Multi-Sector Nutrition Plannnfsp.gov.np/PublicationFiles/b8aae359-15ea-40c4... · 1.9 Achievements of Multi-Sector Nutrition Plan (2013–17) 15 1.10 Analysis of Estimated Costs and

M U LT I - S E C TO R N U T R I T I O N P L A N - I I l ( 2 0 1 8 – 2 0 2 2 )

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Multi-Sector Nutrition Plan

Approved by the Cabinet Meeting of the Government of Nepal on 19 November 2017

(2018–2022)

Government of NepalNational Planning Commission


Singha Durbar, Kathmandu, Nepal2017


Singha Durbar, Kathmandu, Nepal2017

Multi-Sector Nutrition Plan-II

Unofficial Translation

(2018–2022)

Approved by the Cabinet Meeting of the Government of Nepal on 19 November 2017

Multi-Sector Nutrition Plan-II2018–2022

Published byGovernment of NepalNational Planning CommissionSingha Durbar, Kathmandu Tel: (+977)-014211136, 4211158Fax: (+977)-014211700 Email: [email protected]: www.npc.gov.np

Year published: 2017Copyright: National Planning Commission

Photos: © UNICEF Nepal

Recommended citation: NPC (2017). Multi-Sector Nutrition Plan: 2018–2022. Kathmandu: National Planning Commission.

Designed and processed: Print Communication Pvt. Ltd. Tel: (+977)-01 4241355, 4244148, Kathmandu, Nepal

Printed in Nepal

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Throughout the world, ending malnutrition is taken as a basis for achieving social, economic and human development as well as the Sustainable Development Goals. Studies have shown that the health issues caused by malnutrition are serious, long lasting and irreparable. Approximately 36 percent of Nepalese children suffer from stunting and 10 percent from wasting. Therefore, addi-tional efforts from all relevant stakeholders are es-sential to achieve the social and human develop-ment commitments Nepal has made at regional and international forums.

In this context, under the leadership of the Na-tional Planning Commission, and with coor-dinated support from relevant ministries and development partners, the Multi-Sector Nutri-tion Plan (MSNP, 2013–2017) has been imple-mented. It is essential to launch additional efforts targeted to reduce malnutrition in pregnant and lactating mothers, children under the age of two and adolescent girls. Similarly, as a continuation of the current plan, with participation from seven relevant ministries, development partners and other stakeholders, MSNP-II (2018–2022) has been formulated for the upcoming five years. This plan needs to be implemented with priority following the federal structure at all levels – fed-eral, provincial and local, so as to reduce malnu-trition which adversely affects social, economic and human development.

The plan has the target of minimizing the adverse effects on human capital and social and economic development by reducing chronic malnutrition

Message from the Prime Minister

from the current 36 percent to 28 percent in the upcoming five years. As per the World Health As-sembly global targets, malnutrition needs to be reduced to 24 percent of under-fives by the end of 2025. Similarly, the Sustainable Development Goals target is to reduce the percentage to 15 per-cent by 2030. In line with this, the plan attempts to build capacity at all levels of government agen-cies and relevant stakeholders by implementing promotional, preventive and therapeutic mea-sures to reduce the problem of malnutrition in women, children and adolescent girls.

It is essential, with our collective efforts, to re-duce malnutrition among women, children and adolescent girls. For this, our additional commit-ments are essential to achieve the neccessary addi-tional progress while sustaining the achievements made at all levels across the various sectors.

Jay Nepal!Mangsir, 2074

Sher Bahadur DeubaPrime Minister and ChairpersonNational Planning Commission

KATHMANDUNEPALTHE PRIME MINISTER


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Message from the vice Chair

Malnutrition causes 45 percent of all deaths of under 5-year-olds worldwide. Undernutrition hampers their physical, mental and emotional development which in turn adversely affects the overall social, economic and human development of countries.

Approximately 36 percent of Nepal’s children suffer from stunting, 10 percent from wasting and almost 53 percent from anaemia. Forty-one percent of women of reproductive age suffer from anaemia and 17 percent from long term energy deficits. These statistics differ by geographical re-gion and social group.

Studies have shown that malnutrition cannot be addressed by the efforts of the nutrition sec-tor alone and hence the first Multi-Sector Nu-trition Plan (2013–2017) was formulated and implemented in an integrated and coordinated way between nutrition specific and nutrition sensitive sectors. Taking stock of the achieve-ments under MSNP (2013–17) pointed to the necessity of continuing these efforts and thus MSNP-II (2018-2022) has been conceptualized. This new plan aims to make a crucial contribu-tion to achieve the Sustainable Development Goals related to health and nutrition and to help reap the benefits of the demographic dividend by strengthening the future economically productive population.

To ensure its effective implementation, MSNP-II was formulated by all the concerned ministries and development partners including the minis-tries of health; agricultural development; live-stock development; education; water supply and sanitation; women, children and social welfare; and federal affairs and local development, plus development partner agencies and other stake-holders. The National Planning Commission played the coordinating role.

Strong leadership is needed at the local level, as successful implementation at this level will de-termine the achievement of the plan’s outcomes. In this context, various federal, provincial, local and ward level structures are being established to effectively undertake the plan’s programmes and activities.

The NPC will extend various kinds of support, coordination and facilitation to ensure the imple-mentation of this plan at all levels. I expect uni-fied and consolidated support from all relevant stakeholders including all relevant ministries, local governments, development partners, civil society and the private sector.

Swarnim WagleVice ChairNational Planning Commission

GOVERNMENT OF NEPAL

National Planning CommissionSINGHADURBAR, KATHMANDU, NEPALVICE-CHAIRMAN


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Both undernutrition and overnutrition persist among Nepalese women and children although undernutri-tion is more common. The problem of undernutri-tion is specially seen in women of reproductive age and children under the age of five. The main causes of undernutrition are inadequate access to nutritious and diverse food, the poor use of available foods, infectious diseases due to unsafe water and poor hygiene, untimely treatment of diseases, poor use of health services, heavy workloads and poor aware-ness. Stunting, wasting, under-weight, and maternal and child anaemia are the major problems caused by undernutrition. These problems are found in vary-ing degrees among different social groups, classes and communities, and geographical regions.

From the perspective of nutrition, the period from conception until a child’s second birthday are cru-cial — it is known as the “golden thousand days”. During this period, the foods eaten by pregnant women, new mothers and newborns and childcare play a crucial role in growth and development of children. Scientific studies indicate that the prob-lems of undernutrition, such as the breastfeeding of newborns and children, supplementary food, caring habits and behaviour, sanitation, cleanliness, and food security, can be resolved only if programmes are formulated and implemented in a consolidated way with a collective approach.

Under the leadership and coordination of the Na-tional Planning Commission (NPC), the ministries of health; agricultural development; livestock devel-opment; water and sanitation; education; women, children and social welfare; federal affairs and local development, as well as national and international agencies working on nutrition are applying collab-orative efforts through the multisectoral approach to address the problems of malnutrition.

The Sustainable Development Goals for Nepal have targets to reduce stunting to 25 percent, wasting to 4 percent, and anaemia to 10 percent among children under five by the year 2030. Similarly, the government has set a target to reduce anaemia in women of reproductive age to 10 percent on the same timeline.

Considering the research and study findings indicat-ing the need of multisectoral efforts to address mal-nutrition, the government formulated and imple-mented the Multi-Sector Nutrition Plan (MSNP) 2013-2017. As the continuation of this plan, MS-NP-II (2018-2022) has been formulated and will be expanded throughout the country.

The Multi-Sector Nutrition Plan-II (2018-2022) will be implemented at all three levels of govern-ment: federal, provincial and local, with active par-ticipation from the relevant sectors with the local level playing a vital role. In this context, in order to identify various activities under the plan and de-vise a detailed work plan and effectively implement it requires the participation of nutrition and food security committees at state, district, municipality, rural municipality and ward levels. This also requires the technical and financial contribution from devel-opment partners.

To conclude, I would like to express my sincere gratitude to the High Level Committee for Nutri-tion and Food Security formed under the chair-manship of NPC vice-chair for their direction and suggestions in formulating MSNP-II. I would also like to thank the members of the National Nutri-tion and Food Security Coordination Committee (NNFSCC) for their help and suggestions. I also appreciate the contribution of the ministries, donor agencies and development partners for their contri-butions to formulating the Multi-Sector Nutrition Plan-II. I also thank all the staff of the National Planning Commission Secretariat, National Nutri-tion and Food Security Secretariat for helping to produce this new plan.

Prof. Dr. Geeta Bhakta JoshiMemberNational Planning Commission

GOVERNMENT OF NEPAL

National Planning CommissionSINGHADURBAR, KATHMANDU, NEPALMEMBER

Message from NPC Member


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Message from the Prime Minister iiiMessage from the Vice Chair vMessage from the NPC Member viiAbbreviations xExecutive Summary ix

1 Review of Multi-Sector Nutrition Plan (2013–17) 3

1.1 Background 31.2 Introduction 31.3 Global Nutrition Initiatives 41.4 Initiatives to Improve Nutrition in Nepal 51.5 Situation of Nutrition in Nepal 61.6 Progress of Nutrition Programmes 81.7 Analysis of Causes of Malnutrition in Nepal 101.8 Analysis of Other Issues that Affect Nutrition 131.9 Achievements of Multi-Sector Nutrition Plan (2013–17) 151.10 Analysis of Estimated Costs and Expenditure of Multi-Sector Nutrition Plan (2013–17) 181.11 Key Problems and Challenges 181.12 Lessons Learned Implementing MSNP (2013–17) 191.13 The Rationale for MSNP-II 20

2 Multi-Sector Nutrition Plan-II (2018–2022) 25

2.1 Vision 252.2 Goal 252.3 Objectives 252.4 Strategies 252.5 Policy-level Principles and Approaches 252.6 Theory of Change 262.7 Results Framework of MSNP-II (2018–22) 33

3 Implementation of MSNP-II (2018–2022) 43

3.1 Implementation Arrangements 433.2 Target Groups and Prioritization 433.3 Financial Management 443.4 Estimated Costs 443.5 Duration of MSNP-II 463.6 MSNP Committees 463.7 Power to Frame Guidelines 483.8 National Nutrition and Food Security Secretariat 483.9 Responsibilities of Private, Non-government and Academic Sectors 483.10 Capacity Development 503.11 Review, Monitoring and Evaluation 503.12 Documentation and Reporting 50

Contents

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Annex 1: Multi-sector Nutrition Plan-II (2018-2022) Results Framework 53Annex 2: MSNP (2013–17) Related Programmes and Projects Supported by Development Partners 81Annex 3: Commitments for Implementing MSNP 82Annex 4: Contributors to Multisector Nutrition Plan II (2018-2022) 84

References 88

TABLES

Table A: Goal, Outcomes and Outputs of MSNP-II xiiTable 1.1: Nepal’s Status Against Global Nutrition Targets 6Table 1.2: Status of MSNP (2013–17) Nutrition Specific Indicators 16Table 1.3: Budget Allocated to Nutrition by Government of Nepal (GoN) and Development Partners

in MSNP (2013–17) Period 18Table 3.1: Estimated NPC and Sectoral Ministry Costs of Implementing MNSP-II (NPR million) 45Table 3.2: Estimated Nutrition-Specific and Nutrition-Sensitive Costs of Implementing MNSP-2 (NPR million) 45Table 3.3: Estimated Costs of MSNP-II by sources of funds 45Table 3.4: Composition of High Level Nutrition and Food Security Steering Committee (HLNFSSC) 47Table 3.5: Composition of National Nutrition and Food Security Coordination Committee (NNFSCC) 47Table 3.6: Composition of Provincial Nutrition and Food Security Steering Committees (PLNFSSC) 47Table 3.7: Composition of Local Government Nutrition and Food Security Steering Committees 49Table 3.8: Composition of Ward-level Nutrition and Food Security Steering Committees 49

FIGURES

Figure 1.1: Nepal’s progress on World Health Assembly target 1 (40% reduction in number of stunted under 5-year-olds) 7Figure 1.2: Severity of stunting in Nepal’s provinces by WHO categories 8Figure 1.3: Disparities in Stunting Prevalence Among Under-5s in Nepal in 2016 9Figure 1.4: Coverage Progress of Nepal’s Nutrition Specific Interventions in MSNP (2013–17) period 10Figure 1.5: Coverage Progress of Nepal’s Nutrition Sensitive Interventions in MSNP (2013–17) period 11Figure 1.6: Timelines of Preparation of MSNP-II 21Figure 2.1: MSNP-II’s theory of change 27Figure 2.2: MSNP-II Results Structure — Outcome 1 on Nutrition Specific Services 29Figure 2.3: MSNP-II Results Structure — Outcome 2 on Nutrition Sensitive Services 30Figure 2.4: MSNP-II Results Structure — Outcome 3 on the Enabling Environment 32

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AARR average annual rate of reduction ABPMDD Agribusiness Promotion and Marketing Development DirectorateANC antenatal careAWPB annual workplan and budgetBMI body mass indexCLC community learning centreCMAM Community-Based Management of Acute Malnutrition DFID Department for International Development (UK Aid)DFTQC Department of Food Technology and Quality ControlDoCR Department of Civil Registration DoE Department of EducationDoHS Department of Health ServicesDoLS Department of Livestock ServicesDWC Department of Women and ChildrenECED early childhood education and developmentEMIS Education Management Information SystemFAO Food and Agriculture OrganizationFCHV female community health volunteerGoN Government of NepalHLNFSSC High Level Nutrition and Food Security Steering CommitteeHMIS Health Information Management SystemIMAM integrated management of acute malnutritionIMNCI integrated management of childhood illnessITC inpatient therapeutic careIYCF infant and young child feedingJMP Joint Monitoring ProgrammeMIYC maternal, infant and young childMIYCN maternal, infant and young child nutrition MIYCU maternal, infant and young child undernutritionMNP multiple micronutrient powderMoAD Ministry of Agriculture DevelopmentMoF Ministry of FinanceMoFALD Ministry of Federal Affairs and Local DevelopmentMoH Ministry of Health MoLD Ministry of Livestock DevelopmentMoWCSW Ministry of Women, Children and Social WelfareMoWSS Ministry of Water Supply and SanitationMSNP Multi-Sector Nutrition PlanNA not available NDHS Nepal Demographic and Health Survey

abbreviations


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NFC Nepal Food CorporationNLSS Nepal Living Standards SurveyNMICS Nepal Multiple Indicator Cluster SurveyNMIP-DWSS National Management Information Project of the Department of

Water Supply and Sewerage NNFSS National Nutrition and Food Security SecretariatNPC National Planning CommissionNPR Nepali rupeesNRH nutrition rehabilitation homeO&M organisation and managementODF open defecation freeOPD outpatient departmentORS oral rehydration solutionOTC outpatient therapeutic carePHC-ORC primary health care outreach clinicsPNC post-natal carePPE pre-primary educationReSoMal rehydration solution for malnutritionRUTF ready to use therapeutic foodSAM severe acute malnutritionSDG Sustainable Development GoalSUN Scaling Up NutritionToT training of trainersTWG technical working groupUNICEF United Nations Children’s FundUSAID United States Agency for International DevelopmentWASH water, sanitation and hygieneWCF ward citizens forumWFP World Food ProgrammeWHA World Health AssemblyWHO World Health OrganisationWRA women of reproductive age


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Nepal has made strong efforts to address the problem of malnutrition. The Government of Nepal has recognized the need of multi-sectoral efforts to improve the nutrition of its citizens. It developed the first Multi-Sector Nutrition Plan, which was implemented from 2013 led by the National Planning Commission. The second Multi-sector Nutrition Plan (2018/19–2022/23) has been designed as a continuation of MSNP (2013–17).

