Policy analysis of the exacerbated childrens nutrition crisis and - - PowerPoint PPT Presentation

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policy analysis of the exacerbated children s nutrition
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Policy analysis of the exacerbated childrens nutrition crisis and - - PowerPoint PPT Presentation

Nov 17, 2022 46 likes •220 views

Policy analysis of the exacerbated childrens nutrition crisis and interventions that can be made T: +27 51 401 9111 | E: info@ufs.ac.za | www.ufs.ac.za Chantell Witten, RD(SA), PhD Left out of the conversation webinar series 22 July 2020

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Policy analysis of the exacerbated children’s nutrition crisis and interventions that can be made

T: +27 51 401 9111 | E: info@ufs.ac.za | www.ufs.ac.za

Chantell Witten, RD(SA), PhD

Left out of the conversation webinar series 22 July 2020

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In short…the buffet of policy options and the piece-meal food and nutrition interventions for children

T: +27 51 401 9111 | E: info@ufs.ac.za | www.ufs.ac.za

Chantell Witten, RD, PhD

Left out of the conversation webinar series 22 July 2020

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Acknowledgements

This presentation draws heavily on conversations in different spaces and contexts to make sense of the current food (and nutrition) situation. With special thanks and appreciation for:

  • The insights and sobering conversations with women and men serving food to

children and families on the frontlines, mostly in the Western Cape and KZN.

  • The academic conversations, webinars and the flood of scientific papers and op-
  • eds. Mainstream media has never been so alive with food and hunger issues.
  • The inspirational social media engagement with like-minded groups trying to find

home-grown solutions.

  • Deep gratitude to the late Prof David Sanders for his teaching and leadership on

the social justice in food and nutrition. Hunger and malnutrition is an injustice given that we live in a country that is food secure.

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Outline of the presentation

  • Nutrition is much more than hunger
  • South African life course nutrition profile and

landscape before and during covid-19

  • The policy time line against the nutrition profile
  • Food programming for nutrition outcomes
  • Possible interventions
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Nutrition is more than hunger

A – Anthropometry

  • Measures in weight, height,
  • Head circumference
  • Mid-upper arm circumstances
  • Reported changes in any of these

measures, clothes size B – Biochemical

  • Blood values
  • Urine analysis
  • Breastmilk analysis
  • Hair analysis
  • Bone density

C – Clinical manifestations

  • Head to toe changes
  • Night-blindness
  • Angular cheilitis (sores on corner of

mouth)

  • Fatigue and lethargy

D – Dietary changes

  • Food choices
  • Dietary patterns
  • Dietary diversity
  • Nutrient density
  • Nutrient cost analysis
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Life course nutrition profile before and during covid

Before covid-19

  • High levels of maternal obesity(33%), anemia (29%) and iron

depletion (15%)1 with poor birth outcomes (preterm-labour, prematurity, LBW)

  • Increased BF rates (EBF: 8% in 2008 to 32% in 2016) and

from 7 months to 12months)2 – BF rates higher and duration longer among the poor in LMICs3

  • Increase in child stunting (21% in 2008 and 27% in 2016) and
  • besity (4.8% in 2008 and 15% in 2016)2,4
  • Dietary patterns in children were poor – low in variety and

nutrient-density but adequate in calories2,4

  • Nutritious basket of food cost more than the child support

grant5

  • Only ECDs registered with DSD received funding6. Nutrition

adequacy of ECD & NSNP feeding programmes6,7

During covid-19 (limited in nutrition information)

  • Decreased access to food8,9
  • Inadequate food relief in scale and

nutrient content9,10

  • Increased cost of the food basket11
  • Speculation of increasing severe

acute malnutrition12

  • Increasing and deepening food

poverty and hunger13

  • Decreased access to routine health

services13 (no data on BF, childhood disease or food inventory)

  • ~11 000 Severe Acute Malnut cases (2018/2019)
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UNICEF Conceptual framework for malnutrition

Increased dietary inadequacy

  • Less food in

amount and frequency

  • Low quality food

No additional data on disease but

  • Decreased access to PHC

services

  • Lower use of routine

services Immunization (EPI), Growth Monitoring and Promotion, Mid-Upper Arm Circumference (MUAC) screening

  • Diarrhoea, Acute

Respiratory tract Infections (ARI) and SAM top three causes of child death

Malnutrition media debacle12

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1994 2013

Stunting for across nutrition policy timelines

2017 21.6 to 18% (1999 vs 2005)# 27% (2003, 2016)^ 24% (2012)*

#National Food Consumption *SANHANES ^DHS

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Understanding nutrition from a food lens15

Covid conversation Long term negative impact

  • n children and futures
  • Poor health
  • disease
  • Low cognitive

development

  • Delayed

milestones

  • Low education

attainment

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Food & nutrition programming in relation to stages of food security15

In the context of food shortages (poverty), then humanitarian aid is appropriate

  • Food parcels
  • School

feeding?

