A4NH ReSAKSS side event - Opportunities for nutritional monitoring and implementation zambia

1. Opportunities for Nutritional
Monitoring and Implementation
at National Level (The Zambian
Case)
Kambaila Munkoni, UNDP

2. Country Processes – CAADP and SUN
 Most African countries have strategies or are
developing country plans under CAADP and SUN
 Most initial CAADP country plans don’t include
nutrition while most SUN country plans include
agriculture.
 In evaluating CAADP for 2nd decade (2015-2024), three
high–level goals have been added: nutrition, youth
employment, private-sector
 There are common elements but important
variations in CAADP and SUN country plans

3. SUN Baseline Data (2012)
World assembly targets (using various data sources)
 <5 malnutrition (Stunting, Wasting, Overweight)
 Anemia (women 15 – 49 years)
 Low birth weight and <6m exclusive breastfeeding
Nutrition specific : dietary quality for children (4+
groups and IYCF 6 – 24m): micronutrients – zinc
treatment; Vit A supplement for <5 years, etc.
Nutrition sensitivity: water, sanitation, education,
family planning, assisted births by health workers

4. The Opportunities
 Opportunities for data collection exist through
large household Surveys conducted by National
Statistical Office.
 Household surveys such as the Living Conditions
Monitoring Surveys (LCMS or LSMS) and
Demographic and Health Surveys collect a lot of
data which monitor nutrition levels in the
country.
 Data collected (LSMS) -Types of foods consumed
such as staples (maize meal, cassava), pulses &
legumes, vegetables, fruit, and fish.

5. The Opportunities –cont.
DHS data looks at the health of the population
in nutritional areas such as malnutrition,
Pregnant women, etc .
Data is collected specifically to measure the
nutritional levels in the country (food intake
and malnutrition, e.g. Stunting, wasting and
underweight)

6. Anthropometry Measures
 Anthropometry measures (height, weight, BMI) are used
to compute stunting, underweight and wasting).
 Stunting: Chronic malnutrition (height for age) is a
condition reflecting cumulative malnutrition.
 Wasting: acute malnutrition (weight for height) is a
failure to gain weight in association with height.
Associated with starvation.
 Underweight (weight for age) a condition of low weight
in relation to age (difficult to differentiate between
stunting and wasting).
 Feeding practices of children including breastfeed
tendencies of mothers also studied.

7. Measurement
 Stunting is not just overall food consumption but
also a factor of many things
 Robust but imperfect (seasonality) especially
from wild foods and own produce
 Balance – Improve specific foods in a diet and
improve dietary diversity
 Important to link individual and household data
 Individual dynamics in household important
(children, women)

8. Measurement (cont.)
 Minimum threshold for particular groups
currently under discussion
 Link gender and nutritional assessment for
greater impact
 Alone they can be weak but stronger when
combined with nutrition/ gender action
 Link country-level and research program
outcome and impacts.

9. Monitoring
 Nutritional levels are monitored periodically.
 LCMS and DHS collect data periodically & gives an
opportunity to monitor the Nutritional levels in the
country, e.g. LCMS every 2 years.
 Types and expenditures on types of foods consumed
such as staples, legumes, fruits, etc.
 Levels of malnutrition e.g. Stunting, wasting and
underweight been monitored
 Changes in the levels of malnutrition in the country
gives a very good indicator on how the nutritional levels
are improving.
 Continous improvement in the monitoring tools helps to
check on how the implementation programmes are
performing.

10. Pros and Cons of Monitoring through
National Surveys
Pros
Most reliable method of collecting household data
Collect from a large and representative sample
Continous improvement helps to check on how the
implementation programmes are performing.
Cons
Expenditure monitoring used but does not tell much if at all the
foods are eaten by the people.
Most of nutritious food given to husbands and not children who
need them.
Variety of food consumed by households but does not tell at all
they are consumed in a balanced diet.
Monitoring method does not tell if nutrients in the food are lost
due to cooking or food preparation methods

11. Current Commitments
 Institutional commitment: Specific policies and
organizational infrastructure in support. (Program
Against Malnutrition (PAM), mothers feeding lessons at
hospitals.
 Expressed commitment: Verbal declaration of support
for nutrition by high level, influential political leaders.
Legislation, Support from Civil Society Organisation etc.
 Elections gives an opportunity for a nutritional agenda
(e.g., one child one egg per day)
 Budgetary commitment: earmarked allocations of
resources towards nutritional programs. (School
Children feeding programs, Social cash transfer).

12. Programs and Policies- Zambia
 Legislation such as the National Food &
Nutritional policy of 2008 aimed at achieving
sustainable food & nutrition security in the
country.
 Adequate staff ensured by the launching of a
degree program in Food and Nutrition launched at
UNZA
 National food and nutrition security plan (2011 –
2015) and National Agriculture investment plan

13. Targets and Plans - Zambia
 Stunting baseline (2007) (45%) – target to reduce to
30%.
 Strategic direction – agriculture, diet diversity,
micronutrients
 Production supply/efficiency of nutrient dense foods
(animal source, legumes, vegetables and fruits)
 Supplementation, fortification and bio-fortification of
micronutrients (Vitamin A, iodine, iron, folic acid)
 Nutritional programmes which help address
malnutrition (e.g., clinics for children under 5 where
mothers with malnourished babies are taught how to
feed their children).

14. Current Projects
Action plan for 2014 – 2015 (USD 27 M) supported by save
the children UK.
Incorporation CGIAR and partner agriculture – nutritional
programs in different provinces
Studies on Vitamin A with country counterparts given
multiple interventions (supplements to children,
fortification of sugar) and vitamin A trials by HarvestPlus
Request for capacity development
Support to ag-nutrition efforts at sub-national (e.g.
Northern Province)
M&E capacity (links with CAADP and SUN)

15. Conclusion
A lot of opportunities exist which help in
monitoring the levels of nutrition in the country.
Institutions (MoH, MoA, Health and Nutritional
Commission, NSO) and Partners work together in
ensuring that they collaborate in measuring
nutritional levels in the country through data
collection and implementation of nutritional
policies and programs.
Benefits such as increased lifespan may not be
seen immediately but will only be seen after many
years.