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1、NUTRITION,FOR EVERY CHILDUNICEF Nutrition Strategy 20202030iiUNICEF NUTRITION STRATEGY 20202030 United Nations Childrens Fund(UNICEF)December 2020Permission is required to reproduce any part of this publication.Permissions will be fully granted to educational or non-profit organizations.Please conta
2、ct:UNICEFNutrition Section,Programme Division3 United Nations PlazaNew York,NY 10017,USAEmail:nutritionunicef.orgWebsite:www.unicef.orgNote on maps:All maps included in this publication are stylized and not to scale.They do not reflect a position by UNICEF on the legal status of any country or area
3、or the delimitation of any frontiers.The dotted line represents approximately the Line of Control agreed upon by India and Pakistan.The final status of Jammu and Kashmir has not yet been agreed upon by the Parties.The final boundary between the Republic of the Sudan and the Republic of South Sudan h
4、as not yet been determined.The final status of the Abyei area has not yet been determined.Suggested citation:United Nations Childrens Fund.(UNICEF).Nutrition,for Every Child:UNICEF Nutrition Strategy 20202030.UNICEF,UNICEF,New YorkPhoto credits:Cover photo UNICEF/Eric Pasqualli;page 3:UNICEF/Giacomo
5、 Pirozzi;page 25:UNICEF/Giacomo Pirozzi;page 31:UNICEF/Giacomo Pirozzi;page 35:UNICEF/Giacomo Pirozzi;page 39:UNICEF/Giacomo Pirozzi;page 40:UNICEF/UNI235999/Noorani;page 42:AdobeStock;page 44:UNICEF UNI358981/Fazel;page 46:UNICEF/UN0294298/Ralaivita;page 48:UNICEF/UN0339436/Dejongh;page 50:UNICEF/U
6、N022060/Ayene;page 52:UNICEF/UN074047/Giacomo Pirozzi;page 54-55:UNICEF/UNI350848/Dejongh;page 57:UNICEF/UN0343201/Pazos;page 62:UNICEF/UNI335304/Bhardwaj;page 64:UNICEF/UNI353782/Diarassouba;page 66:UNICEF/UNI297260/Schermbrucker;page 68:UNICEF/UN0303588/Herwig;page 71:UNICEF/Giacomo Pirozzi;page 7
7、8:UNICEF/UN022131/Ayene;page 79:UNICEF/UNI303965/Younis;page 80:UNICEF/UNI331756/Diarassouba;page 81:UNICEF/UNI209786/Karimova;page 82:UNICEF/UNI235510/Willocq;page 83:UNICEF/UNI317537/Frank Dejongh;page 84:UNICEF/UN0297779/Nabrdalik VII;page 85:UNICEF/UN0303396/Arcos;page 86:UNICEF/UN0222153/Brown;
8、page 87:UNICEF/UN0342204/Keta;page 99:UNICEF/UN0314410/PudlowskiiiiUNICEF NUTRITION STRATEGY 20202030NUTRITION,FOR EVERY CHILDUNICEF Nutrition Strategy 20202030Who are the main audiences of the UNICEF Nutrition Strategy 20202030?The primary audience of the Strategy is UNICEF staff,particularly progr
9、amme teams working on maternal and child nutrition in development and humanitarian contexts.The Strategy is also destined for UNICEF staff working on nutrition relevant programmes,such as health,water and sanitation,education,protection and social policy,as well as UNICEF leaders who champion our ad
10、vocacy at the national,regional and global levels to make the right to nutrition a reality,for every child.ivUNICEF NUTRITION STRATEGY 20202030ACKNOWLEDGMENTSNutrition,for Every Child is the result of collaboration with a large number of individuals and organizations.UNICEF would like to thank the f
11、ollowing colleagues who willingly gave their time and expertise to develop this vision document,which outlines the UNICEF Nutrition Strategy 20202030:LEAD STRATEGY TEAMVctor Aguayo,Maaike Arts,Yarlini Balarajan,France Bgin,Nita Dalmiya,Stefano Fedele,Saul Guerrero,Chika Hayashi,Diane Holland,Josephi
12、ne Ippe,Roland Kupka,Joan Matji,Christiane Rudert,Harriet Torlesse,Vilma Tyler,Amirhossein Yarparvar,and Noel Marie Zagre.INTERNAL ADVISORY GROUP Jessica Blankenship,Stanley Chitekwe,David Clark,Marco Antonio Estebanez,Grace Funnell,Maureen Gallagher,Melanie Galvin,Aashima Garg,Bernadette Gutmann,An
13、dreas Hasman,Annette Imohe,Jo Jewell,Julia Krasevec,Richard Kumapley,Anne-Sophie Le Dain,Ines Lezama,Jennifer Lopez,Shahira Malm,Grainne Moloney,Reuel Kirathi Mungai,Louise Mwirigi,Vrinda Mehra,Simon Nanama,Anuradha Narayan,Biram Ndiaye,Cristina Perez,Dolores Rio,Mawuli Sablah,Joseph Senesie,Deepika
14、 Sharma,Ruth Situma,Irum Taqi,Guy Taylor,Vanya Tsutsui,Arjan de Wagt,DArcy Williams,and Anna Ziolkovska.EXTERNAL ADVISORY GROUP Nancy Aburto,Food and Agriculture Organization;Nina Acharya,Global Affairs Canada;Philip Baker,Deakin University;Francesco Branca,World Health Organization;Andr Briend,Tamp
15、ere University;Carmen Burbano,World Food Programme;Diana Carter,Food and Agriculture Organization;Nicki Connell,Eleanor Crook Foundation;Antonella Cordone,International Fund for Agricultural Development;Sandro Demaio,EAT Foundation;Carmel Dolan,Emergency Nutrition Network;Jessica Fanzo,Johns Hopkins
16、 University;Wafaie Fawzi,Harvard University;Rafael Flores-Ayala,Centers for Disease Control and Prevention;Elizabeth Fox,Johns Hopkins University;Patrizia Fracassi,Food and Agriculture Organization;Louisa Frey,German Federal Ministry for Economic Cooperation and Development;Esther Goh,Bernard van Le
17、er Foundation;Amador Gmez,Accion Contra el Hambre Spain;Caitlin Gomez,Nutrition International;Alison Greig,Nutrition International;Hinke Haisma,University of Groningen;Lawrence Haddad,Global Alliance for Improved Nutrition;Corinna Hawkes,University of London;Tanya Khara,Emergency Nutrition Network;L
18、auren Landis,World Food Programme;Anna Lartey,Food and Agriculture Organization;James Levinson,Tufts University;Roger Mathisen,Alive&Thrive;Marie McGrath,Emergency Nutrition Network;Purnima Menon,International Food Policy Research Institute;Erin Milner,United States Agency for International Developm
19、ent;Helen Moestue,Save the Children,USA;Scott J.Montgomery,Food Fortification Initiative;CarolynMoore,SPOON Foundation;Stineke Oenema,United Nations System Standing Committee on Nutrition;Victor Ochieng Owino,International Atomic Energy Agency;Abigail Perry,United Kingdom Department for Internationa
20、l Development;Ellen Piwoz,Bill&Melinda Gates Foundation;Victoria Quinn,Helen Keller International;Anushree Rao,Concern Worldwide;Juan Rivera,National Institute of Public Health of Mexico;Marion Roche,Nutrition International;Vincent Rousseau,Global Affairs Canada;Sarah Rowe,Nutrition International;Me
21、era Shekar,World Bank Group;Shelly Sundberg,Bill&Melinda Gates Foundation;Christine Stewart,University of California,Davis;Andrea Torres,Bernard van Leer Foundation;Cesar Victora,Federal University of Pelotas;Anne Walsh,Power of Nutrition;Sophie Whitney,European Commission;Ramani Wijesinha-Bettoni,F
22、ood and Agriculture Organization;and Keith West,Johns Hopkins University.INTERNAL REFERENCE GROUPYoussouf Abdel-Jelil,Jennifer Asman,Bertrand Bainvel,Mariavittoria Ballotta,Wivina Belmonte,Octavian Bivol,Pia Britto,Luciano Calestini,Geert Cappelaere,Philippe Cori,Jan Debyser,Alessandra Dentice,Jan E
23、ijkenaar,Paloma Escudero,Shaffiq Essajee,Gilles Fagninou,Mohamed Malick Fall,Alison Fleet,Manuel Fontaine,Jean Gough,Carla Haddad Mardini,Jumana Haj-Ahmad,Mark Hereward,Tomoo Hozumi,Karin Hulshof,Robert Jenkins,Etleva Kadilli,Afshan Khan,Atif Khurshid,Sun Ah Kim Suh,Marcy Levy,Kerida McDonald,Gregor
24、 von Medeazza,Grainne Moloney,Kelly Ann Naylor,Ana Nieto,Bo Viktor Nylund,Luwei Pearson,Maria Peel,Marita Perceval,Stefan Peterson,Marie-Pierre Poirier,Lauren Rumble,Sagri Singh,Gary Stahl,David Stewart,Rakshya Rajyashwori Thapa,and AlexandraYuster.STRATEGY SUPPORT TEAMYousif Almasri,Christina Calab
25、rese,Tatiana Harmon,TatianaNikolaeva,Nicole Ricasata,Joanna Rogowska,and Sirjana Shakya.EDITING AND DESIGNJulia DAloisio(editing),Vicky Bell(copy editing),and Nona Reuter(design).UNICEF SENIOR MANAGEMENT GROUPOmar Abdi,Henriette Ahrens,Ted Chaiban,Vidhya Ganesh,and Sanjay Wijesekera.The development
26、of Nutrition,for Every Child:UNICEF Nutrition Strategy 20202030 was made possible with financial support from the Governments of Canada,Germany,Luxembourg,the Netherlands,Norway,the UnitedKingdom,and the United States of America.vUNICEF NUTRITION STRATEGY 20202030CONTENTSACRONYMS viPREFACE viiEXECUT
27、IVE SUMMARY viii1.CHILD MALNUTRITION TODAY 22.VISION,GOAL AND OBJECTIVES 243.CONCEPTUAL FRAMEWORK 304.PROGRAMMING PRINCIPLES 345.RESULTS AREAS 38Results Area 1:Early childhood nutrition 42Results Area 2:Nutrition in middle childhood andadolescence 44Results Area 3:Maternal nutrition 46Results Area 4
28、:Nutrition and care for children withwasting 48Results Area 5:Maternal and child nutrition in humanitarian action 50Results Area 6:Partnerships and governance fornutrition 526.A SYSTEMS APPROACH TO NUTRITION 56Working with the food system 60Working with the health system 62Working with the water and
29、 sanitation system 64Working with the education system 66Working with the social protection system 687.PARTNERSHIPS,PROGRAMMING AND PEOPLE 70Strategic partnerships 72Programming approaches 77People and resources 888.WAY FORWARD 92REFERENCES 94viUNICEF NUTRITION STRATEGY 20202030ACRONYMSCSOCivil soci
30、ety organizationHIVHuman immunodeficiency virusFAOFood and Agriculture Organization of the United NationsGNCGlobal Nutrition ClusterMUACMid-upper arm circumferenceNCDNon-communicable diseasesNGONon-governmental organizationRUTFReady-to-use therapeutic foodSBCCSocial and behaviour change communicatio
31、nSDGSustainable Development GoalsSUNScaling Up NutritionUN United NationsUNESCOUnited Nations Educational,Scientific and Cultural OrganizationUNHCRUnited Nations Refugee AgencyUNICEFUnited Nations Childrens FundWASHWater,sanitation and hygieneWFPWorld Food ProgrammeWHOWorld Health OrganizationviiUNI
32、CEF NUTRITION STRATEGY 20202030PREFACEEvery child has the right to nutrition.And today,the need for diets,services and practices that protect,promote and support good nutrition has never been greater.Since 2000,the world has reduced the proportion of children under 5 suffering from undernutrition by
33、 one third and the number of undernourished children by 55 million.This remarkable achievement proves that positive change for nutrition is possible and is happening at scale but there is more work to be done.In 2020,at least one in three children is not growing well because of malnutrition,and at l
34、east two in three are not fed the minimum diet they need to grow,develop and learn to their full potential.That hurts not just children it hurts us all.Our data indicate that the burden of undernutrition and micronutrient deficiencies remains unsolved,particularly in low-and middle-income countries,
35、where about 200 million children are affected by stunting or wasting and almost twice as many suffer from deficiencies in vitamins and other essential nutrients.The added strain of the COVID-19 pandemic could throw an additional 140 million children into poverty in 2020 and increase the number of un
36、dernourished children by 7 million.At the same time,overweight and obesity are rising,including in low-and middle-income countries.With 10 years remaining in the pursuit of the Sustainable Development Goals,it is time for renewed action on ending child malnutrition in all its forms,everywhere.The CO
37、VID-19 pandemic should be a catalyst for progress,so that no child is left behind:this is not a time to lower our collective ambition.The UNICEF Nutrition Strategy 20202030:Nutrition,for Every Child,sets forth our vision,goal and priorities to support governments primary duty bearers of childrens ri
38、ght to nutrition and partners,in scaling up policies,strategies and programmes to end child malnutrition in both development and humanitarian settings.Nutrition has long been at the core of UNICEFs work.In 1990,our malnutrition framework broke new ground in setting out the multiple causes of poor nu
39、trition,with a focus on child undernutrition.In 2020,we have rethought our framework to acknowledge the evolving face of child malnutrition including overweight and obesity.We emphasize the determinants of good nutrition from the diets of children and women,to the care from which they benefit,the fo
40、od environments in which they live,and the ways in which governments and societies underpin childrens right to nutrition through political commitment and societal values.All UNICEF nutrition programmes across regions and countries share a universal premise:prevention comes first,in all contexts;if p
