HEALTH AND NUTRITION SUB-SECTOR STRATEGIES
Strategy 1.2 The HNS is committed to increasing the active participation of communities in the management of their local HCSs through developing strong, active participatory links with shura (community committees) and training and supporting CHWs.
Components of the Basic Package of Health Services
- Maternal and newborn health
- Antenatal (ANC), delivery and postpartum care; family planning; care of the newborn
- Child health and Immunization
- EPI (routine, outreach and mobile); integrated management of childhood illness
(IMCI); promotion of exclusive breast feeding for the first 6 months
- Public nutrition
- Micronutrient supplementation; treatment of clinical malnutrition, fortified flour
- Communicable diseases
- Control of tuberculosis, malaria, and HIVAIDS
- Mental health
- Community management of mental problems; health facility-based treatment of
outpatients and inpatients
- Physiotherapy integrated in PHCS;Orthopedic services expanded in hospitals
- Supply of Essential Drugs
Public Nutrition Program
Strategy 5.1 In collaboration with development partners, the MoPH will take the lead in preventing, identifying, and reducing malnutrition by strengthening and expanding the Therapeutic Feeding Units (TFUs), uplifting knowledge and skills base of the health professionals including NGO staff at health facility and community level and disseminating messages on nutrition to mothers in particular.
Strategy 5.2 The Ministry will promote food and nutrition security for all by adopting a public nutrition approach involving multisectoral interventions that address the underlying causes of malnutrition, including food insecurity, poor social environment, and inadequate access to HCSs. This work will be undertaken, partly through the BPHS and a close link with food security analysis and other social development programs. Quality salt iodization, flour fortification, diarrhoeal interventions and the therapeutic feeding of hospitalized malnourished children will receive focused attention.
The HNS is committed to taking a public nutrition approach that;
- Recognizes the multi-causal nature of malnutrition: The causes of malnutrition are multi-fold and are context-specific. They can be broadly categorized into three groups including food security, social and care environment and health (access and environment). There is significant interaction and synergistic effects between the different causes. While health interventions are an important component, malnutrition cannot be effectively addressed through health interventions alone but require broad-based interventions.
- Reflects an understanding of political, economic, social and cultural factors: The categories of underlying causes, are determined in turn by economic, agricultural, and trade policies. Additionally, cultural and social norms influence people’s ability to access food as well as their food consumption patterns
- Focuses on populations not individuals: Analogous to the difference between curative and public health, public nutrition does not focus only on treatment of individuals but emphasizes an approach that addresses population needs.
- Places nutrition firmly in the public domain: Public nutrition does not belong to any single sector or expertise. Professionals from a broad range of sectors including health professionals, agriculturists, economists, anthropologists, educators, community development workers in addition to nutritionists - need to contribute to the design and implementation of programmes in public nutrition. Public nutrition needs to be integrated into communities, legislation, the private sector and the political domain.
- Focuses on action-oriented strategies: Assessment to describe the extent and severity of the problem of malnutrition, including a description of the risks and causes, are conducted in order to inform the design or revision of interventions. This process is a dynamic one, i.e. Assessment, Action and Analysis (Triple A) concepts are applied throughout the implementation process. This assumes a dynamic process of ongoing review and analysis of process, effectiveness and impact. This understanding will determine appropriate action to be taken.
- Reflects universally accepted best practice and knowledge and reinforces learning: Programme design reflects demonstrated understanding of universally accepted best practice from scientific and nonscientific literature. A process of learning is required, which is evidence-based, involves wide dissemination of lessons learnt and demonstration of translating policies into practice.