Transcript Millennium Development Goals Linkages with Early Child Development and Nutrition The Challenge in India DR.

Millennium Development Goals
Linkages with Early Child Development and Nutrition
The Challenge in India
DR. S.K CHATURVEDI
MD,MNAMS,FIAPSM,FIPHA
UNICEF State Representative for NE/NW states
New Delhi
1. Genesis of Millennium Development Goals
2. Conceptual Framework
3. The Link with Integrated Early Child Development & Nutrition
4. Millennium Development Goals
5. India – Challenges & Opportunities
6. Moving Forward
The Genesis
Millennium summit of UN - September 2000
Commitment to reduce global deprivation and promote sustainable
human development
Millennium Development Goals/ Country Plan Goals
• Quantifiable targets for 2015
• Some 10th Plan Goals more ambitious than the MDGs
A Rights Perspective
• Children’s & women’s rights fundamental to human rights
• UN Convention on the Rights of the Child
• Convention on Elimination of all forms of Discrimination Against
Women
Creating a World Fit For Children
• UN General Assembly Special Session on Children - Sept 2002
• Placing children first on the development agenda
Millennium Development Goals
1.
Eradicate Poverty & Extreme Hunger
2.
Achieve Universal Primary Education
3.
Promote Gender Equality & Empower Women
4.
Reduce Child Mortality
5.
Improve Maternal Health
6.
Combat HIV/AIDS, Malaria & Other diseases
7.
Ensure Environment Sustainability
8.
Develop Global Partnership for development
Young children on the Development Agenda
A conceptual Framework
Fulfillment of the Rights of all children to survive grow and develop to their
full potential without discrimination
Well nourished and healthy child
CARE
Home Health Practices
Home Hygiene Practices
Infant and Young Child Feeding
Psychosocial Care
Care for Girls and Women
Immediate
Conditions
Underlying
Conditions
Secure & Active Learner
Household Securities
(eg Food,Water,Shelter)
Outcome
Child
Family
Empowered Community
& Change facilitators
Access to quality Services
(Health, CDN, WES)
Household/
Community
Education / Learning / Life skills / Information & Communication
Basic
Conditions
Efficient resource use & control
Natural /Human / Economic/Organization Resources
Political, Economic & Social
Structures & Systems
Institutions
and Governance
Natural Resource Base & Environment
Civil Society
/State
Integrated Early Child Development & Nutrition
• Foundation for cumulative lifelong learning and human
development
• Entry point for poverty reduction and human
development strategy
• Early interventions most effective in addressing a life
cycle of multiple deprivation  Poverty
 Gender Discrimination
 Malnutrition
• Sensitive proxy indicator of human development
- % children 0-5 years underweight
Crucial for the achievement of first 6 MDGs
Goal 1
Eradicate Poverty & Extreme Hunger
Halve, between 1990-2015, proportion of people…
Target 1  …whose income is less than $1 a day
Target 2  …who suffer from hunger



Malnutrition erodes human capital, reduces learning
abilities and productivity
For human capital formation, it is critical to prevent
malnutrition, as early as possible
Early Care and Nurturing has a lasting impact on brain
development- especially in the first 3 years
The first 3 years are crucial. They are forever…
Goal 2
Achieve Universal Primary Education
Ensure by 2015…
Target 3  Children everywhere, boys & girls alike, will be able
to complete full course of primary schooling
10th Plan  All children in school by 2003
All children to complete 5 years of schooling by
2007

Early Child Development interventions




Result in increased cognitive and social skills
Improve retention and learning outcomes in primary education
Equality of opportunity for disadvantaged groups
Malnutrition reduces mental capacity & learning ability
e.g. Micronutrient deficiencies such as Iodine (13 IQ points)
Iron Deficiency Anemia (9 IQ points)
Goal 3
Promote Gender Equality & Empower Women
Eliminate by 2005…
Target 4  …Gender disparity in primary & secondary education, &
at all levels of education no later than 2015

Positive early child care practices and parent education
help promote equal learning opportunities for girls and boys

Better nutriture and iron status of girls
improves learning capacity, likely retention and future choices
Goal 4
Reduce Child Mortality
Reduce by 2/3 between 1990-2015
Target 5  …Under 5 Mortality Rate
10th Plan  IMR to be 45 by 2007
IMR to be 28 by 2012

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More than 50% of all child mortality is directly or indirectly
associated with malnutrition
Around 25 % of young child mortality can be prevented
through nutrition and early child care interventions
Goal 5
Improve Maternal Health
Reduce by 75% between 1990-2015
Target 6  …Maternal Mortality ratio