41、revention fails,treatment is a must.This means that the primary objective of our nutrition programmes is to prevent maternal and child malnutrition in all its forms across the life cycle.When efforts to prevent malnutrition fall short,our programmes aim to ensure the early detection and treatment of
42、 children suffering from life-threatening malnutrition.The Strategy recommits to rights-based and context-specific programmes that are informed by evidence and innovation.We expand our traditional focus on early childhood to middle childhood and adolescence.We renew our focus on preventing stunting,
43、wasting and micronutrient deficiencies while increasingly responding to the challenge of childhood overweight and obesity.And we propose a systems approach to nutrition that strengthens the ability of five key systems food,health,water and sanitation,education,and social protection to deliver diets,
44、services and practices that support adequate maternal and child nutrition,making these systems more accountable for sustainable nutritionresults.As Executive Director of UNICEF,I want to emphasize my commitment,and the commitment of UNICEF,to use all opportunities to work for better nutrition in all
45、 programming contexts.I am underscoring this commitment by launching the UNICEF Nutrition Strategy 20202030:Nutrition,for Every Child.In a world living with COVID-19 and increasing inequities,we look forward to working with governments and other partners to put childrens right to nutrition first and
46、 pave the way to a more equitable and sustainable future in the decade tocome.Henrietta Fore,Executive DirectorviiiUNICEF NUTRITION STRATEGY 20202030EXECUTIVE SUMMARYixUNICEF NUTRITION STRATEGY 20202030A triple burden In 2020,the burden of malnutrition remains unsolved,particularly in low-and middle
47、-income countries,where about 200 million children are affected by stunting or wasting and almost twice as many suffer from deficiencies in vitamins and other essential micronutrients.At the same time the number of children with overweight and obesity continues to rise,increasingly affecting childre
48、n from poorer households.Together,these problems can be characterized as a triple burden of malnutrition facing the worlds children:undernutrition,in the form of stunting and wasting,widespread micronutrient deficiencies,and a growing prevalence of overweight and obesity.The backdrop of nutrition ha
49、s changed,and new forces drive the nutrition situation of children globalization,urbanization,inequities,environmental crises,health epidemics and humanitarian emergencies posing critical challenges to feeding children sustainably today and for generations to come.The added strain of the COVID-19 pa
50、ndemic could throw an additional 140 million children into poverty in 2020 and increase the number of undernourished children by 7 million.Vision and goalThe evolving nature of child malnutrition demands a global multifaceted response that supports optimal nutrition at every stage of life.The UNICEF
51、 Nutrition Strategy 20202030 sets forth UNICEFs strategic intent to support national governments and partners in upholding childrens right to nutrition and ending child malnutrition in all its forms.Our vision is“a world where all children,adolescents and women realize their right to nutrition”.This
52、 vision is guided by the Convention on the Rights of the Child,which recognizes the right of every child to adequate nutrition.The goal of the Strategy is“to protect and promote diets,services and practices that support optimal nutrition,growth and development for all children,adolescents and women”
53、.This goal aims to contribute to the goal of the 2030 Agenda for Sustainable Development to ensure childrens access to nutritious diets and to end child malnutrition in all its forms.Results areasThe vision and goals of the Strategy are realized through programmes that share a universal premise:prev
54、ention comes first,in all contexts;if prevention fails,treatment is a must.UNICEF nutrition programmes aim to prevent child malnutrition in all its forms across the life cycle.When efforts to prevent malnutrition fall short,our programmes aim to ensure the early detection and treatment of children s
55、uffering from life-threatening malnutrition,both in development and humanitarian contexts.UNICEF organizes its programming for maternal and child nutrition into six results areas:Results Area 1:Early childhood nutrition encompasses UNICEFs programming for the prevention of all forms of malnutrition
56、in the first five years of life,including undernutrition both stunting and wasting micronutrient deficiencies,and overweight and obesity.Results Area 2:Nutrition in middle childhood and adolescence encompasses UNICEFs programming for the prevention of all forms of malnutrition in middle childhood(ag
57、es 59 years)and adolescence(ages 1019 years),including through school-based programmes.Results Area 3:Maternal nutrition encompasses UNICEFs programming for the prevention of malnutrition in women during pregnancy and breastfeeding two stages of nutritional vulnerability for women and the prevention
58、 of low birthweight innewborns.Since 2000,the world has reduced the proportion of children under 5 suffering from stunting by one third and the number of children who are stunted by 55 million.This remarkable achievement proves that positive change for nutrition is possible and is happening at scale
59、 but there is more work to be done.xUNICEF NUTRITION STRATEGY 20202030Results Area 4:Nutrition and care for children with wasting encompasses UNICEFs programming for the early detection and treatment of children with wasting through facility-and community-based approaches,in all contexts.Results Are
60、a 5:Maternal and child nutrition in humanitarian action encompasses UNICEFs nutrition programming in emergencies and is guided by UNICEFs Core Commitments for Children in Humanitarian Action and our commitments as Cluster Lead Agency for Nutrition.Results Area 6:Partnerships and governance for nutri
61、tion encompasses UNICEFs programming to strengthen the enabling environment for maternal and child nutrition through improved partnerships,data,knowledge,advocacy and financing at global,regional and country levels.For each Results Area,the Strategy outlines the intended results and the programmatic
62、 priorities guiding their achievement between 2020 and 2030.It is important to highlight that UNICEF country programmes are not expected to implement all components of the Nutrition Strategy.A guiding principle of the Strategy is context-specific programming,which is informed by an analysis of the n
63、utrition situation of children and women in a given context determinants,drivers,and potential impact pathways and the human and financial resources andpartnerships available.The triangulation of needs,resources and partnershipsallows UNICEF to identify the results areas and programmatic priorities
64、of the Strategy that are relevant to a given context.The Strategy keeps UNICEF nutrition programmes coherent across regions,countries and programming contexts.A systems approachTo support this vision and goal,our Strategy calls for a systems approach to improving nutrition outcomes.This approach aim
65、s to activate the five systems food,health,water and sanitation,education,and social protection with the greatest potential to deliver nutritious diets,essential nutrition services and positive nutrition practices for children,adolescents and women.This approach captures the interactions and interco
66、nnections across these five systems,avoiding the simplistic thinking that malnutrition has straightforward determinants that operate along linear pathways.We aim to make these five systems better equipped and more accountable for improving nutrition and addressing malnutrition in all its forms.In su
67、mmary,UNICEFs systems approach to nutrition acknowledges the central role of five systems food,health,water and sanitation,education,and social protection in providing nutritious,safe,affordable and sustainable diets for children,adolescents and women,while ensuring adequate nutrition services and p
68、ositive nutrition practices across the life cycle.For each system,our Strategy identifies the result that we intend to achieve and our priority areas of engagement.Strategic shiftsThe Strategy builds on UNICEFs past strategic guidance and programme experience while embracing six strategic shifts to
69、respond to the evolving face of child malnutrition and support national governments and partners in upholding childrens right to nutrition:An explicit focus on addressing child malnutrition in all its forms.Malnutrition,in all its forms,is a violation of childrens right to nutrition.The Strategy aim
70、s to contribute to addressing the triple burden of child malnutrition undernutrition,both stunting and wasting;deficiencies in vitamins and other micronutrients;and overweight and obesity and is aligned with the 2030 Agenda for Sustainable Development,which calls for an end to malnutrition in all it
71、s forms.A comprehensive life cycle approach to nutrition programming.Maternal and child nutrition during the first 1,000 days from conception to age 2 years remains core to UNICEF programmes in both development and humanitarian contexts.In addition,the Strategy calls for an increased focus on nutrit
72、ion in middle childhood and adolescence a window of nutrition opportunity for girls and boys and a chance to break the intergenerational cycle of malnutrition.A deliberate emphasis on improving diets,services and practices.The goal of the Strategy is to protect and promote diets,services and practic
73、es that support optimal nutrition,growth and development.Acknowledging the triple burden of malnutrition,it highlights the centrality of nutritious,safe,affordable and sustainable diets with adequate nutrition services and practices as the foundation of good nutrition for children,adolescents and wo
74、men.xiUNICEF NUTRITION STRATEGY 20202030A systems approach to maternal and child nutrition.The Strategy calls for UNICEF programmes to strengthen the capacity and accountability of five key systems food,health,water and sanitation,education and social protection to deliver nutritious diets,essential
75、 nutrition services and positive nutrition practices for children,adolescents and women.As a multisectoral agency for children,UNICEF is positioned to support a systems approach to nutrition that fosters national ownership and drives sustainableresults.A greater attention to private sector engagemen
76、t.National governments have primary accountability for upholding childrens right to nutrition;however,the private sector has a key role to play.The Strategy calls for UNICEF programmes to engage strategically with public and private sector actors to advocate for business policies,practices and produ
77、cts that support optimal nutrition for all children,adolescents and women,in all contexts.A universal vision and agenda relevant to all countries.Operationally,the Strategy is particularly relevant to low-and middle-income countries,where the triple burden of child malnutrition is greatest.However,g
78、iven the increasing burden of child overweight and obesity globally,UNICEF is also strengthening its work in high-income countries through its country offices and national committees to advocate for and support policies that protect every childs right to nutrition.Partners and peopleStrategic partne
79、rships are core to UNICEFs mandate and are a critical lever for implementing the Strategy.They allow UNICEF to share responsibilities,optimize resources,and maximize results.In countries,national and subnational governments are UNICEFs main partners for implementing the Strategy.UNICEFalso convenes
80、and supports multi-stakeholder partnerships at national,regional and global levels with civil society and non-governmental organizations,bilateral and multilateral partners,philanthropic foundations and donors,academic and research institutions,private sector and media to accelerate progress towards
81、 the nutrition targets of the 2030 Agenda for Sustainable Development.To deliver on the Nutrition Strategy 20202030,UNICEF counts the largest nutrition workforce globally.In 2019,our workforce for nutrition included 640 staff members and more than 1,500consultants leading and supporting the design a
