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Joao McXimenes Timor Leste to Win Stunting.pptx
- 1. 3rd International Conference on Environmental Health “STUNTING & ENVIRONMENTAL HEALTH RISK FACTOR” JOAO MANUEL CORREIA XIMENES, dr. UNIVERSIDADE de DILI TIMOR LOROSA’E June 20, 2022
- 2. No single organization, no single government can act alone to achieve the goal of ending hunger and global malnutrition. Working together, we have the ability to establish powerful partnership that change the global landscape, from one of hunger to one of hope, country by country, community by community, family by family and child by child; until no one goes hunger.
- 3. Stunting refers to a child who is too short for his or her age. These children can suffer severe irreversible physical and cognitive damage that accompanies stunted growth. The devastating effects of stunting can last a lifetime and even affect the next generation.
- 4. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Inadequat e Nutrition - Recurrent infections - Chronic/diseases poor nutrient intake, absorption, utilization People Attitude Support system & Mechanisms Cause & Risk Factors Environment Nature
- 6. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child * The collection of household survey data on child height and weight were limited in 2020 due to the physical distancing measures resulting from COVID-19; only four national surveys with at least some field work in 2020 are included in the JME database. The JME estimates are therefore based almost entirely on data collected before 2020 and do not take into account the impact of the COVID- 19 pandemic.
- 7. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child In 2020,* more than half of all children under 5 affected by stunting lived in Asia and two out of five lived in Africa. In 2020,* more than two thirds of all children under 5 affected by wasting lived in Asia and more than one quarter lived in Africa. In 2020,* almost half of all children under 5 affected by overweight lived in Asia and more than one quarter lived in Africa. GLOBAL OVERVIEW Most children with malnutrition live in Africa and Asia Source: UNICEF, WHO, World Bank Group Joint Child Malnutrition Estimates, 2021 edition. *The collection of household survey data on child height and weight were limited in 2020 due to the physical distancing measures resulting from COVID-19; only four national surveys with at least some field work in 2020 are included in the JME database. The JME estimates are therefore based almost entirely on data collected before 2020 and do not take into SHARE BY COUNTRY INCOME CLASSIFICATION Less than half of all children under 5 live in lower-middle income countries, but nearly two thirds of all children with stunting and three quarters of all children with wasting live there
- 8. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child GLOBAL OVERVIEW Prevalence and Number (millions) affected Source: UNICEF, WHO, World Bank Group Joint Child Malnutrition Estimates, 2021 edition. *The collection of household survey data on child height and weight were limited in 2020 due to the physical distancing measures resulting from COVID-19; only four national surveys with at least some field work in 2020 are included in the JME database. The JME estimates are therefore based almost entirely on data collected before 2020 and do not take into account the impact of the COVID-19 pandemic. Number (millions) of children under 5 affected by stunting, wasting and overweight, global, 2000–2020* Percentage of children under 5 affected by stunting, wasting and overweight, global, 2000–2020* Stunting has declined steadily since 2000 – but faster progress is needed to reach the 2030 target. Wasting persists at alarming rates and overweight will require a reversal in trajectory if the 2030 target is to be achieved.
- 9. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Treats The lifetime costs of stunting ripple far beyond physical measurement. Graphic: Aeri Wittenbourgh
- 10. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Global Objectives & Targets Reducing health inequalities and leaving no one behind is part of the Sustainable Development Goals and the 2030 Agenda for Sustainable Development 2025 Stunting child < 5 yo 40%
- 11. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child World’s stunting fighting concept Energy & Protein Supplements for women Community-based platforms for nutrition education & promotion Government commitment and focus on equity H O W
- 12. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child
- 13. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Standard of Stunting in TL (Anthropometric Standard) Indeks Standard (Z-score) Nutrition Status Category Height per age <- 3 SD Severely stunted - 3 SD s.d. < -2 SD Stunted -2 SD s.d. +3 SD Normal > +3 SD Tall
- 14. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child TL Situation on Stunting Surveys, child <5 yo TLDHS 2010 (58,1%) TLFNS 2013 (50,2%) TLDHS 2016 (47,3%) TLFNS 2020 (47,1%)
- 15. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Factors related to Stunting in TL Nutrition Availability • Dry land, long dry season TL Civilizations • Concept of life • Cultural influences Organizatio ns Sensibility • Political commitment • Policy advocacy • Alliance Health Status • Chroni c diseas e • Comm unicab le diseas e Readiness of support facilities • WASH facility
