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Millennium Development Goals Linkages with Early Child Development and Nutrition

Millennium Development Goals Linkages with Early Child Development and Nutrition. The Challenge in India. DR. S.K CHATURVEDI MD,MNAMS,FIAPSM,FIPHA UNICEF State Representative for NE/NW states New Delhi. 1. Genesis of Millennium Development Goals. 2. Conceptual Framework.

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Millennium Development Goals Linkages with Early Child Development and Nutrition

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  1. Millennium Development GoalsLinkages with Early Child Development and Nutrition The Challenge in India DR. S.K CHATURVEDI MD,MNAMS,FIAPSM,FIPHA UNICEF State Representative for NE/NW states New Delhi

  2. 1. Genesis of Millennium Development Goals 2. Conceptual Framework 3. The Link with Integrated Early Child Development & Nutrition 4. Millennium Development Goals 5. India – Challenges & Opportunities 6. Moving Forward

  3. The Genesis Millennium summit of UN - September 2000 Commitment to reduce global deprivation and promote sustainable human development Millennium Development Goals/ Country Plan Goals • Quantifiable targets for 2015 • Some 10th Plan Goals more ambitious than the MDGs A Rights Perspective • Children’s & women’s rights fundamental to human rights • UN Convention on the Rights of the Child • Convention on Elimination of all forms of Discrimination Against Women Creating a World Fit For Children • UN General Assembly Special Session on Children - Sept 2002 • Placing children first on the development agenda

  4. Millennium Development Goals • Eradicate Poverty & Extreme Hunger • Achieve Universal Primary Education • Promote Gender Equality & Empower Women • Reduce Child Mortality • Improve Maternal Health • Combat HIV/AIDS, Malaria & Other diseases • Ensure Environment Sustainability • Develop Global Partnership for development

  5. Young children on the Development Agenda A conceptual Framework Fulfillment of the Rights of all children to survive grow and develop to their full potential without discrimination Outcome Well nourished and healthy child Secure & Active Learner Child CARE Home Health Practices Home Hygiene Practices Infant and Young Child Feeding Psychosocial Care Care for Girls and Women Immediate Conditions Family Underlying Conditions Household Securities (eg Food,Water,Shelter) Empowered Community & Change facilitators Access to quality Services (Health, CDN, WES) Household/ Community Education / Learning / Life skills / Information & Communication Efficient resource use & control Natural /Human / Economic/Organization Resources Basic Conditions Civil Society /State Political, Economic & Social Structures & Systems Institutions and Governance Natural Resource Base & Environment

  6. Foundation for cumulative lifelong learning and human development Entry point for poverty reduction and human development strategy Early interventions most effective in addressing a life cycle of multiple deprivation - Poverty Gender Discrimination Malnutrition Sensitive proxy indicator of human development - % children 0-5 years underweight Integrated Early Child Development & Nutrition Crucial for the achievement of first 6 MDGs

  7. Goal1 Halve, between 1990-2015, proportion of people… Target 1  …whose income is less than $1 a day Target 2 …who suffer from hunger Eradicate Poverty & Extreme Hunger • Malnutrition erodes human capital, reduces learning abilities and productivity • For human capital formation, it is critical to prevent malnutrition, as early as possible • Early Care and Nurturing has a lasting impact on brain development- especially in the first 3 years The first 3 years are crucial. They are forever…

  8. Goal 2 Achieve Universal Primary Education Ensure by 2015… Target 3Children everywhere, boys & girls alike, will be able to complete full course of primary schooling 10th Plan  All children in school by 2003 All children to complete 5 years of schooling by 2007 • Early Child Development interventions • Result in increased cognitive and social skills • Improve retention and learning outcomes in primary education • Equality of opportunity for disadvantaged groups • Malnutrition reduces mental capacity & learning ability e.g. Micronutrient deficiencies such as Iodine (13 IQ points)Iron Deficiency Anemia (9 IQ points)

  9. Goal 3 Promote Gender Equality & Empower Women Eliminate by 2005… Target 4 …Gender disparity in primary & secondary education, & at all levels of education no later than 2015 • Positive early child care practices and parent education help promote equal learning opportunities for girls and boys • Better nutriture and iron status of girls improves learning capacity, likely retention and future choices

