National nutrition strategies that focus on maternal, infant, and young child nutrition in Southeast Asia do not consistently align with regional and international recommendations.

Tuan T Nguyen,Roger Mathisen,Amy Weissman,Edward A Frongillo,Timothy D Mastro,Ashley Darnell,Jennifer Cashin,Mellissa Withers,Karin Lapping

doi:10.1111/mcn.12937

Abstract

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy and support at birth in seven; and school feeding, deworming, and treatment of severe acute malnutrition in six. All NNS contained programme monitoring and evaluation plans with measurable indicators and targets. Not all NNS covered wasting, exclusive breastfeeding, low birthweight, and childhood overweight. Strategies for achieving NNS goals and objectives were health system strengthening (nine), social and behaviour change communication (nine), targeting vulnerable groups (eight), and social or community mobilization (four). All addressed involvement, roles and responsibilities, and collaboration mechanisms among sectors and stakeholders. There was a delay in releasing NNS in Indonesia, Myanmar, and the Philippines. In conclusion, although Southeast Asian NNS have similarities in structure and contents, some interventions and indicators vary by country and do not consistently align with regional and international recommendations. A database with regularly updated information on NNS components would facilitate cross‐checking completeness within a country, comparison across countries, and knowledge sharing and learning.

Highlights

Most countries in the world are facing multiple and overlapping burdens of malnutrition (Development Initiatives, 2018)
We examined the alignment of nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations
Our analysis found that Southeast Asian NNS have strengths, limitations remain, which may hinder countries' ability to combat the triple burden of malnutrition and to improve health and well-being of their populations

Summary

| INTRODUCTION

Most countries in the world are facing multiple and overlapping burdens of malnutrition (Development Initiatives, 2018). To achieve the goal of ending all forms of malnutrition, since the 1990s starting with the First International Conference on Nutrition (ICN) in 1992, countries have adopted national nutrition strategies and action plans (NNS; FAO & WHO, 1992; WHO, 2018a). National nutrition strategies or action plans (NNS) were available in nine of the 11 countries in Southeast Asia. The reviews found that most countries reported having national nutrition policies and plans of action and programmes to address undernutrition, obesity, diet-related chronic diseases, infant and young child feeding, and vitamin and mineral malnutrition, yet there were identified gaps in their design, content, and implementation (WHO, 2013, 2018a). It is expected that an effective NNS would be aligned with international recommendations, few studies have been conducted to evaluate this aspect of NNS in Southeast Asia.

| Subjects and methods

| RESULTS

Findings

| DISCUSSION