RASUWA -- Mina Lo was 14 when she was married off, and by 18 she had her first baby. Since her husband left for work in the Gulf immediately after birth, the 19-year-old has been taking care of the baby boy all by herself.
Growing up in a tiny village 120km north of Kathmandu, Mina has seen her fair share of children with development disorders caused by malnutrition. “I worry that my baby might not develop to his full potential,” she says.
Nepal is among 10 countries with the highest prevalence of stunting and one of the top 20 countries with the highest number of stunted children, according to UNICEF
. UNICEF explains stunting as chronic under-nutrition during critical periods of growth and development till a child is 60 months. The consequences of stunting are irreversible and in Nepal the condition affects nearly half of all children under five.
Stunting is a measure of height to age of the child, but it is also indicative of how the child is growing cognitively. Experts believe Nepal’s ranking is worrying not just globally but also in South Asia. A 2013 progress report on the Millennium Development Goals (MDGs)
done by Nepal’s National Planning Commission (NPC) says that while the number of stunted children declined from 57 per cent in 2001 to 41 per cent in 2011, it is still far above the 30 per cent target set by the UN.
While inadequate food intake is related to poverty, it is not the sole indicator of malnutrition or increased stunting in Nepal. Since half of stunting happens during pregnancy
, babies need nutrient rich food from their mothers while still in the womb.
Keen to learn more about nutrition and proper childcare, Mina took the help of Mohmaya Acharya, a Female Community Health Volunteer. Acharya told the new mother to eat the green leafy vegetables readily available in her garden and rear chicken for meat and eggs. She also breastfed her baby exclusively for six months and continues to be careful about what she eats as she is still nursing her 14-month-old boy.
Source: MoHP, New Era, & KF International, 2011
Acharya says teaching about nutrition to young mothers is not as difficult as teaching them about sanitation and hygiene
. A common infection such as diarrhoea in the first two years of a child life can be very risky. And if children are suffering from infection due to poor sanitation they can have up to six diarhoeal episodes per year. All the nutrients children are supposed to be using for development are then used to fight against the infection. Even if children recover, they are not as healthy as before.
Food insecurity is a contributing factor to stunting in Nepal, and the country’s central and far-western regions
are the most food insecure and the prevalence of stunting in these areas are as high as 60 per cent. Realising that previous efforts to lessen stunting had not been too effective, the government conducted a Nutrition Assessment and Gap Analysis in 2009
, which recommended building a multi-sector nutrition program to address the gaps in health and nutrition programs.
Nepal is also one of the first countries to commit to the global Scaling Up Nutrition (SUN) movement, which recognises multiple causes of malnutrition and recommends that partners work across sectors to achieve nutritional goals.
In 2012, five ministries in Nepal came together with the NPC and development partners to form the Multi-Sector Nutrition Plan which offers interventions such as providing supplements to expectant mothers, increasing availability of food in the community, improving access to clean and cheap energy sources such as biogas etc. The plan has been implemented in six pilot districts to reduce the current prevalence of malnutrition by one-third.
Stunted development, Sunir Pandey
Stoves and toilets, Buddha Basnyat
Underfed and underfunded, Naresh Newar
Faulty feeding, Suman Pradhan
Charity, away from home, Billi Bierling