9780821384411

Malnutrition in Afghanistan : Scale, Scope, Causes, and Potential Response

by
  • ISBN13:

    9780821384411

  • ISBN10:

    0821384414

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2010-11-01
  • Publisher: World Bank

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Summary

South Asia has the highest rates of malnutrition and the largest number of malnourished women and children in the world. Childhood malnutrition is the main cause of child mortality#xE2;#xAC;#x1D;one-third of all child deaths are due to the underlying cause of malnutrition. For the children who survive, malnutrition results in lifelong problems by severely reducing a child#xE2;#xAC;"s ability to learn and to grow to his or her full potential. Malnutrition directly leads to less productive adults and thus to weaker national economic performance. The negative impact of malnutrition on a society#xE2;#xAC;"s productivity and a nation#xE2;#xAC;"s long-term development is difficult to underestimate. Malnutrition is a key development priority for the World Bank#xE2;#xAC;"s South Asia region. The Bank intends to increase its commitment to reducing malnutrition in the region. As a first step, Bank staff are preparing a series of country assessments such as Malnutrition in Afghanistan. These assessments will be useful for governments and development partners committed to scaling up effective, evidence-based interventions to reduce malnutrition in their countries. Conclusive evidence shows that a multisectoral planning approach, followed by actions in the various sectors, is the most successful method to improve a populations#xE2;#xAC;" nutrition. Malnutrition in Afghanistan provides the background analysis for the development of a comprehensive nutrition action plan. The timing of this report is propitious. The international communities#xE2;#xAC;" interest in the developmental benefits of nutrition programming is high. This analytical report is part of a broader effort by the World Bank South Asia region to increase investments in nutrition, recognizing that good nutrition is important to economic growth and development, and because investing in well-proven nutrition interventions pays high dividends in poverty reduction and national economic development.