82、nd implementation of advocacy,policies and programmes on maternal and child nutrition in development and humanitarian settings,in 130 countries across 7 regions worldwide.Further,more than 3,600 programme staff lead and support the design and implementation of advocacy,policies and programmes for He
83、alth,Education,Water and Sanitation,Child Protection,and Social Policy.UNICEFs multisectoral mandate for children,wide on-the-ground presence,and long-standing role as a trusted adviser to national governments position UNICEF to mobilize national,regional and global partners across public and privat
84、e sectors to tackle the global challenge of child malnutrition.Way forwardNational governments have primary responsibility for upholding childrens right to nutrition.We never lose sight of this foundational principle.Yet,the path to nutritious diets,essential nutrition services and positive nutritio
85、n practices for all children,adolescents and women demands a shared purpose,with commitments and investments required from a range of government,societal,public and private partners.Guided by the goal and programmatic priorities outlined in the UNICEF Nutrition Strategy 20202030,we have an important
86、 opportunity to contribute to ending malnutrition among children,adolescents and women across countries and regions over the final decade towards 2030.We stand ready to support national governments and their partners in upholding the right to nutrition for every child and securing a more just and eq
87、uitable future for children and their families today,and on the path to 2030.2UNICEF NUTRITION STRATEGY 202020301.CHILD MALNUTRITION TODAY3UNICEF NUTRITION STRATEGY 202020304UNICEF NUTRITION STRATEGY 20202030This chapter describes the triple burden of malnutrition globally,its impact on the lives of
88、 children,and the forces shaping childrens diets and nutrition today.It calls for a systems response that delivers diets,services and practices that support good nutrition at every stage of life while sustaining nutrition-responsive development for all children,adolescents and women.Since 2000,the w
89、orld has reduced the proportion of children under 5 suffering from stunting by one third and the number of children who are stunted by 55 million.This remarkable achievement proves that positive change for nutrition is possible and is happening at scale but there is more work to bedone.The triple bu
90、rden of child malnutritionIn 2020,the nutrition situation of the worlds children is characterized by a triple burden of malnutrition.1 The first burden is the continuing scourge of undernutrition,in the form of stunting and wasting,which threatens the survival,growth and development of millions of c
91、hildren and hampers the development of economies and nations.The second burden is micronutrient deficiencies,a hidden form of malnutrition in which children lack the vitamins and minerals that are essential for optimal immune response,skeletal growth and brain development.Thethird burden is the grow
92、ing prevalence of childhood overweight and obesity,once regarded as a condition of the rich and now increasingly affecting children from poorer households in low-,middle-and high-income countries.Stunting and wasting result from poor nutrition in utero,poor nutrient intake in early childhood and/or
93、infection and disease.Children affected by stunting may never attain their full linear growth and their brains may never develop to their full cognitive capacity,which has an impact on their school readiness,learning performance and life opportunities.Childrensuffering from wasting have weak immune
94、systems and face an increased risk of infection and death.If they survive,they are more susceptible to stunted growth and long-term developmental delays.Micronutrient deficiencies:Deficiencies in essential vitamins and minerals can result in devastating consequences for childrens survival,growth and
95、 development.Vitamin A deficiency,iron deficiency,folic acid deficiency,zinc deficiency and iodine deficiency independently or in combination are associated with a significantly increased risk of mortality,morbidity,blindness,hearing impairment,anaemia,poor linear growth and cognitive development,su
96、boptimal learning and school performance,and lower productivity and wages in adulthood.Overweight and obesity result when childrens caloric intake from food and beverages exceeds their energy requirements.Children affected by overweight are at increased risk of obesity and behavioural and emotional
97、problems in childhood,including stigmatization,low self-esteem and mental health problems,including depression.They also suffer an increased risk of obesity and diet-related non-communicable diseases later in life,such as type2 diabetes and cardiovascular disease,which is the leading cause of death
98、worldwide.5UNICEF NUTRITION STRATEGY 20202030The UNICEF State of the Worlds Children 2019:Children,Food and Nutrition indicates that at least one in three children under 5 is undernourished(stunted,wasted or both)or overweight,and at least half suffer from deficiencies in essential micronutrients.Th
99、e latest available data in the 2020 edition of the UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates indicate that globally:144 million children under 5 about 21 per cent are stunted.In South Asia and sub-Saharan Africa,stunting affects one third of children under 5.About half(54 per ce
100、nt)of all children who are stunted live in Asia and more than one third(40 per cent)live in Africa.Ninety-one per cent of the children who are stunted globally live in low-income and lower-middle-income countries(27 and 64 per cent respectively).47 million children under 5 about 7 per cent are waste
101、d.Of these children,almost one third(more than 14 million)are severely wasted.More than two thirds(69 per cent)of all children who are wasted live in Asia and more than one quarter(27 per cent)live in Africa.As many as 92 per cent of all children who are wasted live in low-income and lower middle-in
102、come countries(17 and 75 per cent respectively).38 million children under 5 nearly 6 per cent are overweight.In two regions,Eastern Europe and Central Asia,and the Middle East and North Africa,at least 1 in every 10 children under 5 is overweight.Almost half(45 per cent)of children who are overweigh
103、t live in Asia and more than three-quarters(78 per cent)of all children who are overweight live in lower middle-income and upper middle-income countries(37 and 41 per cent respectively).While only about half of all children under 5 live in lower-middle-income countries,two thirds of all children aff
104、ected by stunting and three quarters of all children with wasting live there*Share is relative to the total number affected across the four country-income groups;this varies from the global totals reported elsewhere in this document because the official Joint Malnutrition Estimates global total is b
105、ased on a model of United Nations regions,2019.The differences are as follows:Stunting official global estimate is 144.0 million;sum of four country-income groups=145.8 million.Wasting official global estimate is 47.0 million;sum of country-income groups=45.3 million.Overweight official global estim
106、ate is 38.3 million;sum of four country-income groups=39.1 million.Distribution of children under 5 in the world,by country income grouping,2019Share of children under 5 affected by stunting in 2019Share of children under 5 with wasting in 2019Share of children under 5 affected by overweight in 2019
107、of all children under 5live in high-incomecountriesof all children under 5live in upper-middle-income countriesof all children under 5 live in lower-middle-income countriesof all children under 5live in low-incomecountriesof all children affected by stunting live in high-income countriesof all child
108、ren affected by stunting live in upper-middle-income countriesof all children affected by stunting live in lower-middle-income countriesof all children affected by stunting live in low-income countriesof all children with wasting live in high-income countriesof all children with wasting live in uppe
109、r-middle-income countriesof all children with wasting live in lower-middle-income countriesof all children with wasting live in low-incomecountriesof all children affected by overweight live in high-income countriesof all children affected by overweight live in upper-middle-income countriesof all ch
110、ildren affected by overweight live in lower-middle-income countriesof all children affected by overweight live in low-income countriesDistribution of children under 5 affected by stunting,wasting and overweight in 201927%46%17%27%64%8%1%75%17%7%1%8%13%37%41%10%FIGURE 1Distribution of children under
111、5 in the world by country income grouping,and distribution of children under 5 affected by stunting,wasting and overweight by income grouping in 2019Note:Income classifications are based on World Bank FY19 classifications.CHILD MALNUTRITION TODAY6UNICEF NUTRITION STRATEGY 202020307UNICEF NUTRITION S
112、TRATEGY 20202030Nearly 4 out of 5 children affected by stunting live in South Asia and Sub-Saharan AfricaThe global number of children under 5 affected by overweight has increased from 30 to 38 million in the last two decades1 in every 3 children with wasting is severely wastedFIGURE 5Number(in mill
113、ions)of children under 5 affected by stunting,by UNICEF region,2019 Note:1.Eastern Europe and Central Asia does not include Russian Federation due to missing data.There is no estimate available for the Europe and Central Asia region or the Western Europe sub-region,due to insufficient population cov
114、erage.2.North America estimate based on United States data.The sum of UNICEF regional estimates do not add up to global total as the global total is based on a model for United Nations regions.FIGURE 7Number(in millions)of children under 5 who are affected by overweight,by region,2000 to 2019Notes:*
115、Eastern Europe and Central Asia sub-region does not include Russian Federation due to missing data.Source for all graphs:UNICEF/WHO/World Bank Joint Child Malnutrition Estimates,2020 edition.FIGURE 6Number(in millions)of children under 5 with wasting and severe wasting,by UNICEF region and global,20
116、19 Note:North America as well as Europe and Central Asia are not shown due to very small numbers for severely wasted;there is no estimate available for the Europe and Central Asia region or Western Europe sub-region due to insufficient population coverage.20002019Number(millions)Number(millions)0123
117、4567895NorthAmericaEasternEurope andCentral Asia*West andCentral AfricaEastern andSouthern AfricaLatin Americaand theCaribbeanSouth AsiaMiddle Eastand NorthAfricaEast Asiaand thePacific1.41.97.93.34.23.82.81.62.310.45.44.23.93.12.32.347.0 million with wastingof which14.3 million have seve
118、re wasting Number of children under 5 with wasting(moderate or severe)Number of children under 5 with wasting(severe only)Sub-SaharanAfricaGlobalEast Asiaand thePacificSouthAsiaMiddle Eastand NorthAfricaLatinAmericaand theCaribbean7.7 m3.1 m14.3 m25.1 million12.1 million47.0 million5.7 million2.1 m1
119、.3 m3.3 million0.1 m0.7 million29.07.128.01.6East Asia and thePacific Latin Americaand theCaribbean56.116.94.7South AsiaNorthAmerica2 0.6EasternEurope andCentral Asia1Middle East and NorthAfricaWest and CentralAfricaEastern andSouthern AfricaGlobal144 millionare affected bystuntingCHILD MALNUTRITION
120、 TODAY8UNICEF NUTRITION STRATEGY 20202030The world is not on course to meet the global nutrition targets for childrenChild malnutrition rates remain unacceptably high.Trends indicate that current progress is insufficient to achieve the World Health Assembly global nutrition targets(2025)and the Sust
121、ainable Development Agenda goals and targets(2030)for the reduction of child stunting,wasting and overweight.Stunting The global prevalence of stunting declined from 32.4 per cent in 2000 to 21.3 per cent in 2019,indicating a one-third(34 per cent)decline at an average annual rate of reduction of 2.
