1000 Days – A Unique Window of Opportunity
Ensuring the Right start to Life through Optimal Maternal and Child Nutrition: Building a Stronger Nation
It was a great privilege to attend a policy forum on 1000 days at the Senate of the Philippines last week. The First 1000 days of a child’s life is fundamental to ensure they ‘survive and thrive’ but malnutrition poses one of the biggest threats to giving children the right start in life, affecting their physical and mental development, even leading to death.
Chronic or long-term malnutrition causes stunting which means they are too short for their age and are impaired both physically and mentally. After 2 years of life, the damage caused by stunting is permanent and irreversible.
The forum was opened by Hon. Juan Edgardo M. Angara followed by Ms. Lotta Sylwander:
With 3.4.million stunted children in the Philippines, everyone needs to pitch in to ensure “every Filipino child has the right start in life”. Optimal nutrition in the first 1000 days – from pregnancy up to the second year of life is fundamental to prevent stunting. Breast feeding rates are still too low and should be exclusive for at least 6 months, but acknowledges the many difficulties in achieving this.
Dr Aashima Gaarg presented the effects of undernutrition from pregnancy to 2 yrs and the nutrition interventions required to prevent stunted body, stunted brain and stunted lives. The economic cost of undernutrition in the Philippines:
- Undernutrition → 3% GDP losses
- Cost of damage caused by typhoon Yolanda → 3.17%
What needs to be done?
- Higher level commitment and accountability for stunting reduction
- Improve coverage of essential nutrition interventions
- Removing bottlenecks and improved access to nutrition care
- Advocacy on the power of nutrition in 1000 days
Dr Rosalie Paje led us through the 1000 days window of opportunity from prenatal to 2 years and the DOH Nutrition Framework for 2014-2025. There are requirements at very stage to break the cycle of malnutrition, but here are a few I picked out from the prenatal stage that will be the main focus for my case study:
- Pregnancy tracking and enrolment to prenatal care services
- Empowering women on preparation of birth plans (facility-based delivery, breastfeeding and rooming-in (not separated from the mother))
Challenges and bottlenecks:
- Common misunderstanding of undernutrition, its economic impact and evidence based solutions
- Stretched capacities for Nutrition Service Delivery at the local level
- Fragmented Nutrition Surveillance
Ms Louise Maule explained how WASH is critical for the first 1000 days – how does it fit in with the Nutrition Framework and interventions? Inadequate WASH increases diarrhoeal diseases, intestinal worms and environmental enteropathy (inflammation of the gut and inability to absorb nutrients through prolonged exposure to this environment, without necessarily experiencing diarrhoeal diseases or intestinal worms).
The end result of course is poor nutritional status and undernutrition. There are 25% more stunted children compared to peers who have not had diarrhoeal diseases. Evidence shows that WASH interventions can reduce stunting by 15%.
What needs to be done?
- By 2022, all Barangays should be declared Zero Open Defecation (ZOD)
- By 2028, universal access to safe and adequate sanitation facilities
- Strong political leadership (which can be hard, particularly when no one wants to be pictured next to a toilet!)
- Increased investment in WASH solutions
- Demonstrating and documenting solutions and model approaches
- Developing inclusive partnerships
Finally, Hon Grace Poe (who is running for President next year) stressed how important it was to target those at the community level, i.e. the Barangay and Captains, who will have knowledge on pregnancies in their district for example. The right start to life through optimal maternal and child nutrition is very important for nation building and increasing the young population.
After the open forum and closing remarks, we signed the Declaration of Commitment to Protect, Respect and Fulfil the Right of Children to Health, Proper Care and Nutrition:
Before we left, I joined the Save team delivering their recommendations for bills to the Senators offices
It also happened to be Senator Villar’s birthday. To celebrate, everyone one in the building was treated to ‘dirty ice cream’. It’s not actually dirty….it’s the term for ‘street’ ice cream – and my first taste of cheese flavour (not the cheddar variety…)!
Like the Hi-5 meeting, this was another great insight, learning and connecting opportunity. Connecting with people and connecting the dots….the challenge ahead is becoming much clearer.
Speak soon! Alli 🙂