Maternal health is compromised by inadequate care and
nutrition of girls and women
Malnutrition, including anemia, is associated with most
major risk factors for maternal mortality
Severe anemia is a major cause of maternal deaths –
around 20 % globally
Goal 6
Combat HIV/AIDS, Malaria & Other diseases
Have halted by 2015…
Target 7  …and begin to reverse the spread of HIV/AIDS

Malnutrition
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
Hastens onset of AIDS among HIV-positive
Weakens resistance to infections and reduces malaria survival rates
Infant & Young Child Feeding
Informed choice important for prevention of mother to child transmission of
HIV/ AIDS
Linking Nutrition & Development Mechanisms
and Instruments
More effective poverty reduction
•
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Nutrition key to addressing inter-generational cycle of poverty
Helps targeting the most vulnerable and at risk
Proxy indicator for multi-sectoral interventions
Strengthened health sector reform
•
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Inclusion of early child care and nutrition increases efficiency and
quality of health services
Using nutrition tools and methods
e.g. Mother Child Care Counseling Package
Improved Governance
•
Community based care interventions promote participatory
processes and capacity
The Challenge in India
• Every fifth young child in the world lives in
India
• Every second young child in India is
malnourished
• Three out of four young children in India are
anemic
• Every second newborn in India is at risk of
reduced learning capacity due to iodine
deficiency
• Vitamin A a public health issue
• Malnutrition limits development potential
and active learning capacity of the child
IMR Reduction needs acceleration…
140
120
100
80
60
69
64
40
40
20
Rural
Total
Urban
Source : SRS Bulletins - RGI
2002
2000
1996
1992
1988
1984
1980
0
Addressing Malnutrition…
51.5%
47.0%
47.1%
45.5%
19.3%
Underweight
Stunted
NFHS 1 (1992-93)
15.5%
Wasted
NFHS 2 (1998-99)
Children 0- 3 years
Promoting early child development is crucial
Prevalence of Underweight Children…
(0-3 years)
Jammu & Kashmir
Himachal
Pradesh
Punjab
Uttaranchal
Haryana
Delhi
Arunachal Pradesh
Sikkim
Uttar Pradesh
Rajasthan
Assam
Bihar
Nagaland
Meghalaya
Manipur
Jharkhand
West
Bengal
Madhya Pradesh
Gujarat
Chattisgarh
Orissa
Diu
Daman
Maharashtra
(49.6%)
Dadar & Nagar
Haveli
Andhra Pradesh
Goa
Karnataka
Tripura
Mizoram
% children 0-3 years below -2 SD
Weight-for-Age, NCHS
 50 %
40-49 %
30-39%
20-29%
Data NA
Source : NFHS II, 1998-99
Pondicherry
Tamil Nadu Karaikal (Pondicherry)
Lakshadweep
Kerala
The boundaries and names shown in this map do not imply official endorsement or acceptance by the UN
Andaman & Nicobar Islands
10th Plan Goals…
Improve Infant and Young Child Feeding Practices
Increase early initiation (colostrum feeding) : 16% to
Increase exclusive breastfeeding 0-6 mths : 55% to
(0-3 mths)
Increase complementary feeding (6-9 mths) : 34%
50%
80%
(0-6 mths)
to
75%
Reduce the prevalence of Underweight (Children Under-3
years) from 47% to 40%
Reduce prevalence of severe under-nutrition in children in the 0-6 years age
group by 50%
Reduce prevalence of anaemia by 25%
and that of moderate/ severe anaemia by 50%
Eliminate Vitamin-A deficiency
Reduce prevalence of IDD to less than 10% by 2010
Achieving the 10th Plan Goals…
• It is possible to achieve these through relatively
simple interventions
• Improved family community care behaviours,
focusing on children Under-3 years of age
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–
–
–
–
Infant and Young Child Feeding
Psychosocial Care
Care for girls and women
Hygiene
Health
• Positive evidence from community based care
projects - even in challenging states
Preventable Under-5 deaths - India
Through universal coverage with individual interventions (2000)
Breast Feeding
Complementary Feeding
Clean Delivery
HiB Vaccine
Clean water, sanitation & hygiene
Zinc
Vitamin A
Antinatal streoids
Newborn temprature management
Tetanus Toxoid
Antibiotics for PRM
Measles vaccine
Nivirapine & replacement feeding
Insecticide treated materials
Antimalarial IPT in Pregnancy
0
Source : Lancet Series
4
8
12
16
Moving Forward…
• Build upon innovative state-specific early child care
approaches
• Enhance quality improvement initiatives in ICDS
• Increase emphasis on improving family/community
early child care practices for younger children Under-3
years in RCH-II & ICDS
e.g. Infant and Young Child Feeding
• Strengthen partnerships for WCD
Panchayati Raj Institutions
Women’s Self Help Groups and community groups
• National Nutrition Mission