Nepal has made remarkable progress in the field of nutrition. According to the regular Nepal de-mographic health surveys (NDHSs), stunting among under-five years children has reduced from 57 percent in 2001 to 35.8 percent in 2016. The process of stunting starts at concep-tion, accelerates until two years of age, and is then irreversible. Therefore, nutrition needs to be improved among mothers and potential moth-ers (i.e. during adolescence and pregnancy) and when children are under two years of age.

Overweight and obesity is an emerging problem due to excessive intake of high amounts of fat, sugar and salt and inactive lifestyles. This is lead-ing to a growing incidence of high blood pressure, diabetes and other non-communicable diseases.

The undernutrition problems of stunting, wast-ing and low weight in children contribute to 52 percent of child mortality in Nepal. And those who survive usually have limited intellectual growth and cognitive development that affects their education.

The World Bank estimates that undernutrition causes losses of up to 3 percent of economic de-velopment. Thus, improving nutrition is a pre-condition to break the cycle of poverty and for sustainable economic development.

Major causes of chronic malnutrition in Nepal are poor feeding and care practices, insufficient nutrient intake, and high rates of infection and

teenage pregnancy. The Nepal Demographic Health Survey, 2016 reported that only 50 percent of babies were breastfed within one hour of birth. Although, the exclusive breastfeeding rate of newborns up to six months of age is 66 percent, only 17 percent of 6–8 months old babies were found receiving minimum acceptable diets while only 35 percent of children aged 6-23 months received minimum acceptable diets. Despite improvements in complementary feeding, families and fathers play little part in promoting this.

According to the Nepal Multiple Indicator Clus-ter Survey, 2014, 20 percent of children under 5 years of age had recently suffered from fever and 12 percent from diarrhoeal disease. These infec-tions lead to malnourishment and the death of young children. According to the 2016 NDHS, 17 percent of women of reproductive age and 30 percent of adolescent girls had chronic energy de-ficiency (BMI less than 18.5kg/m2), while 44 per-cent of adolescent girls were anaemic. Pregnancy in these conditions results in low birth weight babies, a cycle that repeats from mother to child and onwards. Maternal and infant infections are also common problems as are intestinal parasites. Other problems that contribute to malnutrition are that 13 percent of women of reproductive age smoke, while 40 forty percent of women suffer from indirect smoking, and 75 percent are ex-posed to smoke pollution from solid fuel cooking stoves.

According to the Nepal Multiple Indicator Clus-ter Survey, 2014, 48 percent of women aged 20-49 years were first married or in union before age 20 and so teenage pregnancies are common. And 16 percent of women delivered a baby before their eighteenth birthdays. In such cases, maternal care practices tend to be poor. The heavy workloads of many women after delivery is another problem.

Access to and the use of health services has im-proved. The 2016 NDHS reported 53 percent of married women aged 15-49 years using modern

Executive Summary

According to the regular Nepal demographic health surveys (NDHSs), stunting among under-five years children has reduced from 57 percent in 2001 to 35.8 percent in 2016. The process of stunting starts at conception, accelerates until two years of age, and is then irreversible.

Multi-Sector Nutrition Plan-II (2018–2022)


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family planning methods. Maternal care practices have also improved with 84 percent of pregnant women having at least one antenatal or postnatal checkup. Fifty-eight percent of pregnant women used the services of a skilled birth attendant for their deliveries.

According to the Nepal Multiple Indicator Clus-ter Survey, 2014, 93 percent of households used a source of safe drinking water. However only half of the population used toilet facilities while less care was taken for the safe management of cow dung and manure, which creates a polluting en-vironment and spreads disease and parasites. This indicates that personal hygiene and sanitation is still poor in many households.

Although the literacy rate among young women has reached more than 88.6 percent, women’s voices are not adequately heard and they play little part in decision-making. Gender discrimi-nation and social exclusion persist, although they are being addressed in many programmes of the government and its development partners.

The underlying causes of malnutrition have di-minished. Now, only 21.6 percent of the popu-lation live below the poverty line. It however remains challenging to provide enough food in food deficit districts year-round to attain the SDG of zero poverty and hunger. But at the basic level of causality there have been overwhelming improvements in infrastructure including roads, schools and health facilities.

According to the Global Nutrition Report, 2016, scaling up nutrition investments is a high-impact, high-return proposition, with a benefit-cost ratio of 16:1 and a compound rate of return of more than 10 percent. The costs of neglecting nutrition are high, causing economic losses of around 10 percent of gross domestic product.

The design of this Multi-Sector Nutrition Plan-II (2018/19–2022/23) addresses the achievement of the World Health Assembly global targets for 2025, the Sustainable Development Goals for 2030 and nutrition deprivation and causal-ity analysis in Nepal. This plan addresses lessons

The underlying causes of

malnutrition have diminished. Now,

only 21.6 percent of the population live

below the poverty line. It however

remains challenging to provide enough

food in food deficit districts year-round

to attain the SDG of zero poverty and

hunger.

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The implementation of MSNP (2013–17) started in 2013 with the aim of enhancing nutrition to remove it as an impeding factor for human development and for overall socioeconomic development. The new plan continues the MSNP (2013–17) interventions.

learned from MSNP (2013–17). Nutrition re-lated cultural trends, habits, weaknesses in the nutrition sector, gaps and the problems of under-nutrition and over-nutrition have also been anal-ysed. The plan’s logical framework leads on from its theory of change. This plan covers concepts and experiences shared by the related sectoral ministries.

This final draft of MSNP-II was discussed in the National Nutrition and Food Security Coordi-nation Committee and then submitted to the High Level Nutrition and Food Security Steer-ing Committee for endorsement. The endorsed document from the HLNFSSC was approved by the Council of Ministers in November 2017.

The implementation of MSNP (2013–17) start-ed with the aim of enhancing nutrition to remove it as an impeding factor for human development and for overall socioeconomic development.

The new plan continues the MSNP (2013–17) interventions. The goal for the next five years is “Improved maternal, adolescents and child nutri-tion’” which will be achieved by taking to scale nutrition specific and sensitive interventions and by improving the nutrition enabling environ-ment.

The nutrition specific interventions will be large-ly delivered through the health sector, and the nutrition sensitive interventions mainly by the education, agriculture, livestock, water and sani-tation, women and children sectors in collabora-tion with local governments. All these interven-tions will aim to improve the status of nutritional as measured against the incidence of stunting and wasting among under 5-year-olds and low birth weight babies. The plan also aims to reduce chronic energy deficiency among women. The expectation is also to reduce the proportion of mothes and children who are overweight.

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Table A: Goal, outcomes and outputs of MSNP-II

Goal: Improved maternal, adolescent and child nutrition by scaling up essential nutrition-specific and sensitive interventions and creating an enabling environment for nutrition

OUTCOME 1: IMPROVED ACCESS TO AND EQUITABLE USE OF NUTRITION-SPECIFIC SERVICES

Output 1.1: Enhanced nutrition status of women of reproductive age including adolescentsOutput 1.2: Improved infant and young child nutrition and care practicesOutput 1.3: Improved maternal, infant and young child micronutrient statusOutput 1.4: Improved management of severe and moderate acute malnutritionOutput 1.5: Enhanced preparedness for nutrition in emergency responsesOutput 1.6: Capacity built of nutrition-specific sectors

OUTCOME 2: IMPROVED ACCESS TO AND THE EQUITABLE USE OF NUTRITION-SENSITIVE SER-

VICES AND IMPROVED HEALTHY HABITS AND PRACTICES

Output 2.1: Increased availability and consumption of safe and nutritious foodOutput 2.2: Increased physical and economic access to diverse types of foodOutput 2.3: Increased access to safe drinking waterOutput 2.4: Increased access to safe and sustainable sanitation servicesOutput 2.5: Improved knowledge of children and mothers and caretakers of under 5-year-old

children on health and hygiene Output 2.6: Targeted groups have access to resources and opportunities that make them self-reliantOutput 2.7: Nutrition component incorporated in women, adolescent girls and child development

training packagesOutput 2.8: Women, children and out-of-school adolescent girls reached with health and nutrition

care practicesOutput 2.9: Child care homes comply with minimum standards of nutrition careOutput 2.10: Communities empowered to prevent harmful practices (menstrual seclusion [chhau-

padi], food taboos)Output 2.11: Enhanced enrolment of children in basic educationOutput 2.12: Increased adolescent girls’ awareness and improved behaviour on nutritionOutput 2.13: Enhanced access to health and reproductive health services

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OUTCOME 3: IMPROVED POLICIES, PLANS AND MULTI-SECTORAL COORDINATION AT FEDERAL,

PROVINCIAL AND LOCAL GOVERNMENT LEVELS TO ENHANCE THE NUTRITION

STATUS OF ALL POPULATION GROUPS

Output 3.1: MSNP-II included in local, provincial and federal government policies and plansOutput 3.2: MSNP governance mechanism instituted and strengthened at federal, provincial, and

local levelsOutput 3.3: MSNP institutional mechanisms established and functional at federal government levelOutput 3.4: Functional updated information system across all MSNP sectorsOutput 3.5: Enhanced capacity of federal, provincial and local level government to plan and imple-

ment nutrition programmes

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REVIEW OF MULTI-SECTOR NUTRITION PLAN, 2013–17

Chapter 1

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1.1 BackgroundThe Government of Nepal and its development partners are committed to addressing the com-plex problem of malnutrition. The government’s development objectives are outlined in the Con-stitution of Nepal, the Fourteenth Development Plan and the Sustainable Development Goals (SDGs). Economic growth, employment promo-tion, poverty alleviation, post-conflict reconstruc-tion, social transformation and human resource development are the government’s development priorities.

Improving the nutritional status of its citizens is a major priority of the government. Improving nu-trition involves interventions in health and other sectors; thus policies, strategies and plans of the health, agriculture, livestock, water and sanita-tion sectors emphasise good nutrition and food security.

The government is addressing the complex causes of malnutrition through a multi-sectoral approach. Its first Multi-Sector Nutrition Plan (MSNP, 2013-2017) had the following out-comes:1. Improved maternal, infant and young child

feeding.2. Increased maternal, infant and young child

micro-nutrient status.3. Improved management of malnutrition in

children.

MSNP (2013–17) was implemented through the following nutrition-specific and nutrition-sensi-tive programmes:• The ‘direct’ nutrition-specific interventions

targeted individuals and included micronu-trient supplements to under 5-year-olds and adolescents and women during pregnancy and lactation, micronutrient fortification (salt iodization and flour fortification), awareness raising and behaviour change communication

on optimal infant and young child feeding, and the management of severe acute malnu-trition.

• The ‘indirect’ nutrition-sensitive interventions targeted families and communities including on hygiene and sanitation, with cash and in-kind transfers (including child cash grants), nutritious food and diets, school feeding pro-grammes and parental education.

These programmes (most of which are ongoing) were implemented by government line minis-tries, principally the Ministry of Health (MoH), Ministry of Agricultural Development (MoAD), Ministry of Livestock Development (MoLD), Ministry of Education (MoE), Ministry of Wa-ter Supply and Sanitation (MoWSS), Ministry of Federal Affairs and Local Development (Mo-FALD), and the Ministry of Women, Children and Social Welfare (MoWCSW). In addition to funding the regular cross-sectoral nutrition pro-grammes nationwide, the government provided additional funding to implement MSNP (2013–17) in 28 priority districts from its own resources and development partner support.

1.2 IntroductionPeople are malnourished if their diet provides in-adequate nutrients for growth and good health or if they are unable to fully use the food they con-sume due to illness. They are also malnourished if they consume too many calories (overnutrition) (UNICEF 2012).

Malnutrition is caused by poor health, diet, edu-cation, access to resources, empowerment and other factors. Good nutrition, i.e. an adequate well-balanced diet, and regular physical activity are the cornerstones of good health. Poor nutri-tion can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development and reduced productivity.

Nutritional deficiencies among young children

1. Review of Multi-Sector Nutrition Plan (2013–17)

Chapter 1

The government is addressing the complex causes of malnutrition through a multi-sectoral approach.


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and mothers has large economic costs that mani-fest later in an increased burden of disease and losses of human capital and economic productiv-ity. Undernourished children suffer irreparable intellectual impairment and stunted physical growth. Hungry children make poor and less productive students and often make unhealthy workers. All this results in impoverished families and communities and an overburdened health care system.

Undernourished mothers usually give birth to un-derweight babies, thus transferring disadvantages to the next generation. From the perspective of nutrition, a young child’s first 1,000 days (from conception to the second birthday) are critical. Nutrition interventions can have a huge benefit during this period. Subsequent interventions can make a difference, but cannot undo damage re-lated to malnutrition from the first 1,000 days.

Children’s nutrition outcomes are closely related with maternal nutrition. Healthy, well-nourished mothers are more likely to give birth to and nur-ture healthy children. Accordingly, it is important that adolescent girls, pregnant women and lactat-ing mothers receive the range of nutrition-related services and information they need to support their good nutrition.

1.3 Global Nutrition InitiativesThe main initiatives that guide and promote im-proved nutrition at the global level are the Scal-ing Up Nutrition (SUN) Framework, the SDGs and the World Health Assembly’s global nutrition targets (2012).

The momentum to improve nutrition accelerated at the global level from 2009 with the initiation of a global collaborative process, the Scaling Up Nu-trition (SUN) Framework (scalingupnutrition.org). The SUN framework has been endorsed by over 100 international development institutions working in the field of nutrition including UNI-CEF, WFP, FAO, WHO, USAID, DFID, DFAT and the World Bank, and by the governments of 59 countries (the movement). The SUN Move-ment works to build an enabling social, eco-nomic and political environment that ensures all children can reach their full potential. The SUN Movement Strategy and Roadmap (2016-2020) (SUN Movement 2016) calls for the following:

1. Expanding and sustaining an enabling politi-cal environment.

2. Prioritizing and institutionalizing effective ac-tions that contribute to good nutrition.

3. Implementing effective actions aligned with common results frameworks.

4. Effectively using and significantly increasing financial resources for nutrition.

The SUN framework calls for multi-sectoral ap-proaches to improving nutrition, arguing that the essential complementary approaches of nutrition-specific activities and nutrition-sensitive activities both need scaling up.

Almost all countries signed up to the 2030 Agen-da for Sustainable Development committing to comprehensive, integrated and universal trans-formations, including ending hunger and malnu-trition. The agenda focuses on achieving the 17 Sustainable Development Goals by 2030. SDG 2 calls for “Ending hunger, achieving food security and improving nutrition and promoting sustain-able agriculture.” At least 12 of the 17 SDGs have indicators that are relevant to good nutrition with SDGs 1, 2, 3 and 6 closely related to nutrition. Nepal’s enactment of its new 2015 Constitution coincided with the beginning of the SDG period providing the opportunity for the new system of governance to focus on achieving the SDGs.

In 2012, the World Health Assembly (WHA) agreed on the following six global nutrition tar-gets by 2025 (WHO 2012): • 40 percent reduction in the number of chil-

dren under-5 who are stunted• 50 percent reduction of anaemia in women of

reproductive age• 30 percent reduction in low birth weight ba-

bies• no increase in childhood overweight• increase the rate of exclusive breastfeeding in

the first 6 months up to at least 50 percent• reduce and maintain childhood wasting to less

than 5 percent.

