Making Nutrition Central to Development in Haiti

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1 Making Nutrition Central to Development in Haiti JOSELINE MARHONE PIERRE PH, MD, MPH NUTRITION SPECIALIST DIRECTOR OF NUTRITION MINISTRY OF HEALTH, HAITI

2 Presentation Outline Nutrition situation in Haiti and current responses Partnership for nutrition Knowledge creation and advocacy Policy and operational efforts

3 Nutrition situation in Haiti Chronic malnutrition remained stagnant from at about 32% (DHS) Acute malnutrition increased from 5% in 1995 to 7% in 2000 to 9% in 2005 (DHS) Malnutrition rates have been consistently higher in rural areas Chronic malnutrition (stunting): low height-for-age compared to international standards Acute malnutrition: (wasting): low weight-for-height compared to international standards Photo:

4 Chronic malnutrition in 2009 Prevalence among children 6-59 months remains high in most departments Percent Departement Source: 2009 national nutrition survey; departments ordered by population density (highest to lowest left to right)

5 Acute malnutrition in 2009 Prevalence among children 6-59 months is no longer alarming, but is still an important concern Percent Department Source: 2009 national nutrition survey; departments ordered by population density (highest to lowest left to right)

6 Micronutrient deficiencies Iron >60% of children 6-59 months suffer some form of anemia; among anemic children, 72% are less than 24 months (DHS 2005) 46% of women (15-49 years) suffer some form of anemia (DHS 2005) Vitamin A Supplementation coverage is less than the target coverage rate (80%) in all but 2 departments (DHS 2005, UNICEF 2008) Iodine 10% of households use iodized salt (DHS 2005) 3% of children live in a household with iodized salt (DHS 2005)

7 Current response to malnutrition Limited funding allocated to nutrition Funding primarily comes from external sources (NGOs and donors) Patchwork nutrition programs implemented by NGOs with limited coordination Insufficient coverage of programs addressing child and maternal malnutrition Predominant attention to short-term (acute malnutrition), emergency-response, rather than a long-term integrated approach to reducing malnutrition Nutrition is nearly absent from the national strategic framework

8 Partnership for nutrition The Government of Haiti has built a strong partnership with donors and NGOs to coordinate efforts and improve effectiveness in reducing malnutrition Consultative Nutrition Committee (CNC) Led by the Minister of Health and/or Director General and comprised of representatives of the following agencies: WB, IADB, WFP, UNICEF, WHO, USAID and the Director of Nutrition acting as permanent secretary. Purpose: Discuss and decide on strategic orientation to nutrition, information sharing, joint planning, co-financing Comité Technique de Nutrition (CTN) Composed of the Director of Nutrition, NGOs and other partners working in nutrition nationwide Purpose: coordination, information sharing, and contingency planning

9 Knowledge creation and advocacy Objectives To develop a clearer and more comprehensive understanding of the nutrition situation in Haiti To harmonize nutrition messages and priorities To share information with a range of stakeholders To advocate for improved nutrition policies and programs and prompt action to address these problems

10 Knowledge creation and advocacy activities National nutrition survey* ( ) MOH, ACF, UNICEF Assessment of nutrition programs in Haiti (mid-2009) Review of existing programs/policies and identification of promising approaches and innovative tools for scaling up and harmonizing nutrition interventions MOH, World Bank Improving Child Survival and Building Blocks for Social Safety Nets ( ) MOH, IADB, MI, WFP Mapping of nutrition programs in Haiti (early 2010) Geographical coverage of nutrition programs and identification of gaps MOH, WFP, World Bank (building on work done by UNICEF) Cost of Hunger (late 2009-early 2010) Report quantifying cost of malnutrition MOH, WFP Nutrinet (2010) Online information-sharing network MOH, WFP High-level symposium on nutrition (2010) Information sharing, advocacy, strategic planning All partners * SMART survey (Standardized Monitoring and Assessment of Relief and Transitions)

11 Nutrition policy and strategy Development of protocols and norms for addressing malnutrition (2009) Revision of the National Nutrition Policy (end of 2009) Consultative process involving various ministries, NGOs, donors, universities Creation of a National Strategic Nutrition Plan for the period (2010) Involvement of multiple stakeholders Strategic Plan will include specific objectives, cost estimates, and concrete plans for action

12 Operational efforts Development and implementation of effective interventions to reduce and prevent malnutrition in partnership with donors (WB, IDB, UN, USAID, etc.) and NGOs Child Health Weeks (vitamin A supplementation, deworming, vaccination, etc.) Community- and facility-based treatment of acute malnutrition Small-scale initiative using household-focused community workers to provide families with behavior change counseling, a package of evidence-based basic services, and referral to other existing services, where available

13 The Way forward Strengthen leadership of Nutrition Unit/MOH for better coordination with donors and NGOs to reduce malnutrition Build capacity of the nutrition unit Increase resources available for scaling up efforts to reduce child and maternal malnutrition Continue the generation and collection of nutrition data and sharing of information Complete nutrition policy revision and develop a strategic plan for nutrition ( ) Encourage commitment to the strategic plan for nutrition Host a high-level symposium on nutrition to highlight the importance of nutrition in Haiti

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