The micronutrient status of women and children in Nepal improves; but Anaemia, Zinc deficiency, and H. Pylori infections remain public health challenges

Sep 03, 2018

The Nepal National Micronutrient Status Survey Report highlights the micronutrient status of children, adolescents and women, after two decades.

KATHMANDU, 29 AUGUST 2018: After two decades, the Nepal National Micronutrient Status Survey assessed the status of Vitamin ‘A’, iron, folic acid, iodine, zinc, and the condition of anaemia as well as collected information on anthropometry, infectious diseases, blood disorders and markers of inflammation. A total of 12,512 respondents including children, adolescents and women from 4,320 households were surveyed using various methods, in 180 clusters of 73 districts throughout Nepal.

Zinc deficiency has emerged as a new public health challenge in Nepal as 21 out of 100 children between the age of six and 59 months and nearly one-fourth women of reproductive age have a zinc deficiency, the study report indicates. This contributes to the high burden of stunting and morbidity among children and intergenerational cycle of malnutrition.

The Nepal National Micronutrient Status Survey Report launched today further highlights that 20 per cent of children aged between 6 and 59 months, and 40 per cent of non-pregnant women aged 15-49 years, have been infected with the Helicobacter pylori bacteria. Furthermore, about one out of seven adolescent girls and boys were also found to be infected with H. pylori.  This infection may appear as acute gastritis, with people suffering from abdominal pain (stomach aches) or nausea. The more serious consequences of this infection can lead to the development of peptic ulcers and stomach cancer.

"I hope that the scientific evidence generated from this survey will be useful and will meaningfully contribute to the revision of the National Nutrition Policy and Strategies of the Ministry of Health and Population in addressing maternal, adolescent and childhood micronutrient deficiencies", said the Honorable State Minister for Health and Population Dr. Surendra Kumar Yadav. "I will take the findings of this survey very seriously and will guide my Ministry in relation to its utilization in policy revision and implementation thereafter."

Anaemia is a major cause of maternal deaths and of cognitive deficits in young children all around the world. Anaemia prevalence among children aged 6-23 months has significantly reduced from 88 per cent in 1998 to 33 per cent in 2016. The prevalence of anaemia among pregnant women has significantly reduced from 74.6 per cent in 1998 to 27 per cent in 2016. Similarly, the prevalence of anaemia among nonpregnant women has reduced from 66.7 per cent to 20 per cent in the same period. Although the anaemia prevalence among women and children has significantly reduced in the past two decades, these levels are still higher than the WHO cut off for public health significance of 20 per cent.

“While the Government of Nepal has made remarkable progress in improving health outcomes over the past twenty years, continued progress requires addressing socio-ecological differences in health status,” said Carrie Rasmussen, Health Director, USAID/Nepal. “This survey provides the type of detailed data that will allow services to be provided to the people who need them the most. For example, the survey shows that anaemia prevalence is higher among preschool children and women in the Terai, particularly in the Terai Janajati and Terai Dalit ethnic groups; and Vitamin A deficiency is higher among non-pregnant women and children 6-59 months in the Terai (5% and 7% respectively) than in the mountain and hill areas (<1%).”

Vitamin A deficiency is the leading cause of preventable childhood blindness around the world and increases the risk of death from common childhood illnesses such as diarrhea. The study shows that, in Nepal, the Vitamin A deficiency has significantly reduced among children. In 1998, 20.8 per cent preschool children were Vitamin ‘A’ deficient (serum retinol levels < 0.70 µmol/l) as compared to 4 per cent of children aged between six and 59 months in 2016 (serum RBP).

“The survey contains invaluable information on the micronutrient status of women and children, those who are most vulnerable in the country, and is a significant accomplishment by the government", said Tomoo Hozumi, Representative of UNICEF Nepal. "The sheer complexity of such an undertaking, following the last survey 20 years ago, highlights the collaboration and rigour undertaken by all the agencies involved.  Significant funding, time, cooperation, technical skills and resources have been the pillars behind this collective effort. I believe that this survey will guide the way to even stronger and more informed policy decisions related to improving the nutrition for women and children in Nepal.”   

The report further highlights that about nine in ten households (88 per cent) use refined salt in 2016 as opposed to less than 10 per cent of them using the refined salt in 1998.  Ninety-one per cent of salt samples have an ideal iodine level of 15 ppm or more and 68 per cent have excessive iodine levels (>40 ppm).

The median urinary iodine excretion (mUIE) among women in 2016 is 286.2 µg/l which has significantly increased from the value of 114.1 µg/l in 1998. Similarly, the mUIE value among the school aged children 6-9 years in 2016 is 314.1 µg/l as compared to 143.8 µg/l in 1998. The recommended levels of mUIE among women and children is between 100 µg/l to 299.9 µg/l.

The survey was led by the Ministry of Health and Population and executed by United Nations Children's Fund (UNICEF) in 2016, with financial and technical support from the United States Agency for International Development (USAID), the European Union and Centers for Disease Control and Prevention (CDC), Atlanta, with field survey implementation from New ERA.


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