The following are other important global com-mitments signed up to by Nepal:• In 2013, the World Health Assembly agreed

to halt the rise in diabetes and obesity as part

From the perspective of

nutrition, a young child’s

first 1,000 days (from conception

to the second birthday) are

critical. Nutrition interventions

can have a huge benefit during this

period. Subsequent interventions can

make a difference, but cannot undo

damage related to malnutrition from

the first 1,000 days.


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of the adoption of the comprehensive global monitoring framework for the prevention and control of non-communicable diseases WHO 2013).

• Many countries, including Nepal, endorsed the World Health Organisation’s Compre-hensive Implementation Plan on Maternal, Infant and Young Child Nutrition (MIYCN) in 2012 (WHO 2014).

1.4 Initiatives to Improve Nutrition in NepalThe government has instituted a number of nu-trition-related policies and plans:

The National Nutrition Policy and Strategy, 2004 (CHD 2004) guides nutrition programmes and activities in the health sector. Other relevant policies and plans include the National Health Policy 2015, the Nepal Health Sector Strategy Action Plan (2016-2022) and the Food and Nu-trition Security Plan of Action (2014-2024).

The Agriculture Development Strategy, 2015–2035 (MoAD 2015) calls for reducing food-re-lated poverty from 27.6 percent in 2016 to 13 percent in 2026 and 6 percent in 2036. Food and Nutrition Security is one of the strategy’s flagship programs.

The Nepal Health Sector Strategy, 2016-2021 (MoHP 2015) recognises nutrition as a multi-sectoral issue and includes related programmes and activities under the following three action areas:• Maintain comprehensive extension and use

of services — These programmes include dis-tributing Vitamin A capsules to under 5-year-olds and deworming tablets to 1–5 year olds, the distribution and use of zinc tablets for diarrhoea treatment, the distribution of iron folic acid tablets, deworming tablets and vita-min A capsules to pregnant mothers, and the use of iodised salt.

• Programmes to scale up — These pro-grammes include exclusive breastfeeding af-ter birth, complementary feeding (including breastfeeding after 6 months), providing Baal-vita micronutrient powders to 2–23 month olds, handwashing at critical times, the in-tegrated management of severe malnutrition and the production of fortified flour.

• Programmes to assess and revise — These programmes include maternal and child nu-trition improvement related activities, mixing micronutrients in fortified wheat flour and the treatment of child malnutrition.

The Nepal Water Supply, Sanitation and Hy-giene Sector Development Plan, 2016-2030 (MSWW 2016) calls for actions that enhance nutrition including frequent handwashing with soap, safe disposal of faeces, the safe handling and treatment of drinking water and regular nail cut-ting, bathing, and tooth brushing.

And above all, Nepal’s new 2015 Constitution grants all citizens the fundamental right to food and basic health care (GoN 2015).

MSNP (2013-17) calls for nutrition-specific and nutrition-sensitive programmes to address under-nutrition. The health, education, water and sani-tation, agriculture and livestock, local governance and women, children and social welfare sectors have a leading role to play in improving nutri-tion in Nepal. The interventions implemented by these six sectors in Nepal under MSNP (2013–17) are summarised below. • Health — The wide range of health sector nu-

trition interventions included maternal infant and young child nutrition, maternal health care, micronutrient supplementation and the fortification of foodstuffs.

• Education — Education has a large role to play in improving the nutritional knowledge and behaviour of the future generation. Ma-jor MoE nutrition programmes under MSNP (2013–17) were the provision of midday meals in schools, improving water, sanitation and hygiene (WASH) facilities in schools and the inclusion of nutrition topics in curricula.

• Water and sanitation — The water and sani-tation sector is involved in nutrition by pro-moting safe drinking water and sanitation, es-pecially as diarrhoea is a major cause of child mortality. The interventions run in the MSNP (2013–17) period were mainly for safe water supplies and improving hygiene and sanita-tion.

• Agriculture and livestock — The develop-ment of agriculture and livestock production is crucial for improving nutrition. Interven-tions were run under MSNP (2013–17) to en-

MSNP (2013-17) called for nutrition-specific and nutrition-sensitive programmes to address undernutrition. The health, education, water and sanitation, agriculture and livestock, local governance and women children and social welfare sectors have a leading role to play in improving nutrition in Nepal.


6

hance homestead food and livestock produc-tion, to increase the incomes of poor women through credit incentives, and to increase the consumption of micronutrient-rich foods.

• Women children and social welfare — Dur-ing MSNP (2013–17) MoWCSW helped increase the knowledge of children and the mothers and caretakers of young children on hygienic behaviour and empowered commu-nities to address harmful traditional practices such as menstrual seclusion and food taboos.

• Local governance— Local governments have a major role to play in improving nutrition including through social mobilization and the administration of cash transfers and social protection. The contributions to improved nutrition by MoFALD and the local bodies under the previous constitution focussed on the 28 MSNP (2013–17) districts. The new federal units of local governance — provinces and the four levels of local government (met-ropolitan cities, sub-metropolitan cities, ur-ban municipalities and rural municipalities) plus their wards have an important role to play in improving nutrition.

Alongside these sectors, the Nepal Food Corpo-ration and Salt Trading Corporation (under the Ministry of Supplies) supply food to remote dis-tricts and distribute iodised salt and are therefore important MSNP-II stakeholders.

1.5 Situation of Nutrition in NepalAlthough there have been significant improve-ments across the different types of malnutrition (stunting, wasting, underweight, low body mass

index, micronutrient deficiency, overweight and obesity), malnutrition continues to constrain hu-man lives and Nepal’s socioeconomic develop-ment. Malnutrition contributes to more than a third of child mortality in Nepal, and children who survive often lead diminished lives due to impaired cognitive development, reduced eco-nomic productivity and the increased risk of mal-nutrition-related chronic diseases. Overweight and obesity are emerging amongst certain groups.

Nepal made mixed progress on the achievement of the World Health Assembly’s global nutrition targets for 2025 between the base year of 2011 and 2016. It must be noted though that Nepal has made great progress on these indicators over the last two decades.

There were small improvements in stunting (WHA target 1), childhood overweight (WHA 4), exclusive breastfeeding (WHA 5) and child-hood wasting (WHA 6) (Table 1.1). There was a worsening in the situation of anaemia among women and children and a doubling in the preva-lence of low birth weight (although the latter was probably due to the increased number of institu-tional deliveries meaning it was detected more). The childhood overweight and breastfeeding tar-gets have been achieved and efforts need acceler-ating to achieve the other targets.

Note that although overweight is only a minor problem amongst children it has become a seri-ous concern among adults with the 2016 NDHS finding that 22.2 percent of women and 17.1 percent of men were overweight (MoH, New ERA and ICF 2017). The highest incidence was in the highest wealth quintile where 45 percent

TABLE 1.1: NEPAL’S STATUS AGAINST GLOBAL NUTRITION TARGETS

Global nutrition targets for 2025 and 2030Base year situation

ProgressNepal's

WHA targetNepal’s SDG

targets

2011 2016 2025 2030

1 Achieve 40% reduction in the number of children under-5 who are stunted 40.5% 35.8% 25% 15%

2a Achieve a 50% reduction of anaemia in women of reproductive age 35% 40.8% 18% 10%

2b Achieve a 50% reduction of anaemia in children 46.2% 52.7% 23.1% 10%

3 Achieve a 30% reduction in low birth weight 12.1% 24.2%* 8% –

4 Ensure no increase in childhood overweight 1.4% 1.2% ≤1.4% –

5 Increase rate of exclusive breastfeeding in first 6 months to at least 50% 69.6% 66.1% >50% –

6 Reduce and maintain childhood wasting to less than 5% 10.9% 9.7% 5% 4%

There has been a large reduction in

childhood stunting (short height for

age) in Nepal in recent years;

reducing from 57 percent of under

5-year-olds in 2001 to 35.8 percent of

them in 2016.

Source of information: MoH, New ERA and ICF (2017) and *CBS 2015


7

Note: AARR = average annual rate of reduction

FIGURE 1.1: NEPAL’S PROGRESS ON WORLD HEALTH ASSEMBLY TARGET 1 (40% REDUCTION IN NUMBER OF STUNTED UNDER 5-YEAR-OLDS)

2001

2003

2005

2007

2009

2011

2013

2015

2017

2019

2021

2023

2025

2027

2029

2031

2033

60

55

50

45

40

35

30

25

20

15

49.3

57.3

40.537.4 35.8

29.424.7

24.319.5

Existing (AARR 0.031)Required (AARR 0.043)

of women and a third of men were overweight or obese in 2016.

There has been a large reduction in childhood stunting (short height for age) in Nepal in recent years; reducing from 57 percent of under 5-year-olds in 2001 to 35.8 percent of them in 2016 (MoH, New ERA and ICF 2017). Note that the stunting of under 5-year-olds is recognised as the main indicator of malnutrition and so receives the most coverage here.

However, Nepal has fallen behind on the average annual rate of reduction needed to achieve WHA target 1 of a 40% reduction by 2025 in the num-ber of stunted under 5 year-olds (Figure 1.1). The prevalence of stunting in this age group in the 2011 WHA base year was 40.5 percent, amount-ing to 1,108,573 stunted children (CBS popula-tion projection 2011). To reduce the prevalence by 40 percent entails reaching 24.3 percent by 2025, which means having 661,860 fewer stunt-ed children. The average annual rate of reduction between 2001 and 2016 was 3.09 percent. To reach the WHA target of 24.2 percent therefore requires an average annual rate of reduction from 2016 onwards of 4.26 percent.

Note that the same kind of trend and disparity analysis was carried out for all six WHA indica-tors as background analysis for MSNP-II. Only the stunting analysis is included here.

The 2016 NDHS found that 35.8 percent of under-5-year-olds were stunted, although there were considerable variations, as illustrated in Fig-ure 1.2:• 40.2 percent of children stunted in rural areas

compared to only 32.0 percent in urban areas• Children from the poorest wealth quintile

were three times more likely to be stunted (49.2%) than children from the richest quin-tile (16.5%)

• Children of mothers who were not educated were twice as likely to be stunted (45.7%) as children of educated mothers (22.7%)

• Children below 18 months old were less stunted than older children

• 46.8 percent of children in mountain areas were stunted compared to 36.7 percent in the Tarai plains and 32.3 percent in the hills

• Provinces 2, 5, 6 and 7 had above national average rates of stunting with a very high

However, Nepal has fallen behind on the average annual rate of reduction needed to achieve WHA target 1 of a 40% reduction by 2025.


8

1 The dataset used for this paragraph includes NDHS 2016, Nepal Multiple Indicator Cluster Survey (NMICS) 2014, Annual Reports of the Department of Health Services for 2012/2013 and 2014/2015, Nepal Health Facility Survey (NHFS) 2015 and other statistics from government ministries.

The prevalence of wasting (low

weight for height) has fluctuated in

recent years in Nepal from 9.6

percent of under 5-year-olds in 2001

to 11.4 percent in 2014 and 9.7 percent in 2016

FIGURE 1.2: SEVERITY OF STUNTING IN NEPAL’S PROVINCES BY WHO CATEGORIES

.

Creation Date:Map data source(s):

10 April 2017Nepal Gazette (10 March 2017)DoS, GoN

07 51 5037.5 KM

Province 7(35.9%)

Province 6(54.5%)

Province 4(28.9%)

Province 3(29.4%)

Province 1(32.6%)

Province 2(37.0%)

Province 5(38.5%)

Source: Nepal Demographic Health Survey, 2016

Legend

Very high: => 40 percentHigh: 30-39 percentMedium: 20-29 percentLow: <20 percent

Disclaimers: The map is based on The Constitution of Nepal Published by Government of Nepal, Ministry of Law, Justice and Parliamentary Affairs. Law Book Management Board The boundaries are derived using spatial operation in GIS environment on old ward level administrative data from DoS.

prevalence in Province 6 (mid-western Nepal) (54.5%), almost double that in Province 4 (28.9%) (Figure 1.3).

The prevalence of wasting (low weight for height) has fluctuated in recent years in Nepal from 9.6 percent of under 5-year-olds in 2001 to 11.4 percent in 2014 and 9.7 percent in 2016 (MoH, New ERA and ICF 2017). Wasting is a measure of acute undernutrition and represents the failure to receive adequate nutrition in the period im-mediately before the survey.

There was little difference in the rate of wasting between boys (9.5%) and girls (9.8%) in 2016 and only a small difference by residence with 10.2 percent of under 5-year-olds wasted in rural ar-eas versus 9.2 percent in urban areas. Children in the Tarai had the highest prevalence of wasting (12%) compared to children in the hills (6.4%)

and mountains (6.1%). And the prevalence of wasting among infants aged 0-23 months was al-most twice (ranging from 15.2% to 21.3%) that among 48-59 month old infants (6.2%).1

1.6 Progress of Nutrition ProgrammesIn 2017 UNICEF analysed the coverage trends of nutrition specific and sensitive interventions from the MSNP (2013–17) period (and in some cases earlier). This analysis was carried out using sectoral ministry data. Sufficient data was not available to do this analysis for enabling environ-ment interventions. Figures 1.4 and 1.5 show the results of this analysis, with:• the level of coverage of target groups along the

horizontal axis (up to maximum 100% cover-age) and associated recommendations

• the progress of coverage of along the vertical


9

FIGURE 1.3: DISPARITIES IN STUNTING PREVALENCE AMONG UNDER-5S IN NEPAL IN 2016

Source: MoH, New ERA and ICF 2017

PREV

ALE

NCE

%

Male

Female Urban

Rural

Lowest

No Education

24-35m

18-23m

36-47m

12-17m

9-11m

6-8m

≤6m

48-59m

Primary

Mountain

Province 6

Province 5

Province 2

Province 7

Province 1

Province 3

Province 4

Terai

HillsSecondary

Higher

Middle

Fourth

Highest

Second

40.236.0

35.7

49.2

45.7

44.5

41.9

38.5

32.632.3

20.0

36.7

22.7

32.0

35.7

38.7

32.4

16.5

31.5

40.0

39.8

31.9

17.6

13.5

46.8

36.7

29.4

28.9

35.9

37.0

54.560

55

50

45

40

35

30

25

20

15

10

5

0Gender Area of

ResidenceWealth Quintile

MaternalEducation

Age Groups in Months

EcologicalZones

FederalProvinces

NationalAverage

35.8

axis ranging from programmes that have ex-panded significantly to ones that have shrunk.

The recommendations for the interventions in both graphs for the three levels of coverage are:• Need scaling up, strengthening or sustaining

for positive coverage trend interventions.• Need attention, reversing negative trend or

sustaining for negative trend coverage.

Based on the limited data available for this exer-cise, Figure 1.4 shows a mixed trend of progress of the nutrition-specific interventions during the MSNP (2013–17) period, with:• flour fortification being unchanged at 100

percent targeted coverage• the coverage of the treatment of diarrhoea

cases increased by 250 percent, but still only covers about 20 percent of cases

• the proportion of households using iodised salt increased by 50 percent to reach about 80 percent targeted coverage

• exclusive breastfeeding declined to about 56 percent of babies

• the needed financial resources for improving nutrition increased by about 40 percent.

The UNICEF Nepal analysis of the progress of nutrition-sensitive interventions found that 11 of the major selected nutrition sensitive indicators increased their coverage in the MSNP (2013–17) period (Figure 1.5). Only the two married-before-age-18-years indicators had a negative trend. The increases in coverage were for secondary school enrolment, disposal of child faeces, handwashing, and and access to improved sanitation. The most remains to be done on reducing early marriage and installing well-functioning water supply sys-tems, with less than a third of targeted coverage achieved.

Children in the Tarai had the highest prevalence of wasting (12%) compared to children in the hills (6.4%) and mountains (6.1%).


