Health

Intro

A healthy diet is essential to build and maintain strong human brains, bodies and immune systems, allowing people to thrive and reach their full potential.

Improved nutrition outcomes are a key marker of improved health outcomes and a marker of sustainable development: investing in improving nutrition via the health sector helps to accelerate all the SDGs.

However, lack of integration of nutrition results in higher costs and additional burden on health workers and health systems.

By undertaking an integrated approach, efficiencies can be gained, people can more easily access a full range of important health services, and vulnerable populations can be more easily reached.

Why

Why the sector needs to get involved

• Every year, undernutrition¹ is reported as a direct or aggravating factor in nearly half of all deaths in children under 5 years old: addressing undernutrition will help overall mortality figures and result in a healthier population.
• The triple burden of malnutrition, characterized by the coexistence of undernutrition (stunting and wasting), micronutrient deficiencies, and overweight and obesity, has risen dramatically in recent years as a result of diversity of factors including suboptimal diets, placing increased strain on the health system, and failing to address this by implementing effective nutrition strategies will put further strains on the health system in the future.
• Improving nutrition outcomes can enhance the population’s resilience, including to pandemics. The COVID-19 pandemic has shown that malnutrition can exacerbate the impacts of the disease as undernutrition compromises the body’s immunity, and obesity may predispose individuals to its most serious impacts. Reducing malnutrition reduces the burden of COVID-19 and future pandemics on the health system.

Key asks

• Mainstream nutrition interventions in all Maternal, Newborn and Child Health (MNCH) interventions, including antenatal and postnatal care of pregnant women (e.g. provision of folic acid and iron supplementation during antenatal visits in the PHC system), and child health services including immunisation programmes (e.g. providing growth monitoring, supplementary feeding, vitamin supplementation).
• Provide exemptions of health-related fees for pregnant women and children under five including all the nutrition related activities.
• Prioritize financing for health systems that also include integrated nutrition services including prevention, detection of malnutrition and its management for all as part of the package of activities being delivered both at the community and at the clinical levels, in a one stop shop approach, including in hard-to-reach areas.
• Include actions that support investing in nutrition and accelerating nutrition results in the GFF investment case, and systematically invite nutrition stakeholders at the table to work on the investment case. Provide incentives for using health system strengthening grants to improve integration of nutrition-specific and nutrition-sensitive actions.
• Have nutrition included in the UHC2030² activities and in the universal coverage package it entails.
• Scale up the Integrated Community Case Management (iCCM)³ and Integrated Management of Childhood Illnesses (IMCI)⁴ approaches to embed direct nutrition interventions into health sector interventions, including through bundling service delivery across delivery platforms, implementing community-led solutions, updating treatment protocols and health workers’ training curricula⁵.
• Support digitalization of the WHO-UNICEF health protocols including the Community-based Management of Acute Malnutrition Model (CMAM)⁶ to make sure that the nutrition status is assessed in 100% of children under 5 attending consultations at the Primary Health Care (PHC) level. Digital solutions should also comprise stock management for nutrition services to optimize efficiency of inputs management. 
• Integrate nutrition-specific actions across the health sector, to reduce disease and improve dietary intake.
• Provide micronutrient interventions, particularly for children and pregnant women, and monitor micronutrient supplementation delivered to pregnant women through antenatal services and children through child health services.
• Improve the quality and timeliness of nutrition data collection and reporting from health facilities and communities, particularly in relation to reproductive, maternal, newborn and child health services.
• Leverage the underlying importance of consumer demand and consumer purchasing power to diet quality. Invest in education and awareness raising campaigns that help shape consumer behaviour and demand towards healthy diets. 
• Support mothers in recognizing their infants’ cues for feeding, closeness and comfort, and enabled them to respond accordingly to these cues, with a variety of options, during their stay at the facility providing maternity and newborn services.
• Equip maternity and newborn services with a breastfeeding policy that is routinely communicated to staff and parents. Health-facility staff who provide infant feeding services, including breastfeeding support, should have sufficient knowledge, competence and skills to support women to breastfeed.
• Focus on data collection, analysis, planning, and monitoring, on disaggregated nutrition-specific and nutrition-sensitive indicators measuring the nutrition results for children, including primary nutrition outcomes (child stunting, wasting, underweight and anemia), infant and young child feeding (IYCF) indicators, minimum acceptable diet (MAD) and individualdietary diversity scores (ie MDDW). These indicators can be collected through either household surveys or c by adding some specific nutrition indicators in DHIS2.
• Support advocacy in favor of the adoption of decrees regulating marketing of breastmilk substitutes and to ensure that families have access to accurate information about the benefits of breastfeeding.