Boosting coordination for enhanced efforts
Yagya Bahadur Karki, Hon. Member of National Planning Commission and SUN Government Focal Point, together with Min Raj Gyawali, Programme Officer (Nutrition), National Planning Commission/ National Nutrition and Food Security Secretariat (NNFSS) Bharatendu Mishra, Hon. Member of National Planning Commission.
Ingo Neu, REACH International Facilitator, NNFSS Madhu Subedi, Programme Officer (Food Security), National Planning Commission/ National Nutrition and Food Security Secretariat (NNFSS) Jhabindra Bhandari, REACH National Facilitator, NNFSS.
Nepal has developed strategies and plans to address the problem of food insecurity, by promoting nutrition. Social protection schemes in the country are contributing to provide sufficient food and nutritious diet to the poor and socially excluded groups.
Poor nutrition affects the entire population, women and children are especially vulnerable because of their unique physiology and socioeconomic characteristics. Adequate nutrition is critical to children’s growth and
development. The first two-year period from birth is especially important for optimal physical, mental, and
cognitive growth, health, and development (Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc., 2012).
Nepal is one of the poorest countries in South Asia. A high proportion (estimates range from 25%‐55%) of its population lives on less than $1.25/day. Over 66 percent of the population works in the agricultural sector, predominantly subsistence‐oriented family farms. Households employed in agriculture account for more than three quarters of Nepal’s poor. Many of these households are vulnerable to and have been affected by the protracted conflict, drought and other natural disasters. Improvements in agricultural productivity have not maintained pace with population growth, particularly among small landholders and farmers.
In 2012/13, the Department of Agriculture, Ministry of Agriculture Development /Government of Nepal reported that 33 of Nepal’s 75 districts faced food deficit, and mountains and hill districts are chronically food insecure (Bhattarai & Subedi, 2014). Some of the households in the Terai1 area also face acute food shortage.
Almost 32% people in Nepal are living with less than minimum daily requirement of calories required for a healthy life (CBS, Unpublished). However significant disparity prevails between ecological zones, development
regions, rural-urban divide as well as across age, gender, ethnic, and caste groups. Compared to Terai (24%),
the population living with insufficient calorie intake is higher in hilly (36%) and mountainous (38%) areas.
Disparity is evident in the extent of incidences of low calorie intake among development regions ranging from
24.4% in Eastern Development region to 36.3% in Mid-western Development region. By Development Region, the two western (Mid and Far-Western) Development Regions are more calorie deficient compared to three eastern (Eastern, Central and Western) Development Regions. Thus, hilly and mountainous areas of the Mid and Far-Western Development Regions are worst hit by food insecurity and insufficient calorie intake. The hunger situation in Nepal is serious with a Global Hunger Index (GHI) value of 17.3 it is below alarming level, but the condition is considered serious (IFPRI, 2011).
The effect of food insufficiency is well reflected in the health status of the people as high incidences of stunting (low height for age), underweight (low weight for age) and wasting (low weight for height) was observed, particularly among the most vulnerable group of people (NLSS, 2011).
The 2011 Nepal Demographic and Health Survey shows an improvement in child nutritional status between 2006 and 2011 with stunting, wasting and underweight prevalence decreasing from 49% to 41%, 13% to 11% and 39% to
29%, respectively (Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc.,
2012). Nonetheless, chronic undernutrition (stunting) is still widespread, and wide disparities exist across
socioeconomic groups and ecological regions2 with children from the poorest households and those living in the mountain and hill areas exhibiting the highest levels of stunting.
Nepal is an agriculture-based country. More than 60% of the population rely on agriculture for their livelihood. However, the majority of farmers have low land holding as 53% farmers have ≤0.5 ha of cultivable land (NLSS, 2011). As a result, subsistent farming is most common in the country. Farming is done primarily for family consumption and production endeavour is directed towards the fulfilment of family needs. Therefore, improved agriculture is crucial for enhancing food production and thereby ensuring household food security, adequate dietary intake and nutritional status and health. Improved agricultural interventions are vital in sustaining nutrition and health status of impoverished segments of the society, who are more vulnerable to food insecurity and malnutrition.
In Nepal, considerable progress has been made in reducing poverty, increasing productivity, and reducing stunting in children during the decades. However, wasting prevalence or abnormal thinness among children has increased. Disaggregating national estimates reveal important and impressive reductions in childhood stunting across all ecological zones, ranging from a low of 14.7% in mountain districts to a high of 17.2% in the Terai. But stunting prevalence remains at high levels in all three ecologic zones. A different picture emerges with respect to wasting prevalence. The Terai has shown major reductions in childhood wasting; but wasting has significantly increased in the hills and mountain districts. Large disparities in both stunting and wasting rates remain by wealth quintile. Poor children are almost twice as likely to be stunted and wasted compared with their wealthier counterparts.
In order to enhance food and nutrition security in the country, several plans and policies have been developed. The food and nutrition security efforts received impetus after the enactment of the Interim Constitution of Nepal in 2007. At present, there are 12 different policies and 21 different acts to guide the agricultural sector in Nepal. Despite this, prevailing poor coordination mechanisms among major organisations working to enhance food and security, has led to reduced efficiency and effectiveness of the food and nutrition security efforts. The Multi-sector Nutrition Plan (MSNP) has been developed to bolster coordination among different relevant sectors.