10

1.7 Analysis of Causes of Malnutrition in NepalThe following text discusses the main health-re-lated causes of malnutrition in Nepal. 1) Causes — Nepal’s population faces a range of

nutritional problems from deficits in energy intake to imbalances in the consumption of macro and micronutrients. The causes include imbalanced diets; inadequate family care; poor quality water, sanitation and hygiene; in-adequate access to health services; child mar-riage; women’s heavy workloads; women’s lack of access to economic resources; gender-based violence and cultural taboos. The problem of excess intake is also surfacing as changing dietary patterns and lifestyles result in over-weight and obesity.

2) Causes of stunting — The underlying causes of stunting in Nepal are inadequate mater-nal, infant and young child feeding practices, untreated episodes of acute malnutrition, in-fections, and micronutrient deficiencies. Ex-

clusive breastfeeding is sufficient for the first six months after birth while the timely intro-duction of appropriate complementary foods with breastfeeding is essential after six months of age.

Nepal achieved the World Health Assembly target of exclusive breastfeeding of 50 per-cent of infants in early 2015. However, fur-ther efforts are needed to reach the target of the National Infant Young Child Feeding Strategy (CHD 2014) of 80 percent exclusive breastfeeding in the first six months of life by 2020 as in 2016 only 66% of this age group were exclusively breastfed (MoH, New ERA and ICF 2017). The 2016 NDHS found major disparities around this average figure with only 48.6 of female infants exclusively breastfed compared to 63.8 percent of male infants and only 48.3 percent of lowest wealth quintile infants compared to 70.8 percent of infants in the second wealth quintile (MoH, New ERA and ICF 2017).

The underlying causes of stunting

in Nepal are inadequate

maternal, infant and young child

feeding practices, untreated

episodes of acute malnutrition,

infections, and micronutrient

deficiencies.

FIGURE 1.4: COVERAGE PROGRESS OF NEPAL’S NUTRITION SPECIFIC INTERVENTIONS IN MSNP (2013–17) PERIOD

Posi

tive

Tren

dN

egat

ive

Tren

d

Source: DHS MICS 2014, NDHS 2011, NDHS 2006 and MoHP Annual Reports 2009/2010, 2010/2011 and 2014/2015

PP Vit-ASupplementation

Coverage

MNP all

0 25% 50% 75% 100% 125%

350

300

250

200

150

100

50

0

-50

Treatment of Diarrhea(Zinc+ORS)

45-days PP IFA

Feeding during Illness

Financial Resourcesfor Nutrition

MNP Districts MDDCMAM Districts

180+IFA (PW)

IFA (WRA)

Any IFA (PA)

HH Iodized SaltVit-A (6-59m)

Flour Fortification

ExclusiveBreast Feeding

ANC

MMF

MNP 1st

Early Initiation of BF

SAM Cure Rate

Deworming (12-59

Vit-A(6-11m)

Introduction to CF

Deworming (PW)Any IFA (PLW)

Attention and scale-up Reverse negative trend & strengthen Sustain


11

in 2016, only 17 percent of children aged 6–8 months and only 35 percent of children aged 6–23 months had minimum acceptable diets.

In terms of the introduction of appropriate complementary foods after six months of age:• in 2016, only 17 percent of children aged

6–8 months and only 35 percent of chil-dren aged 6–23 months had minimum acceptable diets (MoH, New ERA and ICF 2017)

• in 2014, only 17 percent of children aged 6-23 months in the mid-western Ta-rai had minimum acceptable diet (CBS 2015)

• only 23.5 percent of young children from the middle wealth quintile had at least the minimum acceptable diet compared to 50.2 percent from the richest quintile (CBS 2015).

3) Disease — In Nepal, maternal and infant infections are common and intestinal para-sites are a major public health problem. The 2014 Nepal Multiple Indicator Cluster Survey (NMICS) found that 20.1 percent of under 5-year-olds had suffered fever in the previous two weeks while 12 percent had suffered diar-

rhoea and 7 percent acute respiratory infec-tions in the same period (CBS 2015). These diseases cause malnutrition and can cause the deaths of young children. A major cause of acute respiratory infection is exposure to in-door air pollution — principally smoke from cooking with firewood and other solid fuels. And, although the prevalence of diarrhoea in young children has decreased over the last decade, only 47 percent of children sought advice and treatment from a health facility or provider (CBS 2015).

4) Immunisation — In 2016, only 87 per-cent of children aged 12–23 months had re-ceived all the vaccinations as per the national schedule by their first birthday (MoH, New ERA and ICF 2017). The percentage of non-immunised children reduced to 1 percent in 2016 from 3 percent in 2011.

5) Adolescent nutrition — The NDHS 2016 found that many adolescents, and especially adolescent girls, were malnourished, with 30 percent of 15 to 19 year old girls being under-weight, while 44 percent of them were anae-

FIGURE 1.5: COVERAGE PROGRESS OF NEPAL’S NUTRITION SENSITIVE INTERVENTIONS IN MSNP (2013–17) PERIOD

Attention &scale-up

SustainReverse negativetrend & strengthen

20-24 Womenmarried before

15 years


18 years

25-29 Womenmarried

before 15Well-functioning

water supply scheme

Child faecesdisposed

safely

Access to Improved Sanitation

Literacy rate (15-24 years)

Cash grants

Net EnrolmentPrimary Education

Improved Drinking Water Source

Secondary school set enrolment prevalence

Coverage25%0% 50% 75% 100%

Hand washingsoap + water


18 years

150

100

50

0

-50

Posi

tive

Tren

dN

egat

ive

Tren

d

Recommendations:


12

Although the poverty level

reduced from 49 percent in 1992 to 21.6 percent in 2016 (NPC

2016a), certain areas of the

country are food insecure and suffer

food deficits. The affordability,

consumption and absorption of local

food is a problem in the Tarai,

Mid-West and Far Western regions.

mic (MoH, New ERA and ICF 2017). This means they are poorly prepared for the rigours of motherhood, which often translates into them having low birth weight babies.

6) Harmful practices — Maternal and child care is still beset by too frequent pregnancies, inadequate awareness of health services, unse-cured deliveries, inappropriate care of babies, and the lack of qualified health workers’ in ru-ral areas.

The other factors that compromise health and nutrition are as follows:7) Food security — Although the poverty lev-

el reduced from 49 percent in 1992 to 21.6 percent in 2016 (NPC 2016a), certain areas of the country continue to be food insecure and suffer food deficits. The affordability, con-sumption and absorption of local food is a problem in the Tarai, Mid-West and Far West-ern regions.

8) Early marriage — Teenage marriage is com-mon in Nepal with 48 percent of women aged 20-49 years having first married or been in a union before age 18 years (CBS 2015). This results in almost a quarter of mothers (16 per-cent) having a live birth before the age of eigh-

teen (CBS 2015). And maternal care practices are often poor with only 57 percent of women having received a health check following de-livery or a post-natal care visit within two days of delivery of their most recent live birth (CBS 2015).

9) Smoke — The 2016 NDHS found that 13 percent of women smoked while far more were exposed to domestic smoke pollution from the use of solid fuel for cooking inside homes (MoHP, New ERA and ICF 2012).

10) WASH — The lack of proper sanitation threatens the health of many people. About half the population still defecate in the open, 27.5 percent of households lack a specific place for hand washing (CBS 2015) and cow manure and dung is often carelessly managed, creating a polluting environment that spreads disease and parasites such as worms.

11) Traditional harmful practices — Tradi-tional practices that are harmful to health per-sist in certain areas and among certain caste groups. This includes adolescent girls and women not being allowed to consume milk, yoghurt or ghee during menstruation. Men-strual seclusion (chhaupadi) is still practised in the Mid-West and Far West. And inadequate

12


13

Nepal has seen impressive improvements in recent years on human development, infrastructure, transport networks, communication, social services, the expansion of cooperatives and self-initiated local development. These provide the foundation for many kinds of improvements including for improved nutrition.

menstrual hygiene is commonplace leading to infection and disease, sometimes triggering anaemia, resulting in undernutrition.

12) Natural disasters — Nepal’s vulnerability to natural disasters was demonstrated by the impact of the 2015 earthquakes that displaced many people from their homes, destroyed crops and disrupted healthy nutrition in thou-sands of households.

13) Education and infrastructure — Large im-provements in education and infrastructure have ameliorated major causes of malnutri-tion. The literacy rate among young women (15-24 years) now stands at 88.6 percent meaning they are more educated and aware about health and nutrition issues. The large improvements in Nepal’s road network makes it easier to transport foodstuffs around the country.

1.8 Analysis of Other Issues that Affect NutritionNepal’s current situation provides many oppor-tunities and significant challenges to improve nu-trition as a key driver of socioeconomic growth. Nepal has seen impressive improvements in re-cent years on human development, infrastruc-ture, transport networks, communication, social services, the expansion of cooperatives and self-initiated local development. These provide the foundation for many kinds of improvements including for improved nutrition. The major development challenges faced by Nepal include the lack of jobs, reliance on remittance incomes, deep-rooted discrimination, the underdevelop-ment of agriculture and unplanned urban growth.

1.8.1 ECONOMIC

In 2015, Nepal adopted the ambitious aims of graduating from least developed country status (LDC) to developing country status by 2022, and middle-income country status by 2030 (NPC 2015). To become a developing country Nepal needs to achieve a certain human asset index score. This score is calculated based on (i) per-centage of population undernourished; (ii) mor-tality rate of children under 5-years of age; (iii) gross secondary school enrolment ratio; and (iv) adult literacy rate. These are all affected by nu-tritional status meaning that good nutrition is a precondition for Nepal to graduate to developing

and middle income status. This ambition is a spur for improved nutrition.

The third Nepal Living Standards Survey (NLSS 3) reported a shrinking income gap between the poor and the rich (CBS 2011).

Although the annual income of the poorest 20 percent of the population had increased consider-ably, poverty persists among a fifth of the popula-tion. The rate of joblessness remains high, par-ticularly among women and young people, with youth unemployment being the major cause of the high rate of migration of young people from rural to urban areas and to work abroad. In 2011, 55 percent of households were receiving remit-tance incomes with an average of $773 per year (CBS 2011). And the trend has increased with remittances accounting for 29.2 percent of gross domestic product in 2014/15.

NLSS 3 found that agricultural development was neglected with the percentage of irrigated land remaining stagnant at 54 percent compared to NLSS 2 in 2003/04 while the percentage of farmers holding less than 0.5 hectares of land had increased.

1.8.2 SOCIAL

NLSS-3 found that people’s access to basic fa-cilities had improved. It found that 95 percent of households could reach a primary school and 74 percent a health centre within 30 minutes’ travel. It also reported improved access to banking, mar-ket centres, paved roads and safe drinking water. The 2016 NDHS found that the use of health services had increased:• The proportion of married women (15-49

years) using any modern method of contra-ception increased from 48 percent in 2011 to 53 percent in 2016.

• The proportion of pregnant women receiv-ing at least one antenatal check-up by skilled health personnel increased from 58 percent in 2011 to 84 percent in 2016 with 69 percent of women having received the recommended four antenatal check-ups.

• The percentage of women delivering their ba-bies in a health facility increased from 36 per-cent in 2011 to 58 percent in 2016 (MoHP, New ERA and ICF 2016).


14

Job creation and other development efforts are hindered by persistent discriminatory socio-cul-tural practices that cause the social and economic exclusion of women and people from marginal-ized groups. The development-related results of gender discrimination and social exclusion vary between Nepal’s urban and rural areas and be-tween its regions/provinces. For example, the Mid and Far-western regions ranked the lowest on the Gender Empowerment Measure and the Gen-der-related Development Index (GDI) (UNDP 2015). It is likely that deep-rooted exclusionary practices will remain in the near future.

1.8.3 POLITICAL

Nepal is instituting a federal system of gover-nance under its 2015 constitution with a three-tiered structure that devolves executive and legis-lative powers to provincial and local governments (metropolitan cities, sub-metropolitan cities, ur-ban municipalities and rural municipalities). This involves restructuring the civil service and laws to protect and empower women and other tradi-tionally marginalized people. This system of de-volved governance provides many opportunities for improving the health and nutritional status of Nepal’s people.

1.8.4 DEMOGRAPHY

Nepal has a young population. It is estimated that 44 percent of its 28.4 million people are under 19-years-old. Given current trends, Ne-pal should be able to benefit from its youth-based demographic dividend until at least 2050 (UNCT Nepal 2017). The rapid demographic changes are due to declining birth and death rates and improved life expectancy. Nepal needs to prepare itself for these changes and invest in today’s children so they become more productive on entering the workforce. There is a finite win-dow of opportunity until the proportion of the working-age population starts to decrease. Dur-ing this time, the proportion of working-age peo-ple is high compared to dependent young and old people, which provides favourable conditions for socioeconomic development. This highlights the urgency of investing in children to ensure they are more productive when they enter the work-force. At the same time investments need making to reduce malnutrition and develop human capi-tal focusing on children under-5 and adolescents.

Eighteen percent of Nepal’s population live in urban and peri-urban areas with an estimated ur-ban growth rate of 3 percent per year (in 2014)

Nepal is instituting a federal system

of governance under its 2015

constitution with a three-

tiered structure that devolves

executive and legislative powers to provincial and

local governments.


15

2 Achham, Baitadi, Bajhang, Bajura, Bara, Bardiya, Dadeldhura, Dailekh, Dhanusha, Dolpa, Doti, Humla, Jajarkot, Jumla, Kalikot, Kapilvastu, Khotang, Mahottari, Mugu, Nawalparasi, Panchthar, Parsa, Rautahat, Rolpa, Rukum, Saptari, Sarlahi and Udayapur

(Bakrania 2015). However, much of this popula-tion growth is amongst the urban poor, who live in unsanitary, overcrowded and unhealthy condi-tions that especially put mothers and children at risk (HEART 2013).

1.9 Achievements of Multi-Sector Nutrition Plan (2013–17)MSNP (2013-2017) was implemented from 2014 in 28 districts.2 It was also partially im-plemented in other districts with the support of non-government organisations. Its main aim was to reduce chronic malnutrition (stunting) by achieving the following three outcomes that broadly match the nutrition specific, nutrition sensitive and enabling environment outcomes of MSNP-II (see Section 2.1):1. Improved maternal, infant and young child

feeding.2. Increased maternal, infant and young child

micro-nutrient status.

3. Improved management of malnutrition in children.

A) LONG-TERM IMPACT

During the MSNP (2013–17) period chronic malnutrition (stunting) reduced by 12 percent from 40.5 percent in 2011 to 35.8 percent in 2016, which is a great achievement. This achieve-ment was greatly facilitated by the Fourteenth Plan prioritising improved nutrition (NPC 2016b) with a tripling of the budget for nutrition programmes from NPR 5,220 million spent in FY 2013/14 to NPR 19,260 million allocated in 2017/18.

However, much remains to be done as 27 per-cent of under 5-year-olds remain moderately or severely underweight and 5.4 percent severely un-derweight. Ten percent are moderately or severely wasted or too thin for their height and 2 percent are severely wasted (MoH, New ERA and ICF 2017).

During the MSNP (2013–17) period chronic malnutrition (stunting) reduced by 12% from 40.5% in 2011 to 35.8% in 2016.


