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REPORTS FROM THE AGENCIES

World Health Organization.  No increase in childhood overweight


 Increase rate of exclusive breastfeeding until 6 mo post-
Comprehensive Implementation partum to at least 50%
Plan on Maternal, Infant, and  Reduce and maintain childhood wasting to ,5%
Young Child Nutrition. Geneva,
Action Plan and Proposed Activities
Switzerland, 2014 To help communities and nations meet these goals, the WHO
put forth 5 priority actions and concomitant proposed ac-
Shelley McGuire
tivities that they propose be jointly implemented by the
Washington State University School of Biological
Sciences, Pullmann, WA
WHO, its member states, and international partners. These
actions are briefly described here.

Action 1: Create a supportive environment for the


implementation of comprehensive food and nutrition
policies
Background Included in this action item are revision of nutrition policies
The World Health Organization (WHO) has long advocated to comprehensively address the double burden of undernu-
for and worked toward substantial and sustained improvements trition and overweight with a human right-based approach,
in maternal, infant, and child nutrition around the globe. inclusion of nutrition in each country’s overall development
This is in large part because of the many acute and long- policy, and establishing effective intersectoral governance
lasting negative impacts that poor maternal/infant nutrition mechanisms for implementation of nutrition policies at both
has on not only individuals but entire communities and nations. national and local levels. The WHO plans to support these
Together, maternal and child undernutrition are estimated efforts by improving access to normative and policy guide-
to account for 11% of the global burden of disease, and child- lines, knowledge products, tools, and expert networks. The
hood malnutrition is considered the root cause of mortality WHO also urges international partners to engage in interna-
in ~35% of all deaths among children younger than the age of tional coordination of mechanisms or partnership, strengthen
5 y. Malnutrition can also lead to lifelong deficits in cognitive international cooperation to harmonize standards and pol-
abilities, academic achievement, and work productivity. As icies, and implement global advocacy initiatives that increase
such, improving nutrition in early life and during a woman’s public awareness of the need to expand nutrition-related
reproductive years has far-reaching implications on many levels programs.
both directly and indirectly related to basic health outcomes.
Action 2: Include all required effective health interventions
Overarching Goals with an impact on nutrition in national nutrition plans
From results of a previously conducted review and policy On the basis of the notion that there are myriad, proven
analysis of its member states, the WHO concluded that, al- interventions that can improve maternal, infant, and young
though effective nutrition actions exist worldwide, they are child nutrition (see link below), these types of intervention
often not implemented on a sufficiently large scale to be approaches should be considered for implementation when
effective. In addition, policies and actions are often inade- feasible. Development or strengthening of legislative, regulatory,
quate, given the complexity and challenges at hand. In response, and/or other measures to control the marketing of human
the WHO recently issued a guide for action in this regard. milk substitutes to ensure implementation for the International
This 2014 publication, summarized here and titled “Com- Code of Marketing of Breast-Milk Substitutes is specifically
prehensive Implementation Plan on Maternal, Infant, and recommended within this action item. Other proposed ac-
Young Child Nutrition,” was endorsed by the WHO’s 65th tivities include strengthening health systems, promoting uni-
World Health Assembly that convened in Geneva, Switzerland, versal coverage and principles of primary health care, and
in 2012. The objective of this plan was to provide detailed and engaging in vigorous campaigns to promote breastfeeding at
dove-tailed implementation strategies to address key global tar- the local level.
gets for reducing maternal, infant, and young child malnutri-
Action 3: Stimulate development policies and
tion. These goals are to be attained by 2025 and are listed here.
programs outside the health sector that recognize
 40% reduction in children younger than 5 y who are stunted and include nutrition
 50% reduction in prevalence of anemia in reproductive- To reduce the double burden of undernutrition and
age women overweight, the WHO recognizes the importance of simulta-
 30% reduction in annual incidence of low-birth weight neously engaging multiple sectors, including agriculture,

134 ã2015 American Society for Nutrition. Adv. Nutr. 6: 134–135, 2015; doi:10.3945/an.114.007781.
food processing, trade, social protection, education, labor, financing tools for funding the expansion of nutrition
and public information, in the quest to improve worldwide programs worldwide.
nutrition. The ultimate goals of this action item are to pro-
mote the demand for and supply of healthier food and to Action 5: Monitor and evaluate the implementation
eliminate constraints to its access. Implementation is of policies and programs
envisioned to involve establishment of a dialogue be- Finally, as with most well-delineated plans related to im-
tween health and other government sectors to consider pol- proving public health, this one recommends the devel-
icy measures that could improve the nutritional status of the opment and use of a well-defined monitoring framework
population and reduce conflict between current sectoral pol- to provide accountability for the actions implemented.
icies and health policies. The WHO also urges international This framework should follow a proposed set of indicators
partners to involve themselves in analyzing evidence as developed by the WHO (see link below). Proposed activ-
of effectiveness of interventions aimed at improving ities include the implementation of the WHO child growth
food security, social welfare, and education in low-income standards to monitor individual growth patterns and popula-
countries. tion levels of stunting, wasting, and overweight and the col-
lection and exchange of information between organizations
Action 4: Provide sufficient human and financial with the aim of ensuring global coverage of the databases.
resources for the implementation of nutrition
interventions For More Information
This action item recognizes the enduring and undeniable A free on-line version of this report can be found at http://
fact that these action plans and associated implementation www.who.int/nutrition/publications/CIP_document/en/. The
strategies will require substantial financial, technical, man- WHO review of food and nutrition policies of member states
agerial, and human resources for them to be successful. In can be accessed at http://www.who.int/nutrition/publications/
addition, greater efficiencies will be needed in funding pro- policies/global_nut_policyreview/en/. To read the afore-
grams, including better alignment of donor investment with mentioned document outlining effective nutrition intervention
national priorities, and measures to reduce costs of inter- programs, go to http://www.who.int/nutrition/publications/
ventions such as micronutrient supplements and ready-to- infantfeeding/essential_nutrition_actions/en/. For more
use foods. The plan recommends that member states information about the WHO monitoring and evaluation
implement a comprehensive approach to capacity build- indicators, see http://www.who.int/nutrition/EB128_18_
ing, including workforce development and leadership de- backgroundpaper4_nutrition_indicators.pdf?ua¼1. The In-
velopment; provide support to local communities; and ternational Code of Marketing of Breast-Milk Substitutes
establish a budget line and national financial targets for is available at http://www.who.int/nutrition/publications/
nutrition. It also recommends exploration of innovative infantfeeding/9241541601/en/.

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