UNDER NOURISHED CHILDREN (UNDER FIVE)

Children have a right to good nutrition, which right is safeguarded through various national and international human rights instruments that recognize motherhood and childhood as periods entitled to special care and assistance.

Nutritional status is a key indicator for a bevy of developmental factors, such as hunger, poverty, poor health, and inadequate education and social conditions. Poorly nourished children cannot grow and develop properly, resist infections, or learn to their full potential. Undernutrition is estimated to lower a country’s GDP by as much as 6%. There is a vicious cycle between poverty and undernutrition, resulting in largely irreversible losses in physical and cognitive potentials, as well as increased healthcare costs. Children aged less than five years are at particular risk because they have special nutritional requirements.

Nepal has made encouraging progress on child nutrition and mortality in recent years. Between 1990 and 2005, for example, the prevalence of underweight under-fives declined from 57 percent to 39 percent. By 2010, the under-five mortality rate had decreased to 50 deaths per 1,000 live births, surpassing the MDG target of 54 for 2015. The share of under-fives stunted or short for their age decreased from nearly half (49 percent) in 2006 to 41 percent in 2011. The proportion of children below expected weight for their age also decreased from 39 to 29 percent. However, the latest figures still put Nepal among the 10 countries with greatest undernutrition problems in the world. The rate of undernutrition among children has remained largely unchanged between 1975 (52 percent) and 2006 (49 percent). Food insecurity is pervasive, with more than 41% of the population undernourished. The fact that chronic undernutrition has not changed for four decades despite huge investment warrants a re-examination of plans and programmes.

Inadequate food in the household is a result of insufficient food production as well as inability to access food. Lack of access to land, limited income-generating and livelihood opportunities, an inequitable food distribution system and the absence of markets all contribute to child undernutrition.

Other major contributory factors are poor hygiene and sanitation practices; lack of clean water and an unhealthy environment around the household and community; inadequate access and use of health and nutrition services and lack of proper care for mothers and children in the home; and their increased vulnerability and marginalization due to factors such as the conflict, internal displacement and migration.

There are wide disparities within the country depending on geographic location, ethnic or caste origin, and socioeconomic status. Dalits, Madhesi communities and Muslims, for example, have the highest rates of undernutrition in comparison to other caste/ethnic groups, regardless of urban or rural residence.

The National Health Sector Plan II aims to improve the nutritional status of the population. A sector-wide approach adopted in 2005 for financial assistance to the health sector also includes funding for nutrition. The National Nutrition Policy and Strategy 2008 is a key policy document guiding interventions under the Ministry of Health and Population. The Department of Food Technology and Quality Control under the Ministry of Agriculture and Cooperatives has a National Nutrition Programme providing food-based training, education, communication and research. The Ministry of Local Development has also initiated a social protection measure, with cash grants to improve the nutritional status of children from five districts of the Karnali Zone and Dalit communities nationwide.

In 2011, the government initiated a process to adopt a multisectoral approach to address nutrition issues. The National Planning Commission has made efforts to put nutrition high on the agenda and to coordinate and guide various multisectoral initiatives; in 2012, it launched the Multi-Sector Nutrition Plan 2013-2017 which focuses nutritional-status support interventions on expectant mothers and the first 1,000 days of a child’s life. Nepal has also been selected as a focus country for global nutrition initiatives such as Scaling Up Nutrition, drawing attention from the global community.