16

TABLE 1.2: STATUS OF MSNP (2013–17) NUTRITION SPECIFIC INDICATORS

IndicatorBaseline

Progress Status

MSNP target

2012 2016 2017

Outcome 1: Improved maternal, infant and young child feeding

1.1. % of children born in last 24 months who were put to the breast within one hour of birth 44.5 55 56

1.2. % of infants 0–5 months of age who received only breast milk during the previous day 70 66 88

1.3. % of infants registered for growth monitoring who reached 6 months in the last month who were exclusively breastfed for the first 6 months NA 28.5 36

1.4. % of infants registered for growth monitoring who reached 6 months in the last month who were timely initiated complementary feeding at 6 months of age NA 27.5 34

1.5. % of infants 6–8 months of age surveyed who received solid, semi-solid or soft foods in the previous day 70 73.5 88

1.6. % of children 6-23 months of age who were receiving a minimum acceptable diet (apart from breast milk) 24 36 42

Outcome 2: Increased maternal, infant and young child micro-nutrient status

2.1. % of children under 5-69 months with anaemia 46 52.7 69

2.2. % of women aged 15-49 years with anaemia 35 40.8 53

2.3. % of women who delivered in previous 6 months who reported consuming all 180 iron folic acid tablets during pregnancy 49.8 42 75

2.4. % of women surveyed who delivered in previous 6 months who reported consuming anthelminthics during pregnancy 55.1 70 83

2.5. % of women who delivered in previous 6 months who reported consuming all 45 tablets of iron folic acid postpartum 55.6 45 83

2.6. No. of students in grades 1-10 in private and public schools who received deworming tablets in previous six months (1,000s) 1,919 1,636 2,581

2.7. % of households where adequately iodized (>15ppm) salt was present 80 95 >95

2.8. % of children aged 6-23 months surveyed who consumed multiple micronutrient powder (MNP) in previous 7 days NA 78.8 80

2.9. % of children under-5 who had diarrhoea in two weeks preceding the survey 14 8 7

2.10. % of children under-5 who had symptoms of acute respiratory infections in two weeks preceding the survey 5 6.7 3

2.11. % of children aged 6-59 months who received vitamin A supplements in previous six months 90.4 90.3 >95

2.12. % of children aged 12-59 months who received antihelminthics in previous six months 83.7 79 >95

2.13. % of women reporting receiving vitamin A supplementation within 6 weeks following a live birth in previous three years 40.3 49.1 60

Outcome 3: Improved management of malnutrition in children

3.1. % of cases of severe acute malnutrition discharged who recovered 89 84 >75

3.2. % of cases of severe acute malnutrition discharged who defaulted 4.8 9 <15

3.3. % of cases of severe acute malnutrition discharged who died 1.3 0 <10

3.4 % of children aged 0-23 months underweight among those registered for growth monitoring 3 3.3 12

3.5. No. of children under-5 with severe acute malnutrition registered 6,646 11,517 8,308

Source: MoH, New ERA and ICF 2017; DoHS 2016

Note: All Outcome 1 and Outcome 2.1 to 2.5 targets were based on the WHA targets (2012–2025). Since 2017 is about midway to 2025, it was assumed that the target for 2017 would be half the WHA target for most of the indicators. The outcome 3 targets were based on the minimum standard in humanitar-ian response (SPHERE Standard).


17

Most programmes implemented under MSNP (2013–17) addressed the causes of malnutrition and contributed to improving the nutritional status of all Nepal’s women and children.

B) PROGRESS AGAINST NUTRITION SPECIFIC

OUTCOME

Although good progress was made against many of the MSNP (2013–17) targets, only the follow-ing five had been achieved or almost achieved by 2016: immediate breastfeeding (target 1.1), the presence of adequately iodized salt (2.7), the con-sumption of MNP (2.8), children who suffered diarrhoea (2.9) and deaths among discharged se-vere acute malnutrition cases (3.3) (Table 1.2).

There has been progress on mitigating micro-nutrient deficiencies (vitamin A, iron and iodine) of essential dietary components (USAID nd), al-though a below average proportion of households use iodized salts, vitamin A supplementation and iron supplementation in the hills and mountain regions of the Mid-west (CBS 2015). In 2014, 81.5 percent of households nationwide were us-ing adequately iodized salt (15 parts per million), which is less than the targeted 90 percent (CBS 2015).

Maternal care has improved with increased access to antenatal care with 6% of pregnant women having at least one session with a skilled health worker and 59.5% at least four sessions by any provider (MoH, New ERA and ICF 2017). In 2014, 58 percent of mothers had a post-natal health check-up (CBS 2015).

Two major concerns are the management of di-arrhoea and anaemia in children, with the rate of anaemia among 15-59 month olds increasing between 2011 and 2016 (MoH, New ERA and ICF 2017). The recently conducted Nepal Mi-cronutrient Survey hopes to identify the cause of this. Also, see Figure 1.5 for progress of nutrition-sensitive interventions.

C) PROGRESS AGAINST NUTRITION SENSI-

TIVE OUTCOME

Most programmes implemented under MSNP (2013–17) addressed the causes of malnutrition and contributed to improving the nutritional sta-tus of all Nepal’s women and children. Among the achievements, the 2016 NDHS found that:• 72.5 percentage of households had specific

places for hand washing where water and soap or another cleansing agent was present

• 53 percent of married women of 15-49 years were using family planning methods.

The agriculture sector has added nutrition indi-cators into its management information system (NEKSAP), which further strengthen monitor-ing and evaluation. And with support from UNI-CEF, bottom-up planning has been started in both nutrition specific and nutrition sensitive ar-eas. Also, See Figure 1.5 for progress of nutrition-sensitive interventions.

D) PROGRESS AGAINST ENABLING ENVIRON-

MENT OUTCOME

MSNP (2013–17) activities strengthened the enabling environment for nutrition. An MSNP institutional mechanism is now in place with the lead role taken by the National Planning Com-mission (NPC). A High-Level Nutrition and Food Security Steering Committee and a Na-tional Nutrition and Food Security Coordination Committee were formed in 2011. District level nutrition and food security steering committees were formed in most districts over the course of MSNP. External development partners are sup-porting the National Nutrition and Food Securi-ty Secretariat (NNFSS), which helps NPC man-age nutrition-related issues.

The sectoral ministries responsible for health; ag-riculture; livestock; water and sanitation; educa-tion; women, children and social welfare; and lo-cal governance implemented MSNP (2013–17). Three technical working groups were formed in 2011/12 to support i) advocacy and communi-cation, ii) capacity development, and iii) moni-toring, evaluation and information management. The six sectoral ministries have all included nutri-tion and food security in their working policies. An M&E framework was used to measure the progress of MSNP.

The programmes under MSNP (2013–17) were implemented in the 28 districts through the Ministry of Health, MoFALD and the other sec-toral ministries in coordination with NPC. The government allocated budget to the district level for implementing the plan, which was reflected in district development committees’ annual pro-grammes. These funds were spent by sectoral line agencies according to the decisions of district nu-trition and food security steering committees.

A range of development partners provided tech-nical and financial support to the government to formulate and implement MSNP (2013–17).


18

From 2013, the partners implemented MSNP activities through their projects and programmes. Some worked in the same districts and deciding in which areas they would work. The govern-ment and its development partners implemented MSNP in a total of 60 districts. A summary of MSNP (2013–17) programmes and projects sup-ported by donors is given in Annex 2.

1.10 Analysis of Estimated Costs and Expenditure of Multi-Sector Nutrition Plan (2013–17)The amount allocated for nutrition by the gov-ernment and its development partners almost tripled over the course of MSNP (2013–17) from NPR 7,210 million ($69 million) in 2013 to NPR 19,241 million ($184.9 million) in 2017. The proportion provided by the government and its development partners varied from year to year with the government overall contributing 46 per-cent and development partners 54 percent.

GoN Development partners Total 2013

Budget (NPR million) 3,408 3,802 7,210

Proportion 47% 53% 100%

2014



2015



2016


Proportion 54% 46% 100

2017


Proportion 72% 28% 100

Total (2013–2017)



TABLE 1.3: BUDGET ALLOCATED TO NUTRITION BY GOVERNMENT OF NEPAL AND DEVELOPMENT PARTNERS IN MSNP (2013–17) PERIOD

Source: NPC, Annual Development Programme, Part 1:

Including on and off-budget figures two-thirds of MSNP (2013–17) expenditure came from development partner support. These local bud-gets were planned by the district nutrition and food security steering committees and were spent through sectoral line agencies to reach the various target groups.

1.11 Key Problems and ChallengesThe following were the main issues that hindered the implementation of MSNP (2013–17): 1. Disparities — The large disparities in access

to adequate nutrition and good quality health care between people living in urban and rural areas and between the wealthiest and poorest people make it difficult for poor rural dwellers to improve their nutritional status.

2. Quality of services — Poor quality health care sometimes impedes the delivery of health services to the populations who are most vul-nerable to undernutrition.

The amount allocated for

nutrition by the government and its development partners almost tripled over the

course of MSNP (2013–17) from

NPR 7,210 million ($69 million)

in 2013 to NPR 19,241 million

($184.9 million) in 2017.


19

3. Traditional practices — Erroneous food and social practices in more conservative commu-nities impede the correct intake of nutrients for mothers and children and their care.

4. Inadequate data — Inadequate data on the nutritional status of women and children af-fected the adoption of evidence based plan-ning.

5. Budgets — The insufficient and late release of budgets led to inadequate health services and made it difficult to run local nutrition and awareness programmes. This was a cause of the limited progress on increasing awareness and protection for mothers and their children, and ending child marriage and harmful food practices during menstruation and pregnancy.

6. Assessment of financial investments — It was difficult to assess the financial invest-ments by the different sectors as their budget and programme codes differed.

7. Weak institutional structure — Inadequate

personnel, institutional and individual capac-ity gaps, and rapid staff turnover hindered the implementation of MSNP (2013–17). Existing institutional structures and human resources were not fully mobilised to improve nutrition and food security and there was, in some cases, inadequate coordination between higher and lower authorities. Also, sectoral ministries gave a low priority to nutrition.

1.12 Lessons Learned Implementing MSNP (2013–17)• More convergence and complementarity are

needed while implementing MSNP interven-tions.

• Improved information management and the sharing of information is needed for the suc-cess of the multi-sectoral nutrition approach.

• The MSNP key sectors need to improve own-ership, the assignment of roles and respon-sibilities and the commitment of time and

More convergence and complementarity are needed while implementing MSNP interventions.

19


20

resources to nutrition as competing priorities and workloads delayed MSNP (2013–17) in-terventions.

• There needs to be more technical assistance and capacity building support to all MSNP sectors at community and institutional levels.

1.13 The Rationale for MSNP-IIThis introductory chapter concludes with a sum-mary of the main reasons for producing the fol-low-on MSNP-II:• Impact of stunting — In Nepal, one out of

three children still suffer from stunting. Stunt-ed children under-5-years-old are less likely to survive their fifth birthdays, and those who survive are unlikely to achieve adequate physi-cal growth and mental and cognitive develop-ment. The stunting process occurs from con-ception to two years of age and is irreversible.

• Micronutrient deficiency — Many Nepalis, and especially the most vulnerable and wom-

en and children, are affected by micronutrient deficiencies. This increases the risk of mortali-ty in infancy and childhood, impairs cognitive functions and hinders national socioeconomic development.

• Build on MSNP (2013–17) — Most of the proposed MSNP-II activities will build on the achievements of MSNP (2013–17)

• Graduation from LDC status — The gradu-ation of Nepal from LDC status by 2022 is contingent on improving nutrition. All the criteria needed to graduate (income, human assets index and economy vulnerability index) demand nutrition programmes for children and women in one way or another.

• Reaping the demographic dividend — The demographic window of opportunity for Ne-pal began around 1992 and will start to close around 2047. During this time the number and proportion of working-age population will be high providing very favourable condi-

The graduation of Nepal from LDC status by

2022 is contingent on improving

nutrition.

20


21

June 2016-May 2017 :Desk review of imple-mentation of MSNP-I (2013-2017)

9 September 2016 :Malnutrition causality analysis workshop

31 August 2016 :Nutrition deprivation analysis workshop

21-22 February 2017 : MSNP-II theory of change workshop

April-May 2017 :Draft MSNP-II shared for feedback and inputs

August 2017 :Costing of MSNP-II

19 November 2017 :MSNP-II approved by Cabinet

30 March 2017 :MSNP-II results framework work-shop

May-September 2017 : MSNP-I review by NPC

October 2017 :Endorsement of MSNP-II by NPC (Coordination Comittee, Steering Comit-tee and NPC Board)

FIGURE 1.6: TIMELINE OF PREPARATION OF MSNP-II

tions for socioeconomic development. To reap this dividend the government must invest in early childhood development, health, nutri-tion, education, water, sanitation and hygiene, child protection, adolescents’ development and social protection.

• Global development imperatives — Malnu-trition is a major issue to be addressed under the SDGs (2016-2030). These new develop-ment goals provide a massive opportunity for the national and international community to upscale nutrition initiatives and secure good nutrition for all. And the Lancet causality framework for maternal and child undernutri-tion (The Lancet 2013) and the Global Scal-ing Up Nutrition (SUN) Movement remain key driving forces for improvements worl-wide.

Set against this strong rationale, in 2016/17 the National Planning Commission (NPC) formu-lated the second MSNP (MSNP-II) with support from its development partners to outline a set of core values that reflect the country’s social and economic priorities. The plan is based on consul-tations with a wide range of public and private stakeholders and on the analysis of nutrition de-privations, causality, disparities, inequities, bot-tlenecks, a desk review, recommendations from the Lancet 2013 series on maternal and child nu-trition (The Lancet 2013) and other global and national priorities. Figure 1.6 shows the process undertaken to prepare MSNP-II beginning in June 2016 and concluding with the plan’s ap-proval by the Cabinet in November 2017.

Malnutrition is a major issue to be addressed under the SDGs (2016-2030).


2222


23

MULTI-SECTOR NUTRITION PLAN-II (2018–2022)

Chapter 2

23


2424


25

2.1 VisionTo reduce malnutrition so that it no longer im-pedes people’s potential and performance towards enhanced human capital and overall socioeco-nomic development.

2.2 GoalImproved maternal, adolescent and child nutri-tion by scaling up essential nutrition-specific and sensitive interventions and creating an enabling environment for nutrition.

2.3 ObjectivesThe three objectives (that are directly related to MSNP-II’s three outcomes):• To increase the number of service delivery in-

stitutions to improve access to and the use of nutrition-specific services.

• To increase access to and the use of nutrition sensitive services including improving health-related behaviour.

• To improve policies, plans and multi-sectoral coordination at federal, provincial and local government levels to create an enabling envi-ronment to improve nutrition.

2.4 StrategiesMSNP-II will take the following strategies:1. Scale up multisector nutrition programmes

across Nepal to ensure qualitative, equitable and gender-informed nutrition services for all.

2. Develop positive nutrition behaviour by run-ning advocacy, communication and participa-tion campaigns and through public engage-ment programmes.

3. Foster cooperation, partnership, coordination and the sharing of lessons learned and best practices on improving nutrition.

4. Promote and use innovative technologies and initiatives for improving nutrition.

5. Internalise and implement nutrition interven-

tions in federal, provincial and local govern-ment policies and plans.

6. Strengthen monitoring, evaluation, study and research for evidence-based planning, decision making and implementation.

2.5 Policy-level Principles and Approaches• Prevailing government policies and per-

spective plans — MSNP-II will be the basis for the implementation of the parts of the Fourteenth Plan (2016/17–2018/19) (NPC 2016b) on improving nutrition. MSNP-II has been designed and will be implemented in compliance with the Constitution of Nepal, 2015 (GoN 2015) and with related regula-tions.

• Inclusiveness and gender equity — Inter-ventions under MSNP-II will promote social inclusion and gender equity especially in the hills and mountains of the Mid-West and Far West and in the central Tarai. MSNP-II will support the socially inclusive, gender sensitive and child-friendly continuum of care.

