a review of current nutritional problem of Nepal.

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A review of current nutritional problem of Nepal:

A review of current nutritional problem of Nepal Presentation of :Rajeev Nepal Email:rjeev@yahoo.com College:lagrandee international college City:pokhara,NEPAL Level: Bachelor of public health(BPH) 1

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Introduction :

Introduction Nutritional status of people of Nepal is a public health problem all over the country. Nepal is one of the least well‐nourished countries in the world. Even though progress made in nutrition programme but still problem in malnutrition, iron deficiency anemia and worm infestation among the children, adolescents and women are prevaling . 3

Contd….:

Contd …. The most common forms of malnutrition is protein-energy malnutrition ( PEM),iodine , iron and vitamin A deficiency. Even moderately acute and severely acute malnourished children are more likely to die from common childhood illness than those adequately nourished. In addition, malnutrition constitutes a serious threat especially to young child survival and is associated with one third of child mortality. Malnutrition remains a serious obstacle to child survival, growth and development in Nepal. 4

Contd…:

Contd … Continue breast feeding more than six month without practicing for complementary feeding and worm infestation causes malnutrition among the infant and children. At present,data shows about 49 % under 5 years children are suffering from stunting, 13% wasting, 39% under weight, 49 % protein energy malnutrition and 48 % anemia. Anemia prevalence among the non-pregnant women 34% and pregnant 42%. 5

Contd…:

Contd … National studies over the last 50 years show malnutrition rates in children under 5 years of age persist at rates around 50 %. At current mortality levels, one in every twenty one children dies before reaching the age of one year, while one in every sixteen does not survive to their fifth birthday. Although child mortality has reduced in recent years, malnutrition amongst the increased number of surviving children remains unacceptably high. 6

Objectives :

Objectives General objective 1.To review the nutritional problem of Nepal. Specific objectives 1.To study the nutritional health status of people of different age group. 2.To study the trend of nutrional status. 3.To study the pervalance of nutrional problems in different ecological zones. 7

Methodology :

Methodology This data was gathered from the secondary data source. This views and figures was taken from different journals and their reviews and also took data from Annual report. For this review, a literature was searched using PubMed , and Google Scholar. Articles published in languages other than English and Nepali were excluded . 8

Findings and results:

Findings and results The first health survey of Nepal which was done in 1965/66 tried to get information on the diet and nutritional status of the Nepalese people. A total of 6,321 people from 957 households from nineteen different sites within the country were covered. It was found that the diet as a whole is lacking in protein, calcium, Vit . A, riboflavin and ascorbic acid. Nepal National Nutrition Status Survey,1977/78 A survey of 749 children, between one to five years of age, was done.The findings of this survey in Bara and Parsa districts were as follows 9

Contd…:

Contd … Table : Status of Nutrition Degree of Malnutrition % Severe malnutrition 11.8 Mild malnutrition 36.4 Good nutrition 51.6 Family Health Survey of 1996 It showed that on the basis of height-for-age there is considerable chronic malnutrition among Nepali children - overall 48% of children under 3 years are stunted and 20% severely stunted . 10

Contd…:

Contd … Female children were more likely to be stunted (50%) or severely stunted (22%) than male children (47% and 19% respectively). Goitre prevalence survey in 1965-66 The survey in the 3 geographical regions showed that 55% of the population had goitre . Another survey in 1969 found rates of goitre prevalence to be between 74 and 100% in Jumla and Trishuli . 11

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Contd … Nutritional status of Nepalese children under 5 ye ars According to the NDHS, 2001,half (51%) of the children under 5 years were stunted and 21% severely affected with 10% of children wasted and 1% severely wasted Nutritional status of Nepalese: Parameters Overall Urban areas Rural areas Children under 5yr: Stunned 51% 37% 52% Wasted 10% 8% 10% Underweight 48% 33% 49% Women aged 15-49 yrs Thin (BMI <18.5) 27 % 17% 28% Height below 145cm 15% 13% 16% 12

Trend of Nutritional Status of under 5 children(in %) :