122、2 per cent.The global number of children who are stunted declined from 199 million in 2000 to 144 million in 2019 a 28 per cent reduction,with an average annual rate of reduction of 1.7 percent.The number of children who are stunted declined in all country-income groups of concern except low-income
123、countries.Similarly,the number of children who are stunted declined in all regions except in sub-Saharan Africa,where it increased by 7.5 million between 2000 and 2019.Global progress over the last two decades is insufficient to reach the World Health Assembly and the Sustainable Development Agenda
124、target to reduce the number of children who are stunted by 40 per cent by 2025 and 50 per cent by 2030.Wasting The prevalence of wasting is highly influenced by seasonality in food insecurity and disease patterns particularly diarrhoea,pneumonia and malaria making it difficult to identify reliable t
125、rends over time.203020252020200995199012.1%39.335.732.429.226.024.823.121.320.819.017.2prevalenceStuntingProjected055404550STUNTINGTarget:12.1%Projected:17.2%2030 Notes:SDG 2030 target is a 50%reduction in the number of children under 5 who are stunted.Source:UNICEF/
126、World Health Organization/World Bank Group Joint Malnutrition Estimates,2019 edition.Projections are based on analyses conducted by the UNICEF/WHO/World Bank Income Group Joint Malnutrition Estimates Working Group.FIGURE 8Projections for stunting in children under 5 compared to 2030 targetsCHILD MAL
127、NUTRITION TODAY9UNICEF NUTRITION STRATEGY 20202030However,in the last decade,the global prevalence of wasting has hovered around 7-8 per cent and the number of children who are wasted has remained stagnant at around 50 million.Thus,the global declines seen in child stunting have not been seen in was
128、ting,particularly in South Asia the global epicentre for wasting where the prevalence among children under 5 is about 15 per cent.Global stagnation in child wasting indicates that,unless rates of decline improve significantly,the world will not achieve the World Health Assembly and the Sustainable D
129、evelopment Agenda target to reduce the prevalence of wasting to below 5 per cent by 2025 and below 3 per cent by 2030.Overweight The prevalence of overweight is increasing in almost all age groups,all regions,and all country-income groups.The global number of children under 5 who are overweight incr
130、eased from 30.3 million in the year 2000 to 38.3 million in 2019,indicating a 26 per cent increase,with an average annual rate of increase of 1.3 per cent with sizable increases in East Asia and the Pacific(32 per cent),North America(35 per cent),Eastern Europe and Central Asia(44 per cent)and the M
131、iddle East and North Africa(64 per cent).However,overweight estimates for older children help illustrate the true scale of the challenge.According to the NCD Risk Factor Collaboration,the proportion of children aged 519 who are overweight rose from around 1 in 10(10.3 per cent)in 2000 to a little un
132、der 1in 5(18.4 per cent)in 2016.2 Without a reversal in trends,the world will not achieve the Sustainable Development Agenda target to reduce theprevalence of child overweight in children under 5 to below 3 per cent by 2030.Note:Income classifications are based on World Bank FY19 classifications.Sou
133、rce:NCD Risk Factor Collaboration(NCD-RisC)(2017).Worldwide trends in body-mass index,underweight,overweight,and obesity from 1975 to 2016:A pooled analysis of 2416 population-based measurement studies in 1289 million children,adolescents,and adults,The Lancet,390(10113),pp.26272642Source:UNICEF/Wor
134、ld Health Organization/World Bank Group Joint Malnutrition Estimates and NCD Risk Factor Collaboration(2017).100%755025002005201020152016Upper-middle-income countriesHigh-income countriesLower-middle-income countriesLow-income countries200020165.510.3FIGURE 9Trend in percentage of countri
135、es by World Bank income group where at least 10 per cent of children aged 519 years are overweightFIGURE 10Increase in overweight among under-5 and 519-year-old children and young peopleUnder 5 years519 years5.618.4CHILD MALNUTRITION TODAY10UNICEF NUTRITION STRATEGY 20202030Childrens diets are unacc
136、eptably poor across the life cycle Childrens nutritional needs evolve and change across every stage of development in the womb,throughout childhood,until the end of adolescence.Despite the importance of good nutrition across the life cycle,an analysis of the most recent data indicates that globally,
137、at all ages,millions of children,adolescents and women are not benefiting from diets that support healthy growth and development.Early childhoodInfancy and early childhood(i.e.,the first five years of life)are a time of rapid growth and nutritional vulnerability during which young children undergo v
138、ast physiological changes.The first two years of life are especially crucial.The absence of exclusive breastfeeding in the first six months,and the lack of diverse and nutritious complementary foods thereafter,can lead to stunting,wasting and micronutrient deficiencies and can predispose children to
139、 overweight,obesity and diet-related non-communicable diseases.3,4Breastmilk has no substitute.UNICEF and the World Health Organization(WHO)recommend that infants start breastfeeding within one hour of birth,be exclusively breastfed for the first six months and continue breastfeeding until 2 years o
140、f age or beyond.Globally,only about half(49 per cent)of newborns are put to the breast in the first hour of life and less than half(44 per cent)of infants under 6 months of age are exclusively breastfed.Almost all regions have made gains in exclusive breastfeeding:the proportion of infants who are e
141、xclusively breastfed increased by 20 per cent between 2005 and 2018.However,millions of children are not receiving these benefits owing to a lack of support for breastfeeding as a public health priority,poor counselling and support to mothers who choose to breastfeed,and the aggressive promotion of
142、breastmilk substitutes.Indeed,between 2008 and 2013,sales of milk-based formula grew by 41 per cent globally and 72 per cent in upper middle-income countries.When children reach 6 months of age,breastmilk alone is no longer sufficient to meet their energy and nutrient requirements.Childrens nutritio
143、nal needs between the ages of 6 and 23 months are greater per kilogram of body weight than at any other time of life,making them especially vulnerable to nutritional deficiencies and growth faltering.5 Introducing a diverse range of complementary foods alongside breastfeeding protects children again
144、st illness and death,ensures healthy growth and development,prevents stunting,wasting and micronutrient deficiencies in early childhood and protects against overweight and obesitylater in life.FIGURE 11Trends in percentage of infants aged 05 months exclusively breastfed,by UNICEF region,around 2005
145、and around 2018Notes:Analysis based on a subset of 80 countries with comparable trend data covering 74 per cent of the global population for around 2005(20032008)and for around 2018(20132018).Regional estimates are presented only where available data represent at least 50 percent of the regions popu
146、lation.*To meet adequate population coverage,Latin America and Caribbean does not include Brazil and Eastern Europe and Central Asia does not include Russian Federation.Source:UNICEF Global Databases,2019.20052018GlobalMiddle East and North AfricaSouth AsiaWest and Central AfricaEastern Europe and C
147、entral Asia*East Asia and PacificLatin America and Caribbean*Eastern and Southern Africa395654383433320252835CHILD MALNUTRITION TODAYThe proportion of infants aged 05 months exclusively breastfed increased by 20 percent in the last decade11UNICEF NUTRITION STRATEGY 20202030The most recent
148、 data on the quality of complementary foods and feeding practices indicate that globally two in three children aged 623 months(72 per cent)are not fed even the minimum diverse diet needed to grow healthy.While most children(more than 75 per cent)in this age group are fed breastmilk and grains(wheat,
149、rice,corn or others),46 per cent are not fed any fruits or vegetables and 60 per cent are not fed nutrient-dense foods such as eggs,fish or meat,although global recommendations indicate that young children should consume such foods daily(or as often as possible).6 By region,the poorest dietary diver
150、sity figures are recorded in South Asia(18 per cent)and sub-Saharan Africa(22 per cent).Globally,there are stark disparities in the prevalence of minimum dietary diversity by wealth status.Less than one in five children(18 per cent)from the poorest households are consuming foods from at least five o
151、ut of eight food groups,indicating that income is a barrier to accessing diverse and nutrient-dense complementary foods.Yet even in richer households,less than two in five(38 per cent)of children are fed a minimum diverse diet,suggesting that factors other than income are at play,such as knowledge,c
152、onvenience and desirability.Studies on infant feeding practices in low-and middle-income settings have found that young children were more likely to be fed commercially-produced snack foods than nutritious complementary foods and that childrens preference for such foods outweighed affordability and
153、other factors in mothers decision-making.7 In addition,there is widespread,inappropriate promotion of commercial foods,including labelling and marketing that encourages the introduction of food before 6 months of age,and the consumption of products that contain high amounts of sugar and artificial f
154、lavours,with inappropriate food consistency and false nutritional and health claims.Between the ages of 2 and 4 years,children start to choose their own food and may eat outside the home,exposing them to new influences.During this stage of life,the positive eating habits and behaviours of caregivers
155、,family members,educators and peers become particularly influential.8FIGURE 12Percentage of infants aged 05 months fed infant formula,by UNICEF region,2018Notes:Between 2008 and 2013,sales of(typically cows)milk-based formula grew by 41 per cent globally and by 72 per cent in upper-middle-income cou
156、ntries such as Brazil,China,Peru and Turkey.Analysis based on a subset of 73 countries with available data between 20132018,covering 61 percent of the global population.Regional estimates are presented only where available data represent at least 50 percent of the regions population.*To meet adequat
157、e population coverage,East Asia and Pacific does not include China and Latin America and Caribbean does not include Brazil.Data not available for Europe and Central Asia and North America.Source:UNICEF Global Databases,2019.Global28%28%6%6%4%11%37%Middle East and North AfricaSouth AsiaWest&Central A
158、fricaEast Asia and Pacific*Latin America and Caribbean*Eastern and Southern AfricaGlobally,sales of milk-based formula grew by 41 per cent between 2008 and 2013 and by 72 per cent in upper middle-income countriesCHILD MALNUTRITION TODAY12UNICEF NUTRITION STRATEGY 20202030Fewer than 1 in 3 children e
159、ats foods from the minimum number of food groupsOnly 1 in 5 children from the poorest households and rural areas eats foods from the minimum number of food groups60%of children worldwide are not fed nutrient-dense foods like eggs,meat or fish46%of children worldwide are not fed any fruits or vegetab
160、lesRuralUrbanRichestPoorest23962282136Eastern and Southern AfricaWest and Central AfricaMiddle East and North Africa(2018)South AsiaEast Asia and the PacificLatin America and theCaribbeanGlobal 7876484430282222WHAT ARE YOUNG CHILDREN EATING?The importance of first foodsChildren need diver
161、se foods from at least five out of eight food groups to grow,develop and learnWithout enough diet diversity,children do not get enough nutrients to grow and develop well,with devastating toll on childrens bodies,brains and life opportunities.UNICEF and WHO recommend that children at this age eat a m
162、inimum of five of eight food groups daily.GrainsDairy Other fruits&vegetables Vitamin A rich fruits&vegetablesBreastmilkLegumesEggsFlesh foods%Note:Analysis based on a subset of 74 countries with disaggregated data available between 2014-2019 with the exception of China where the latest available es