• Affirmative action — Affirmative action poli-cies will be introduced in favour of poor peo-ple, women and disadvantaged communities to maximise their participation in, and ben-efits from, MSNP-II’s interventions. The lead-ership and management skills of women and disadvantaged communities (Dalit, Janajatis [ethnic groups] and others) will be improved. The plan will seek to ensure that their voices are heard in local decision-making processes, including by mainstreaming and institution-alizing their participation in local institutions.

• Flexible and process-oriented approach — MSNP-II will translate the government’s commitments on improving nutrition, state restructuring and the engagement of line agencies with communities to improve the de-livery of public goods and services. The sup-

2. Multi-Sector Nutrition Plan-ii (2018–2022)

Chapter 2

Improved maternal, adolescent and child nutrition by scaling up essential nutrition-specific and sensitive interventions and creating an enabling environment for nutrition.


26

port provided to line agencies and local gov-ernments will be flexible and process-oriented and will include innovative and context-spe-cific approaches for responsive, inclusive, and accountable governance through participatory development. Procedures for working with communities and targeting the poorest and most disadvantaged people will be rationalised and harmonised.

• Transparency and accountability — MSNP-II will be transparent in its operations, budgets, decision making, communications, coordination among line agencies and non-state agencies and in reaching remote areas. It will delineate the roles and responsibilities of all actors and take a systemic approach to increase accountability at all levels.

• Information and communication — Behav-iour change communication will be organised to raise civic awareness about chronic malnutri-tion and actions needed to improve maternal and child nutrition, focussing on reaching the most marginalized, poorest segments and tak-

ing into account gender related factors. Civil society organisations, parliamentarians, other elected representatives, and decision makers will be mobilised with advocacy activities.

2.6 Theory of ChangeTheories of change explain how activities are understood to produce results that contribute to achieving intended impacts. Using this tool sharpens the focus on what needs to be addressed and the changes needed at government, commu-nity, family, and individual levels to reduce mal-nutrition.

MSNP-II’s theory of change (Figure 2.1) helps the different sectors to see their roles in imple-menting MSNP-II. It shows the desired impact of MSNP-II to address the main nutrition-relat-ed problems, which range from stunting of under 5-year olds to childhood wasting. Below are the three outcomes of MSNP-II and the intervention areas (outputs) that the five sectors, plus NPC and local governance, need to carry out under to achieve the desired impact.

MSNP-II’s theory of change helps the

different sectors to see their roles in implementing

MSNP-II.

26


27

FIG

URE

2.1

: M

SNP-

II’S

TH

EORY

OF

CH

AN

GE

Des

ired

impa

ct:

Out

com

es:

Inte

rven

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s

Gov

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nce

Ap

pro

ach

Impr

ove

mat

erna

l, ad

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cent

and

chi

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tion

, so

that

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uman

cap

ital

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nom

ic d

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al

1. (N

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spec

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acc

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ion-

spec

ific

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ices

2. (N

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sens

itive

) Im

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bits

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tices

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Enab

ling

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Impr

oved

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ans

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ti-se

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al c

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dera

l, pr

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l gov

ernm

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hanc

e th

e nu

triti

on st

atus

of a

ll po

pula

tion

grou

ps

Impa

ct In

dica

tors

(WH

A G

loba

l Nut

ritio

n Ta

rget

s, 20

25):

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ting

Anae

mia

Low

birt

h w

eigh

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rwei

ght

Brea

stfee

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ting

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e nu

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on in

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pol

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pla

ns w

ith a

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ity a

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cial

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egra

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t.5.

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by st

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M&

E sy

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Fede

ral A

ffair

s and

Loc

al D

evel

opm

ent

1. E

nsur

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e in

clus

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of M

SNP-

II in

fede

ral,

prov

inci

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cal g

over

nmen

t pla

ns

2.

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ngth

en M

SNP

gove

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r exp

licit

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et in

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on n

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at fe

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and

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4. A

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cal i

mpl

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ce M

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& im

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and

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, inc

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early

ch

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n 36

-59

mon

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iver

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od (c

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mes

and

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and

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geta

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ove

the

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labi

lity

of, p

hysic

al

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omic

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gs

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ck

Dev

elop

men

tE

duca

tion


2828


29

GO

AL:

IM

PR

OV

ED

MAT

ER

NA

L, A

DO

LESC

EN

T A

ND

CH

ILD

NU

TR

ITIO

N B

Y SC

ALI

NG

UP

ESS

EN

TIA

L N

UT

RIT

ION

-SPE

CIF

IC

AN

D S

EN

SIT

IVE

INT

ER

VE

NT

ION

S A

ND

CR

EAT

ING

AN

EN

AB

LIN

G E

NV

IRO

NM

EN

T F

OR

NU

TR

ITIO

N

Out

com

e 1:

Impr

oved

acc

ess t

o an

d eq

uita

ble

use

of n

utrit

ion-

spec

ific

Out

put 1

.1 E

nhan

ced

nutr

ition

stat

us o

f W

RA

incl

udin

g ad

oles

cent

s

Out

put 1

.2:

Impr

oved

infa

nt a

nd

youn

g ch

ild n

utrit

ion

and

care

pra

ctic

es

Out

put 1

.4:

Impr

oved

man

agem

ent

of se

vere

and

mod

erat

e ac

ute

mal

nutr

ition

Out

put 1

.5:

Enha

nced

pre

pare

dnes

s fo

r nut

ritio

n in

emer

genc

y. re

spon

ses

Out

put 1

.6:

Cap

acity

bui

lt of

nutr

ition

spec

ific

sect

ors

Out

put 1

.3: I

mpr

oved

MIY

C m

icro

nutr

ient

sta

tus

1.1.

1 O

rgan

ize a

nd

impl

emen

t ful

ly-

nour

ished

vill

ages

/w

ards

incl

udin

g G

1000

D c

omm

u-ni

catio

n ca

mpa

ign

1.1.

2 Re

vita

lize

Scho

ol

Hea

lth a

nd N

utri-

tion

Prog

ram

me

in-

clud

ing

prom

otio

n of

hea

lthy

diet

ary

habi

ts an

d ph

ysic

al

activ

ities

1.1.

3 R

aise

aw

aren

ess a

nd

serv

ices

for h

ealth

y tim

ing

and

spac

ing

of p

regn

ancy

1.1.

4 C

ondu

ct b

ar-

rier a

naly

sis fo

r in

crea

sed

ANC

se

rvic

e ut

iliza

tion

1.1.

5 In

tegr

ate

and

expa

nd a

dole

scen

t-fri

endl

y he

alth

and

nu

triti

on se

rvic

es

1.2.

1 C

ondu

ct M

IYC

N c

oun-

selli

ng a

t all

heal

th se

ctor

pl

atfo

rms v

iz. h

ealth

m

othe

r’s g

roup

mee

tings

, im

mun

izatio

n, A

NC

, PN

C, G

MP,

PHC

-ORC

, IM

NC

I & O

PD se

rvic

es1.

2.2

Con

duct

regu

lar g

row

th

mon

itorin

g co

unse

lling

at

PHC

-ORC

s and

hea

lth

faci

litie

s1.

2.3

Diss

emin

ate

IEC

& B

CC

m

ater

ials

thro

ugh

heal

th

faci

litie

s, &

FC

HV

s to

com

mun

ities

& h

ouse

-ho

lds r

egul

arly

1.2.

4 C

ondu

ct fo

od p

repa

ratio

n &

coo

king

dem

onstr

a-tio

ns to

pre

pare

loca

l nu

triti

ous f

oods

(e.g

. nu

triti

ous fl

our/

porr

idge

(li

to),

jaul

o/kh

icha

di u

s-in

g lo

cal f

oods

tuffs

1.2.

5 En

gage

med

ia fo

r do

cum

enta

tion

and

dis-

sem

inat

ion

of M

IYC

N

prog

ram

me

1.2.

6 R

aise

aw

aren

ess o

n nu

tri-

tion

incl

udin

g es

sent

ial

new

born

car

e

1.3.

1 M

aint

ain

and

susta

in ro

utin

e di

strib

utio

n of

V

itam

in A

cap

sule

and

dew

orm

ing

tabl

ets t

o ch

ildre

n un

der 5

yea

rs1.

3.2

Incr

ease

cov

erag

e an

d co

mpl

ianc

e of

iron

folic

ac

id a

nd d

ewor

min

g am

ong

preg

nanc

y an

d po

st-pa

rtum

wom

en1.

3.3

Scal

e-up

hom

e fo

od fo

rtifi

catio

n w

ith M

NP

in ta

rget

ed a

rea

1.3.

4 R

aise

aw

aren

ess t

o pr

omot

e ho

useh

old

use

of

two-

child

-logo

iodi

zed

salt

1.3.

5 R

aise

aw

aren

ess t

o pr

omot

e co

nsum

ptio

n of

ro

ller-

mill

pro

duce

d fo

rtifi

ed fl

our a

nd ri

ce1.

3.6

Initi

ate

rice

fort

ifica

tion

in g

over

nmen

t (N

FC) a

nd se

lect

ed la

rge

rice

mill

s.1.

3.7

Con

duct

rese

arch

to im

prov

e co

mpl

ianc

e of

IF

A su

pple

men

tatio

n1.

3.8

Con

duct

bar

rier a

naly

sis o

n lo

w c

over

age/

com

plia

nce

of M

NP

1.3.

9 Pr

ocur

e an

d su

pply

nut

ritio

n co

mm

oditi

es fo

r re

gula

r and

em

erge

ncy

prog

ram

mes

(Vita

min

A,

IFA,

dew

orm

ing

tabl

ets,

MN

P, RU

TF,

th

erap

eutic

milk

, ReS

oMal

) 1.

3.10

Sca

le-u

p fo

rtifi

ed su

per c

erea

l flou

r dist

ri-bu

tion

in d

istric

ts w

ith h

igh

prev

alen

ce o

f ac

ute

mal

nutr

ition

to p

regn

ant a

nd la

ctat

ing

wom

en a

nd 6

-23

mon

ths c

hild

ren

unde

r M

CH

N p

rogr

amm

e

1.4.

1 Ex

pand

and

es

tabl

ish O

TC

an

d IT

C c

entre

s fo

r man

agem

ent

of se

vere

acu

te

mal

nutr

ition

in

child

ren

unde

r 5

1.4.

2 Sc

ale-

up N

RH

in

50+

bed

ho

spita

ls1.

4.3

Con

duct

per

i-od

ic n

utrit

ion

asse

ssm

ents

and

coun

selli

ng a

t co

mm

unity

leve

ls1.

4.4

Con

duct

bar

-rie

r ana

lysis

on

serv

ices

rela

ted

to

SAM

man

age-

men

t1.

4.5

Scal

e-up

and

str

engt

hen

IMN

-C

I pro

gram

me

1.4.

6 Es

tabl

ish a

nd

stren

gthe

n nu

tri-

tion

info

rmat

ion

and

surv

eilla

nce

syste

m in

nor

mal

an

d hu

man

itar-

ian

situa

tions

1.5.

1 Es

tabl

ish

loca

l lev

el

nutr

ition

cl

uste

rs a

nd

cond

uct

quar

terly

co

ordi

natio

n m

eetin

g 1.

5.2

Upd

ate

an

d de

velo

p nu

triti

on in

em

erge

ncy

prep

ared

-ne

ss fo

r re

spon

se a

nd

cont

inge

ncy

plan

ning

at

loca

l lev

els.

1.6.

1 Re

fresh

er

trai

ning

for

HW

s &

FCH

Vs a

t all

leve

l on

MI-

YCN

pac

kage

1.6.

2 O

rgan

ize

basic

trai

ning

on

MIY

CN

pa

ckag

e to

ne

wly

recr

uit-

ed n

utrit

ion

supe

rviso

rs

and

nutr

ition

offi

cers

1.6.

3 O

rgan

ize

nutr

ition

ch

ampi

on

lead

ersh

ip

deve

lopm

ent

even

ts1.

6.4

Con

duct

ro

utin

e da

ta q

ualit

y as

sess

men

ts (R

DQ

A) u

s-in

g nu

triti

on

prog

ram

me

rela

ted

HM

IS

tool

s

FIG

URE

2.2

: M

SNP-

II R

ESU

LTS

STRU

CTU

RE

— O

UTC

OM

E 1 O

N N

UTR

ITIO

N S

PEC

IFIC

SER

VIC

ES


30

Out

com

e 2:

Impr

oved

acc

ess t

o an

d th

e eq

uita

ble

use

of n

utrit

ion-

sens

itive

serv

ices

and

impr

oved

hea

lthy

habi

ts an

d pr

actic

es

Out

put 2

.1:

Incr

ease

d av

aila

bilit

y an

d co

nsum

p -tio

n of

safe

an

d nu

triti

ous

food

s

Out

put 2

.2:

Incr

ease

d ph

ysic

al a

nd

econ

omic

ac-

cess

to d

iver

se

type

s of f

ood

Out

put 2

.3:

Incr

ease

d ac

cess

to sa

fe

drin

king

w

ater

Out

put 2

.4:

Incr

ease

d ac

cess

to sa

fe

and

susta

in-

able

sani

tatio

n se

rvic

es

Out

put 2

.5:

Impr

oved

kno

wle

dge

of ch

ildre

n an

d m

othe

rsan

d ca

reta

kers

of u

nder

5

child

ren

on h

ealth

an

d hy

gien

e

Out

put 2

.6: T

ar-

gete

d gr

oups

hav

e ac

cess

to re

sour

ces

and

oppo

rtun

ities

th

at m

ake

them

se

lf-re

liant

Out

put 2

.7: N

utri-

tion

com

pone

nt in

-co

rpor

ated

in w

omen

, ad

oles

cent

girl

s and

ch

ild d

evel

opm

ent

trai

ning

pac

kage

s

2.1.

1

Mak

e av

aila

ble

agric

ultu

re a

nd li

vesto

ck

inpu

ts (i.

e. se

eds,

fert

ilize

rs, b

reed

s) a

t ho

useh

old

and

com

mun

ity le

vels

2.1.

2

Prov

ide

tech

nica

l sup

port

(tra

inin

g,

dem

onstr

atio

n) to

pro

mot

e pr

oduc

tion

of

fruits

, veg

etab

les,

nutr

itiou

s roo

ts, c

erea

ls an

d pu

lses t

o in

crea

se c

onsu

mpt

ion

of

dive

rsifi

ed fo

ods i

n ho

useh

olds

2.1.

3

Incr

ease

pro

duct

ion

and

prom

ote

con-

sum

ptio

n of

fres

h fru

its a

nd g

reen

leaf

y ve

geta

bles

2.1.

4

Build

cap

acity

of l

ives

tock

farm

ers a

nd

entre

pren

eurs

to in

crea

se m

ilk, m

eat a

nd

egg

prod

uctio

n2.

1.5

Te

chni

cal s

uppo

rt fo

r mic

ro a

nd a

ltern

ativ

e sm

all i

rrig

atio

n to

pro

duce

div

ersifi

ed a

nd

mic

ronu

trie

nt ri

ch fo

ods

2.1.

6

Supp

ort f

ood

prod

ucin

g in

dustr

ies t

o ad

opt

good

man

ufac

turin

g pr

actic

es (G

MP)

and

re

late

d sy

stem

s2.

1.7

Tr

ain

agric

ultu

re a

nd li

vesto

ck e

xten

sion

office

rs a

nd st

aff o

n fo

od sa

fety

, foo

d pr

o-ce

ssin

g an

d nu

triti

on2.

