Suchergebnisse

BACKGROUND: The public health burden of undernutrition remains heavy and widespread, especially in low-income countries like Nepal. While predictors of undernutrition are well documented, few studies have examined the effects of political will and quality of policy or program implementation on child growth. METHODS: Data were collected from two nationwide studies in Nepal to determine the relationship between a metric of nutrition 'governance' (the Nutrition Governance Index), derived from interviews with 520 government and non-government officials responsible for policy implementation and anthropometry measured for 6815 children in 5556 households. We employed Generalized Estimating Equation (GEE) and multilevel regression models. RESULTS: A higher NGI (more effective nutrition governance) is positively associated with height-for-age as well as weight-for-height in children over 2 years of age compared to younger children (HAZ; β = 0.02, p 24 months old). Mothers' education, child's age, BMI and no fever in the past 30 days were also protective of stunting and wasting. Seven percent and 17% of the overall variance in HAZ and WHZ, respectively, are accounted for by variations across the 21 district locations in which sampled households were located. Mean HAZ differs considerably across districts (intercept = 0.116, p < 0.001). CONCLUSIONS: These results highlight the importance of effective management of policy-based programming and resource use to bring about nutrition gains on the ground. The NGI explained a non-negligible amount of variation in HAZ and WHZ, which underscores the fundamental role that good governance plays in promoting child nutrition and growth, and the value of seeking to measure it to assist governments in moving policies from paper to practice.

With less than five years to go before 2015, work has begun on a post-2015 development agenda. This report - sixth in the series published by ADB, ESCAP and UNDP on MDG achievement in Asia and the Pacific region - is part of that effort. The report, Accelerating Equitable Achievement of the MDGs: Closing Gaps in Health and Nutrition Outcomes, focuses on disparities in MDG achievement within and between countries, to address major bottlenecks holding back MDG progress in Asia and the Pacific region. Even countries making rapid economic progress continue to lose shocking numbers of children before their fifth birthdays as well as thousands of mothers who die unnecessarily during childbirth. Given the lagging performance on health outcomes in the region, the report delves into the causes and shows the many opportunities that exist to achieve good health for all. It discusses options, both within and outside of the health sector that could help bring about a turnaround in performance on health in the region, thus accelerating progress in achievement of all the MDGs. The report is a result of wide consultations, not just amongst ADB, ESCAP and UNDP, but also with many UN agencies participating in the Regional Coordination Mechanism. The report is a resource which policy makers, development practitioners and other stakeholders should find useful in addressing the remaining challenges in achieving the MDGs

PR ; IFPRI3; CRP4; ISI; Stories of Change in Nutrition ; PHND; SAO; A4NH ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

The Indian state of Odisha has made significant strides to address health and nutrition in the last 25 years. We used public data, policy and program documents, published literature, and interviews with program and policy decision-makers, development partners, civil society members (n=29) and community members (n=45) to analyze these changes. Factors that contributed to scale up of health and nutrition interventions and the food security program included overarching policy support, financing at the national and state level, leadership across sectors from government to civil society and development partners, capacity and stability of tenure of bureaucrats, and state innovations in service delivery interventions. Barriers that may impede further progress include lack of sanitation, low levels of women's education, early marriage in girls, livelihood distress, and uneven progress across social groups.

This study summarizes estimates and lessons learned from application of the scaling up nutrition (SUN) methodology to assess public financing for nutrition in Bhutan. Using Bhutan's classification of nutrition interventions, per capita public financing for addressing malnutrition is estimated to be Nu 2,003 (approximately United States (U.S.) 29 dollars, 1 percent of gross domestic product (GDP), and 3 percent of total government expenditures), 30 percent of which was for nutrition-specific activities, and about one-third the level of public spending on health. The level of public spending for nutrition is similar in magnitude - and in the shares across nutrition-specific and nutrition-sensitive interventions - when compared with other developing countries; recent estimates from Asia indicated an average of 2 percent of aggregate government expenditures went toward addressing nutrition, with a 20 percent share for nutrition-specific interventions. Despite the level of spending increasing from Nu 1,744 in financial year (FY) 2013-14, there does not appear to be any increase in priority to nutrition over the course of the 11th five-year plan (FYP): increases in the levels of expenditure for nutrition have resulted from growth of the economy and not because of higher budget allocation to addressing nutrition. The largest nutrition-specific expenditures were those related to the national school feeding program and the largest nutrition-sensitive expenditures were those related to water, sanitation, and hygiene (WASH) programs. Notably, the financing locus for nutrition-related expenditures lies within the Ministry of Education (MoE) and the Ministry of Works and Human Settlement (MoWHS). Although Bhutan defines nutrition-specific and nutrition-sensitive interventions somewhat differently from how they are defined globally, the magnitude of resources allocated toward improving nutrition appears similar to those in other developing countries even when adjusted to enhance global comparability.