163、timates are from the year 2013.Source for all figures:UNICEF Global Databases,2020.FIGURE 15 Percentage of children aged 623 months fed each of the eight food groups,2019Note:Analysis based on a subset of 73 countries with data available between 20142019 covering 60 per cent of the global population
164、.FIGURE 13Percentage of children aged 623 months eating at least 5 of 8 food groups(Minimum Dietary Diversity),by UNICEF region,2019 Note:Regional and global estimates based on the most recent data for each country between 20142019 with the exception of China where the latest available estimates are
165、 from the year 2013.No data available for the Middle East and Nort africa regions for 2019,therefore 2018 data is included.FIGURE 14 Percentage of children aged 623 months eating at least 5 of 8 food groups by wealth quintile and place of residence,global,2019 1234567813UNICEF NUTRITION STRATEGY 202
166、02030While the majority of young children consume breastmilk,they are not eating enough animal-source foods,fruits,legumes or vegetables and rely heavily ongrains2 in 3 children aged 623 months are not eating foods from the minimum number of food groupsThe youngest children those aged 611 months hav
167、e the least diverse diets 83784734847522520357132244Low-income countriesLower-middle incomecountriesUpper-middle income countries*What are young children eating based on country income level?%FIGURE 17Percentage of children aged 623 months fed food groups,by type,by World Bank
168、income group,2018Note for Figure 17:Analysis based on a subset of 72 countries with data available between 20132018 covering 61 percent of the global population.Income groupings are based on the FY19 World Bank income classification.Estimates by World Bank income groups are only displayed if availab
169、le data represents at least 50 percent of the population.*To meet adequate population coverage,upper-middle-income countries do not include Brazil,China and the Russian Federation.Source:UNICEF Global Databases,2019.FIGURE 16Percentage of children fed food groups,by type and age,global,2018Source:UN
170、ICEF Global Databases,2019611 months1223 months%897065854251526142638Except for breastmilk,the percentage of young children consuming any of the other 7 food groups is systematically higher in upper-middle-income countries than in low-and lower-middle-income countriesThe percentage of chi
171、ldren consuming non-dairy animal source foods such as eggs,meat,poultry and fish in upper-middle-income countries is nearly twice higher than in low-and lower-middle-income countriesCHILD MALNUTRITION TODAY14UNICEF NUTRITION STRATEGY 2020203005 months6 months2 years34 years59 years 1014 years1519 ye
172、ars Lack of exclusive/continued breastfeeding Marketing of breastmilk substitutes Lack of dietary diversity Low feeding frequency Eating ultra-processed foods Drinking sugar-sweetened beverages Inadequate diets:excess sugar,salt and fats,lacking vitamins and minerals Marketing of unhealthy,ultra-pro
173、cessed foods Lack of physical activity FIRST FOODS6 months2 yearsBREASTFEEDING02 yearsEATING AT HOME WITH PARENTS,SIBLINGS AND CAREGIVERSLess autonomyMore autonomyGROWTH&APPETITEDIETSINFLUENCESRISKS Source:Elizabeth Fox,Characteristics of childrens dietary needs,intake patterns,and determinants that
174、 explain their nutrition behaviors(unpublished).As growth rates increase and decrease,so does appetite in equal measureEATING OUT WITH FRIENDSFOOD AND NUTRITION ACROSS CHILDHOODAt all ages,most children are not eating diets with enough nutrients or diversity,and they are eating foods containing too
175、much sugar,salt and fat.The risks at each age can lead to one or more forms of malnutrition:stunting,wasting,micronutrient deficiencies,or overweight and obesity.These conditions can affect school performance and lifelong economic opportunities,and present health risks into adulthood.15UNICEF NUTRIT
176、ION STRATEGY 2020203059 years 1014 years1519 years Snacking Skipping or missing meals Negative self-image Peer influence on food choiceCHILDHOOD DIETS319 yearsEATING AT SCHOOLMore autonomyGROWTH&APPETITEDIETSINFLUENCESRISKS Source:Elizabeth Fox,Characteristics of childrens dietary needs,intake patte
177、rns,and determinants that explain their nutrition behaviors(unpublished).As growth rates increase and decrease,so does appetite in equal measureEATING OUT WITH FRIENDSAt every stage of childhood,children have unique nutritional needs,influences,risks and eating behaviours 16UNICEF NUTRITION STRATEGY
178、 20202030Middle childhoodThis time of transition,between 5 and 9 years of age,is marked by continued,steady growth.Research shows the potential of good nutrition to support catch-up growth during this stage of life,after early stunting,indicating that children who were stunted in early childhood and
179、 catch up in middle childhood could perform similarly in cognitive tests to children who were never stunted.9 The period of middle childhood is also important for establishing eating habits that support healthy growth and development.While the childs family,school and broader social forces all affec
180、t food availability,food environments and food choices,children also start taking some responsibility for their own diets.Childrens appetites and food intake can vary widely and may increase before a growth spurt and decrease during slower growth periods.10 Reliable data on the nutritional status an
181、d diets of children in middle childhood are worryingly scarce.The data at our disposal indicate that children in low-and middle-income countries,especially in poorer households and rural areas,have diets that consist mainly of staples such as cereals,roots or tubers,with few nutrient-rich animal-sou
182、rce foods such as eggs,dairy,meat or fish.11 Moreover,far too many school-age children around the world are missing breakfast,12 eating too few fruits and vegetables,and consuming too many snacks that are high in sugar,salt and saturated fat such as cookies,sweets and sugar-sweetened beverages,which
183、 are often marketed to them.Low consumption of fruits and vegetables is particularly concerning given that children who eat these foods in childhood are more likely to continue this habit in adulthood.13 The school food environment is often obesogenic,promoting the consumption of foods that contribu
184、te to overweight and obesity.Ultra-processed foods and sugar-sweetened beverages are often sold to children in school cafeterias or at convenience stores and street stalls near schools.In addition,advertisements for sugar-sweetened beverages,pastries and sweets CHILD MALNUTRITION TODAYremain common
185、outside schools and can influence food choices among children.14AdolescenceAdolescence is a time of rapid physical and psychosocial development.Adolescent boys have higher nutrient requirements than girls owing to a faster growth rate and greater gain in bone growth and muscle mass.15 Adolescent gir
186、ls have higher iron requirements than boys because of the onset of menstruation and may be especially vulnerable to malnutrition,as gendered cultural norms mean girls often lack access to nutritious food,nutrition services,and education opportunities.16Adolescence presents a window of opportunity fo
187、r establishing lifelong dietary habits that support nutritional well-being today and for future generations.Yet globally,far too many adolescents fail to consume diets that give them the foundation for long,healthy and productive adult lives.Adolescents in rural areas often have limited food options
188、 and are susceptible to seasonal food shortages,particularly in low-and middle-income countries,while adolescents living in urban environments are often surrounded by fast food and nutrient-poor snacks and beverages,including in low-and middle-income countries.Twenty-one per cent of school-going ado
189、lescents consume vegetables less than once a day,34 per cent consume fruit less than once a day,42 per cent consume soft drinks daily,and 46 per cent consume fast food at least weekly.Half of adolescent girls in low-income and rural settings in middle-income countries eat fewer than three meals a da
190、y,with most missing breakfast.Snacking is common during the day and lunch is often eaten outside the home.17Most adolescents make food choices based on factors other than nutritional composition.External influences such as disposable income to spend on snacks and fast food,peer pressure,the desire t
191、o fit in among friends and food marketing greatly influence what adolescents eat.Body image affects food choices as Adolescence a time of rapid growth and development is also a window for establishing dietary habits that support nutritional well-being today and for future generations.Middle childhoo
192、d is important for catch up growth and for establishing eating habits that support good nutrition and healthy development.17UNICEF NUTRITION STRATEGY 20202030well.Depending on the local context,adolescents may perceive either excess weight or thinness as a sign of well-being and attractiveness.Resea
193、rch shows that eating disorders during adolescence are not limited to high-income countries.18 Food marketing,packaging and aspirational status symbols can also greatly influence adolescents food choices.Fast food and prepared snacks are widely available in urban areas and are especially appealing t
194、o young people;they can also be signs of social status.Being able to afford fast food and soft drinks can be perceived as a sign of middle-or upper-class status in some contexts,leading adolescents from poorer economic backgrounds to look forward to consuming fast food and soft drinks on special occ
195、asions to fit in with their peers.19 Pregnancy and breastfeedingThe first 1,000 days from conception to a childs second birthday are a time of rapid growth and nutritional vulnerability during which young children undergo vast physiological changes,beginning in the womb.Pregnancy and breastfeeding a
196、re nutritionally distinct periods in a womans life.Energy requirements increase by an average 300 kcal/day during pregnancy and by 640 kcal/day during breastfeeding,and key vitamins and other micronutrients,such as iron,folic acid,zinc and calcium,are in high demand.20 To support childrens optimal g
197、rowth and development and womens well-being during pregnancy and lactation,women need access to nutritious,safe and affordable diets;antenatal and postnatal care services,including nutrition counselling and support;and a healthy environment that enables access to healthy foods,adequate nutrition ser
198、vices and positive nutrition practices.Despite significant data gaps,available information indicates that diet quality among pregnant and breastfeeding women from low-and middle-income countries is often insufficient to meet their high nutrient needs,sometimes due to significant energy deficits and
199、often to deficits in essential nutrients owing to lack of access to fruits,vegetables and animal-source foods(eggs,dairy,fish and meat).21,22 As a result,an estimated 10 per cent(154 million)of women aged 2049 years are too thin,33 per cent(520 million)are anaemic,and 36 per cent(567 million)are ove
200、rweight.These three conditions threaten womens well-being as well as the survival,growth and development of their young children.During pregnancy,diets lacking in nutrients such as iodine,iron,calcium and zinc carry negative consequences for the mother and the newborn,including maternal anaemia,pre-
201、eclampsia,haemorrhage,maternal death,newborn death,premature birth,intrauterine growth retardation and low birthweight.Indeed,more than 20 million infants annually are born with low birthweight,more than half of them in South Asia.23,24 Poor quality diets in the post-partum period among breastfeedin
202、g mothers can negatively affect the quality of breastmilk,maternal micronutrient status,and weight retention.Globally,insufficient progress has been made in reducing undernutrition and anaemia among women,including pregnant women and breastfeeding mothers.Meanwhile,overweight and obesity have increa