1.8

Tr

ain

farm

ers o

n fo

od sa

fety

, foo

d pr

oces

s-in

g an

d nu

triti

on

2.1.

9

Stud

y an

d im

prov

e lo

cal f

ood

reci

pes

2.1.

10 U

pdat

e an

d di

ssem

inat

e fo

od c

ompo

sitio

n ta

bles

2.1.

11 D

issem

inat

e fo

od b

ased

die

tary

gui

delin

es

to lo

cal g

over

nmen

ts2.

1.12

Dev

elop

and

mul

tiply

BC

C m

ater

ials

incl

udin

g au

dio

visu

als o

n fo

od sa

fety

, foo

d pr

oces

sing

and

nutr

ition

2.2.

1 En

hanc

e ac

cess

and

ut

iliza

tion

of

anim

al so

urce

fo

ods

2.2.

2 Pr

omot

e an

d su

ppor

t pr

oduc

-tio

n an

d co

nsum

ptio

n of

fish

incl

ud-

ing

supp

ort

to e

stabl

ish

com

mun

ity

pond

s for

pr

oduc

tion

and

loca

l co

nsum

ptio

n

2.5.

1 C

onstr

uct,

esta

blish

and

pr

omot

e us

er fr

iend

ly

hand

was

hing

fa

cilit

ies i

n ho

useh

olds

an

d in

stitu

-tio

ns2.

5.2

Rai

se a

war

e-ne

ss o

n ha

nd

was

hing

at

criti

cal t

imes

in

com

mun

ities

, sc

hool

chi

ldre

n an

d he

alth

w

orke

rs.

2.5.

3 R

aise

aw

are-

ness

on

men

-str

ual h

ygie

ne

man

agem

ent

in c

omm

u-ni

ties a

nd

scho

ols.

2.5.

4 R

aise

aw

are-

ness

abo

ut

food

hyg

iene

in

com

mun

i-tie

s

2.3.

1 C

onstr

uct

and

repa

ir w

ater

supp

ly

sche

mes

in

com

mun

i-tie

s and

in

stitu

tions

th

roug

h w

ater

safe

ty

plan

s and

pr

ojec

ts2.

3.1

Prom

ote

alte

rna-

tive

and

inno

vativ

e te

chno

logi

es

for s

uppl

y w

ater

2.3.

3 Pr

omot

e ho

useh

old

wat

er

treat

men

t op

tions

2.6.

1 Su

ppor

t com

mun

ity

seed

ban

ks.

2.6.

2 Su

ppor

t wom

en a

nd

disa

dvan

tage

d gr

oups

to

pro

duce

and

con

-su

me

anim

al li

vesto

ck

prod

ucts.

2.6.

3 Pr

ovid

e sta

rt-u

p en

tre-

pren

eurs

hip

gran

ts to

w

omen

coo

pera

tives

fo

r soc

ial a

nd e

co-

nom

ic e

mpo

wer

men

t 2.

6.4

Prov

ide

start

-up

entre

pren

eurs

hip

gran

ts to

wom

en

grou

p m

embe

rs fo

r so

cial

and

eco

nom

ic

empo

wer

men

t.2.

6.5

Trai

ning

and

orie

nta-

tions

for i

ncom

e ge

n-er

atio

n an

d bu

sines

s pr

omot

ion

(veg

etab

le

& fr

uit p

rodu

ctio

n,

anim

al h

usba

ndry

, liv

esto

ck, t

ailo

ring

)2.

6.6

Link

the

distr

ibut

ion

of c

hild

pro

tect

ion

gran

ts to

nut

ritio

n in

al

l dist

ricts.

2.6.

7 In

clud

e nu

triti

on

as a

maj

or o

bjec

tive

of so

cial

pro

tect

ion

prog

ram

mes

2.4.

1 Sen

sitize

com

-m

uniti

es to

ra

ise a

war

enes

s fo

r con

struc

-tio

n, m

ain-

tena

nce

and

hygi

enic

use

of

impr

oved

ho

useh

old

toi-

lets

incl

udin

g sa

fe d

ispos

al o

f ch

ild fa

eces

2.4.

2 Sup

port

and

str

engt

hen

WAS

H

coor

dina

tion

com

mitt

ees

and

loca

l gov

-er

nmen

t to

ac-

cele

rate

OD

F ca

mpa

igns

.2.

4.3 S

uppo

rt

cons

truc

tion

and

man

age-

men

t of c

hild

, ge

nder

and

dif-

fere

ntly

abl

ed

frien

dly

toile

ts in

clud

ing

men

-str

ual h

ygie

ne

man

agem

ent

faci

litie

s at

insti

tutio

ns

2.7.

1 In

tegr

ate

nutr

ition

m

odul

es

in tr

aini

ng

pack

ages

in

clud

ing

GBV

pre

-ve

ntio

n

and

resp

onse

tr

aini

ng,

lead

ersh

ip,

com

mun

ity

prot

ectio

n,

busin

ess

deve

lop-

men

t and

lif

e sk

ills

trai

ning

.

FIG

URE

2.3

: M

SNP-

II R

ESU

LTS

STRU

CTU

RE

— O

UTC

OM

E 2 O

N N

UTR

ITIO

N S

ENSI

TIV

E SE

RV

ICES

GO

AL:

IM

PR

OV

ED

MAT

ER

NA

L, A

DO

LESC

EN

T A

ND

CH

ILD

NU

TR

ITIO

N B

Y SC

ALI

NG

UP

ESS

EN

TIA

L N

UT

RIT

ION

-SPE

CIF

IC

AN

D S

EN

SIT

IVE

INT

ER

VE

NT

ION

S A

ND

CR

EAT

ING

AN

EN

AB

LIN

G E

NV

IRO

NM

EN

T F

OR

NU

TR

ITIO

N

30


31

Out

put 2

:8: W

omen

, ch

ildre

n an

d ou

t-of

-sch

ool a

dole

scen

t gi

rls re

ache

d w

ith

heal

th a

nd n

utrit

ion

care

pra

ctic

es

Out

put 2

.10:

C

omm

uniti

es e

mpo

w-

ered

to p

reve

nt h

arm

ful

prac

tices

(men

strua

l se

clus

ion

[chh

aupa

di],

food

tabo

os)

Out

put 2

.12:

In

crea

sed

adol

esce

nt

girls

’ aw

aren

ess a

nd

impr

oved

beh

avio

ur

on n

utrit

ion

Out

put 2

.9:

Chi

ld c

are

hom

es c

ompl

y w

ith m

inim

um

stand

ards

of

nutr

ition

car

e

Out

put 2

.11:

En

hanc

ed

enro

lmen

t of

child

ren

in

basic

edu

catio

n

Out

put 2

.13:

En

hanc

ed a

cces

s to

hea

lth a

nd

repr

oduc

tive

heal

th se

rvic

es

2.8.

1 O

rgan

ize tr

aini

ngs f

or

mem

bers

of w

omen

co

oper

ativ

es a

nd c

hild

cl

ubs o

n nu

triti

on

sens

itive

serv

ices

.

2.8.

2 L

ife sk

ill d

evel

opm

ent

prog

ram

mes

for o

ut-

of-s

choo

l ado

lesc

ent

girls

2.9.

1 M

onito

r chi

ld

care

hom

es

com

plia

nce

with

min

imum

sta

ndar

ds o

f pr

ovisi

on o

f nu-

triti

on se

nsiti

ve

serv

ices

.

2.9.

2 P

rom

ote

nutr

i-tio

n se

nsiti

ve

serv

ices

at c

hild

ca

re h

omes

.

2.9.

3 In

tegr

ate

nutr

i-tio

n co

mpo

-ne

nt in

chi

ld

prot

ectio

n ca

se

man

agem

ent

trai

ning

and

se

rvic

es.

2.9.

4 D

epriv

ed

(Bip

anna

) inf

ant

nutr

ition

pro

-gr

amm

e (N

PR

50,0

00 g

rant

for

wom

en c

oope

ra-

tive)

2.10

.1 R

un b

ehav

-io

ural

cha

nge

com

mun

icat

ion

activ

ities

to

prev

ent h

arm

-fu

l tra

ditio

nal

prac

tices

.

2.10

.2 R

un c

ampa

igns

to

pre

vent

mar

-ria

ge u

ntil

age

20 (3

50 a

dole

s-ce

nts,

390

stake

-ho

lder

s, 84

0 dh

ami-j

hakr

i in

39 in

tera

ctio

n pr

ogra

mm

es.

2.10

.3 C

arry

out

pro

-gr

amm

es to

shift

so

cial

nor

ms

and

harm

ful

prac

tices

on

food

tabo

os

that

pre

vent

m

enstr

ual h

y-gi

ene,

ade

quat

e nu

triti

on fo

r ad

oles

cent

s, et

c.

2.11

.1 R

un w

elco

me

to

scho

ol c

ampa

igns

for

basic

edu

catio

n.2.

11.2

Pro

vide

ade

quat

e re

-so

urce

s to

all s

choo

ls to

hav

e EC

ED/P

PE.

2.11

.3 P

rovi

de d

iver

sified

an

d nu

triti

ous m

id-

day

mea

ls to

chi

ldre

n in

bas

ic e

duca

tion.

2.11

.4 E

CED

faci

litat

ors,

com

mun

ity le

arni

ng

cent

res (

CLC

) fac

ili-

tato

rs, f

ocal

teac

her

and

heal

th te

ache

rs

and

food

man

age-

men

t com

mitt

ees i

n co

ordi

natio

n w

ith

FCH

Vs e

ngag

e pa

rent

s to

impr

ove

thei

r kno

wle

dge

on

heal

th, h

ygie

ne a

nd

nutr

ition

.2.

11.5

Nut

ritio

n m

onito

ring

of b

asic

edu

catio

n stu

dent

s.2.

11.6

Bui

ld n

utrit

ion

capa

city

of E

CD

fa

cilit

ator

s, C

LC

faci

litat

ors,

heal

th

teac

hers

and

food

m

anag

emen

t com

-m

ittee

in sc

hool

s

2.12

.1 R

un c

ampa

igns

for g

irls’

educ

atio

n to

incr

ease

en

rolm

ent i

n sc

hool

s in

targ

eted

are

a. (G

ende

r Pa

rity

Inde

x in

NER

1:

00 (1

-8).

2.12

.2 C

reat

e pr

iorit

y m

inim

um

enab

ling

cond

ition

s (c

lass

room

s, te

ache

rs,

text

boo

ks, W

ASH

, boo

k co

rner

s) in

scho

ols.

2.12

.3 B

uild

sepa

rate

func

tiona

l to

ilets

with

gro

up h

and

was

h fa

cilit

ies,

espe

cial

ly

for g

irls i

n sc

hool

s.2.

12.4

Pro

vide

safe

drin

king

w

ater

in sc

hool

s.2.

12.5

Pro

mot

e he

alth

y be

hav-

iour

thro

ugh

skill

s-ba

sed

heal

th e

duca

tion

in

scho

ols.

2.12

. 6 R

evise

hea

lth a

nd n

utri-

tion

curr

icul

um.

2.12

.7 E

stabl

ish fo

od m

anag

e-m

ent c

omm

ittee

s in

all

scho

ols p

rovi

ding

mid

-da

y m

eals.

2.12

.8 D

evel

op a

set o

f edu

ca-

tiona

l tra

inin

g pa

ckag

es

on d

isaste

r risk

redu

ctio

n (D

RR

) for

stud

ents,

te

ache

rs a

nd sc

hool

man

-ag

emen

t com

mitt

ees.

2.13

.1 P

rovi

de re

prod

uc-

tive

heal

th in

for-

mat

ion

serv

ices

in

scho

ols a

nd

heal

th fa

cilit

ies

for b

oys a

nd

girls

.

2.13

.2 P

rovi

de k

now

l-ed

ge o

n im

por-

tanc

e of

del

ayed

fir

st pr

egna

ncy

afte

r mar

riage

.

2.13

.3 P

rovi

de in

form

a-tio

n to

scho

ol

stude

nts o

n be

nefit

s of u

se o

f fa

mily

pla

nnin

g m

etho

ds.

2.13

.4 B

ehav

iour

cha

nge

com

mun

icat

ion

for i

ncre

asin

g up

take

of r

outin

e m

easle

s and

ru

bella

imm

uni-

zatio

n.

31


32

3.1.

1 In

corp

orat

e MSN

P-II

in fe

dera

l plan

s an

d po

lices

3.1.

2 In

corp

orat

e MSN

P-II

in p

rovi

ncia

l lev

el pl

ans a

nd p

olic

ies

3.1.

3 In

corp

orat

e M

SNP-

II in

loca

l go

vern

men

t plan

s an

d pl

anni

ng

proc

esse

s

3.1.

4 O

rgan

ize jo

int

annu

al re

view

m

eetin

gs am

ong

MSN

P-II

sect

or

min

istrie

s at f

eder

al

level

3.1.

5 Ad

voca

cy m

eetin

gs

for i

ncre

asin

g nu

tritio

n bu

dget

(a

t lea

st 3.

5% o

f to

tal)

at fe

dera

l and

pr

ovin

ce le

vels

3.1.

6 D

evelo

p nu

tritio

n bu

dget

code

3.5.

1 D

evel

op n

atio

nal

capa

city

bui

ldin

g m

aste

r pla

n fo

r M

SNP-

II.

3.5.

2 Im

plem

ent c

apac

ity

deve

lopm

ent m

aste

r pl

an a

t all

leve

ls.

Out

com

e 3:

Impr

oved

pol

icie

s, pl

ans a

nd m

ulti-

sect

oral

coo

rdin

atio

n at

fede

ral,

prov

inci

al a

nd lo

cal

gove

rnm

ent l

evel

s to

enha

nce

the

nutr

ition

stat

us o

f all

popu

latio

n gr

oups

.

Out

put 3

.1 M

SNP-

II in

-cl

uded

in lo

cal,

prov

inci

al

and

fede

ral g

over

nmen

t po

licie

s and

pla

ns

3.2.

1 O

rgan

ise H

igh

Leve

l N

utrit

ion

and

Food

Sec

u-rit

y St

eerin

g C

omm

ittee

(H

LNFS

S) m

eetin

gs tw

ice

a ye

ar.

3.2.

2 O

rgan

ise N

atio

nal N

utri-

tion

and

Food

Sec

urity

C

oord

inat

ion

Com

mitt

ee

mee

tings

qua

rter

ly.

3.2.

3 Se

nd c

ircul

ar a

nd fa

cilit

ate

form

atio

n of

nut

ritio

n an

d fo

od se

curit

y ste

erin

g co

m-

mitt

ee in

pro

vinc

es.

3.2.

4 Fo

rm n

utrit

ion

and

food

se

curit

y ste

erin

g co

mm

it-te

es a

t pro

vinc

e le

vel

3.3.

1 St

reng

then

Nat

iona

l Nut

ritio

n an

d Fo

od

Secu

rity

Secr

etar

iat a

t NPC

.3.

3.2

Car

ry o

ut o

rgan

izatio

n &

man

agem

ent

surv

ey o

n in

clud

ing

NN

FSS

in N

PC.

3.3.

3 Fa

cilit

ate

endo

rsem

ent o

f the

O&

M

surv

ey re

port

.3.

3.4

Recr

uit s

taff

for N

FSS

as p

er a

ppro

ved

orga

nogr

am.

3.2.

5 O

rgan

ise n

utrit

ion

and

food

secu

rity

steer

ing

com

mitt

ee m

eetin

gs tw

ice

a ye

ar a

t pro

vinc

e le

vel.

3.2.

