Child malnutrition still remains a major concern

Heath Minister Dasho Dechen Wangmo and the Country Director for WFP Bhutan, Carrie Morrison launched the ๐—™๐—ถ๐—น๐—น ๐˜๐—ต๐—ฒ ๐—ก๐˜‚๐˜๐—ฟ๐—ถ๐—ฒ๐—ป๐˜ ๐—š๐—ฎ๐—ฝ (๐—™๐—ก๐—š) Bhutan findings and recommendations last month


Bhutan has made substantial progress in poverty reduction in recent years with household poverty declining from 23 percent to eight percent between 2007 and 2017. Nevertheless, malnutrition remains a major concern.

According to the Fill the Nutrient Gap (FNG) Bhutan, the country is facing a triple burden with over a fifth of children under five stunted, a high prevalence of micronutrient deficiencies reflected in high rates of anemia and outbreaks of vitamin B deficiency, and a rapid increase in overweight and obesity.

The FNG process in Bhutan was undertaken by the World Food Programme (WFP) in collaboration with the Ministry of Health, to support the implementation of the National Nutrition Strategy and Action Plan.

With funding from the World Bank, the FNG exercise was initiated in early 2022 with technical assistance from the Systems Analysis for Nutrition team at WFP headquarters.

The FNG states that the triple burden of malnutrition poses a major obstacle to human capital development in Bhutan. Progress in addressing malnutrition has been uneven, with worse nutrition outcomes among households in rural areas and in lower wealth quintiles.

To prevent all forms of malnutrition, it states that all individuals need to be able to access and afford healthy, nutrient-dense, and diverse diets, including the most vulnerable individuals such as children under two and pregnant and lactating women.

Therefore, the government has prioritized the fight against malnutrition as one of the most effective entry points for human development, poverty reduction and economic development.

This is reflected in landmark policies such as the Food and Nutrition Security Policy of Kingdom of Bhutan (2014), the 12th Five Year Plan (2019-2023) which identifies food and nutrition security as a National Key Result Area and, more recently, the National Nutrition Strategy and Action Plan (2020-2025).

The stakeholder engagement and analytical processes took place throughout 2022. After baseline diet cost and affordability results were shared, stakeholders participated in a prioritization exercise to identify those interventions that should be simulated and compared.

As the modelling simulation was carried out, national experts from the health, education and agriculture sectors provided inputs and validated the findings.

A final multistakeholder workshop was convened in December 2022 in which attendees identified priorities for sectoral actions for nutrition based on the FNG results.

The priority for sectoral action includes poor dietary quality and overconsumption of staples are key drivers of malnutrition in Bhutan. Meeting nutrient needs costs more than four times as much as meeting only energy needs.

Nearly three in 10 households, accounting to 27 percent, cannot afford to meet their nutrient need. Dietary patterns and suboptimal food choices also made nutritious diets less affordable, particularly for individuals with elevated nutritional needs.

Shocks, such as disruptions in supply chains, threaten to increase the proportion of households that cannot afford a nutritious diet and might reverse progress that has been made in the fight against malnutrition.

It also states that adolescent girls and pregnant and lactating women are especially vulnerable to malnutrition. However, targeted interventions can make an essential contribution to closing the nutrient gap.

Schools also play an essential role in ensuring access to good nutrition through provision of diverse and fortified meals and targeted supplementation.

For health system, the stakeholder recommends to introduce multiple micronutrient supplements for nutritionally vulnerable groups including adolescent girls, nuns and pregnant and lactating women.

It also recommends to strengthen infant and young child feeding practices, including promotion of exclusive breastfeeding for children under six months and complementary feeding for children six to 23 months.

Similarly, for education system, it recommended to utilize schools to establish healthy habits early in life through nutrition education and provision of diverse and healthy school meals.

It further recommends leveraging schools as a platform to reduce the consumption of sweetened snacks and beverages and salt through both restrictions on the use of sugary and ultra-processed foods within schools.

โ€œInvest in rice fortification infrastructure and capacity to supply all schools, including private schools, day schools currently without meal programmes, and monasteries and nunneries with fortified rice,โ€ it states.

Further, it recommended to review adequacy of the stipend provided to schools for local food procurement and revise the basket of centrally procured non-perishable commodities to improve the nutritional quality of school meals.

For food system, it recommended to leverage the success of the rice fortification programme by reviewing rice fortification standards to maximize the impact of fortification together with complementary targeted interventions.

Strengthening the capacity of blending facilities to scale-up fortified rice to unreached schools and commercial markets for the general population were other recommendations.