View
8
Download
0
Category
Preview:
Citation preview
Symposium 1
Maternal, Infant and Young Child
Nutrition
July 3 - 4, 2019
Hotel Istana, Kuala Lumpur, Malaysia
1
Low Birth Weight and Stunting in Malaysia – tackling the persistent problems
Zalma Abdul Razak Nutrition Division
Ministry of Health Malaysia
2
BACKGROUND
WHAT MORE TO BE DONE
WHAT HAVE WE DONE
01
02
03
CONTENT
3
BACKGROUND LOW BIRTH WEIGHT & STUNTING 01
4
DEFINITION OF LOW BIRTH WEIGHT
5
11.19 11.22 11.07
11.41
11.2
11.53 11.41
10
10.2
10.4
10.6
10.8
11
11.2
11.4
11.6
11.8
12
2010 2011 2012 2013 2014 2015 2016
Pe
rce
nta
ge (
%)
TRENDS OF LOW BIRTH WEIGHT IN MALAYSIA
Source: Department of Statistics Malaysia, DOSM 6
NPANM III Target: < 8% (by 2025)
LOW BIRTH WEIGHT IN MALAYSIA
1 in 10
7
DEFINITION OF UNDERNUTRITION
#anakmalaysiatinggi 8
STUNTING
• Children are stunted if their height or length-for-age is below -2 SDs of the WHO Child Growth Standards median, and those below -3 SDs are considered as severely stunted (WHO, 2006).
• A sign of past or chronic undernutrition and cannot measure short-term changes in undernutrition.
Stunted
Severely Stunted
#anakmalaysiatinggi 9
Prevalence of Underweight, Stunting, Wasting & Overweight among Under 5 Children in
Malaysia
National Health and Morbidity Survey 2006 -2016
#anakmalaysiatinggi 10
STUNTING PREVALENCE IN MALAYSIA BY STATES (NHMS 2016)
12
18.1
34
14.1
19.1
25.7
20.3 23.7
20.8 18.5
26.1 23.1 23.5
10.5
24.3
0
5
10
15
20
25
30
35P
erc
en
tage
(%
)
-------------------------------------------------------------------------------------------------------------------------------
Upper Middle Income Countries = 6.9%
#anakmalaysiatinggi 11
STUNTING PREVALENCE IN MALAYSIA BY HOUSEHOLD INCOME (NHMS 2016)
29.8
22.3 25.1
18.4 19.8
17.4
0
5
10
15
20
25
30
35
< RM 1,000 RM 1,000 -RM 1,999
RM 2,000 -RM 2,999
RM 3,000 -RM 3,999
RM 4,000 -4,999
> RM 5,000
Pe
rce
nta
ge (
%)
#anakmalaysiatinggi 12
FACTORS CONTRIBUTING TO
STUNTING
1. Maternal stature
2. Mothers nutritional status (underweight or obese)
3. Maternal age at birth
4. Low birth weight
5. Women who did not receive any interventions
13
Maternal Characteristics
#anakmalaysiatinggi
Factors Contributing to
Stunting
14
Infant and Young Child Feeding and Care Practices
1. Infants who received poor breastfeeding practices
2. Children who did not receive early initiation of breast feeding
3. Children who were not exclusive or predominantly breastfed
4. Children with illness, such as fever and diarrhoea
#anakmalaysiatinggi
FACTORS CONTRIBUTING TO
STUNTING
15
Socio Demographic Factors
1. Strata (urban/ rural areas)
2. Sex of the children
3. Maternal education
4. Poor households
5. Race
#anakmalaysiatinggi
WHAT HAVE WE DONE TACKLING THE PERSISTANT PROBLEMS 02
16
Nutrition Intervention Programs/ Activities for Pregnant Women
1. Iron Folate supplementation
2. Full Cream Milk Powder Supplementation Programme
3. Nutrition education and counselling for pregnant women.
4. Cooking demonstration at clinics and communities
17
Nutrition Intervention Programs/ Activities for Children Under 5 Years
1. Breastfeeding Promotion
2. Baby-Friendly Hospital Initiative (BFHI)
3. Baby-Friendly Clinic Initiative (KRB)
4. Code Of Ethics For The Marketing Of Infant Foods And Related Products
5. Promotion Of Infant And Young Child Feeding/ Complementary feeding
6. Training on Child Growth Monitoring and IYCF Counselling (adapted from the Combined Course on Growth Assessment and IYCF Counselling, WHO, 2012)
7. Rehabilitation Program for Undernourished Children (Food Basket)
8. Community Feeding Program (targeted at aborigines)
18
Nutrition Intervention Programs/ Activities for Community & others
1. Cooking demo at clinics and community
2. Healthy menu at nurseries/preschools
3. Dissemination of nutritional knowledge in accordance to target groups such as children, parents, teachers and caregivers of nurseries
4. Improving skills on healthy food preparation amongst parents, teachers and caregivers of nurseries through training/ courses
19
WHAT MORE TO BE DONE TACKLING THE PERSISTANT PROBLEMS 03
20
Strengthening infant and young child feeding practices with improved counselling and care of breastfeeding mothers.
Increase knowledge and skills of parents using affordable and nutritious complementary foods.
Broadcast of TV & radio spots focusing on early initiation & exclusivity; continuing promotion of infant feeding.
Strengthening growth monitoring system – develop procedure to cater cases at risk of malnourished especially stunting
Collaborative engagements with other agencies – public, private, NGOs.
Use social and behavior change communication to address knowledge, behavior and social culture - beliefs and practices related to infant and young child feeding.
Partnership with global network –UNICEF, WHO, World Bank, ILSI, WABA
Built up alertness and awareness on malnourished issue focusing on stunting – to the community
21
22
CONCEPTUAL FRAMEWORK OF DETERMINANTS OF UNDERNUTRITION (UNICEF 2013)
Stunting & low birth weight is everybody’s business
23
COLLECTIVE EFFORTS ARE NEEDED FROM VARIOUS PARTNERS
Governments, Private Sectors, NGOs, Others
24
Let's walk & work together,
for the Future of Our Children
25
Recommended