Thank you for giving such an opportunity.
Please find herewith my comments:
1. Do you have any general comments on the draft Framework for Action?
Draft framework when it was read I felt that this is something which is really required at this juncture to address the nutritional needs and also to refine and revise some of the ongoing strategies at the policy level. Discussions and concerns that was flowing till this time need to stop and look at such plan of action and seriously demands a strong commitment on the part of all the nutrition and health professionals to make our people healthy and to ensure a better life for children.
= Do you have any comments on chapter 1-2?
Referring to 2.2. Better governance on Nutrition: Institutional arrangements at the national level should focus on developing collaborations with the Non-Governmental organisations in the health sector and this might be important to address two of the four key elements mentioned under 2.1. Enabling environment- Leadership for progress on nutrition at all levels and enhanced capacities for strong and sustainable effective action
Also, referring to Facilitation of effective implementation at all levels: Intensive social mobilization should primarily focus on mobilizing children and adolescent girls in schools and colleges to make it sustainable and effective action
= Do you have any comments on chapter 3 (3.1 Food systems, 3.2 Social Protection; 3.3 Health; 3.4 International trade and investment)?
3.1. Food systems: Gender sensitive intervention also should focus on developing nutrition sensitivity. This will help in the long run to reinforce the need for the intake of nutrient dense foods. Availability of locally grown nutrient dense foods at an affordable price is always possible and proper steps to be taken towards making such foods available. This will increase the accessibility of such foods to the vulnerable population and thus enable them to make a healthy dietary choice.
Promoting the concept of developing food gardens by involving communities at the village level and integrating such programmes into the existing nutrition programmes will address the affordability and accessibility issues of some of the nutrient rich foods.
3.2. Social protection: Public food distribution schemes, ensuring universal coverage etc., should have a special team focussing on nutrition related issues. Strengthening the capacities of the human resources and using these resources in studying the impact of all such programmes will have a definite contribution in the long run to refine and understand the role of such interventions in reaching the millennium development goals
3.3. Health: Nutrition should become an integrated and parallel function in the existing health systems. Nutrition has a preventive function in breaking the vicious cycle of malnutrition that gets transferred from the mother to the child
3.3.1. Delivery of effective nutrition interventions: Deploying the resources at the primary health centre level and collaborating with Non Governmental health service institutes will help to develop the evidence for effective strategy development.
3.3.4. Nutrition education for behavior change: Rapid evidence development on the Knowledge, Attitude and Practices of women against dietary choices and food consumption at this point is important as this will help to assess the impact of ongoing projects and for any revision in policy or implementation if required. This will help to understand the changes in the existing behavior from earlier and what kind of interventions would improve this further.
= Do you have any comments on chapter 4-5? Nil
2. Does the Framework for Action adequately reflect the commitments of the Rome Declaration on Nutrition, and how could this be improved?
3. Does the Framework for Action provide sufficient guidance to realize the commitments made?
I feel that the success of this framework lies in effective execution and evaluation at the national level.
Stringent monitoring system at the national level
Brining in nutrition as a parallel support pillar in achieving the health goals of the countries only will ensure effective buy in at all levels. Otherwise amalgamation of health and nutrition always makes nutrition as a second priority since addressing the immediate health need is more important for any health system rather than focussing on preventive aspect.
Effective collaboration between the local bodies and the key stake holders is crucial.
A guidance on the above aspects also would help
4. Are there any issues which are missing in the draft Framework for Action to ensure the effective implementation of the commitments and action to achieve the objectives of the ICN2 and its Declaration?
Regards,
M.Asha Latha
Associate Public Health Specialist
Allen Foster Community Eye Health Research Centre
Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care (ICARE)
L V Prasad Eye Institute (LVPEI)
L V Prasad Marg, Hyderabad – 500 034
Asha Latha