Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional Status and General Health in Asia

Acknowledging the multi-disciplinary approach and multi-sectorial support needed to translate the latest scientific findings on improving micronutrient status into new policy, the SMILING consortium based the current Action on the following concepts:

1. Taking into account the current, transitional and future landscape

Despite a long recognition of their impact on health, micronutrient deficiencies still represent the most important undernutrition problem in developing and emerging countries in South-East Asia. However, most of these countries are now facing a more or less rapid transitional period (demographical, economical, cultural and nutritional).

Consequently, in the coming years the double burden of malnutrition, i.e. the coexistence of undernutrition and overnutrition, may increase if no efficient preventive programs (interventions) are implemented.

It is essential to take into account the future nutritional, environmental, economic, socio-cultural and political landscape in order to predict their impact on nutrition interventions and identify now actions needed to be taken to solve actual undernutrition, especially micronutrient deficiencies and to prevent emerging new nutritional challenges, such as overweight and obesity, which may also have a negative impact on micronutrient status.

2. Acting now for the future

Undernutrition, especially micronutrient deficiencies, early in life, i.e. during the gestational phase (foetal period) and the first years of life, are key factors determining the development of the individual, as well as the health and social well-being of adults, particularly when postnatal environment is changing dramatically.

Preventing micronutrient deficiencies in women of reproductive age before and during pregnancy and in infants and young children is essential for their entire lives and for the coming generations.

3. Right time for action

Because the evidence from research is so overwhelming that different preventive interventions offer high development returns and that the MDGs cannot be achieved without urgent attention to nutrition, time pressures to develop a commitment and allow the preparation of a detailed joint action plan by developing and emerging countries, civil society and external partners.

4. South-Asian centre of gravity

Asia is a wide and highly populated continent with a lot of disparities in and between the countries in the regions. The SMILING consortium includes 5 countries from South-Asia at different stages of development and diverse political, economic,administrative and social systems, allowing a broad approach in diverse contexts.

Individual country nutrition strategies and programs, while drawing on international evidence of good practice, must be country-owned and built on the country’s specific needs and capacities.

South-Asian countries and institutions have to identify their own opportunities and constraints in order to ensure appropriate and sustainable solutions to their nutritional problems.

These constraints and opportunities need to be understood to ensure empowerment and identify appropriate capacity development mechanisms for successful implementations.

Beyond the specific situations of each selected South-Asian countries, diversity of situations would allow identifying global strategies for the whole of Asia that will be prioritized by each country according to its specific situation.

5. Sustainable and general strategies

Nutrition needs to be integrated within other sectors such as health, social protection, agriculture, education, urban and rural development.

Furthermore, actions to control nutritional problems need to be sustainable over the long-term and provide food and nutritional security to all.

This will require both understanding and engagement by governments and civil society, with support of non–governmental and international organizations. Long-term accomplishments will depend on ownership, capacity and commitment by developing countries.

6. Stakeholder involvement

The link between scientific knowledge and action needs to be effective and for this a broad stakeholder viewpoint is needed. This will also help to fully understand perception of nutritional problems, opportunities and constraints for taking action.

Stakeholder groups will come from multiple sectors, including South-East Asian governments, private sector, administrators, health professionals, communities, and public interest/nongovernmental organizations, research institutions as well as Northern-based organizations (bilateral donors, United Nations agencies, international non-governmental organizations, universities and research institutes).

Successful country-wide strategies require multi-sectorial ownership: by governments, civil society and the private sector.

7. Political engagement

Policy-makers at the highest level need to be convinced that investment in nutrition is essential and profitable for the country and its population. Available scientific knowledge has to be presented in such a manner that translation into action becomes imperative.

8. Empowering women

Adolescent girls and women in reproductive age are key targets if potential rapid improvement of micronutrient status is to be achieved in these crucial
vulnerable groups and in young children.

Consequently the project will identify ways to prioritize women of reproductive age, especially before and during pregnancy and during lactation (including, for instance, maternal education and intra-family food distribution).