- 16. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Unhealthy People Uncompetitive people Low Productivity Increase health expenditure Life expectancy Treat for Develop TL People and Country MMR (557/100.000), Neonatal death (90,9%), endemic TB GDP : $ 0.55 USD (40,8 %) F:M = (60,2 yo : 58,6 yo) DHS – 2010
- 17. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child
- 18. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child TL fight Stunting : National Strategies - National Strategic Plan 2011-2030 - National Health Sector Strategic Plan 2011-2030 lean to UHC - National Policy on Nutrition and Food security - National Action Plan for Nutrition and Food Security - KONSSANTIL Framework
- 19. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child TL fight Stunting : National Strategies Implimentation 1. Nutrition espesific intervention programm 1.Adolescent health and preconception nutrition 2.Maternal dietary supplementation 3.Breastfeeding and Complimentary feeding 4.Dietary supplement for children 5.Feeding behavior and simulation 6.Treatment of acute severe malnutrition 7.Disease prevention and management 8.Nutrition intervention in emergencies
- 20. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child TL fight Stunting : National Strategies Implimentation 2. Nutrition Sensitive Programmes and Approach 1.Agriculture and food security 2.Social safety nets 3.Early child development 4.Maternal mental health 5.Women’s empowerment 6.Child protection 7.Classroom education 8.Water and sanitation 9.Health and family planning services
- 21. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child TL fight Stunting : National Strategies Implimentation 3. Building an enabling environment 1.Rigorous evaluation 2.Advocacy strategy 3.Horizontal and vertical coordination 4.Accountability, incentives regulations and legislation 5.Leadership program 6.Capacity investment 7.Domestic resource mobilization
- 22. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Good Practices Local-base settings; use proper & modern agriculture technology for food security Minimized utilization of pesticides School Health Programm along side with School Nutrition Programm WASH facilities in Health Facilities Stakehold er & Partnershi p involveme nt Communit y-base programm Industrialized local food Timor Lorosa’e nowadays approachment
- 23. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Promot e Healthy Life Fight Malnourishmen t Public Health Students roles Knowledg e & Attitude Communi ty Influencer Communit y Driver Role Models Community Advocator
- 24. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child Key message When we forget the morality we might still stand as well as we break the rules…until we let one of us HUNGER, we as just fail as mankind
- 25. UNICEF, WHO, The World Bank. Levels and trends in child malnutrition: Key findings of the 2021 Edition of the Joint Child Malnutrition Estimates – UNICEF | for every child
- 26. * 1. Reducing Stunting in Children; Equity considerations for achieving the Global Nutrition Targets 2025; WHO, 2018 2. Scaling Up Nutrition in Practice; Effectively Engaging Multiple Stakeholders; WHO, 2014 3. SUN Movement Strategy - 2012 to 2015; 2012 4. Changing Food System for Better Nutrition; WHO, 2013 5. Global Nutrition Targets 2025; Stunting Policy Brief; WHO, 2014 6. Planu Estratejiku Nasional Setor Saude II 2020-2030 7. Planu Estratejiku Nasional Nutrisaun Setor Saude 2022- 2026
Editor's Notes
- Note that regional and global wasting and severe wasting estimates are only presented for the most recent year, 2020, unlike stunting and overweight estimates for which an annual time series is available from 2000 to 2020. This is because the JME are based on national-level country prevalence data, which come from cross-sectional surveys (i.e., a snapshot at one point in time) that are collected infrequently (every three to five years) in most countries. Since stunting and overweight are relatively stable over the course of a calendar year, it is reasonable to track changes in these two conditions over time with these data, whereas wasting is an acute condition that can change frequently and rapidly. An individual child can be affected by wasting more than once in a calendar year (i.e., can recover but then become wasted again in the same year), and the risk of wasting in many contexts can be driven by seasonal variations, which can result in seasonal spikes in prevalence. For example, wasting prevalence, in some contexts, may double between the post-harvest season (often associated with higher food availability and weather patterns that are less likely to cause disease) and the pre-harvest season (often associated with food shortages, heavy rains and related diseases that can affect nutrition status). Given that country surveys can be collected during any season, the prevalence estimate from any survey may be at a high or low; or it may fall somewhere in between if data collection spanned across several seasons. Thus, the prevalence of wasting captures the situation of wasting at a specific point in time and not over an entire year. Variations in seasons across surveys make it difficult to draws inferences on trends. The lack of methods to account for seasonality and incident cases of wasting and severe wasting are the main reasons why the JME does not present annual trends for these forms of malnutrition.