Nutrition

Good nutrition is the bedrock of child survival, health and development

Malnutrition checking
UNICEF/UN043780/Nazer

Challenges

Malnutrition is a major impediment to children’s physical, cognitive and social development, considering the irreversible impact of stunting and wasting. Undernutrition is directly related to suboptimal infant and young child feeding (IYCF) practices, food insecurity, unsafe drinking water, poor sanitation and hygiene, lack of quality health services and essential medicines.

Most childhood illnesses and deaths are preventable or treatable with high-impact, low-cost interventions

feeding
UNICEF/2018/Nazer

Unfortunately, the prevalence of undernutrition in DPRK remains a concern. The Multiple Indicator Cluster Survey (MICS) in 2017, showed that there is a decrease in under-five stunting, 28 per cent in 2012 to 19.1 percent in 2017 at national level with great disparities between provinces as prevalence of stunting reach as high as 31.8 per cent in Ryanggang province. The same survey indicated that 2.5 per cent of under-five children were wasted and 0.5 per cent severely wasted.  

UNICEF’s Nutrition programme has grown to cover 90 percent of the DPRK with delivery of therapeutic foods to wasted and stunted children. According to an independent evaluation, these nutrition services and health system capacity building have directly contributed to averting 13 deaths of children under five each day in 2016.

a mother holds her smiling child in hospital after recovering from being malnourished
UNICEF DPRK/2018/Nazer

Acutely malnourished under five children are 10–12 times more at risk of dying because of common childhood infections like diarrhoea and respiratory infections if not timely treated

The UNICEF DPRK nutrition programme works at national, provincial, county and community levels to ensure availability of up-to-date, effective policies, and that technical and operational guidelines are in place to promote child survival opportunities. The programme is working directly with Government partners to upgrade the national policies to prevent and treat undernutrition among under-five children and among mothers in order to break the intergenerational cycle of undernutrition with special focus on promotion of adolescent girls’ nutrition.

Quality of service delivery is improved through capacity development of health workers on promotion of optimum Infant and Young Child Feeding (IYCF) practices, prevention and treatment of undernutrition among under-five children countrywide and prevention and treatment of various micronutrient deficiencies affecting mothers and children under five. The programme also supports Government of DPRK partners to produce iodized salt for household consumption and combat iodine deficiency disorders.

Solutions

UNICEF supports the Ministry of Public Health and other partners to administer a package of selected high-impact low-cost nutrition-specific interventions country-wide:  

  1. Treatment and prevention of acute malnutrition through screening and referral to health facilities in 189 out of 210 counties equipped with nutrition measuring equipment and high energy dense, nutrient supplement for treatment of severe malnutrition (RUTF). So, called MUAC screening – the measurement of the mid-upper arm circumference with a simple color-coded tape – and early referral of severe and moderate acute malnourished children is institutionalised in all nurseries and all public health care facilities countrywide. Annually, about 40,000 severe acute malnourished and 80,000 moderate acute malnourished children are treated in the Nutrition programme supported by UNICEF. 
  2. About 1.6 million under-five children, or 90 percent, are reached twice a year with country-wide Child Health Days campaigns since 2015. In these massive campaigns, the health system undertakes MUAC screening, early referral of undernutrition, vitamin A supplementation, deworming and micronutrient powder provision for home fortification of complementary foods of all 6-23 months’ old infants. 
  3. Promotion of optimum IYCF practices including, early initiation of breastfeeding, exclusive breastfeeding for six months and timely introduction of age-appropriate fortified complementary foods. Increasing frequency and promotion of diversified complementary foods with animal proteins (one-egg a day) and continue breastfeeding for at least two years.
  4. Prevention and treatment of multi-micronutrient deficiencies among under-five children and pregnant and lactating women, as well as of iodine deficiency.