55 per cent of Afghan children under the age of 5 cannot develop physically or mentally, as they should, because of chronic nutritional deficiency. Children in the poorest communities are more than twice as likely to be stunted as children from the richest communities. Stunted children are also more likely to contract diseases and lack access to basic health care, and to not attend school. Girls who are stunted are more likely to give birth to babies who have a higher chance of becoming stunted. UNICEF is supporting nutrition activities in 30 provinces so that 30 per cent of under five children and pregnant and lactating women have access to and utilise quality community and facility based interventions for the prevention and management of malnutrition (Severe Acute Malnutrition (SAM), stunting and  micronutrient deficiencies. UNICEF manages Community Management of Acute Malnutrition (CMAM) programmes through NGOs in these 30 provinces, including the procurement of supplies for 55 Therapeutic Feeding Units (TFUs).

UNICEF, in collaboration with WHO, is in the process of establishing a National Nutrition Sentinel Surveillance System. UNICEF is also technically and financially supporting the National Nutrition Survey and developing a national nutrition communication strategy with a focus on the first 1000 days as the “window of opportunity.”

UNICEF is currently the lead agency for the Nutrition Cluster in Afghanistan, a consortium of government and NGO partners that coordinate emergency preparedness and response. As the Nutrition Cluster lead, UNICEF is working to identify and address cluster capacity and resource gaps in order to make sure the nutrition situation is monitored and the needs of children and pregnant and lactating women are addressed both in day-to-day and emergency situations.

Current situation and key issues: Nutrition is both an immediate and an underlying cause of maternal and under 5 mortalities in Afghanistan. Under-nutrition contributes to 45% of under-5 deaths globally in the form of foetal growth restriction, sub-optimum breastfeeding, stunting, wasting and deficiencies of vitamin A and zinc.

Afghanistan has the world’s highest rate of stunting in children under five – 60.5% (this is a 2004 figure; the latest National Nutrition Survey 2013 is in preparation). Such high stunting rates are considered “a silent emergency”. Disaggregation by age from 2004 survey reported stunting in 70% of children between 2 to 3 years of age. 

nappropriate or poor feeding practices of infant and young children are strongly linked with under-nutrition. Almost all Afghan babies are breastfed, but only 54% of children aged less than six months are exclusively breastfed. Even at the earliest ages, almost 40% of children receive liquids or foods other than breast milk, which puts them at increased risk of consuming contaminated foods and water. Minimum meal frequency, one indicator of appropriate infant feeding – is only 17.8% nationally with poor practice across all geographic, wealth and educational categories. Infant feeding practices are not only affected by poverty, but also by a mother’s level of awareness and the extent to which social norms influence her decision-making.  Knowledge and awareness among caregivers and children, especially adolescents, is important for children’s health and nutrition. The 2004 National Nutrition Survey showed that literacy and education level were key determinants for either men or women to be aware of health and nutrition issues. Men in particular lack awareness of maternal and child health issues. In a patriarchal society where men make many decisions affecting the wellbeing of women and children, this is a matter of serious concern.

Nutritional status of children is highly correlated with the nutritional status of mothers. There is a vicious cycle of malnourished mothers having small babies who grow up to become stunted mothers. In societies where women lack empowerment women and children suffer from poor nutrition status, and this has a direct impact on national GDP and the IQ of the next generation.

Despite improvements in health outcome indicators over the past decade, the health system still faces a number of challenges.Nutrition services are limited at all levels in Afghanistan and only starting to be addressed in the recent years. There is no dedicated in-service training or trained health-care providers who can offer counseling on maternal and child nutrition or assess under-nutrition. As a result, rates of stunting, severe acute malnutrition and micronutrient deficiencies are underestimated and receive much less focus than they should. Detailed causality analysis indicates clearly that not only do investments in the health and nutrition sector need to be sustained and expanded, but also that the best and most cost-effective results will come from a comprehensive multi-sectoral approach involving all the tools available in the pursuit of human development.




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