Under-nutrition has been a long standing public health problem in Nepal. Forty-nine per cent of Nepali children have been suffering from chronic forms of malnutrition, i.e., stunting and about one fourth of Nepal women has low BMI (<18.5). In Nepal, 39 per cent of children are underweight, 13 percent are wasted and 42 percent are anaemic (NDHS 2006).
Malnutrition during pregnancy increases the risk of complications and maternal death as well as the likelihood of low birth weight. Similarly, under-nutrition among children impacts on health, education and work productivity, and is a major impediment to the economic growth and development of the country. Malnutrition is detrimental for overall physical growth and mental and cognitive development in children. Despite many progress, particularly in controlling micronutrients deficiency disorders made on nutrition over the past decade in Nepal, malnutrition still remains a serious challenge for public health program. The prevalence of malnutrition varies widely across regions and socio-economic groups.
In view of the situation of nutrition in Nepal, a multiplicity of problems and challenges remain. Out of them, some problems and challenges are following:
- Inadequate of tangible support for nutrition interventions and insufficient prioritization of nutrition issues at national as well as local levels.
- Poor coverage of many essential nutrition interventions, including the prevention and control of anaemia among children, and management of severe acute malnutrition, addressing the issues of wasting and addressing the issues of adolescents and maternal malnutrition. Poor coverage is the result of weaknesses in the demand and provision of services.
- The available opportunities to integrate nutrition interventions into all possible contacts with service providers are missed, which limits coverage and impact. There are also inadequate linkages between programs and projects in different sectors, divisions that could provide synergistic services to address the issues of malnutrition.
- Key decisions about priorities and resource allocations for nutrition are made at the local government level, where the understanding on nutrition and how to deal with nutrition problems is limited. Very few nutrition professionals exist to provide high quality technical advice to local government authority efforts to address malnutrition.
- Limited financial resources are made available for nutrition interventions in Nepal. However, all like-minded actors are trying to provide specific attention on addressing nutrition issues. Still there is low understanding of the severity of the problem, and the concrete actions that can be taken to address it.
- In Nepal, effective nutrition architecture under health system and at different levels need to be established with well-defined terms of reference and enhanced capacity. Further, monitoring of nutrition status through the systems and the coverage of nutrition interventions at national and sub-national levels should be strengthened.
Different studies and researches have shown that unless nutrition interventions are implemented at a large scale, and with the necessary resources and institutional structures for sustainability, they will not be able to significantly affect national rates of malnutrition. Without a major national effort to address the issues outlined above, it is highly unlikely that Nepal will meet the MDG goals for maternal and child nutrition, health or poverty reduction. In line with the MDG targets and goals set by the Government of Nepal (GoN), a National Nutrition Strategy has been developed in 2004 and edited in 2007/08 to guide actions to improve nutrition in the country. Within this strategy, responsibilities for implementing actions to improve nutrition fall under multiple sectors, but mainly within the health, education, agriculture and livestock sectors.
In recognition of the need for concerted efforts to address under-nutrition within health sector, the Nutrition Program of Child Health Division ensures implementation of various activities on nutrition aspects in Nepal.