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Pan American Alliance for Nutrition and Development for the Achievement of the Millennium Development Goals: Conceptual

Pan American Alliance for Nutrition and Development for the Achievement of the Millennium Development Goals: Conceptual Premises. Mirta Roses Periago September 29, 2009. 49 th Directing Council of the PAHO 61 st Session of the Regional Committee of WHO for the Americas.

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Pan American Alliance for Nutrition and Development for the Achievement of the Millennium Development Goals: Conceptual

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  1. Pan American Alliance for Nutrition and Development for the Achievement of the Millennium Development Goals:Conceptual Premises Mirta Roses Periago September 29, 2009 49th Directing Council of the PAHO 61st Session of the Regional Committee of WHO for the Americas

  2. Millennium Development Goals Improve Maternal Health Eradicate Poverty & Hunger Combat HIV/AIDS, Malaria & Other Disease Universal Primary Education Ensure Environmental Sustainability Gender Equality & Empower Women Develop a Global Alliance for Development Reduce Child Mortality

  3. Greater risk of: Preventable deaths Infectious diseases Non communicable diseases Vulnerability to disasters Intrauterine growth retardation Impaired sanitation Adolescence pregnancy Stunting Illiteracy, poor instruction Unemployment Diminished: Physical performance Work capacity Mental development Physical growth Individual & social productivity Transgenerational transmission of malnutrition

  4. Estimated contribution of the determinants underlying the reduction of child malnutrition, 1970-1995 Health Food 19.3% 26.1% Maternal status 11.6% Maternal education 43.0% Source: Smith and Haddad. Overcoming child malnutrition in developing countries, past achievements and future choices. International Food Policy Research Institute. Washington DC 2000.

  5. Maternal and Child Undernutrition • Disease • Food insecurity • Inadequate housing • Illiteracy • Inadequate health services • Poor environmental conditions • Unemployment • Family violence • Low productivity Determinants • Poverty • Right violations • Inequities • Discrimination

  6. School age Children Children de 2 a 5 y Children 6 a 24 m Pregnancy Adolescents • Inadequate breastfeeding and complementary feeding practices • Incomplete immunizations • Lack of adequate care and stimulation at the household • Lack of access to delivery services • Lack of skilled birth attendance • Inadequate neonatal care Children 2 a 6 m • Incomplete immunization • Inadequate and insufficient food • Parasitic and infections diseases • Accidents • No breastfeeding • Inadequate complementary feeding • Incomplete Immunization • Lack of adequate care and stimulation at the household Delivery and Newborn • Lack of access to adequate prenatal care • Prevention of alcohol and tobacco consumption • Anemia and maternal malnutrition • Household violence • Parasitic and infection diseases • Sexual and reproductive health • Pregnancy prevention in adolescents

  7. Conceptual Premises • To develop approaches that emphasize the modification of determinants, rather than addressing only outcomes • To replace a one sector approach with a multi-sector approach centered on determinants • To build an institutional framework for coordinating joint efforts at the local, regional, national, transnational and regional levels • To identify integrated interventions using a life-course approach using evidenced-based information • To identify social and geo-demographic groups and scenarios to implement interventions • To monitor and evaluate the interventions in a comprehensive rather than fragmented manner

  8. The old versus the new focus of nutrition and development Centered in individual determinants (health and food) Orientated toward the mitigation of consequences Developed and implemented with a single sector vision The old The new • More emphasis on social determinants (at the level of the family and social and physical environment) • Oriented toward addressing the causes • Developed with a multi-sector and inter programmatic vision

  9. The old versus the new focus of nutrition and development Conceptualized with a vertical hierarchy Focus at the level of the individual The old The new • Implemented using a horizontal organization and in the context of alliances • Multi-level focus, including individual and contextual determinants and their interaction

  10. “What to do…?” UNESCO Work together to address social determinants in a coordinated way UNCT ILO FAO, WFP, IICA Literacy and quality education PAHO, UNFPA, UNICEF Empowerment and with respect for intercultural differences Access to worthy employment UN-HABITAT, PAHO, UNEP Nutrition and food security Prevention and control of disease Healthy housing PAHO , UN-HABITAT Improved indoor kitchens Safe household water Systems of disposal for human and household waste UNDP Strengthen capacity for local management

  11. The challenge is to work: Together In coordination Simultaneously Addressing all fronts Permanently In the same groups and territories

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