Trend of Nutritional Status of under 5 children(in %) 13

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Contd … National demographic and health survey 2006, Table1:Prevalance of stunting,wasting & underweight(in%) among children <5yrs in development region of Nepal in 2006 16

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Prevalance of stunting,wasting & underweight(in%) among children <5yrs in urban and rural areas of Nepal in 2006 Prevalance of stunting,wasting & underweight(in%) among children <5yrs in ecological zone of Nepal in 2006 17

Contd…:

Contd … A more recent report, World Health Statistics 2010 It indicates that 49·3 percent of under five years children of Nepal are stunted and 38·8 percent are underweight. But the report of Nepal Health Development Partnership 2009 shows reduction in the percentage of underweight (from 39% to 34%) among the same age group. 18

Contd…:

Contd … Comparisons between South-East Asia Region (SEAR) and the Nepal WHO 2009 Nutrition profile of member countries of SEAR shows that Nepal ranks second highest in the prevalence of stunting and second lowest in wasting among under fives. The data also show Nepal has lower prevalence of underweight i.e., (38·6)than Bangladesh (48%),India (42·5%), and Timor Leste (48·6%)and higher compared to the rest countries within this region. 19

Discussion :

Discussion The results of this qualitative analysis suggest that, in a five year period (2001-2006), reduction in the prevalence of stunting from 51% to 49% is a modest decline compared to reduction in the prevalence of underweight from 48% to 39%; a marked decline in the same period. WHO, Global Database on Child Growth and Malnutrition (Nepal) showed a fall in the percentage of stunting by 7·8% (from 57·1 % in 2001 to 49·3% in 2006) and a reduction in the percentage of underweight by 4·2% (from 43% in 2001 to 38·8% in 2006). Rural areas have higher prevalence (above national averages) for all three nutritional indicators 20

Contd…:

Contd … The Terai region (in southern Nepal) has lower prevalence of stunting. The far-western region has the highest prevalence of underweight while the eastern region has the lowest prevalence. 21

Conclusion :

Conclusion There is some but insufficient progress in the condition of nutritional status in children under five years of age in Nepal. The results of this review suggest that there is a modest decline in the level of stunting, a marked decline in the level of children underweight, but a slight increase in the level of wasting from the year 2001 to 2006 when the national demographic health survey was conducted. 22

Contd…:

Contd … The results indicate that reducing the prevalence of underweight to 27 %, stunting to 28%, and wasting to 5% in under five years children by the end of 2015 (MDGs) continues to be a challenge 23

Recommendation :

Recommendation The government of Nepal should give first priority to the nutrition interventions to reduce the malnutrition. The actions of the Ministry of health and population should become more visible. Strategic planning should be performed before start of the nutritional programmes . Holistic concepts to address underweight, stunting, and wasting should be launched separately from programmes that address the nutritional problem as a whole. 24

Contd…:

Contd … This article is assumed to be helpful to policy makers, nutritional expert, and everyone interested in knowing the situation of nutrional status among under five years children in Nepal. 25

Reference :

Reference Health Survey of Nepal. Brown ML, Worth RM & Shah NK, 1968; Am. Jou . Clin . Nut. Rana T. A situational analysis of nutritional problems in Nepal. 1990; Nep Paed Soc J Sharma PR, Child nutrition yesterday, today and tomorrow. 1979; Narayani Health J, Report of the National Nutrition Strategy Workshop. 1978 Pokhara . Nutrition status survey of under 6 years olds of Bode,Bhaktapur . 1984; Nep Paed J Krantz ME, Nutrition problems and programmes in Nepal. J Nep Med Assoc 1979; 26

Contd…:

Contd … (WHO). Nutrition profile of member countries (Nepal). [Internet] 2009 [cited 2010 Oct 02]; Nepal Demographic and Health Survey 2006]. (WHO). Global database on child growth and malnutrition. [Internet] 2008 [cited 2010 Oct 03]; Prevalence estimates are based on WHO standards.]. Ministry of Health and Population (MOHP) [Nepal], New ERA, and Macro International Inc. Nepal Demographic and Health Survey 2006. Kathmandu, Nepal: Ministry of Health and Population, New ERA, and Macro International Inc., 2007. 27

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