Table of Contents

Forewordp. xiii
Prefacep. xv
Acknowledgmentsp. xvii
Abbreviationsp. xix
Overviewp. 1
Nutrition Situation in Afghanistanp. 1
Conceptual Frameworkp. 2
Determinants of Undernutrition in Afghanistanp. 3
Political Economy, Institutional and Implementation Arrangements, and Capacity to Address Undernutritionp. 4
Programs, Gaps, and Opportunitiesp. 7
Recommendationsp. 11
Referencesp. 15
Introductionp. 17
Rationalep. 17
Afghanistan: Country Contextp. 23
Methods and Analytical Approachp. 26
Structure of the Reportp. 26
Notep. 27
Referencesp. 27
The Current Nutrition Situation in Afghanistanp. 29
Child Undernutrition: Overviewp. 30
Child Undernutrition: Vitamin and Mineral Deficienciesp. 32
Maternal Undernutrition: Underweightp. 36
School-Age Children and Adults: Vitamin and Mineral Deficienciesp. 37
Summary of Data and Data Gapsp. 40
Notesp. 41
Referencesp. 42
The Determinants of Undernutrition in Afghanistanp. 45
The UNICEF Frameworkp. 45
Food Security: Inadequate Access and Availability of Foodp. 47
Health and Health Servicesp. 51
Health Environmentp. 54
Care for Women and Childrenp. 55
Nutrition Awarenessp. 60
Summaryp. 61
Notesp. 62
Referencesp. 63
Political Economy and Capacity to Address Undernutritionp. 65
Pillar 1: Nutrition Is Recognized as Foundational to National Developmentp. 66
Pillar 2: Adequate Local Capacity Is Built and Supported to Design and Execute Effective Nutrition Policies and Programsp. 82
Referencesp. 84
Current Programs, Gaps, and Opportunitiesp. 87
Pillar 3: Cost-Effective, Direct Nutrition Interventions are Scaled Up, Where Applicablep. 87
Pillar 4: Determinants of Undernutrition Are Addressed through Multisectoral Approachesp. 108
Pillar 5: Coordinated Support for Nutrition Is Provided by Development Partnersp. 130
Notesp. 132
Referencesp. 133
Recommendationsp. 137
Pillar 1: Nutrition Is Recognized as Foundational to National Developmentp. 137
Pillar 2: Adequate Local Capacity Is Built and Supported to Design and Execute Effective Nutrition Policies and Programsp. 138
Pillar 3: Cost-Effective, Direct Nutrition Interventions are Scaled Up, Where Applicablep. 139
Pillar 4: Determinants of Undernutrition Are Addressed through Multisectoral Approachesp. 143
Pillar 5: Coordinated Support for Nutrition Is Provided by Development Partnersp. 145
Notesp. 145
Referencep. 145
Methodologyp. 147
Network Assessmentp. 147
Synthesis and Analysis of Available Nutritional Epidemiology Datap. 149
Analysis of Available KAP Datap. 149
Review of the BPHS Regarding Nutritionp. 150
Review of Programs in Other (Nonhealth) Sectors That Affect or Could Affect Nutritionp. 150
Capacity Assessment of the MOPH's Public Nutrition Department and Other Institutional Structures to Lead and Implement Scaled-Up, Effective Multisectoral Nutrition Interventionsp. 150
Analytical Approachp. 151
Referencesp. 151
Nutrition Data Collection in Afghanistanp. 153
Referencep. 155
Cultural Beliefs Relating to Infant and Young Child Feedingp. 157
Beliefs about Energy-Rich Foods for Infants and Young Childrenp. 157
Beliefs about Protein-Rich Foods for Infants and Young Childrenp. 158
Beliefs about Fruits and Vegetables for Infants and Young Childrenp. 160
Notep. 161
Referencep. 161
Summary of Services Provided through the Ministry of Public Health Basic Package of Health Servicesp. 163
Nutrition Components of the Basic Package of Health Servicesp. 165
The Afghanistan National Development Strategy Structurep. 169
Organizational Chart of Ministry of Public Health's Public Nutrition Department (under Preventive Medicine)p. 171
Organizational Chart of the Ministry of Agriculture, Irrigation, and Livestockp. 173
Job Description for Provincial Nutrition Officersp. 175
Assessment of Capacity in Government Entities Responsible for Nutritionp. 181
The MOPH's PNDp. 181
The MAIL's Home Economics Departmentp. 186
Referencep. 189
Public Nutrition Partners According to the Type of Roles and Responsibilitiesp. 191
Simple Growth Promotion Card Developed for Demonstration Project in Afghanistan (BASICS III Project)p. 195
Overview of the Components of the Government Nutrition System in Afghanistanp. 197
Glossaryp. 199
Indexp. 203
Boxes
Goal of the Global Action Plan for Nutritionp. 22
Cereal Deficits in Afghanistanp. 47
Predominant Breastfeedingp. 58
Key Constraints to Optimal IYCF Practices in Afghanistanp. 59
Pillars of the Global Action Plan Pertinent to National Infrastructure for Nutritionp. 66
HNSS and MOPH Mission Statementsp. 69
The Public Nutrition Approachp. 70
Guiding Features of Afghanistan's Public Nutrition Strategy, 2009-13p. 72
Guiding Policy Principles of the Public Nutrition Strategy, 2009-13p. 73
Priority Nutrition Challenges for Afghanistan, 2009-13p. 74
The Four Programs of the NADFp. 75
Pillars of the Global Action Plan for Nutrition Relevant to Program Implementationp. 88
Direct Nutrition Interventions Recommended under Pillar 3p. 88
Highlights of the Afghan Strategy on Prevention and Control of Vitamin and Mineral Deficienciesp. 89
Highlights of the National Strategic Plan for IYCFp. 94
IYCF Intervention Achievements, as of 2010p. 96
Community-Based Growth Promotion as a Platform for IYCF and Other Activitiesp. 98
Using a Packaged Approach to Interventionsp. 111
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