APPENDIX 1: THE NUTRITION COUNTRY PROFILE: A TOOL FOR ACTION T
he two-page country profiles present a range of evidence needed to assess country progress in improving nutrition and nutrition-related outcomes. The first step in using the nutrition country profiles is to explore all types of data shown: demographic factors; anthropometric and other nutrition status measures for children, adolescents, and adults; coverage of evidence-based interventions; financial data; policy and systems factors; and broader determinants. They are organized as shown in Table A.1.
Key questions that can be answered in reviewing the data include the following:
• Are trends in nutritional status measures moving in the right direction? How prevalent are risk factors for diet-related noncommunicable diseases? Is the country progressing toward achieving the World Health Assembly targets for 2025?
• How high is coverage for each intervention? Do trends in in- fant and young-child feeding practices show improvements? Are there major gaps in coverage for specific interventions?
• How diverse and adequate is the food supply? Are support- ive policies and institutional arrangements in place to enable delivery of needed nutrition-specific and nutrition-sensitive programs?
The second step in using the nutrition country profiles is to identify opportunities to address coverage gaps and weaknesses in the health system and policy framework so that progress can be rapidly achieved in improving child, adolescent, and adult nutrition. Questions to ask include the following:
• Are the coverage and policy data consistent with the epide- miological situation? This inquiry can be broken down into more specific questions:
¤ If stunting prevalence is high, are levels low for the in- fant and young-child feeding practices? Would a focus
on ensuring adherence to the International Code of Marketing of Breast-milk Substitutes and promoting optimal breastfeeding practices help to drive progress on reducing stunting?
¤ In countries where low birth weight and short stat- ure among women of reproductive age are highly prevalent, are sufficient resources being targeted to improve the provision of high-quality family planning and antenatal and delivery care? Is legislation in place to reduce the percentage of women who have a first birth before the age of 18, such as laws prohibiting child marriage and policies that facilitate women’s increased enrollment in secondary school?
¤ Are there patterns in the risk factors for noncommu- nicable diseases and trends in adolescent and adult overweight and obesity that suggest clear actions? For example, high prevalence of adult overweight and obesity and prevalence of raised blood pressure and blood glucose levels suggest the need for program- matic action targeted at changing food consumption and exercise patterns and improving access to healthy food options. Guidelines on diabetes and hypertension should also be in place and enforced.
• In countries experiencing high levels of stunting and increas- ing levels of child and adult overweight, are sufficient re- sources being spent on nutrition-specific and nutrition-sen- sitive interventions that address this double burden? Does undernutrition feature in the country’s national development plan, and are community and school-based strategies in place to improve access to diverse diets and increase healthy eating and exercise habits?
The profiles are meant to be a stimulus to action. Instances of gaps and shortcomings, as well as evidence of progress, should serve as signals for further investigation.
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