding maternal and child nutrition.

3. The conclusions and recommendations are as follows:

- it is important to consider the first mdg has two targets: one is to reduce by half the number of people living in less than a dollar a day, and two, to reduce by half the proportion of people who suffer from hunger. These two targets area closely linked.

- the problem is not so much how to address malnutrition, but how to scale up what approach we know. The technologies and approaches to address these problems are available but their utilization is low. Guidelines are available for addressing nutritional problems and chronic food insecurity. But tailoring available means and strategies to the local epidemiology and context, and scaling up these interventions is of the utmost urgency for reducing malnutrition and associated deaths, disability and disease in the asia region.

- asia has the resources, means and the expertise to reach the first mdg goal, but only with strong cooperation. Investment is needed in people’s health, in women, children and in the welfare and growth of future generations. In order to achieve that, there has to be increased partnership and collaboration to finance and to have available technical expertise, not only in health and nutrition but also in policy formulation, advocacy, and awareness raising. Actions have to be practical, achievable, and results oriented.

- national governments would need to take full ownership for improving the situation of women and children in their countries. There has to be sufficient commitment to prioritize and resource such programs; by identifying integrated and effective solutions, and through advocacy to achieve their implementation.

- many in asia suffer from micronutrient deficiencies because of affordable foods that have been fortified with micronutrients only consumed by small proportion of the population.

- food fortification is important to complement diversification, supplementation and public health interventions in order to increase the micronutrient intake of the population. When appropriate, governments should consider subsidizing such products.

- to develop food fortification initiatives, new paths need to be explored such as a closer collaboration between public and private sectors to produce fortified food that can be reached especially for the poor. In order to encourage fortified food production, the private sector will need public sector’s support from the government, health and research community and international agencies in calling for fortified products. Besides, the private sector will also need public awareness regarding the importance of micronutrients in order to create a demand for affordable fortified products on the market.

- in order to plan micronutrient interventions we need to know the level of intake in a population and to determine what the major problems are in acquiring adequate dietary intake. This will assist in planning and prioritising resources.

- surveillance systems in all countries are recommended to measure changes in dietary intake as well as to monitor nutritional status. This will enable timely preventative measures at an early stage before reaching problems of public health dimensions. Nutritional surveillance is less expensive and more cost effective than large scale assessment.

- all countries are recommended to adopt the international anthropometric standards. This is not only important for comparisons between countries but also because all human beings have the same potential for growth. Large scale assessments and malnutrition can be underestimated if national standards used are.

- it is important to recognize that the cost of alleviating micronutrient deficiencies is low and the cost-benefit is great.

- learning has to come from both research and community levels. Interventions should not be vertical but need to be integrated and sustainable. Community involvement leads to sustainability and must be given adequate time and means to develop.

- in conclusion, nutrition is not the domain of only nutritionists and ministries of health. All sectors, finance, education, and other divisions of the government have to be involved. All countries must put appropaite policies in place that combat malnutrition including micronutrient deficiencies to be at the heart of poverty reduction strategies. And this can only be achieved in collaboration with their counterparts in the government.