203、sed,with women now bearing a disproportionate burden of overweight and obesity in low-and middle-income countries.25,26Womens diets are influenced by food affordability,household dynamics,gender inequality and social and cultural norms affecting their ability to make decisions about their nutrition
204、and care.Barriers to nutritious diets during pregnancy include limited knowledge about the quantity and nutrient quality of food to eat and the amount of weight to gain,lack of access to and unaffordability of nutritious foods,and cultural and social taboos and norms that dictate what women can and
205、cannot eat.27 As gender roles change and women increasingly enter the workforce,their dietary choices may also be driven by time and convenience.With increasing industrialization,the shift from traditional diets towards highly processed and other high-calorie foods is a key contributor to womens die
206、ts,which increasingly include energy-rich,nutrient-poor highly processed foods,contributing to the epidemic of obesity in low-and middle-income countries.28,29 CHILD MALNUTRITION TODAYPregnancy and breastfeeding are nutritionally distinct periods in a womans life.Energy requirements increase by an a
207、verage 300 kcal/day during pregnancy and by 640 kcal/day during breastfeeding,and key vitamins and other micronutrients,such as iron,folic acid,zinc and calcium,are in high demand.18UNICEF NUTRITION STRATEGY 20202030Multiple forces are shaping childrens diets and nutrition globallyThe backdrop of nu
208、trition has changed,and new forces drive in positive and negative ways the nutrition situation of children around the world.Globalization and urbanization have changed food availability,food environments and food practices.Millions of families have left the countryside and moved to cities,leaving be
209、hind traditional diets for processed foods that are frequently high in salt,sugar and fat,and low in essential nutrients and fiber.Women are increasingly joining the formal workforce and many of them receive little or no support from families,employers or society to help balance work responsibilitie
210、s with their persistent role as primary caregivers.Socio-economic inequities are increasing in most parts of the world and many families are changing the way they eat or feed their children because of poverty and the rising cost of good diets.Finally,the climate crisis,the loss of biodiversity,the d
211、amage done to water,air and soil,and the increasing number,duration and complexity of health epidemics and humanitarian crises pose critical challenges to feeding children sustainably today and for generations to come.Globalization has changed food availability,options and choices.Since the mid-1990
212、s,food has been included in world trade agreements,meaning that business forces are now shaping the availability,price and marketing of food.This limits the ability of national governments to protect and promote the right to food and nutrition for their children and citizens.30 Families who can affo
213、rd it may have greater access to diverse foods.However,low-income consumers and the urban and rural poor suffer the greatest consequences of inequitable food systems and unhealthy food environments.31 As markets in high-income countries have matured,food and beverage companies seek to expand markets
214、 in low-and middle-income countries.In globalized markets,ultra-processed foods are pervasive and highly profitable,given their low production cost and long shelf life.Today,these ultra-processed foods are found even in remote rural areas in low-and middle-income countries,whereas fresh vegetables a
215、nd fruits are often not.32Urbanization has translated into more people living in cities today than ever before.Urban families typically buy their food,and income becomes a key factor in what they eat.Those who can afford it rely less on starchy carbohydrates and tend to consume more meat,more food o
216、utside the home,and more ultra-GLOBALIZATION URBANIZATION ENVIRONMENT EMERGENCIES INEQUITIES GLOBALIZATION URBANIZATION ENVIRONMENT EMERGENCIES INEQUITIES GlobalizationUrbanizationHealthEpidemicsHumanitarianemergenciesEnvironmentalcrisesInequitiesFIGURE 18Multiple forces are shaping childrens diets
217、and nutrition globallyprocessed foods.33 For the urban poor,eating nutritious foods becomes a challenge,and they rely heavily on street food,which is often high in fat,salt and sugar and accounts for about a quarter of household food spending in low-and middle-income countries.34 In cities,many poor
218、 families live in food swamps,characterized by an abundance of high-calorie,low-nutrient,processed foods.Caregivers,adolescents and children in cities are also highly exposed to the influential marketing of processed foods,including in public spaces,such as schools and surrounding areas,and in socia
219、l media and radio and television commercials that target children and adolescents.35 Inequities undermine access to good diets,essential nutrition services and adequate nutrition practices.The world is home to an estimated 385 million children living in extreme poverty.For these children,access to a
220、 good diet is out of reach.They are also least likely to have access to essential nutrition services,safe drinking water and safe sanitation.Cost prevents many children from eating a diverse range of nutrient-rich foods,particularly children from the poorest families,who spend a greater share of the
221、ir income on food.CHILD MALNUTRITION TODAY19UNICEF NUTRITION STRATEGY 20202030Research shows that the cost of nutrient-rich foods is a significant barrier to diversifying young childrens diets,and that nutritious foods are often the least affordable.36,37 Poorer families tend to select less expensiv
222、e,lower-quality food.38 Those in cities may live in food deserts where food options that support childrens healthy growth and development are scarce,and nutrient-poor,high-calorie,ultra-processed foods are readily accessible and affordable.39 Environmental crises,including climate-related disasters
223、such as extreme heat,drought,floods and storms,have doubled in number since 1990.These conditions have damaged agriculture and dramatically altered the quantity,quality and price of food available to children and families,causing food crises and increasing food and nutrition insecurity in rural and
224、urban areas.40,41,42 Industrial food production also plays a major role in climate change,contributing one third of the greenhouse gas emissions globally,43 and its heavy use of fresh water,fertilizers and pesticides has an immense ecological impact,contributing to environmental degradation and affe
225、cting childrens nutrition.Food production is also implicated in the loss of biodiversity,which affects childrens food security and dietary diversity.44,45 The lack of diversity in crop production has led to increasingly homogeneous diets around the world:46 Just three crops rice,wheat and maize now
226、account for nearly two thirds of the global caloric intake.47 Health epidemics have the potential to threaten global health and nutrition security,with direct and indirect implications for maternal and child nutrition.Diseases such as Ebola,influenza,severe acute respiratory syndrome(SARS)and the co
227、ronavirus disease(COVID-19)pandemic have disproportionately affected vulnerable populations in Nutrition and COVID-19The COVID-19 pandemic is also a child nutrition crisis due to its worrying impacts on household incomes and food,health,education,and social protection systems.In particular,the pande
228、mic has exacerbated maternal and child malnutrition through three major pathways poor access to nutritious diets,essential nutrition services,and adequate feeding and dietary practices resulting from measures implemented to stop the spread of the virus(e.g.,physical distancing,school closures,trade
229、restrictions and country lockdowns);the pressure imposed on the health system to care for the people affected by the disease;and the socio-economic shocks resulting from increased unemployment,inequities and poverty.low-and middle-income countries.Shaped by many of the forces described above,as well
230、 as climate change and the human-animal interface,todays health epidemics can spread more quickly and widely across borders.The COVID-19 pandemic has exacerbated maternal and child malnutrition through three major pathways poor access to nutritious diets,essential nutrition services,and adequate fee
231、ding and dietary practices resulting from measures implemented to stop the spread of the virus(e.g.,physical distancing,school closures,trade restrictions,and country lockdowns);the pressure imposed on the health system to care for the people infected;and the socio-economic shocks resulting from inc
232、reased unemployment and poverty.Humanitarian emergencies are increasing in number,duration and complexity.Historically,efforts to address malnutrition in emergencies have focused on identifying and treating children with severe wasting.However,other forms of malnutrition,including stunting and micro
233、nutrient deficiencies,occur in and are aggravated by emergencies.48 In protracted humanitarian crises,the prevalence of stunting is increasing,while rates of wasting continue to be high.49 Between 2005 and 2017,the average length of crises that received an inter-agency funding appeal rose from four
234、to seven years.50 As a result,emergency preparedness and response are turning to approaches that combine short-and long-term solutions to prevent avoidable deaths while protecting,promoting and supporting child growth and development.In 2019,UNICEF and its partners treated more than 4 million childr
235、en with severe acute malnutrition in humanitarian settings globally.51 However,future action needs to put emphasis on reducing the number of children affected by wasting,while providing treatment to those in need.CHILD MALNUTRITION TODAY20UNICEF NUTRITION STRATEGY 20202030Improving child nutrition r
236、equires a multifaceted response The evolving nature of child malnutrition demands a new global response:one that delivers diets,services and practices that support good nutrition at every stage of life while sustaining nutrition-responsive development for all children,adolescents and women.This resp
237、onse must acknowledge the central role of the food system working together with the health,water and sanitation,education,and social protection systems to provide nutritious,safe,affordable and sustainable diets for children,adolescents and women,while ensuring adequate nutrition services and positi
238、ve nutrition practices across the life cycle.FIGURE 19Improving maternal and child nutrition requires a systems approachHealthSystemEducationSystemFoodSystemWater&SanitationSystemSocialProtectionSystemThe benefits of a systems approach to maternal and child nutrition are two-fold:It captures the int
239、eractions and interconnections across systems food,health,water and sanitation,education,and social protection avoiding the simplistic thinking that malnutrition has straightforward determinants that operate along linear pathways.It crystallizes a shared purpose across systems better diets and bette
240、r nutrition for children,adolescents and women recognizing a shared responsibility and the need to mobilize attention and resources from a variety of governmental,public,private and societal actors.Achieving nutrition results depends on the capacity of five systems to deliver nutrition-specific inte
241、rventions at every stage of life,while supporting nutrition-responsive development at scale:Thefood systemneeds to operate in ways that empower children,adolescents and families to demand nutritious foods.Secondly,it needs to ensure that nutritious foods are safe,available,affordable and sustainable
242、.Finally,it needs to create healthy food environments.Governments must set standards that are aligned with childrens best interests and create a level playing field for producers and suppliers.Producers and suppliers need to ensure that their actions including food production,labelling and marketing
243、 are aligned with these standards.Evidence shows that when nutritious foods are affordable,convenient and desirable,children and families make better food choices.CHILD MALNUTRITION TODAYNutrition and climate changeDiets and their supporting food systems can nurture both people and planetary health.
