Because every child deserves healthy, nutritious food
Context and challenges
Over the past few decades, the health status of children in the Maldives has improved dramatically. In just ten years, rates of undernutrition among children were nearly halved, and rates of exclusive breastfeeding jumped from 10 to 48 percent, and then from 48 to 64 percent over the next decade. Despite these improvements, malnutrition rates for children under age 5 are still high for a middle-income country.
Nearly one in five children is stunted, an irreversible condition marked by low height for a child’s age. Stunting is caused by a lack of adequate nutrients at an early age, debilitating both cognitive and physical growth for the rest of a child’s life. As a result, stunted children struggle to achieve in both school and the work force later in life. In some areas of the country, the number of stunted children rises to one in four, illustrating a high level of inequity among certain islands and atolls.
In some regions of the Maldives, one in four children are stunted – a condition with an irreversible impact on lifelong growth and development.
In addition, 17.3 percent of children in the Maldives are underweight while 10.6 percent are wasted. The latter is a condition which, as its name suggests, causes a child’s muscle and fat tissues to “waste” away to the bone. Confounding this situation, a Ministry of Health study found 22 percent of first grade students to be overweight or obese. Both under- and over-nutrition are classified as malnutrition, and regardless of the form, it can drain a child’s ability to develop and perform normally.
In the Maldives, obesity is largely due to increased consumption of packaged, unhealthy foods and a limited knowledge of proper nutrition. In some island communities, accessing fresh fruits, vegetables and legumes throughout the year can be a problem – and throughout the country, less than 6.5 percent of Maldivians are eating enough healthy produce, according to the Ministry of Health. As a result, there are high rates of micronutrient deficiencies among children under age 5, along with women of reproductive age.
In addition, most pregnancies in the Maldives are unplanned. Because of this, women rarely have a chance to prepare for pregnancy, and families can miss a critical window of opportunity to maximize their child’s health status. Research shows that unless a developing fetus receives the right nutrients, often, the effects of stunting will begin at conception. Half of the world’s children become stunted in this way, highlighting the need for proper nutrition knowledge and healthy eating practices during pregnancy.
The first 1,000 days of life – from conception until a child reaches their second birthday – is a period of rapid physical, cognitive and social growth. Any deficits in development by age 2 are largely irreversible.
Lastly, 36 percent of babies are not exclusively breastfed in their first six months of life, according to the Ministry of Health. Breast milk provides children with nutrients essential for their development and protects infants from deadly illnesses likes pneumonia and diarrhea. If a child is not breastfed, they can be inadvertently stripped of the nutrients hand-picked to spur their growth.
Though malnutrition among children is decreasing, overall, these rates have not kept pace with the rest of the country’s rapid development. Unhealthy social norms, along with limited national systems of monitoring nutrition rates, make it easy for nutrition issues to fall through the cracks.
UNICEF works at multiple levels to promote the importance of nutrition during childhood. We support and educate caregivers, health care staff and entire communities, and advocate for stronger child nutrition policies at the national level. We also push for the needs of vulnerable children – those who are most susceptible to poor nutrition practices – and ensure the right programs reach them and their families. And, we help the government improve monitoring systems for nutrition programs, supporting the country’s efforts to increase the nutritional levels of all its citizens.
Improving nutrition in the first 1,000 days
The first 1,000 days of a child’s life are a critical window of opportunity for growth. The right nutrients are required for a child’s brain to develop, immune system to strengthen, and metabolism to regulate, an assembly of systems that will later prevent chronic disease and illness. To capitalize on the first 1,000 days, one of UNICEF’s key objectives is to improve knowledge of nutrition among pregnant women and caregivers.
By assessing the context of nutrition in the Maldives, we work with our partners to identify the behaviors and situations that impact children’s health. Together, we implement a strategy to change harmful behavior (and dissolve common misconceptions) around nutrition in the first 1,000 days. UNICEF supports our partners to hold awareness sessions and food demonstrations for parents, boosting caregivers’ understanding of nutrition and its value. We also produce resources to enrich these sessions, while also integrating messages on child care and the importance of play for children.
Improving nutrition in schools
There is near universal enrollment of children at primary school age in the Maldives. By infusing nutrition education into the school system, UNICEF and partners are targeting children where they spend most of their days: the classroom. We work with the Ministry of Education to design and implement nutrition interventions for schools, creating health-conscious environments where children can cultivate life-long nutrition habits.
We are supporting the Ministry’s development of a School Nutrition Policy, a food guide, and resource materials to help teachers conduct nutrition sessions in the classroom. We also support the creation of other school nutrition policies, along with food standards and guidelines for the classroom. To tackle obesity among children, UNICEF is working with partners to design, implement and test a model that addresses obesity in early childhood, working with health facilities, parents and preschools to raise awareness of over-nutrition.
Training health workers on nutrition and breastfeeding
UNICEF works with our partners to train health workers on nutrition, breastfeeding and infant and young child feeding practices. We help create safe spaces in hospitals where mothers can breastfeed. With partners, we also equip hospital staff with the knowledge and materials they need to promote breastfeeding to new mothers. To date in the current program cycle, which is operating from 2016 to 2020, we have reached health workers in 10 atolls, ensuring they are equipped to help parents initiate breastfeeding and practice proper feeding techniques in their child’s first 1,000 days of life. We also support the government to strengthen growth monitoring systems around nutrition and breastfeeding, keeping track of the country’s progress on a national level.