1. KENYA ON COURSE
PRESENTER: GLADYS MUGAMBI HEAD OF NUTRITION AND DIETETICS MINISTRY OF HEALTH KENYA

2. Outline
WHA Targets
Why should countries invest in improving nutrition?
Nutrition situation in Kenya
What we can do to accelerate malnutrition reduction

3. World Health Assembly Targets 2025

4. Why invest in improving nutrition?
Human Rights
Alive and thriving
Economic
Benefits
Intergenerational
equity

5. of all child deaths from poor
nutrition
Malnutrition –single greatest contributor to child mortality. It accounts for more than a half of deaths among under-fives
None BF infants and children have a 7 fold and 5 fold greater risk of death from diarrhea diseases and RTI respectively

6. Progress on Nutrition Status in Kenya

7. Nutritional Status of Children26 4 11
*Based on the 2006 WHO Child Growth Standards

8. Progress in addressing malnutrition
The country has made progress towards reduction of malnutrition among children under five years
Stunting (short for age) has decreased from 35 to 26 percent
Wasting (low weight for height) has decreased from 7 to 4 percent in 2014
Underweight has reduced from 16 to 11 percent
We have achieved Millennium Development Goal target of 11 percent for underweight
Proportion of children less than 6 months who are exclusively breastfeeding (that is breastfeeding without being given anything else not even water) has increased from 32 to 61 percent
*Source KDHS 2014

9. Trends in Nutritional Status of Children
*Based on the 2006 WHO Child Growth Standards

10. Nutrition situation at county level
West Pokot and Turkana have the highest proportions of underweight children
West Pokot and Kitui counties have the highest proportions of stunted children
Turkana, Marsabit and Mandera have the highest proportion of wasted children
*Source KDHS 2014

13. Breastfeeding Status for Children Under 6 Months
*Source KDHS 2014

14. Exclusive Breastfeeding trends
Proportion of children younger than age 6 months who are exclusively breastfed has markedly increased over the years
2003 KDHS
KDHS
2014 KDHS
13%
32%
61%
The proportion of children less than 6 months using a bottle with a nipple has decreased from 25 to 11 percent
Only 21 percent of children age 6-23 months consume an acceptable diet

15. Kenya on course to meet WHA targets WHA target 2008 2014
U5 stunting
35.3
26.0
Anaemia
15-49yrs
48%
25.0
LBW 10
5.6
U5 overweight
4.1
EBF rates 32
61.4
U5 wasting
6.7
4.0

16. Prevalence of under-5 stunting (%)
Progress on reducing Stunting, but only one country on course to meet all the 5 WHA Targets for 2025
Prevalence of under-5 stunting (%)
On course
Off course, some progress
Off course, no progress
Not enough data to make assessment

17. Some progress on reducing Wasting: 4 countries on course to meet World Health Assembly Targets for 2025

19. Some progress on increasing Exclusive Breastfeeding Rates: 2 countries off course to meet World Health Assembly Targets for 2025
On course
Off course, some progress
Off course, no progress
Not enough data to make assessment

20. What has been our priority
1. Policy direction and positioning
Guided by the New Kenyan Constitution (2010)
Article 43 (1 c) - every person has the right to be free from hunger and article 53 – (1c) every child has the right to basic nutrition – much progress has been made in the policy environment for nutrition in Kenya in the last 5 years
Maternal and Infant Young Child Nutrition Policy Guidance:
Food and Nutrition Security Policy (2012)
Breastmilk Substitutes (Regulation and Control) Act
Maternal, Infant and Young Child Nutrition Policy & Strategy 2013
National Nutrition Action Plan
Maternity Protection (14 weeks) and paternity leave (2 weeks) through Employment Act (2004 /2007)
National Guidelines for Prevention of Mother to Child Transmission of HIV

21. What Has Been Our Priority?
2. Giving effect to the international code of marketing breast milk substitute through enactment of national legislations (BMS) Act- this has seen improvement of breastfeeding rates

22. What Have We Done?
3.Successful implementation of the national nutrition action plan to combat malnutrition: elements
Improve the nutritional status of women of reproductive age ( years), children and vulnerable groups
To improve the quality of diets of the Kenyan population
Improve access to quality curative nutrition services including TB, HIV, diabetes, hypertension etc
Strengthen coordination and partnerships among the key nutrition actors

23. We implement high impact nutrition intervention that seek to:
What Have We Done?
We implement high impact nutrition intervention that seek to:
Integration of nutrition services in MCH, health facilities and outreaches including:
IFAS supplementation, Vitamin A, MNPs
Implementing of baby Friendly Hospital and Community Initiative
Use of Community health Volunteers and mother to mother support groups
Capacity building of health workers to provide nutrition services including NCD support
Fortification of salt, maize, wheat flour, fats and oils with micronutrients
Provision of the nutrition commodities e.g. Vitamin A supplements
Capacity building of ECD teachers on de-worming and Vitamin A supplementation
Nutrition messaging through use of media especially local radios and social platforms such as facebook and twitter

24. What Have We Done?
Establishment of strong government leadership and coordination: Kenya has well-coordinated structures for implementation of nutrition actions,
Nutrition Inter-agency Coordinating Committee (NICC)-multi-stakeholder and multi-agency platform that coordinates nutrition in Kenya.
Kenya’s engagement (since 2012) in the global Scaling Up Nutrition (SUN) Movement
Strong support from donors
Good monitoring and research
Enhanced human resources for health

25. Next Steps
Continue to provide nutrition services through platforms such as beyond zero campaign
Promotion of healthy diets and lifestyles to prevent diseases malnutrition
Implementation of National and County action plan
Continued resource mobilization & advocacy
Community engagement to create demand for nutrition services
Use of media to share nutrition messages

26. Working Together
Addressing malnutrition in Kenya requires a multi-stakeholder approach & Government is leading national efforts to scale up nutrition
Civil Society
Technical Community
United
Nations
Donors
Government Partners
Business

27. What can Governments
& other stakeholders
do about it?

28. 1. Show Commitment

29. 2. Measure Coverage of Nutrition Programs
Avula et al., forthcoming

30. 3. Strive for Policy Coherence

31. 4. Cash: Invest More in Nutrition Actions

32. x x Donors More resources are needed for nutrition
to meet WHA undernutrition targets
Spending on nutrition specific interventions,
Governments
Donors x x
R4D and World Bank estimates for stunting reduction

33. 5. Community: Delivery and accountability

34. 6. Count: Invest in Data to Monitor Success

35. Calls to Action Commitment Coverage Coherence Cash Community 6. Count
Set national targets for malnutrition reduction
Make a Nutrition for Growth commitment at Rio 2016
Coverage
Increase coverage of nutrition programmes & measure coverage
Coherence
Think multi-sectorally
Build alliances between nutrition & other communities
Cash
Find more funding for nutrition action
Community
Strengthen front line delivery
6. Count
Identify the data gaps that hinder action—and fill them