244、However,in many parts of the world they are driving child malnutrition,environmental degradation and climate change.At the same time,climate change is eroding and reversing progress in ending child malnutrition.The bi-directional relationship between nutrition and climate presents UNICEF with an opp
245、ortunity to address the interconnected pandemics of undernutrition,obesity,and climate change through nutrition programming that protects and promotes nutritious,safe,affordable and sustainable diets for children,adolescents and women while preventing environmental degradation and climate change.21U
246、NICEF NUTRITION STRATEGY 20202030Thehealth systemneeds to invest in the nutrition knowledge and skills of primary health care workers,who are the front line between the health system,children and families.Services to prevent malnutrition such as support for breastfeeding,complementary feeding,micron
247、utrient supplementation,deworming,dietary counselling,and maternal nutrition must be delivered during pre-and postnatal health care contacts.Screening for and addressing anaemia,micronutrient deficiencies,growth faltering and overweight also require health system skills and supplies.Finally,governme
248、nts should systematically integrate the early detection and treatment of children with wasting into routine services,given the high mortality risk associated with wasting.Thewater and sanitation systemplays a critical role in preventing all forms of malnutrition by ensuring access to free,safe and p
249、alatable drinking water and safe sanitation and hygiene services.Safe drinking water is key to a good diet,and safe sanitation protects children from infection and enteropathy,ensuring their bodies can use nutrients fully.Although investments in water and sanitation infrastructure are important,soci
250、al and behaviour change communication to protect,promote and support safe food handling and optimal feeding and hygiene practices including handwashing with soap at critical times must be mainstreamed in communities,health facilities and schools.Theeducation systemcan deliver interventions to suppor
251、t good diets and good nutrition.In schools,nutrition education should ensure that children and families learn to make adequate food choices.Schools should promote healthy food environments,with access to nutritious foods and safe and palatable drinking water,and zero tolerance for junk food and beve
252、rages.In some contexts,school feeding programmes may be needed for vulnerable children.Inaddition,schools can deliver integrated programmes for the prevention of anaemia and micronutrient deficiencies through micronutrient supplementation,point-of-use fortification,deworming prophylaxis and counsell
253、ing to encourage dietary habits that support healthy growth and development.Thesocial protection systemcan provide a crucial safety net to improve the diets and nutrition of children,adolescents and women from the most vulnerable families.Social protection programmes can improve access to nutritious
254、 and diverse diets through food transfers,food vouchers or cash transfers.They can also secure access to essential nutrition services by removing barriers to pre-and postnatal care and nutrition counselling and through vouchers for school-based nutrition programmes,for example.In addition,the social
255、 protection system is essential to protect household food and nutrition security by preventing the depletion of livelihoods,including in emergencysituations.Nutrition has gained greater attention in recent years.Governments are increasingly laying out policies,programmes and budgets to improve the n
256、utrition situation of children.For these investments to foster real change,governments and their development partners must recognize two key realities:The nutritional needs of children are unique,and uniquely important.Preventing child malnutrition,in all its forms,must be a national development pri
257、ority,and children,adolescents and women must therefore be at the heart of food and nutrition policies,strategies and programmes,in all contexts.There are no magic bullets to address child malnutrition sustainably.Countries will only meet the challenge of child malnutrition by working across five sy
258、stems:food,health,water and sanitation,education,and social protection.These systems need to be made accountable for nutrition results.Governments must lead action against child malnutrition,in all contexts,driving policies,programmes and budgets for child nutrition.Yet,the path to good nutrition fo
259、r all children,adolescents and women demands a shared purpose,with commitments and investments required from governments,development partners,civil society organizations,the private sector,training and research institutions,and the media.CHILD MALNUTRITION TODAY22UNICEF NUTRITION STRATEGY 20202030UN
260、ICEF Nutrition Strategy Framework 20202030This document lays out UNICEFs strategic intent to support national governments and partners in upholding childrens right to nutrition and ending child malnutrition in all its forms.Chapter 1,Child Malnutrition Today,describes the triple burden of malnutriti
261、on globally,its impact on the lives of children,and the forces shaping childrens diets and nutrition.It calls for a systems response that delivers diets,services and practices that support good nutrition at every stage of life while sustaining nutrition-responsive development for all children,adoles
262、cents and women.Chapter 2,Vision,Goal and Objectives,presents a declaration of intent for UNICEFs role in maternal and child nutrition.It outlines the vision,goal and objectives of the UNICEF Nutrition Strategy 20202030,which are guided by the Convention on the Rights of the Child and contribute to
263、the goal of the 2030 Agenda for Sustainable Development to end child malnutrition in all its forms.Chapter 3,Conceptual Framework,outlines the UNICEF Conceptual Framework on the Determinants of Maternal and Child Nutrition.The Conceptual Framework describes the enabling,underlying and immediate dete
264、rminants that contribute to preventing malnutrition in all its forms,and the positive human and social development outcomes resulting from improved maternal and child nutrition,in all contexts.Chapter 4,Programming Principles,presents the six universal principles of UNICEF programming for maternal a
265、nd child nutrition.These principles guide the design and implementation of UNICEF nutrition programmes that are rights-based,equity-focused,gender-responsive,context-specific,evidence-informed and systems-centred.Chapter 5,Results Areas,describes what UNICEF nutrition programmes do in six results ar
266、eas.Under each results area,we describe the results to which we intend to contribute and our programmatic priorities and actions.All UNICEF nutrition programmes across regions and countries share a universal premise:prevention comes first,in all contexts;if prevention fails,treatment is a must.Chapt
267、er 6,A Systems Approach to Nutrition,outlines how UNICEF intends to strengthen five key systems food,health,water and sanitation,education,and social protection to deliver diets,services and practices that support adequate nutrition for children.It describes the results to which UNICEF aims to contr
268、ibute and our priorities for engagement in making these systems more accountable for nutrition.Chapter 7,Partnerships,Programming and People,describes how UNICEF implements its Nutrition Strategy 20202030.It highlights the role of strategic partnerships,programming approaches,and human and financial
269、 resources in translating the vision,goals and objectives of the Strategy into measurable nutrition results for children,adolescents and women,everywhere.The Strategy Framework(right)reflects the differentelements of the UNICEF Nutrition Strategy20202030 and how they are inter-linked.23UNICEF NUTRIT
270、ION STRATEGY 20202030NUTRITION,FOR EVERY CHILDSustainable Development Agenda 2030Convention of the Rights of the ChildFull realization of childrens right to nutritionEnsure access by all people,including infants,to nutritious,safe and sufficient food all year round,and end hunger and malnutrition in
271、 all its formsVISIONGOALOBJECTIVESObjective 1Objective 2Objective 3Objective 4PROGRAMMINGPRINCIPLESRESULTSAREASFoodSystemHealthSystemWater andSanitationSystemEducationSystemSocialProtectionSystemA SYSTEMSAPPROACHRESOURCESHuman and financialPARTNERSHIPSGovernments and partners Situation analysis Advo
272、cacy Policy design Programme scale-up Community engagement Capacity building Supply chains Financing Data,monitoring and evaluation Knowledge,innovations and learning PROGRAMMING APPROACHESIMPLEMENTINGTHE STRATEGYUNICEF Nutrition Strategy Framework 20202030 Results Area 1EarlychildhoodnutritionNutri
273、tion in middle childhood and adolescenceMaternal nutrition Nutrition and care for children with wastingResults Area 2 Results Area 3Results Area 4Results Area 5Maternal and child nutrition in humanitarian action Results Area 6Partnerships and governance for maternal and child nutritionA world where
274、all children,adolescents and women realize their right to nutrition.To protect and promote diets,services and practices that support optimal nutrition,growth and development for all children,adolescents and womenTo prevent undernutrition,micronutrient deficiencies,and overweight in early childhood(t
275、he first five years of life)To prevent undernutrition,micronutrient deficiencies,and overweight in middle childhood and adolescenceTo prevent undernutrition,micronutrient deficiencies,and overweight in mothers,and low birthweight in newbornsTo ensure the early detection and treatment of wasting and
276、other forms of life-threatening acute malnutrition in early childhoodRights-basedContext-specificEvidence-informedSystems-centredEquity-focusedGender-responsive 24UNICEF NUTRITION STRATEGY 202020302.VISION,GOAL AND OBJECTIVES25UNICEF NUTRITION STRATEGY 20202030MaliECARO26UNICEF NUTRITION STRATEGY 20
277、202030This chapter presents a declaration of intent for UNICEFs role in maternal and child nutrition on the path to 2030.It outlines the vision,goal and objectives of the UNICEF Nutrition Strategy 20202030,which are guided by the Convention on the Rights of the Child and contribute to the goal of th
278、e 2030 Agenda for Sustainable Development to end child malnutrition in all its forms.The Convention on the Rights of the Child recognizes every childs right to nutrition,from birth to 18 years of age.UNICEF has been a global force behind the ratification of the Convention by 196 countries,making it
279、the worlds most widely ratified human rights treaty.52 As the Convention celebrates its thirtieth anniversary(19892019),we recognize the great progress achieved in realizing childrens right to nutrition,while also acknowledging that millions of children are still not growing,developing and learning
280、to their full potential as a result of malnutrition in its multiple forms.The 2030 Agenda for Sustainable Development is a plan of action for people,planet and prosperity.Its 17 Sustainable Development Goals seek to end poverty and hunger,in all their forms and dimensions,ensuring that all human bei
281、ngs can fulfil their potential in dignity and equality;protect the planet from degradation,including through sustainable production and consumption;and ensure current and future generations can enjoy prosperous and fulfilling lives resulting from sustainable economic and social progress in harmony w
282、ith nature.53The UNICEF Nutrition Strategy 20202030,is guided by the Convention of the Rights of the Child,builds on past guidance,54 strategic plans,55 and programme experience,56 and supports the goals of the 2030 Agenda for Sustainable Development.57 TheStrategy outlines UNICEFs intention to supp
283、ort a global response to the challenge of child malnutrition over the next decade,with national governments and partners.Four features make UNICEF uniquely positioned to mobilize national,regional and global partners across public and private sectors to tackle the global challenge of child malnutrit
284、ion:UNICEFs nutrition mandate for every child including children affected by humanitarian crises through our role as Sector and Cluster Lead Agency for Nutrition.UNICEFs multisectoral mandate for children and our expertise and experience in nutrition,health,water and sanitation,education,protection
285、and social policy.UNICEFs wide on-the-ground presence,with over 12,000 staff and nutrition programmes for children,adolescents and women in more than 130 countries.UNICEFs long-standing role as a trusted adviser to national governments and partners at national,regional and global levels.The UNICEF N
286、utrition Strategy 20202030 is guided by the Convention of the Rights of the Child and supports the goals of the 2030 Agenda for Sustainable Development,which like childrens rights are universal,indivisible and interdependent,balancing the economic,social,cultural and environmental dimensions of sust
287、ainable development.27UNICEF NUTRITION STRATEGY 20202030VISIONA world where all children,adolescents and women realize their right tonutrition.The vision of the UNICEF 20202030 Nutrition Strategy is guided by the Convention on the Rights of theChild,which recognizes that adequate nutrition is the ri
288、ght of every child,everywhere.GOALTo protect and promote diets,services and practices that support optimal nutrition,growth and development for all children,adolescents and women.The goal of the UNICEF 20202030 Nutrition Strategy contributes to the goal of the 2030 Agenda for Sustainable Development
