(formerly IRIN News) Journalism from the heart of crises

Government and UNICEF to tackle nutrition crisis

School kids at the Navanthurai RCTMS (Roman Catholic Tamil Mixed School). Health studies on the Jaffna peninsula have revealed a high incidence of borderline malnutrition in some schools.
Brennon Jones/IRIN

For more than 20 years Sri Lanka has been grappling with high rates of under-nutrition among children younger than five, according to health experts.

"For a country that has a very good health and educational system, the child nutrition levels are quite paradoxical to the overall situation," Phillippe Duamelle, the country representative for the UN Children's Fund (UNICEF), told IRIN. "Our surveys indicate that one in every three children [under five] is underweight, leading to stunting and wasting."

According to the World Health Organization (WHO), more than 14 percent of under-fives suffer from acute malnutrition. In areas affected by the long-running war, the figure could be as high as 26-30 percent. The increase has been partially triggered by rapidly rising food prices, a WHO Health Action in Crises report for 2-8 June 2008 stated.

"We have known these figures for almost 20 years now," Vishaka Perera, WHO's national professional officer, told IRIN. "The moment the figure is above 10 percent, it is considered a national-level emergency and we have tried to deal with it for over two decades now."

''For a country that has a very good health and educational system, the child nutrition levels are quite paradoxical to the overall situation.''

Duamelle said that despite the high rates of malnutrition among children, the problem had not been regarded as a priority by authorities. "Nutrition needs to be given the proper attention and addressed the right way," he told IRIN, saying adequate nutrition was crucial to the physical and mental development of young children.

Targeted intervention

UNICEF and the government jointly carried out a national nutritional survey, released on 20 June, on the basis of which, Duamelle told IRIN, an intervention package will be formulated to target vulnerable under-fives.

UNICEF will approach international donors for funding. The Ministry of Health and UNICEF will be directly involved in the implementation and projects will include educational and nutritional programmes at village and community level.

"We have the full support of the government, which is very much aware of the situation and what needs to be done to rectify it," Duamelle told IRIN.

"We know that a minimum package of high-impact and cost-effective interventions can be integrated into the lifestyles of women and children to ensure that good nutrition practices are sustained," Nimal Siripala de Silva, the Minister of Health, said at the launch of the programme.

Photo: OCHA/Sri Lanka
The World Food programme provides a morning meal of rice and dahl to students at the Puliyadymunai Government Tamil Mixed School (GTM) in Batticaloa district

"Golden interval"

The UNICEF country director told IRIN the programme would target children between one and two years old, a period in human development referred to by health experts as the golden interval. "These years are very, very critical in a child's growth."

Key areas that would be covered include feeding practices, encouraging breast feeding in the first six months after birth and nutritional complementary foods thereafter. The transition from exclusive breastfeeding to family foods, referred to as complementary feeding, typically covers the period from six to 18-24 months of age, Duamelle said.

WHO's Perera said that if the long-running cycle of under-nutrition is to be broken, health experts have to change the behavioural and feeding patterns of young children.

"We have to go hard on changing behavioural patterns, try to change not only what is eaten but how it is eaten," she said. "We need to change quantity, quality and the diversity of the food."

Both believe the low nutritional levels can be improved with a sustained effort.

"We have never had a food famine in the country and food and healthcare are readily available," Perera said. "It is just that we have to pay attention to the feeding patterns involving young children."


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