MSNP has highlighted the importance to all relevant sectors working for enhancing food and nutrition security with particular emphasis on coordinated and collaborative efforts among them. Agriculture sector plan and strategies give emphasis on nutrition and food security. The agriculture sector in Nepal is primarily attempting to: (i) increase the availability of quality foods through homestead food and livestock production; (ii) increase the income of poorer women through credit incentives; (iii) promote increase in consumption of micronutrient rich foods; (iv) reduce the workload of women and provide them with a healthy and efficient energy; and (v) develop the capacity of the sector and strengthens linkages with other sectors. In this context, Nepal has developed the Agriculture Development Strategy (ADS) and Food and Nutrition Security Plan of Action to address the problem of food insecurity and promote nutrition.
Social protection and social security
The Interim Constitution of Nepal (2007) has guaranteed to protect the rights of every citizen, which states that “the state will follow a policy to pay special attention to protect the interest of women, orphans, children, old age people, and the disabled, incapable and endangered race”.
Social security has been recognized as critical to citizens’ rights. Social security is linked to enhancing social equity and justice. In recognition of this fact, the Government of Nepal has included a provision for social security in the Interim Constitution. With the intention of expanding social security rights for citizens, the Social Security Programme (Operational Procedure), 2008 has been formulated and implemented under the Local SelfGovernance Act, 1999. The Government of Nepal has been implementing various social security programmes for decades. The growing emphasis on the protection and promotion of the rights of citizens of the country also requires an assessment of current interventions, which may give valuable inputs for the future development of policies and programmes.
The following are some of the social transfer programmes in Nepal that support and target the vulnerable groups in Nepal to address their poverty and to improve nutritional status.
Social transfer programmes in Nepal
- Cash transfer, social protection programme including safety net programmes and in kind transfers (e.g. social pensions for senior citizensthroughout the country, children, people with disability, endangered indigenous people, scholarships and food for work, school meal programme) and conditional cash transfers (e.g. maternity benefits and school meal programme)
- Free social services (including essential health care services – free drug, free antenatal checkup and incentives of transportation, free uterine prolapsed operation, free immunization and contraceptives etc. and basic education)
- Poverty reduction and social empowerment programmes aimed at various marginalised communities and women (Poverty Alleviation Fund-PAF, Ministry of Women Children and Social Welfare-MoWCSW) in collaboration with development partners)
- Pensions and social insurance mainly focused on formal sector employees (Employees Provident Fund, Citizen Investment Fund)
- Labour market interventions like labour legislations; vocational and skill development trainings; rural community infrastructure works and so on.
These are some of the other social protection initiatives in Nepal. Food aid is one of the important schemes to reduce hunger and malnutrition by providing food and/or cash to highly food insecure households. School meal programmes address malnutrition by providing nutritious mid-day meals and serve as incentive for regular school attendance. Child protection grants target marginalised children from birth until five years of age in five districts of Karnali, the most remote zone of Nepal.
The following are some other examples of social transfer schemes of the Government with relevance to nutritional security in the country:
- Safe delivery incentive and free delivery service with the incentive to mothers who have attended
regular Antenatal Care (ANC) and Postnatal Care (PNC) services addressing maternal and neonatal health
- Free health services for senior citizens, ultra poor, poor, helpless, disabled and Female Community Health Volunteers (FCHVs)
- Formal sector social security and health insurance against unemployment, sickness, accident and for old age
- District block grants and top up grants to finance local governance and community development to
promote local development and strengthen good governance locally
- Disability allowance, social pensions for elderly people, single woman’s allowance, education grants, technical education scholarship for girl children, geographical grant for disadvantaged groups and marriage allowance (for wedding expenses for widows from socially excluded groups and inter-caste marriages)
- Allowance for ex-combatants of Maoist Party, subsistence allowance for the families affected by insurgency for the political stability and social justice which will ultimately contribute to health and nutrition status of people
- Transportation subsidy on iodized salt distribution for the promotion of the consumption of
adequately iodized salt to improve coverage and reduce iodine deficiency disorders.
All the social protection initiatives and relevant inter ventions ultimately support nutritional issues through increasing purchasing capacity and changing behaviour. All these efforts have been made on the basis of geographic situation, socio-economic condition and focusing the poor and vulnerable communities.
- Legal provisions in the act and regulations make local bodies more responsible towards implementing nutrition and social protection programmes at local level
- Circulated directives to the local bodies play vital role for the effective implementation of activities to improve nutritional status of pregnant women and children
- Implementation of interventions and activities jointly among the relevant sectors and stakeholders gives multiple outcomes in reducing the chronic malnutrition.
Case Study Bibliography
CBS. (Unpublished). Small-area Estimation of Food Insecurity and Undernutrition in Nepal. Nepal: Central
Bureau of Statistics
IFPRI. (2011). Global Hunger Index. International Food Policy Research Institute. .
Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc. (2012). Nepal Demographic and Health Survey 2011. Kathmandu, Nepal: Ministry of Health and Population (MOHP) [Nepal], New ERA, and ICF International Inc. NLSS. (2011). Nepal LivinNepal Living Standards Survey. Kathmandu, Nepal.: Central Bureau of Statistics.