Islamic Republic of Afghanistan, Ministry of Public Health: National Public Nutrition Policy and Strategy 1394 – 1399 (2015 – 2020), Revised in March 2015

FOREEWORD

Good nutritional status is fundamentally important for ensuring and maintaining health and enhancing physical and cognitive capacity of populations. Thus, the economic growth and social development of a nation is highly dependent on a well-nourished population.

In contrast, nutritional deficiencies lead to increased morbidity and mortality among the population and retard economic growth. More than one-third of deaths among children under five years old worldwide are attributed to malnutrition, and the World Bank estimates that many countries lose at least 2 – 3 percent of their Gross Domestic Product (GDP) due to malnutrition. Thus, in 2008, the Copenhagen Consensus, composed of world renowned economists, selected five nutrition interventions among the top 10 most cost-effective national investments in developing countries. Yet again, the 2012 Copenhagen Consensus rated interventions to reduce malnutrition in children <5 years old as the top investment priority for developing countries.

Although there have been improvements in some indicators of nutritional status of the Afghan population during the past decade, the 2013 National Nutrition Survey indicates that the public health burden of malnutrition is still among the highest in the world. Furthermore, there is substantial variation in the prevalence of various indicators of nutritional deficiency, especially among women and young children, across the nation’s provinces. For example, although the 2013 data indicate that the prevalence of stunting (or chronic malnutrition) has decreased by about 20 percentage point since 2004, the prevalence of this indicator ranges from about 24% to >70% across the country. Another important improvement is indicated by a significant improvement in iodine status of the population; the median urinary iodine concentration among school age children was >170µg/L in 2013, compared to 49 µg/L in 2004. This is likely due to the substantial production and marketing of iodized salt in the country since 2003.

To effectively improve the nutritional status of the population over time, evidence-based intervention must be sustainably implemented with adequate quality and high coverage into the foreseeable future, and tracked through a systematic program monitoring and surveillance system. Therefore Ministry of Public Health (MoPH) considers nutrition as a fundamental priority, and has listed nutrition interventions as the first pillar of MoPH’s Strategic Plan for 2011-2015. In addition to the MoPH is advocating for and supporting food based interventions through public-private sector partnerships, the delivery of preventive and therapeutic nutrition services through the health care system is one of the seven components of the Basic Package of Health Services (BPHS) and part of the Essential Package of Hospital Services (EPHS). The MoPH continues to strengthen the capacity of its Public Nutrition Department (PND) through the recruitment and development of competent staff at the central and provincial levels. The role of the MoPH is integral and committed to the successful implementation of almost all inter-sectoral strategies and efforts toward improved nutrition for every Afghan.

The Public Nutrition Strategy for 2009 – 2013 guided the programs and activities of the MoPH and PND. So as to further improve and support population based nutrition interventions based on the latest international guidance and recommendations as well as lessons learned from national programs, the Public Nutrition Department led a comprehensive revision of the public nutrition policy and strategy in 2014. Thus, the Public Nutrition Strategy for 2015-2020 strategy was finalized after several rounds of consultation with development partners and stakeholders and includes six overarching components:

1. Implement evidence-based nutrition-specific interventions of high quality and coverage with more emphasis on preventive nutrition programs and services that target females of childbearing age and young children, especially those <24 months old

2. Inform the public about the role of nutrition in physical health and cognitive development, and promote dietary practices to prevent malnutrition and its related health consequences, especially among children <24 months old.

3. Advocate for public nutrition policies and adequate resources to support quality and high coverage interventions as essential components of the national development agenda.

4. Improve multi-sectoral coordination to help increase coverage of quality nutrition-specific and nutritionsensitive interventions.

5. Develop human resource capacities in planning, implementation and evaluation of nutrition interventions and strengthen the role and capacity of the PND.

6. Strengthen the national capacity to track the quality, coverage and impact of public nutrition interventions and services to guide future policies and strategies.

The MoPH calls upon all partners; donor community, UN agencies, technical nutrition NGOs, BPHS implementers, private sector, academia and especially the Cabinet of Ministers and other relevant governmental institutions to recognize and acknowledge the critical role of nutrition as a national development and security priority and play their important roles in the implementation of the Public Nutrition policy and Strategy for 2015-2020.

Best regards,

Dr. Ferozudin Feroz Minister of Public Health,
Islamic Republic of Afghanistan