国际粮食政策研究所-是否有数据可用于跟踪马尔代夫营养政策、方案和成果的进展？（英）-2021_42页_621kb

Summary of "Are Data Available for Tracking Progress on Nutrition Policies, Programs, and Outcomes in Maldives?"

Core Content

This report, prepared by the International Food Policy Research Institute (IFPRI) and the UNICEF Regional Office for South Asia (ROSA), evaluates the alignment of Maldives' nutrition policies and programs with globally recommended nutrition actions and assesses the availability of data to track progress on these actions, determinants, and outcomes. The study is part of the DataDENT initiative, which aims to improve nutrition data systems in South Asia.

Main Objectives

1. Assess the extent to which Maldives' policies and programs address recommended nutrition actions across the life-course.
2. Examine the availability of data to track progress on nutrition actions, determinants, and outcomes.

Key Findings

3.1 Policy Coverage of Nutrition Actions

• Global nutrition actions: 53 recommended actions across the life-course.
• Applicable in Maldives: 49 of the 53 actions.
• Policies addressed: 31 of the 49 applicable actions.
• Programs addressed: 31 of the 49 applicable actions.
• Unaddressed actions:
  • Adolescence: Daily or intermittent IFA supplementation, preventive deworming, food supplementation.
  • Preconception: Daily or intermittent IFA supplementation, preventive deworming.
  • Pregnancy: Calcium supplementation, preventive deworming, advice on calcium consumption.
  • Delivery and postnatal period: Optimal timing of umbilical cord clamping, IFA and food supplementation for malnourished lactating women, food supplementation for complementary feeding.
  • Early Childhood: Iron-containing MNP, daily IFA supplementation, identification of severe or moderate underweight, inpatient/outpatient management of SAM, and management of MAM.

3.2 Determinants Targeted in Strategies

• Immediate determinants:
  • Breastfeeding (early initiation, exclusive, continued).
  • Complementary feeding (timely introduction, dietary diversity, meal frequency, acceptable diet).
  • Infectious diseases: Not adequately addressed (diarrhea, ARI).
• Underlying determinants:
  • Women's education (high school completion).
  • Sanitation and hygiene (improved facilities, safe water, handwashing, safe disposal of faeces).
  • Food security.
  • Social protection schemes.
  • Women's status (appropriate age of marriage and childbirth): Not addressed.

3.3 Nutrition Outcomes Targeted

• Global nutrition targets:
  • Stunting, wasting, and overweight among children under five: Addressed.
  • Anemia among non-pregnant women 15–49: Not addressed.
  • Overweight among school-age children and adolescents: Not addressed.
• Country-specific targets:
  • Anemia among pregnant women: Addressed.
  • Non-communicable diseases (NCDs) such as diabetes and hypertension: Addressed.

Data Availability

4.1 Data on Program and Policy Actions

• Population-based surveys:
  • MDHS 2016–17 and NMNS 2010 were reviewed.
  • Data available:
    • Contraception, ANC screening (first trimester and ≥4 visits), IFA supplementation, tetanus toxoid vaccination, weight monitoring, advice on birth preparedness, and exclusive breastfeeding.
  • Data not available:
    • Advice on weight after weighing, IFA consumption, early breastfeeding and skin-to-skin contact, optimal feeding of low-birth-weight infants, KMC counseling, IYCF counseling, growth monitoring, and postnatal care for babies and women at specific intervals.

4.2 Data on Determinants

• Immediate determinants:
  • Data on most indicators (breastfeeding, complementary feeding, dietary diversity, meal frequency, etc.) were available.
  • Missing data:
    • Maternal dietary diversity during pregnancy.
    • Household food insecurity.
    • Coverage under social protection schemes.
• Underlying determinants:
  • Data on sanitation, hygiene, and food security were available.
  • Missing data:
    • Early marriage and early childbirth.
    • Women's education and status (appropriate age of marriage and childbirth).

4.3 Data on Nutrition Outcomes

• Nutrition outcomes:
  • Data on most outcomes were available, with the exception of anemia among non-pregnant women 15–49 years.
  • Missing data:
    • Anemia among non-pregnant women 15–49 years.
    • Overweight among school-age children and adolescents.

Conclusions and Recommendations

5.1 Policy Gaps

• Maldives' nutrition policies and programs do not fully address all recommended nutrition actions, especially those related to adolescents, preconception, and early childhood.
• Key determinants such as infectious diseases and women's status (marriage and childbirth age) are not sufficiently targeted in the national strategy.

5.2 Data Gaps

• Population-based surveys lack data on several critical nutrition actions and determinants.
• Limited data on maternal dietary diversity, household food insecurity, and coverage under social protection schemes.
• Anemia among non-pregnant women and overweight among school-age children are not tracked through available surveys.

5.3 Recommendations

• Update national policies and programs to include all recommended nutrition actions, particularly those related to adolescents and early childhood.
• Revise population-based surveys to capture data on missing nutrition actions and determinants.
• Strengthen data systems to better monitor key nutrition outcomes and underlying determinants.
• Integrate data collection with administrative systems to improve the comprehensiveness and timeliness of nutrition data.

References and Appendices

• Appendix 1: Full list of nutrition actions addressed by policies and programs.
• Appendix 2: Program implementation and operational guidelines.
• Appendix 3: Activities included in national strategies to address determinants.
• Sources: WHO guidelines, SDGs, GNMF, and national policy documents.