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Child malnutrition: Impact on achieving the 2030 SDGs

11 Sep 2022

  • Disparity between Health Ministry and aid agency data
  • Lack of up-to-date data challenges analytical process
  • Poor crop yields and inflation affect nutrition
  • Stakeholder consultation and multi-agency cooperation needed
  • Children, especially those in vulnerable communities, at greater risk
By Sarah Hannan  Last week, the spotlight was turned towards child malnutrition in Sri Lanka, with concerns about the country’s worsening child malnutrition, causing some to question the accuracy of the data presented by international aid agencies. Where does Sri Lanka stand in terms of child malnutrition? There is no straightforward answer as there are disparities in the data sets available from international agencies and the Ministry of Health. Moreover, insufficient data in recent years has made it more challenging to determine the actual levels. Poor quality of diet, poor maternal health, socioeconomic status, and war and conflict can affect malnutrition in children. In Sri Lanka’s case, policies and programmes to alleviate child malnutrition are in place, yet the drop in agricultural output due to the repercussions of the chemical fertiliser ban and high food inflation poses significant challenges to ensuring the country achieves its nutrition-related targets. When The Sunday Morning spoke to Sustainable Development Council Director General Chamindry Saparamadu, she noted that focusing on the data at hand alone was not enough as there were pockets of communities that had different nutrient requirements based on their dietary and lifestyle habits. “If we are to look at the Sustainable Development Goals (SDGs) that Sri Lanka has to achieve, each of these parameters is interlinked; if we should fall back on one goal, it will have a reactive impact on the rest of the SDGs. For instance, declining child malnutrition levels will correlate to achieving SDGs set for Zero Hunger, Good Health and Well-being, Quality of Education, Decent Work and Economic Growth, and Reduced Inequalities.” Multi-sectoral approach In addressing issues relating to nutrition, a multi-sectoral approach and partnerships have been proposed, capitalising on Public-Private Partnerships (PPPs) and others as well as innovative techniques such as the ‘food bank’ concept.  Increasing engagement and partnerships with private sector stakeholders to address these challenges in reducing malnutrition can effectively contribute to the target achievement of SDGs 2.2 on reducing malnutrition, 3.1 on maternal mortality rate, and 3.2 on child mortality. In addition, the prevalence of stunting, which is an indicator of malnutrition among children, although relatively high, shows a declining trend where the World Health Organization-modelled estimates of stunting among children below the age of five years were recorded at 16% in 2020, declining from 17.3% recorded by the Government in 2017.  Explaining how child malnutrition should be ideally measured, Saparamadu drew attention to how, even among well-meaning families where both parents were working, dietary and lifestyle habits could cause various deficiencies in children due to the child not consuming the necessary nutrients. “We often see how some families depend on fast food/ordering food and most of these meals do not provide a balanced diet for a growing child. Take for instance a child growing up in a rural or estate setting; the lack of access to and availability of certain types of proteins can affect the growth of a child, prompting wasting and stunting,” she shared. National Emergency Nutrition Plan Taking into consideration the forecasts of a possible food shortage and the alerts issued over child malnutrition in Sri Lanka, the Ministry of Health published a National Emergency Nutrition Plan in August based on a survey conducted by the Medical Research Institute during the ‘pre-economic crisis’ period from September to December 2021. Based on the findings of the survey, several proposals to improve the nutrition of the country as a whole were proposed as follows: Proposal 1: Cash transfer schemes to provide nutrition security to the most vulnerable communities over a period of 6-9 months.
  1. To provide the minimum requirement of a food basket to all vulnerable pregnant mothers for nine months and lactating mothers for six months.
  2. To provide cash/voucher assistance schemes for nutrition-specific items in the food basket to identify communities (estate/urban under settlement/nutritionally-deprived poor families identified through routine health programmes). This will be coupled with sample menus with approximate portions for freshly-cooked meals for preschool children (2-5 years), primary school children (6-10 years), adolescents (11-18 years), and adults.
Proposal 2: Nationally-designed foster schemes to support vulnerable preschools, schools, and children identified with severe acute malnutrition, providing full coverage in providing the school meal for primary schools and preschools in targeted areas and supporting children under five who are severely malnourished through foster schemes:
  1. To support the school meal programme for primary schools through a foster scheme where smaller schools, which are attended by vulnerable communities, can be targeted (about 3,000 schools).
  2. To support all Government-managed preschools that have fewer than a determined amount of children.
  3. To support severely-malnourished children detected through the child growth monitoring programme to be nutritionally supported through a foster scheme for a period of six months.
Proposal 3: Addressing micro-nutrition insecurity through nutrition-dense home gardening. 
  • To promote and empower nutrition-sensitive home gardening to achieve household micronutrient security in 50% of households in Sri Lanka. Educate the public using the brief guide prepared – means of achieving micro nutrient security through home gardening
  • To utilise all field officers at the GN level to take the message of nutrition-based home gardening, provide technical assistance and a follow-up mechanism on household level adoption of home gardening
  • To utilise all CBOs and CSOs at the GN level to act as ‘community mobilisers’ to give necessary support throughout the process
  • To monitor and evaluate at the divisional, district, provincial, and national level
Proposal 4: Cash management support to communities at risk in order to provide necessary knowledge and competencies to the identified and potentially vulnerable communities on managing the available finances.
  1. To provide cash management/financial literacy support to estate and urban under-settlement populations and employees in the formal sector inclusive of middle-income groups in the formal sector.
  2. To educate secondary school and youth groups in organised settings on financial literacy. 
Proposal 5: Self-sufficiency model to achieve nutrition security through an Agri support economic model at the village level, utilising existing human and other natural resources to full potential in selected villages throughout the country.  Round-up on Sri Lanka’s food security
  • United Nations World Food Programme (WFP) Regional Director for Asia and the Pacific John Aylieff recently concluding his visit to Sri Lanka noted that the latest WFP surveys indicated that hunger was rising sharply in Sri Lanka, where nearly half of the households interviewed were facing challenges in accessing food, amid income losses, record levels of food price inflation, disruptions to the food supply chain, and severe shortages of basic commodities including fuel.
  • ‘Hunger hotspots – FAO-WFP early warnings on acute food insecurity: June to September 2022 Outlook’ listed Sri Lanka in the list of hotspot countries compared to the January 2022 edition of the same report as the country faces a slowdown in strong economic recovery since the end of 2020 that was renewed by supply chain disruptions and emerging macroeconomic difficulties.
  • ‘Global Report on Food Crises’ records that between 2017 and 2022 Sri Lanka had been listed as a country that was facing a food crisis only once. Yet it had never been listed as a country that had a major food crisis.
  • Listed as low- or middle-income countries/territories that did not meet FAO’s Global Information Early Warning System Team criteria, Sri Lanka has however experienced a shock to food security in 2021, for which external assistance from FAO and/or WFP was requested.
  • Sri Lanka was among the 24 countries/populations that had data gaps or lacked sufficient evidence to produce estimates of people in crisis or worse (IPC/CH Phase 3 or above) or equivalent in 2021.
  • In 2021, conflict/insecurity, weather extremes, and economic shocks, including Covid-19-related economic effects, that were often interlinked and mutually reinforcing, rendered it difficult to specify a singular trigger of each food crisis experienced by countries.
Ensuring equal access to quality education Following the completion of the second Voluntary National Review for the 2030 Agenda of SDGs and preparing the data platform, which measures the progress towards achieving the SDGs for Sri Lanka, areas of focus were identified to improve the quantity and quality of the education sector. During a discussion held on Friday (9) at the Ministry of Education with the participation of the Sustainable Development Council officials, the following was proposed among the goals related to education and the drawing up of strategic plans to achieve them:
  • Ensuring that all children complete free, equal, and high-quality primary and secondary education covered by 10 goals under Sustainable Development Goal No. 4 under the purview of the Ministry of Education
  • Have access to quality pre-primary, technical, and vocational education and increase the number of youth and adults with relevant skills, including access to tertiary education, technical, and vocational qualifications for sustainable employment and entrepreneurship
  • Inclusive and effective education on sustainable development, children, persons with disabilities, and gender sensitivity, creating a learning environment
  • The need to speed up the preparation of a validation framework including preconditions in relation to achieving the main goals of increasing the number of quality teachers and increasing the financial allocation for educational needs
     


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