289、 to ensure childrens access to nutritious diets and to end child malnutrition in all itsforms.GoodPracticesGoodServicesGoodDiets Good Nutritionfor Children,Adolescents and WomenVISION,GOAL AND OBJECTIVESOBJECTIVESThe Strategy supports four nutrition objectives for children,adolescents and women in b
290、oth development and humanitarian contexts.Objective 1:To prevent undernutrition,micronutrient deficiencies and overweight in early childhood(i.e.,the first five years of life).Objective 2:To prevent undernutrition,micronutrient deficiencies and overweight in middle childhood and adolescence(i.e.,519
291、 years of age).Objective 3:To prevent undernutrition,micronutrient deficiencies and overweight in women particularly during pregnancy and breastfeeding and to prevent low birthweight in newborns.Objective 4:To ensure the early detection and treatment of wasting and other forms of life-threatening ac
292、ute malnutrition in early childhood.28UNICEF NUTRITION STRATEGY 20202030STRATEGIC SHIFTSAs the previous section mentions,the UNICEF Nutrition Strategy 20202030 outlines UNICEFs intention to support a global response to the challenge of maternal and child nutrition.The Strategy builds on UNICEFs past
293、 guidance and programme experience while embracing six strategic shifts to respond to the evolving face of child malnutrition and support national governments and partnersin upholding childrens right tonutrition.1An explicit focus on addressing child malnutrition in all its forms.The UNICEF Nutritio
294、n Strategy 20202030 is guided by the Convention on the Rights of the Child,which recognizes every childs right to nutrition.Malnutrition,in all its forms,is a violation of this right.Hence,the Strategy aims to contribute to addressing the triple burden of child malnutrition:undernutrition,both stunt
295、ing and wasting;deficiencies in vitamins and other micronutrients;and overweight,obesity and diet-related non-communicable diseases.Therefore,the Strategy is aligned with the 2030 Agenda for Sustainable Development,which calls for an end to malnutrition in all its forms.2A comprehensive life cycle a
296、pproach to nutrition programming.The Nutrition Strategy 20202030 calls for UNICEF programmes to focus on four key stages of life early childhood,middle childhood,adolescence,and motherhood with specific programmatic priorities and intended results for each stage of life.While maternal and child nutr
297、ition during the first 1,000 days from conception to age 2years remains core to UNICEF programmes in all contexts,good nutrition during middle childhood and adolescence is both a right and a window of opportunity for growth,development and learning,particularly for girls,and for breaking the interge
298、nerational cycle of malnutrition.3A deliberate emphasis on improving diets,services and practices.The goal of the UNICEF Nutrition Strategy 20202030 is to protect and promote diets,services and practices that support optimal nutrition for all children,adolescents and women.This goalis guided by the
299、2020 Conceptual Framework on the Determinants of Maternal and Child Nutrition,which builds on previous conceptual thinking by UNICEF.Acknowledging the triple burden of malnutrition,the Framework highlights the centralityof nutritious,safe and affordable diets and adequate nutrition services and prac
300、tices as the foundation of good nutrition forchildren,adolescents and women.29UNICEF NUTRITION STRATEGY 202020304A systems approach to maternal and child nutrition.Most of the nutrition results that we aim to achieve require engagement with multiple systems to ensure that all children benefit from n
301、utritious and safe diets,adequate nutrition services,and positive nutrition practices.Therefore,the Nutrition Strategy 20202030 calls for UNICEF programmes to strengthen the capacity and accountability of five key systems food,health,water and sanitation,education,and social protection to deliver nu
302、tritious diets,essential nutrition services and positive nutrition practices for children,adolescents and women.As a multisectoral agency for children,UNICEF is positioned to support a systems approach to nutrition that drives sustainable results.5A greater attention to private sector engagement.Goo
303、d governance for nutrition requires public and private partners that are accountable for supporting childrens right to nutrition.National governments have primary accountability for upholding this right;however,the private sector has a key role to play as a provider of food,goods and services.The UN
304、ICEF Nutrition Strategy 20202030 calls for UNICEF programmes to engage strategically with public and private sector actors to advocate for business policies,practices and products that support optimal nutrition for all children,adolescents and women,in all contexts.6A universal vision and agenda rel
305、evant to all countries.Childrens right to nutrition is universal and so is the UNICEF Nutrition Strategy 20202030.Operationally,the Strategy is particularly relevant to low-and middle-income countries,where UNICEF programmes and country presence are larger and the triple burden of child malnutrition
306、 is greater.However,with the increasing burden of child overweight,obesity and diet-related non-communicable diseases,UNICEF is strengthening its work through country offices and national committees in high-income countries to advocate for and support policies and programmes that protect the right o
307、f all children to adequate nutrition.STRATEGIC SHIFTS30UNICEF NUTRITION STRATEGY 202020303.CONCEPTUAL FRAMEWORK31UNICEF NUTRITION STRATEGY 2020203032UNICEF NUTRITION STRATEGY 20202030This chapter outlines the UNICEF Conceptual Framework on the Determinants of Maternal and Child Nutrition.The Concept
308、ual Framework describes the enabling,underlying and immediate determinants that contribute to preventing malnutrition in all its forms,and the positive human and social development outcomes resulting from improved maternal and child nutrition,in all contexts.FIGURE 20UNICEF Conceptual Framework on t
309、he Determinants of Maternal and Child Nutrition,2020.A framework for the prevention of malnutrition in all its forms.Age-appropriate,nutrient-rich foods including breastmilk in early childhood with safe drinking water and household food securityAge-appropriate dietary practices including responsive
310、feeding and stimulation in early childhood with adequate food preparation,food consumption and hygiene practicesImproved survival,health,physical growth,cognitive development,school readiness and school performance in children and adolescents;improved survival,health,productivity and wages in women
311、and adults;and improved prosperity and cohesion in societies.Healthy food environments,adequate nutrition,health and sanitation services,and healthy living environments that promote good diets and physical activityENVIRONMENTSFEEDINGFOODMATERNAL AND CHILD NUTRITIONCAREGood care,driven by adequate se
312、rvices andpractices for children and womenDIETSGood diets,driven by adequate food andfeeding for children and womenUnderlyingdeterminantsImmediate determinantsOutcomesfor children and womenEnablingdeterminantsGOVERNANCEPositive social and cultural norms and actions to advance childrens and womens ri
313、ght to nutritionSufficient resources including environmental,financial,social and human resources to enable childrens and womens right to nutritionGood governance including political,financial,social and public and private sector actions to enable childrens and womens right to nutritionRESOURCESNORM
314、SThe UNICEF Nutrition Strategy 20202030 introduces UNICEFs Conceptual Framework on the Determinants of Maternal and Child Nutrition,2020.It builds on UNICEFs 1990 Conceptual Framework on the Causes of Child Malnutrition,58 which has guided nutrition programming over the last decades,and differs from
315、 it in three ways:First,it acknowledges the evolving face of child malnutrition,which manifests itself as a triple burden:undernutrition,including stunting and wasting;deficiencies in essential vitamins and other micronutrients;and overweight and obesity.These forms of malnutrition,which often coexi
316、st,are driven by poor diets and poor care practices and services.Second,it highlights the role of diets and care as immediate determinants of maternal and child nutrition.Good diets are driven by adequate food and feeding.Good care is driven by adequate services and practices.Diets and care influenc
317、e each other.The co-occurrence of good diets and good care leads to adequate nutrition for children and women across the life course.Third,it uses a positive narrative about what contributes to good nutrition in children and women,providing conceptual clarity about the enabling,underlying and immedi
318、ate determinants of adequate nutrition;their vertical and horizontal interconnectedness;and the positive survival,growth,development,performance and economic outcomes resulting from improved nutrition.33UNICEF NUTRITION STRATEGY 20202030The enabling determinants are the political,financial,social,cu
319、ltural and environmental conditions that enable good nutrition for children and women.In the 2020 Conceptual Framework,the enabling determinants are organized into three categories:CAREDIETSUnderlyingdeterminantsImmediate determinantsIMPROVED NUTRITION FOR CHILDREN AND WOMENEnablingdeterminantsENVIR
320、ONMENTSFEEDINGFOODOutcomesRESOURCESGOVERNANCENORMS Governance:Good governance refers to the political,financial,social and public and private sector actions needed to enable childrens and womens right to nutrition.Resources:Sufficient resources refer to the environmental,financial,social and human r
321、esources needed to enable childrens and womens right to nutrition.Norms:Positive norms refer to the gender,cultural and social actions to enable childrens and womens right to nutrition.The underlying determinants are the food and nutrition services and practices available to children and women in th
322、eir households,communities and environments to enable good nutrition.In the 2020 Conceptual Framework,they are organized into three categories:Food,which comprises age-appropriate,nutrient-rich foods including breastmilk and complementary foods for children in the first two years of life with safe d
323、rinking water and household food security for all children and women.Feeding,which comprises age-appropriate dietary practices including breastfeeding,responsive feeding and stimulation in early childhood with adequate food preparation,food consumption and hygiene practices for all children and wome
324、n.Environments,which comprise healthy food environments,adequate nutrition,health and sanitation services,and healthy living environments that prevent disease and promote good diets and physical activity for all children and women.The immediate determinants of maternal and child nutrition are diets
325、and care,which influence each other.Diets:Good diets are driven by adequate food and feeding to support good nutrition for children and women.Care:Good care is driven by adequate services and practices to support good nutrition for children and women.The co-occurrence of good diets and good care lea
326、ds to adequate nutrition for children and women across the life course.The outcomes resulting from improved nutrition for children and women manifest in the short and long term and include:In childhood and adolescence Improved survival,health,physical growth,cognitive development,school readiness an
327、d school performance.In adulthood and for societies Improved survival,health,productivity and wages in adults,and improved prosperity and social cohesion for societies.CONCEPTUAL FRAMEWORK34UNICEF NUTRITION STRATEGY 202020304.PROGRAMMING PRINCIPLES35UNICEF NUTRITION STRATEGY 2020203036UNICEF NUTRITI
328、ON STRATEGY 20202030This chapter outlines the six universal principles of UNICEF programming for maternal and child nutrition.These principles guide the design and implementation ofUNICEF nutrition programmes that are rights-based,equity-focused,gender-responsive,context-specific,evidence-informed a
329、nd systems-centred.The vision of the UNICEF Nutrition Strategy 20202030 is universal,applying equally to children,adolescents and women everywhere.This vision is implemented through programming at the global,regional,national and subnational levels,guided by six principles:Rights-basedUNICEFs approa
330、ch to nutrition programming is guided by the Universal Declaration of Human Rights(1948),the Convention on the Elimination of all Forms of Discrimination Against Women(1979)and the Convention on the Rights of the Child(1989),which recognize childrens and womens right to nutrition.UNICEF supports nat
331、ional governments and other duty-bearers including caregivers,service providers and the private sector in respecting,protecting and fulfilling this right.UNICEF also supports rights-holders children,adolescents and women to demand diets,services and practices that support adequate nutrition and hold
332、 duty-bearers to account.Equity-focusedUNICEFs approach to nutrition programming is guided by the conviction that reducing inequities is right in both principle and practice.Inequities prevent the most marginalized children and women from having access to nutritious,safe,affordable and sustainable d
333、iets and adequate nutrition services and practices.Nutrition policies and programmes that place a deliberate focus on the most vulnerable can reduce inequities(right in principle)and improve impact(right in practice),given that all forms of malnutrition are increasingly concentrated among the poorest and most marginalized children,adolescents,women,families and communities.Gender-responsiveUNICEFs