  10. Goal 4 Reduce Child Mortality Reduce by 2/3 between 1990-2015 Target 5 …Under 5 Mortality Rate 10th Plan  IMR to be 45 by 2007IMR to be 28 by 2012 • More than 50% of all child mortality is directly or indirectly associated with malnutrition • Around 25 % of young child mortality can be prevented through nutrition and early child care interventions

  11. Goal 5 Improve Maternal Health Reduce by 75% between 1990-2015 Target 6 …Maternal Mortality ratio • Maternal health is compromised by inadequate care and nutrition of girls and women • Malnutrition, including anemia, is associated with most major risk factors for maternal mortality • Severe anemia is a major cause of maternal deaths – around 20 % globally

  12. Goal 6 Combat HIV/AIDS, Malaria & Other diseases Have halted by 2015… Target 7 …and begin to reverse the spread of HIV/AIDS • Malnutrition • Hastens onset of AIDS among HIV-positive • Weakens resistance to infections and reduces malaria survival rates • Infant & Young Child FeedingInformed choice important for prevention of mother to child transmission of HIV/ AIDS

  13. Linking Nutrition & Development Mechanisms and Instruments More effective poverty reduction • Nutrition key to addressing inter-generational cycle of poverty • Helps targeting the most vulnerable and at risk • Proxy indicator for multi-sectoral interventions Strengthened health sector reform • Inclusion of early child care and nutrition increases efficiency and quality of health services • Using nutrition tools and methods e.g. Mother Child Care Counseling Package Improved Governance • Community based care interventions promote participatory processes and capacity

  14. The Challenge in India • Every fifth young child in the world lives in India • Every second young child in India is malnourished • Three out of four young children in India are anemic • Every second newborn in India is at risk of reduced learning capacity due to iodine deficiency • Vitamin A a public health issue • Malnutrition limits development potential and active learning capacity of the child

  15. IMR Reduction needs acceleration… 69 64 40 Source : SRS Bulletins - RGI

  16. Addressing Malnutrition… Children 0- 3 years Promoting early child development is crucial

  17. Prevalence of Underweight Children… (0-3 years) Jammu & Kashmir Himachal Pradesh Punjab Uttaranchal Haryana Delhi Arunachal Pradesh Sikkim Uttar Pradesh Assam Rajasthan Nagaland Bihar Meghalaya Manipur Jharkhand Tripura J Mizoram West Bengal Madhya Pradesh Gujarat Chattisgarh Orissa % children 0-3 years below -2 SDWeight-for-Age, NCHS Diu Daman Maharashtra (49.6%)  50 % Dadar & Nagar 40-49 % Haveli 30-39% Andhra Pradesh 20-29% Goa Data NA Karnataka Source : NFHS II, 1998-99 Pondicherry Tamil Nadu Karaikal (Pondicherry) Lakshadweep Kerala Andaman & Nicobar Islands The boundaries and names shown in this map do not imply official endorsement or acceptance by the UN

  18. 10th Plan Goals… Improve Infant and Young Child Feeding Practices Increase early initiation (colostrum feeding) : 16% to 50% Increase exclusive breastfeeding 0-6 mths : 55% to 80%(0-3 mths) (0-6 mths) Increase complementary feeding (6-9 mths) : 34% to 75% Reduce the prevalence of Underweight (Children Under-3 years) from 47% to 40% Reduce prevalence of severe under-nutrition in children in the 0-6 years age group by 50% Reduce prevalence of anaemia by 25% and that of moderate/ severe anaemia by 50% Eliminate Vitamin-A deficiency Reduce prevalence of IDD to less than 10% by 2010

  19. Achieving the 10th Plan Goals… • It is possible to achieve these through relatively simple interventions • Improved family community care behaviours, focusing on children Under-3 years of age • Infant and Young Child Feeding • Psychosocial Care • Care for girls and women • Hygiene • Health • Positive evidence from community based care projects - even in challenging states

  20. Preventable Under-5 deaths - India Through universal coverage with individual interventions (2000) Source : Lancet Series

  21. Moving Forward… • Build upon innovative state-specific early child care approaches • Enhance quality improvement initiatives in ICDS • Increase emphasis on improving family/community early child care practices for younger children Under-3 years in RCH-II & ICDS e.g. Infant and Young Child Feeding • Strengthen partnerships for WCD Panchayati Raj Institutions Women’s Self Help Groups and community groups • National Nutrition Mission

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