KATHMANDU, AUGUST 14
Child malnutrition is a serious issue that has a significant impact on children's health and development. Malnutrition includes both undernutrition (wasting, stunting, and micronutrient deficiencies) and overnutrition (obesity).
Data from 53 developing countries with nationally representative information on child weight-for-age show that 56 percent of child deaths were linked to malnutrition.
Rural areas in Nepal have higher rates of malnutrition than urban areas because of limited access to nutritious food, healthcare services, and education. Disparities in malnutrition rates are evident across different socio-economic groups, with children from the poorest households being the most affected.
Efforts to combat child malnutrition in Nepal are ongoing through multiple stakeholders, including the government, multilateral and bilateral agencies, and non-governmental organisations such as the Government of Nepal, which has implemented several initiatives aimed at improving the status of malnutrition, such as the Multi-Sector Nutrition Plan (MSNP) and the School Meal Programme (SMP), among others.
According to the Nepal Demographic and Health Survey 2022, 25 per cent of children under the age of five are stunted (short for their age), 8 per cent are wasted (thin for their height), 19 per cent are underweight, and 1 per cent are overweight. 43 per cent of children aged 6-59 months and 34 per cent of women aged 15-49 had anaemia. 10 per cent of women aged 20-49 and 27 per cent of adolescent girls aged 15-19 had short stature.
Similarly, 26 per cent of adolescent girls had a low Body Mass Index (BMI). The prevalence of overweight or obesity is 35 per cent in women and 6 per cent in adolescent girls. 56 per cent of women aged 15 to 49 eat meals with little dietary variety, 54 per cent consume unhealthy foods, and 66 per cent drink sweet beverages.
Existing legal and policy arrangements ensure child nutrition in Nepal. The Constitution of Nepal, for instance, guarantees several fundamental rights that are directly related to children's nutrition: the right to a clean environment (Article 30), the right to health (Article 35), the right to education (Article 31), the right to food (Article 36), and the rights of children (Article 39). These rights emphasise the value of nutrition for all citizens.
The Right to Food and Food Sovereignty Act of 2018 prioritises the establishment of a robust nutrition system. It discusses nutrition and people's right to food.
The Local Government Operation Act of 2017 defines the roles of rural municipalities and municipalities in terms of basic health and sanitation. It entails developing, implementing, and enforcing policies, laws, standards, and action plans for basic health, sanitation, and nutrition.
MSNP III 2024-2030 has a long-term goal of "ending malnutrition, building productive human capital, and promoting overall socioeconomic development."
The National Nutrition Strategy 2020 aims to increase access to "nutrition-specific" and "nutrition-sensitive" services in order to significantly reduce all forms of malnutrition in newborns, children, women, and adolescents while also improving nutritional status.
Additionally, major child malnutrition programs in Nepal include the multi-sectoral nutrition plan III, which will be implemented at all 753 local levels and 77 districts. Creating outdoor and indoor treatment centres in health facilities to treat and manage acute malnutrition in children under the age of five.
The 16th Plan (2024/25-2028/29) addresses micronutrient deficiencies through strategies such as supplementation, fortification, and local food diversification.
The Nutrition-Friendly Local Governance (NFLG) Implementation Guideline 2021 aims to improve the nutritional well-being of women, children, and adolescents while also integrating nutrition considerations across multiple sectors.
The School Sector Development Plan (SSDP) 2016-2023 is critical to addressing child malnutrition because it recognizes schools as strategic platforms for promoting children's nutritional well-being and overall development.
The Nepal government is also conducting a Child Cash Grant for children under 5 years of age. The Ministry of Home Affairs distributed this subsidy. Rs. 532 per month is available per child.
The Government of Nepal has provided child subsidies to all Dalit children under the age of five in all 77 districts. The midday meal program is still in place at community schools' primary levels, from Early Childhood Development to Grade Six.
Despite all of the legal provisions, there are several gaps that must be addressed. According to Dipesh Ghimire, PhD, who recently conducted policy research on the state of child nutrition in Nepal, there is a shortage of human resources, particularly at the local level, a lack of inter-level and institutional coordination, limitations of need-based targeted programs, inadequacy of social behaviour change programs, and insufficient coordination and collaboration among the three levels of government and stakeholders.
"Limited public awareness of balanced diets, particularly among school-aged girls, and easily available junk food and packaged food in markets surrounding schools, which can sometimes lead to inadequate midday meals provided by schools," he told the Himalayan Times. "The decline in production and consumption of local traditional nutritious crops, difficulties in integrating budgets allocated by development partner organisations into government nutrition programs, issues with program duplication, and ineffective resource mobilisation have exacerbated the problems."
Ghimire stated that the government should create and implement a comprehensive national nutrition policy that includes clear guidelines for maternal and child nutrition, school feeding programs, and public education campaigns about healthy eating habits.
"The federal government should introduce a specific budget code dedicated to nutrition. It's crucial to establish a systematic and effective monitoring framework or system for nutrition and health-related plans and programs," he added. "Increasing the amount of child nutrition allowance and ensuring its nationwide expansion to support families in providing adequate nutrition for children. Policies and laws should be developed to encourage the private sector to invest in CSR programs aimed at improving the nutritional status of children."
