Thursday, August 9, 2007

Malnutrition is severe in Nepal: Indicating continued poverty and backwardness for decades to come

No matter how much fighting is done for politics, or no matter how much we hypothesise about social transformation, we are heading towards a grim future of this country,instead of getting towards positive transformation, if malnutrition is not addressed. Nation is built by those who grew up with proper nutrition in their childhood. Here is an eye-opening status for Nepal, an article by Tom Atwood on the Kathmandu Post, published in August 9 edition. There is a great war to win!

Malnutrition takes toll on GDP, IQ


KATHMANDU, Aug 9, 2007.

Seven years after Nepal committed itself to the task of halving malnutrition by the year 2015 - one of the Millennium Development Goals - general malnutrition remains a serious problem. Over the past 25 years, general malnutrition levels have decreased at a miniscule rate. This obviously means the status of malnutrition as a public health problem will remain for decades to come. .
According to the World Bank, decreased productivity and IQ levels resulting from malnutrition are causing a loss of up to 3 percent in GDP, which amounts to around Rs 18 billion annually.

At present, Nepal has one of the highest levels of malnutrition in South Asia. A study conducted by the Ministry of Health and Population (MHP) in 2006 shows that 49 percent of children under the age of 5 are stunted - an indicator which compares height to age and reflects chronic malnutrition.

Despite its pervasiveness, malnutrition, however, generally goes unnoticed. In Nepal, it is difficult to explain to mothers that their children are not short because short is the norm here. Surrounded by small door jambs, low ceilings, and a 50 percent stunted population, tall members of the population stick out, and the erroneous myth that Nepali people are inherently short perpetuates itself unnoticed.

In a sense, being short is not the problem. It is the process and consequences of becoming short that keep developing nations on their knees. In response to adverse conditions created by malnutrition, children become less active and less responsive to stimulus, which causes sub-optimal mental and physical development.

During the first two years of life, 80 percent of the brain develops. Studies however show, that those years are frequently marked by insufficient nourishment, disease, and subsequently, malnutrition and stunting. "Between the ages of six months and three years, the percentage of stunted children in Nepal rises from 11.6 to nearly 60 percent," according to the 2006 survey of MPH.

While malnutrition indices peak during early childhood and either level off or begin to decline slowly after age three, there is reason to believe that the damage done is irreversible. "There is actually a very, very tight window of opportunity between conception through the first two years of life," says Meera Shekar from the World Bank, "If we miss this window, we miss a whole generation."

The consequences of early malnutrition ripple through society. A recent World Bank report shows that one percent decrease in adult height due to childhood stunting correlates with 1.4 percent loss of productivity, and that stunting in general is associated with as much as 11-point decrease in IQ. The result is that schools can be built and jobs created, but without proper nutrition Nepal's economic and social development will continue to be held back.

When searching for a solution to malnutrition in Nepal, the most common misconception is that it stems entirely from lack of food security and cannot be reduced unless general poverty is addressed first. World Bank studies, however, make it clear that extreme poverty and insufficient food are part of the problem, but are far from being the entire problem.

In fact, according to the UN Common Country Assessment (UNCCA) for Nepal, two major causes of malnutrition are poor feeding practices and inadequate child care. At the age of six months, breast milk is no longer a sufficient source of nourishment for a child. Most mothers then supplement their milk with rice porridge. Often, rice porridge is bulky and energy deficient, and children, who have small stomachs, cannot eat enough porridge to fulfill their dietary needs unless they are fed five or six times a day. Unfortunately, Nepal Family Health Survey shows that mothers with heavy workloads and limited control over their use of time have difficulty feeding their children so often.

Furthermore, when children begin eating supplementary foods and start to explore their surroundings with greater ease, non-sterilized foods and sub-standard sanitary conditions increase the child's risk of infection drastically. According to the 2006 MHP survey, prevalence of illness peaks between 6 months and two years. Illness, in turn, causes decrease in appetite, and mothers usually feed sick children less when, in fact, they require extra energy to combat their illness and continue to develop and grow.

Recently, a number of initiatives have successfully reduced malnutrition in parts of Nepal. Amongst others, Save the Children's Positive Deviance Program, United Mission to Nepal's nutrition project, and the Ministry of Local Development's Decen0tralized Action for Children and Women program have yielded positive results by addressing malnutrition through holistic, community based reform.

As Meera Shekar says, "Nutrition is an investment issue. It is something that can drive economic growth rather than ride on the coat-tails of economic growth, because children who are well-nourished have been shown to have much higher income potential as adults."

Posted on: 2007-08-08 19:35:06 (Server Time)

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