1.4 Strategies
The following general strategies have been pursued to address the nutritional situation in Nepal:
- Promote, facilitate and utilise community participation and involvement in all nutrition activities;
- Develop understanding and effective co-ordination among various concerned Sections, Divisions and Centres within the Department of Health Services;
- Maintain and strengthen co-ordination among other agencies involved in nutrition activities, i.e., the Ministries of Agriculture, Education, Local Development and the National Planning Commission, as well as with international development partners, NGOs, INGOs and private sector;
- Decentralise authority to the region, district, Health Post, Sub Health Post and community for needs assessment, planning, implementation, and monitoring;
- Conduct national advocacy and social mobilisation campaigns;
- Integrate/incorporate activities (such as Expanded Programme on Immunisation, Integrated Management of Childhood Illness, Maternal and Child Health and Family Planning programmes etc.) into nutrition plans;
- Develop a systematic approach for monitoring and evaluation of all nutrition program activities;
- Celebrate Nutrition week (Poush 10-16) to raise awareness about the importance of Nutrition;
- Implement School Health and Nutrition Program as per National Strategy; and
Specific strategies are as follows:
1.4.1 Infant and Young Child Feeding (IYCF)
- Create awareness regarding the importance of growth monitoring and timely introduction of complementary foods through Mothers Groups, radio, TV news and poster/pamphlets, and counsel mothers on growth-patterns and proper child caring practices;
- Provide growth-monitoring services at Outreach Clinics, Sub Health Posts, Health Posts and PHCC;
- Integrate breast-feeding training with growth monitoring promotion and link breastfeeding promotion with child care programmes;
- Increase awareness among medical professionals through advocacy efforts, such as by including sessions on breastfeeding on seminars/workshops held by various associations;
- Establish mother€™s groups support to protect existing good practices regarding breast-feeding at the community level;
- Celebrate Breastfeeding Week (August 1-7) as an advocacy for the protection and promotion of breastfeeding;
- Encourage social marketing of low cost fortified blended complementary food targeting infants and young children 6-23 months of age.
1.4.2 Control of IDD
- Strengthen the implementation of Iodized Salt Act, 2055 for regulation and monitoring of iodized salt trade to ensure that all edible salt is iodized;
- Increase the accessibility and market share of iodized packet salt with €˜two-child€™ logo;
- Create awareness about the importance of use of iodized salt for the control of iodine deficiency disorders;
- Explore the possibility of progress evaluation system in IDD control program on a rotational basis in all 5 development regions;
- Expand iodized salt social marketing campaign in EDR & CDR.
1.4.3 Control of Vitamin A Deficiency (VAD)
- Distribute high-dose vitamin A capsules to children between 6 and 59 months biannually through FCHVs;
- Advocate for increased home production, consumption and preservation of Vitamin A rich foods at the community level;
- Explore the fortification of suitable foods (such as sugar and cooking oil) with Vitamin A;
- Strengthen the usage of Vitamin A Treatment protocol;
- Supplementation of Vitamin A capsule (200000 IU) to postpartum mothers through healthcare facilities and community volunteers;
- Treatment of night-blind pregnant women with low dose Vitamin A capsule (25,000 IU) through healthcare facilities (in Sunsari, Chitwan and Parsa districts only);
1.4.4 Control of Iron Deficiency Anaemia (IDA) and Postnatal
- Increase the coverage and compliance of iron/ folate supplementation for pregnant women;
- Reduce the burden of parasitic infestations (helminths, malaria and Kalazar);
- Identify and implement food fortification to increase the dietary iron intake focusing on commercial as well as small-scale community based fortification initiatives;
- Promote dietary diversification to improve the quality of food consumed with an emphasis on bio-available iron;
- Promote maternal care practices and services to improve health and nutritional status of mother and babies;
- Identify and implement the effective modalities to address iron deficiency in young children, adolescents and non-pregnant women of reproductive age;
1.4.5 Deworming
- Distribute de-worming tablet to all children aged 1-5 years along with vitamin A capsule distribution;
- De-worming of pregnant women through health facilities with single dose tablet (Albendazole 400 mg) starting from 2nd trimester (4 months) of the pregnancy;
Follow up the comprehensive deworming work plan.
