KENYA
Ministry of Health Scaling Up Nutrition Kenya Country Experience Terry Wefwafwa, Division of Nutrition, Ministry of Health
Structure of presentation 1.Background Information 2.Status of SUN in Kenya as in line with the four SUN Indicators 3.Challenges 4.Opportunities
Background - Kenya Country Context New Constitution & Devolved Government -(47 Counties) Demographic Data (Projection for 2013) Population 43.8 million Children Under Five 6.7 million Population Growth Rate (2010) 2.7 % Nutrition Data (DHS 2008-2009) Stunting 35.3 % Wasting 6.7 % Low Birth Weight 5.6 % Overweight 4.7 %
Background - Kenya Country Context Good Nutrition Practices Exclusive Breastfeeding 32 % Complementary Feedingwith at least 4 groups per day (6-23 months (3 + food groups for breastfed children and 4 + for non-breastfed children) 54 % Vitamin and Mineral Intake Zinc Treatment for Diarrhea 0.2 % Pregnant Women receiving Iron Folate Supplementation 12.0% De-worming (12-59 months) 37.5 % Vitamin A Supplementation (6-59 months)* 66.3 % Presence of Iodised Salt in the House 97.6 %
Background -SUN in Kenya SUN similar to National Food and Nutrition Security Policy Developed coasted National Nutrition Action Plan (2012 2017) 30 th Country to sign up to SUN movement in November 2012 SUN movement formally launched on 5th and 6th November 2012 at a National Symposium on SUN with launch of the Action Plan
Indicator 1: Bringing People together for action 1. SUN Government Focal Point in place 2. Nutrition Interagency Coordinating Committee (NICC) - presently serves as the multistakeholder and multi-agency platform that coordinates nutrition in country 3. Intergovernmental SUN Coordination Team 4. Civil Society Network - UN Network 5. Donor Network EU Convener 6. Business Network 7. Higher level coordination structures of Food and Nutrition Security Policy under establishment National Food Security and Nutrition Steering Committee (NFSNSC) National Food and Nutrition Security Secretariat (NFNSS) UN agencies (UNICEF/WFP/WHO/FAO) supporting two SUN positions (SUN Government Coordinator and SUN Nutrition Advisor)
Bring People together - Coordination Structures Nutrition Interagency Coordination Committee MIYCN Steering Committee MIYN Working group Nutrition Technical Forum Urban Working group National Micronutrient Deficiency Control Committee Supplementation Working group Healthy Diets and lifestyle Steering Committee Obesity Working Group Advocacy and Communicatio n Working Group Capacity working group Emergency Nutrition Information working group National Food Fortification Alliance Dietary Diversity Working group Response advisory working group Research Monitoring and Evaluation
Indicator 2: Policy Environment & Legal Framework Constitution of Kenya (2010), article 43 - every person has the right to be free from hunger and article 53 - every child has the right to basic nutrition. National Food and Nutrition Security Policy launched October 2012. (multi-sectoral) National Nutrition Plan of Action 2012 to 2017, launched during 1 st National Nutrition Symposium (November 2012). Breast Milk Substitutes (Regulation and Control) Act (2012) enacted (October, 2012) Mandatory fortification of cereals and oils passed (October 2012) Various Policy Statements, Guidelines and Detailed work plans for given nutrition areas developed Employment Act maternity protection Food Policy assigned to Cabinet Secretary MOA Nutrition Policy assigned to Cabinet Secretary MOH Nutrition sensitive policies, strategies and plans: National Development and Poverty Reduction (Kenya VISION 2030; and Economic Recovery Strategy for wealth and employment creation 2003), Agriculture (Agriculture Sector Development Strategy 2010-2015), Education & Health (National School Health Policy 2009), Labor & Social protection (National Social Protection Policy 2012), Health (Kenya Health Policy 2012-2030)
Indicator 3: Aligning Programmes to a Common Results Framework National Nutrition Action Plan 2012-2017 (NNAP)-provides a framework for coordinated implementation of Kenya s commitment to nutrition The plan has 11 strategic objectives focusing on e.g. high impact nutrition interventions prevention and management of non communicable diseases monitoring and evaluation systems enhancing coordination mechanisms. Has a performance monitoring and evaluation framework. Disseminated at national level, County level dissemination & development of County Specific Nutrition Action Plans is ongoing.
Indicator 4: Financial Tracking and Resources Mobilization The total cost of the National Nutrition Action Plan (NNAP) over five years is Kenya Shillings (KSHs) 70 billion (approximately $824 million), averaging $165 million per year, with a per capita annual cost of less than $4. The majority of resources (70% or $573) are targeted at children under five years of age. The costing of the NNAP, conducted over a three month period, was spearheaded by the Kenyan Government and UN and other partners, with input from additional stakeholders. Nutrition Specific Interventions 88 % Nutrition Sensitive Approaches 3.5 % (Health, Water and Sanitation Cost Only) Strengthening Governance 8.5 %
Financial Tracking and Resources Mobilization Continued. Government spending on nutrition-specific interventions through health sector is estimated at 0.5% of the annual health budget, with a rate of 0.1-0.2% growth annually over past five years. Nutrition budgets are mainstreamed as the NNAP is aligned to the government s broader Medium Term Development Plan. The previous year s annual operating budget for the Division of Nutrition ~ $10 million (40% is government funded and 60% is off budget). The government has to source off budget funding. Sources include: UNICEF; WFP; ECHO; JICA; EU; UK Aid; World Bank; MI; GAIN; USAID Development of a financial tracking tool and review of actual expenditure for nutrition programmes is planned
Challenges Devolved government structures (47) which do not have adequate technical support and financial capacity High level government coordination structures not operationalized Coordination presently functioning mainly at Divisional level Weak linkagebetween the pillars of the National Food and Nutrition Security Policy Limited resources for the roll out of the National Food & Nutrition Policy and the National Nutrition Action Plan System for financial tracking and expenditure monitoring for programmes inadequate Weak linkage of nutrition interventions with Social protection programmes Weak linkage of the results frameworks of key policy documents across key sectors. Weak monitoring and evaluation of policies across sectors Most of the nutrition support has been for ASALS for humanitarian aid.
Opportunities Good will and strong existing technical capacity from UN agencies and donor community Facilitative policy environment SUN integration into the FNSP structures and finalization of FNSS FNSP passed as a Sessional Paper of parliament Devolution with provision for county food and nutrition security committees. The Jubilee government manifesto high priority for food security.
Possible UN Support Continued technical and capacity building support Support for appointment of high ranking SUN focal point Finalization of the Food & Nutrition Security Strategy. Support in operationalizing the high level FNSP Coordination structures Support government to facilitate all counties to SUN Advocate for increased government budget allocation to nutrition. External Resource Mobilization to include funding for development nutrition Advocacy at AU and other Regional bodies for African Governments to make declaration on funding for nutrition Development of Financial tracking and expenditure framework and monitoring for nutrition programs Support government to enhance private sector investment in food and nutrition security and promotion of pro-poor growth.
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