  • ECD feeding?
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Key proven practices, services and policy interventions for the prevention and treatment of malnutrition16

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Staples and non-staples (eggs, vegetables) consumption on underweight17 Microeconomic food policies that keep the price of food staples low can contribute toward reducing child underweight

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This is should not be an option

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Proposed interventions (nothing new) just better

In addition to the call for Universal Basic Income Grant

  • Macro economic food policies to control food prices and

introduce a fixed priced child-focused food basket in addition to the Child Support Grant

  • Strengthen and scale-up Infant and Young Child feeding

support in the home, in communities and at workplaces

  • Scale up and intensify household food production and small

scale farming supported by nutrition education

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What is needed

  • Immediate activation and engagement of civil society on South Africa’s

National Food and Nutrition Security Plan (2018-2023)

  • Build nutrition capacity across different sectors (DSD, DBE, Agri/Rural

Development)

  • Inclusion of sound nutrition data elements in the next NIDS-CRAM

wave or similar survey inclusion of Nutrition researchers

  • Civil society organizations to engage nutrition expertise to strengthen

their food relief and food support efforts to mainstream nutrition in all programming (ECD, GBV, HIV/TB, enterprise development etc)

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References

1. Symmington et al (2019). Maternal iron-deficiency is associated with premature birth and higher birth weight despite routine antenatal iron supplementation in an urban South African setting: The NuPED prospective study. y. PLoS ONE 14(9): e0221299 2. National Department of Health (NDoH), Statistics South Africa (Stats SA), South African Medical Research Council (SAMRC), and ICF. 2018. South Africa Demographic and Health Survey 2016 Key Findings. Pretoria, South Africa, and Rockville, Maryland, USA: NDoH, Stats SA, SAMRC, and ICF 3. Breastfeeding in the 21st century. https://www.who.int/pmnch/media/news/2016/breastfeeding_brief.pdf 4. Shisana et al(2013) South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press. 5. National Agriculture Marketing Council (2019). https://www.namc.co.za/wp-content/uploads/2019/04/NAMC-Food-Basket-Price-Monthly-Apr-2019.pdf 6. KIDS (2019). South African Early Childhood Review 2019. file:///C:/Users/witte/Downloads/SA-ECR_2019_12_09_2019_online_pages.pdf 7. Hazell E. JET Education Services. 2016. Report on the Implementation Evaluation of the National School Nutrition Programme. Pretoria. Department Basic education; Department Planning, Monitoring and Evaluation. https://www.education.gov.za/Portals/0/Documents/Publications/NSNP%20Documents/1.%20NSNP_report%20final_17092016.pdf?ver=2018-11-09-083250- 753 8. InSession (2020) https://www.parliament.gov.za/storage/app/media/Publications/InSession/2020-09/final.pdf 9. Heneck, S (2020) https://www.dailymaverick.co.za/article/2020-04-23-covid-19-informal-traders-will-need-support-after-the-lockdown/#gsc.tab=0 10. BBC News (2020). https://www.bbc.com/news/av/world-africa-52701571/coronavirus-south-africans-in-massive-queues-for-food-parcels) 11. Pietermaritzburg Economic Justice and Dignity Group (2020). https://businesstech.co.za/news/finance/410141/heres-how-much-the-average-price-for-a- household-food-basket-has-increased-in-south-africa/#:~:text=The%20group%20found%20that%20the,R3%2C486.23%20in%20June%202020. 12. Vermeulen et al (2020). https://theconversation.com/food-aid-parcels-in-south-africa-could-do-with-a-better-nutritional-balance-136417 13. Evans S and Cowan (2020). https://www.news24.com/news24/analysis/analysis-gray-vs-mkhize-child-malnutrition-surge-is-coming-was-gray-or-mkhize-right- 20200528 14. van den Berg et al (2020) https://cramsurvey.org/wp-content/uploads/2020/07/Van-der-Berg-Coronavirus-Lockdown-and-Children-1.pdf 15. Gross et al (2000). https://www.semanticscholar.org/paper/Four-dimensions-of-food-and-nutrition-security%3A-and-Gross- Sch%C3%B6neberger/de6300535f6cc2904f623588db79a5cb6418d017 16. Bhuta et al (2008) What works? Interventions for maternal and child undernutrition and survival. The Lancet, DOI:10.1016/S0140-6736 17. Torless et al (2003). Association of household rice expenditure with child nutrition states indicates a role for macro-economic food policy to combat

  • malnutrition. Journal of Nutrition 13:1320-25
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Thank you