In Central Asia and Caucasus, necessities and the progress
Amir h YarparvarHealth and Nutrition SpecialistUNICEF Regional Office for Europe and Central Asia
Regional Nutrition Capacity Development and Partnership Platform
1974
1980
1990s screensInvading
1978Primary Health CareAlmata Declaration
0
50
100
150
200
1971
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2017
Under-5 Mortality trends in my country (per 1,000 live births) 1971-2017
Numbers of U5 children affected by double-burden in ECAR (millions)
3.6
1.61.8
3.2
Stunting Obesity2000 2017
6.5 poor feeding
6.1 Anemic
2.2 Low Birth Weight
Trends in the percentage of overweight children under 5, 2000 – 2017- Fastest in ECARSource: UNICEF, WHO, World Bank Group Joint Child Malnutrition Estimates, 2018
22
32 32 3339
5256
0
10
20
30
40
50
60
East Asiaand thePacific
Europe andCentral Asia
Middle Eastand North
Africa
West andCentralAfrica
LatinAmerica &
theCaribbean
South Asia Eastern andSouthern
Africa
Exclusive Breastfeeding % in ECA Region, SOWC 2018
Iodine nutrition in the region (IGN 2017)
298250248242
204204203
195188182
175174
166157
141124
114107
1009087.5
Georgia (2017)
Kazakhstan (2006)
Croatia (2009)
Armenia (2017)
Azerbaijan (2008)
Moldova (2012)
Romania (2014)
Serbia (2007)
Turkmenistan (2006)
Bulgaria (2008
TFYR Macedonia (2003)
Montenegro (2007)
Belarus (2015)
BIH (2005)
Uzbekistan (2005)
Region
Kyrgyzstan (2009)
Turkey (2007)
Albania (2012)
Ukraine (2002)
Tajikistan (2016)
Median UIC (µg/L) in ECA Region, 2017 update
99.997
9491.9
85.485.4
76.175.675.37474
70.970.768.9
6253.653.1
44.332.2
20.7
0 20 40 60 80 100 120
GeorgiaArmenia
TFYR MacedoniaBulgariaBelarus
KazakhstanKyrgyzstan
AlbaniaTurkmenistan
RomaniaTajikistan
RegionMontenegro
TurkeyBosnia and Herzegovina
AzerbaijanUzbekistan
MoldovaSerbia
Ukraine
Households consuming iodized salt (%), ECA Regional Average, 2017
We have failed to stop the inter-generational hazards of Anemia in ECA Region
3732 30
24
34 3430
26
Central Asia Caucasus SEE Countries CEE
Prevalence of Anemia among Women of reproductive Age, 2017 SOFI
2005 2017
0
10
20
30
40
50
60
70
80
90
0.0
5.0
10.0
15.0
20.0
25.0
Prevalence of Stunting Vs GNI/Capita/100, Central Asia and Caucasus, 2018
GNP/Capita/100 stunting
Nutrition governance proxy profile, ECAR 2016
61%
44%
44%
72%
31%
56%
16.7%
0
0% 20% 40% 60% 80%
National Body on Nutrition
Dedicated National expert
Subnational nutrition focal points
National Nutrtion plan or policy
Costed Nutrition P or P
National policy/SP on NCD
Univerity degree program on PHN orCommunity Nutrition
Nutrition Capacity Building Network inCentral Asia
Small proportion of national budgets is dedicated to Food and Nutrition systems and nutrition governance
61.11%
16.67%
Other medical studies, with minorcourses on nutrition
Degrees on Public Health in Nutrition/Community Nutrition
No single nutrition education program in Central Asia and Caucasus
Nutrition specialty not recognized in Central Asia and Caucasus
Only in Easter Europe
Nutrition training profile in ECAR, 2016
• 2014, Second International Conference on Nutrition (ICN2) in Rome, States commitments
• 2015: SDG
• United Nations (UN) Decade of Action on Nutrition (2016–2025)
Regional Nutrition Capacity Development and PartnershipCentral Asia and Caucasus
In 2016-2017 a consultative process was launched to build consensus on the gapsThe states recognized:1. A major gaps in the nutrition workforce capacities at all
levels of:• preventive primary health care (PHC) • Tertiary level of care/ therapeutic • Academic education and research sector (fully absent)
2. That fast economic growth and development not utilized to further improve the nutritional wellbeing
3. That fast urbanization contributes to the double-burden4. The double-burden in need of upgraded capacities
What is the Regional Nutrition Capacity Develop Network and Partnership platform:
1- a systematic & sustainable2- cross-border 3- Partnership &4- capacity development &5- state-owned platform/ network
Who are members?• Relevant ministries to Nutrition and Food security; • National and regional Nutrition Academies• Relevant development partners• IFIs/ development banks• Communities• Private sector
The aims of the Regional Nutrition Capacity Develop Network and Partnership platform
1. Build the leadership and governance capacity in nutrition 2. Strengthen regional policy advocacy for improved financing for
nutrition results 3. Re-Defining and positioning nutrition services in PHC system to
respond to the double burden including the defining the minimum needed workforce
4. Enhance the capacity of the nutrition workforce with the right set of knowledge, skills and competency sets (short, mid and long term strategies)
5. Reinforce the multidisciplinary and system straightening approaches (utilizing i.e, health, food, education, social protection and legislative systems)
6. Collaborate region-wide to generate applied evidence and evidence-informed policy making and programming
7. Share lessons learned and replicable good practices
Added value of a regional approach• Stronger political leverage to influence the development agenda • Better visibility for nutrition in the region • Huge commonalities among countries and vast space for
collaboration• Less duplication, more experience sharing and coordination• Building on the past experience of the regional forums and SUN • More attractive for resource mobilization• Enabling a holistic and multi-sectoral system approach to
nutrition • Collective wisdom
Where do we stand now?• In July 2018, with support of 4 UN Agencies, UNICEF,
FAO, WHO and WFP the platform is launched
• Kazakhstan Gov volunteered to chair the secretariat
• A Work Plan and MOU is developed and signed on the occasion of 40th Anniversary pf Almaty PHC conference
• Next meeting of RNPP in March 2019 “sustainable food systems and nutrition governance for healthy diets Central Asia and Caucasus- Through the eyes of children and adolescents”
Conclusion
• Urgent need to develop the capacity of nutrition governance Central Asia and Caucasus (research, education and service)- Partners are most welcomed
• Intersectoral and system based actions to be accelerated in the region to address the rapidly growing double burden
• Interested institutions/ academies/ agencies please reach me for further details
Inside an apple there are few seedsInside a seed there are thousands of apples,It’s a learning concept,To be seed, not an apple…