6 Fo

rm n

utrit

ion

and

food

secu

rity

coor

di-

natio

n co

mm

ittee

s at p

rovi

nce

leve

l.3.

2.7

Org

anise

nut

ritio

n an

d fo

od se

curit

y co

ordi

natio

n co

mm

ittee

mee

tings

qua

r-te

rly a

t pro

vinc

e le

vel.

3.2.

8 Ap

poin

t nut

ritio

n fo

cal p

erso

ns fo

r all

sect

oral

min

istrie

s at p

rovi

nce

leve

l.3.

2.9

Org

anise

them

atic

tech

nica

l wor

king

gr

oup

mee

tings

at f

eder

al le

vel q

uart

erly.

3.2.

10 F

orm

nut

ritio

n an

d fo

od st

eerin

g co

m-

mitt

ees a

t loc

al g

over

nmen

ts le

vel a

nd

mee

t reg

ular

ly.3.

2.11

For

m n

utrit

ion

and

food

stee

ring

com

mitt

ee a

nd re

gula

r mee

tings

at w

ard

leve

l in

MSN

P lo

cal g

over

nmen

ts.3.

2.12

Fac

ilita

te to

ass

ign

coor

dina

tors

(e

xisti

ng st

aff o

r out

sour

ced)

at l

ocal

go

vern

men

ts to

ove

rsee

MSN

P-II

in

terv

entio

ns.

3.4.

1 U

pdat

e M

SNP

info

rma-

tion

port

al a

nd m

ake

it fu

nctio

nal.

3.4.

2 Li

nk a

nd u

pdat

e nu

triti

on

info

rmat

ion

at c

entr

al le

v-el

(HM

IS, E

MIS

, WAS

H,

agric

ultu

re, l

ives

tock

and

lo

cal g

over

nanc

e).

3.4.

3 Pr

ovid

e tr

aini

ng o

n w

eb-

base

d M

SNP

repo

rtin

g sy

stem

at f

eder

al a

nd

prov

ince

leve

l.3.

4.4

Doc

umen

t & d

issem

inat

e go

od p

ract

ices

, les

sons

le

arne

d an

d ca

se st

udie

s.3.

4.5

Dev

elop

and

revi

ew m

oni-

torin

g an

d ev

alua

tion

fram

ewor

k fo

r all

MSN

P se

ctor

s at f

eder

al le

vel.

3.4.

6 D

evel

op a

nd re

view

mon

i-to

ring

and

eval

uatio

n fra

mew

ork

for a

ll M

SNP

sect

ors a

t pro

vinc

e le

vel.

3.4.

7 En

sure

dev

elop

men

t of

mon

itorin

g an

d ev

alu-

atio

n fra

mew

ork

for a

ll M

SNP

sect

ors a

t loc

al

leve

l.

Out

put 3

.2: M

SNP

gove

r-na

nce

mec

hani

sm st

reng

th-

ened

at f

eder

al, p

rovi

ncia

l, an

d lo

cal l

evel

s

Out

put 3

.3:

MSN

P-II

in

stitu

tiona

l mec

hani

sms

func

tiona

l at f

eder

algo

vern

men

t lev

el

Out

put 3

.4: F

unct

iona

l up

date

d in

form

atio

nm

anag

emen

t sys

tem

acr

oss a

ll M

SNP-

II se

ctor

s

Out

put 3

.5: E

nhan

ced

capa

city

of

fede

ral,

prov

inci

al a

nd lo

cal g

over

n-m

ent t

o pl

an &

impl

emen

t nut

ritio

n pr

ogra

mm

es

FIG

URE

2.4

: M

SNP-

II R

ESU

LTS

STRU

CTU

RE

— O

UTC

OM

E 3 O

N T

HE

ENA

BLIN

G E

NV

IRO

NM

ENT

GO

AL:

IM

PR

OV

ED

MAT

ER

NA

L, A

DO

LESC

EN

T A

ND

CH

ILD

NU

TR

ITIO

N B

Y SC

ALI

NG

UP

ESS

EN

TIA

L N

UT

RIT

ION

-SPE

CIF

IC

AN

D S

EN

SIT

IVE

INT

ER

VE

NT

ION

S A

ND

CR

EAT

ING

AN

EN

AB

LIN

G E

NV

IRO

NM

EN

T F

OR

NU

TR

ITIO

N


33

2.7 Results Framework of MSNP-II (2018–22)Based on the theory of change, MSNP-II aims to achieve the following three outcomes:

1. Improved access to and the equitable use of nutrition-specific services.

2. Improved access to and the equitable use of nutrition-sensitive services and improved healthy habits and practices.

3. Improved policies, plans and multi-sectoral coordination at federal, provincial and lo-cal government levels to enhance the nutri-tion status of all population groups.

Outcome 1: Improved equitable utilization of nutrition specific services.The outputs under this outcome address the im-mediate causes of malnutrition. The health sec-tor is responsible for achieving the following six outputs and implementing the associated 33 key activities (see Figure 2.2):

OUTPUT 1.1: ENHANCED NUTRITION STATUS

OF WRA INCLUDING ADOLESCENTS

Key interventions: 1.1.1 Organize and implement fully-nourished

village/ward including Golden 1000 Days communication campaign.

1.1.2 Revitalize School Health and Nutrition/Weekly Iron Folic Acid Supplementation programme including promoting healthy dietary habits and physical activities.

1.1.3 Raise awareness and services for healthy timing and spacing of pregnancy and in-crease access to and utilisation of family planning tools.

1.1.4 Conduct barrier analysis for increased ANC services utilization.

1.1.5 Integrate and expand adolescent-friendly health and nutrition services.

OUTPUT 1.2: IMPROVED INFANT AND

YOUNG CHILD NUTRITION AND CARE

PRACTICES

Key interventions: 1.2.1 Conduct maternal, infant, young child

and newborn (MIYCN) counselling at all

health sector platforms viz. health moth-er’s group meetings, immunization, ANC, PNC, growth monitoring, PHC-ORC, IMNCI and OPD services.

1.2.2 Conduct regular growth monitoring coun-selling at PHC-ORCs and health facilities.

1.2.3 Disseminate IEC and BCC materials through health facilities and FCHVs to communities and households regularly.

1.2.4 Conduct food preparation and cooking demonstrations on preparing local nutri-tious foods (e.g. nutritious flour/porridge (lito), jaulo/khichadi using locally avail-able food products.

1.2.5 Engage media for documentation and dis-semination of MIYCN programme.

1.2.6 Raise awareness on nutrition including on essential newborn care.

OUTPUT 1.3: IMPROVED MIYC

MICRONUTRIENT STATUS

Key interventions: 1.3.1 Maintain and sustain routine distribution

of Vitamin A capsules to children under 5 years and deworming tablets to children of 1-5 years.

1.3.2 Increase coverage and compliance of iron folic acid and de-worming among women during pregnancy and post-partum.

1.3.3 Scale-up home fortification with MNP in targeted areas.

1.3.4 Raise awareness to promote household use of two-child-logo iodized salt.

1.3.5 Raise awareness to promote consumption of national roller-mill produced fortified flour.

1.3.6 Initiate fortification process in production of national roller mills and in foods sup-plied by Nepal Food Corporation.

1.3.7 Conduct qualitative study for improved compliance of IFA supplementation.

1.3.8 Conduct barrier analysis for low coverage and compliance of MNP.

1.3.9 Procure and supply nutrition commodities for regular and emergency programmes (VAC, IFA, deworming tablets, MNPs, RUTF, therapeutic milk, ReSoMal).


34

OUTPUT 1.4: IMPROVED MANAGEMENT OF

SEVERE AND MODERATE ACUTE MALNUTRI-

TION

Key interventions: 1.4.1 Expand and establish OTC and ITC to

manage severe acute malnutrition in chil-dren under 5 years.

1.4.2 Scale-up nutrition rehabilitation homes (NRHs) in 50+ bed hospitals.

1.4.3 Conduct periodic nutrition assessments and counselling at community level.

1.4.4 Conduct barrier analysis to identify barri-ers to seek services related to SAM man-agement.

1.4.5 Scale-up and strengthen IMNCI pro-gramme.

1.4.6 Establish and strengthen nutrition infor-mation and surveillance system in normal and humanitarian situations.

OUTPUT 1.5: ENHANCED PREPAREDNESS FOR

NUTRITION IN EMERGENCY RESPONSES

Key interventions: 1.5.1 Establish local nutrition clusters and con-

duct quarterly coordination meetings at local levels.

1.5.2 Update and develop nutrition in emergen-cy preparedness for response and contin-gency plans at local levels.

OUTPUT 1.6: BUILT CAPACITY OF NUTRITION

SPECIFIC SECTORS

The aim of this output is to implement the ca-pacity development measures recommended in the capacity development plan that will be implemented by the nutrition specific sector. Key activities: 1.6.1 Conduct refresher training for health work-

ers and FCHVs at all level on the MIYCN package.

1.6.2 Organize basic training on the MIYCN package to newly recruited nutrition super-visors and nutrition officers.

1.6.3 Organize nutrition champion leadership development events.

1.6.4 Conduct routine data quality assessment (RDQA) for nutrition programme related HMIS tools.

Outcome 2: Improved access to and equitable utilisation of nutrition sensitive services and improved healthy habits-practices.The outputs under this outcome address the basic causes of malnutrition. These outputs are clus-tered under nutrition sensitive elements. Health, agriculture, livestock, WASH, education women and children, and local governance will be re-sponsible to attain this outcome. There are 13 outputs and 59 key activities under this outcome (see Figure 2.3).

OUTPUT 2.1: INCREASED AVAILABILITY AND

CONSUMPTION OF SAFE AND NUTRITIOUS

FOODS

The following key interventions will be imple-mented by the agriculture and livestock sector: 2.1.1 Make available agriculture and livestock

inputs (i.e. seeds, fertilizers, breeds) in-cluding at households and community levels.

2.1.2 Provide technical support (training, dem-onstrations) to promote the production of fruits, vegetables, nutritious roots, cereals and pulses to improve the consumption of diversified foods at household level.

2.1.3 Increase production and promote con-sumption of fresh fruits and green leafy vegetables.

2.1.4 Build capacity of livestock farmers and en-trepreneurs to increase milk, meat and egg production.

2.1.5 Provide technical support for micro and alternative small irrigation to produce di-versified and micronutrient rich foods.

2.1.6 Technical support to food processing in-dustries on good manufacturing practices and quality promotion measures through training, workshops and observation.

2.1.7 Training on food safety, food processing and nutrition to farmers.

2.1.8 Study and improve local food recipes.2.1.9 Update the food composition table.2.1.10 Update and disseminate the food compo-

sition table.


35

2.1.11 Update and disseminate food-based di-etary guidelines in local governments.

2.1.12 Develop and multiply BCC materials in-cluding audiovisuals on food safety, food processing and nutrition.

OUTPUT 2.2: INCREASED PHYSICAL AND

ECONOMIC ACCESS TO DIVERSIFIED FOOD

The following key interventions will implement-ed by the agriculture and livestock sector:

2.2.1 Enhance access to and use of animal prod-uct foods.

a) Establish livestock and food markets.b) Distribute chilling vats to dairies.

c) Raise awareness about consumption of livestock related foodstuff.

2.2.2 Promote and support production and con-sumption of fish including support for establish-ing community ponds.

OUTPUT 2.3: INCREASED ACCESS TO SAFE

DRINKING WATER

The following key interventions will be imple-mented by the water and sanitation sector:2.3.1 Construct and repair water supply schemes

in communities and institutions ensuring water safety plan.

2.3.2 Promote alternative and innovative tech-nologies for providing water supplies.

2.3.3 Promote household water treatment op-tions.

OUTPUT 2.4: INCREASED ACCESS TO SAFE

AND SUSTAINABLE SANITATION SERVICES

The following key interventions will be imple-mented by the water and sanitation sector:2.4.1 Sensitize communities to raise awareness

for construction, maintenance and hygien-ic use of improved household toilet includ-ing the safe disposal of child faeces.

2.4.2 Support and strengthen WASH coordina-tion committees, and local government to accelerate ODF campaigns.

2.4.3 Support for construction and management of CGD friendly toilet facilities including menstrual hygiene management facilities at institutions.

2.4.4 Support to construct safe food hygiene fa-cilities (silauta covers, dish drying racks).

OUTPUT 2.5: IMPROVED KNOWLEDGE ON

HYGIENIC BEHAVIOUR OF CHILDREN AND

MOTHER AND CARETAKERS OF UNDER 5

CHILDREN

The water and sanitation sector is responsible for implementing the following key activities.2.5.1 Construct, establish and promote user-

friendly hand washing facilities in house-holds and institutions.

2.5.2 Raise awareness on hand washing at criti-cal times to communities, school children and health workers.

2.5.3 Raise awareness on menstrual hygiene management in communities and schools.

2.5.4 Raise awareness to promote safe food hy-giene at community level.

OUTPUT 2.6: TARGETED GROUPS HAVE AC-

CESS TO RESOURCES AND OPPORTUNITIES

THAT ARE ESSENTIAL FOR MAKING THEM

SELF-RELIANT

All the plan’s sectors will be responsible to attain this results, particularly the women and children, agriculture and livestock sectors. The key inter-ventions under this output are the following:

2.6.1 Support community seed banks.2.6.2 Support women and disadvantaged group

participation in producing and marketing safe and nutritious food. Raise awareness to increase consumption of these foods.

2.6.3 Provide start-up entrepreneurship grants to women group members for social and economic empowerment.

2.6.4 Provide basic entrepreneurship training to women entrepreneurs groups for the socio-economic empowerment of women.

2.6.5 Provide training and orientation for IGA and business promotion (vegetable, fruits, production, animal husbandry, livestock lining with agricultural sector, tailoring).

2.6.6 Link child protection grants to child nu-trition in all districts (including distribu-tion).

2.6.7 Include nutrition as a major objective of the Social Protection Programme.


36


37

OUTPUT 2.7: NUTRITION COMPONENT

INCORPORATED IN WOMEN, ADOLESCENT

GIRLS AND CHILD DEVELOPMENT TRAINING

PACKAGES

The women and children sector will be respon-sible to coordinate and attain this result and carry out the following activity: 2.7.1 Integrate nutrition module in existing

training packages: Gender based violence prevention and response training, leader-ship, community protection, business de-velopment and life skills training.

OUTPUT 2.8: WOMEN, CHILDREN AND OUT

OF SCHOOL ADOLESCENT GIRLS REACHED

WITH HEALTH AND NUTRITION CARE PRAC-

TICES

The women and children sector is responsible to coordinate and attain this result and carry out the following activities: 2.8.1 Training members of women cooperatives

and child clubs on nutrition sensitive ser-vices:a) Leadership developmentb) Gender based violence managementc) Social protectiond) Entrepreneurship developmente) Reproductive healthf ) Gender based violence management

(male and female participation).2.8.2 Life skill development programmes to ado-

lescent girls in and out of school:a) Menstrual hygiene managementb) Gender violence management, women

trafficking orientation to adolescent girls.

c) Life skill development training to ado-lescent girls.

d) Nutrition and child care related train-ing to child club and village child pro-tection committees.

OUTPUT 2.9: CHILD CARE HOMES COMPLY

WITH MINIMUM STANDARDS OF NUTRITION

CARE SERVICES

The women and children sector will be respon-sible to coordinate and attain this result and carry out the following activities: 2.9.1 Monitor child care homes for compliance

with minimum standards of nutrition sen-sitive services.

2.9.2 Promote nutrition sensitive services at child care homes.

2.9.3 Integrate nutrition component in child protection case management training and services.

2.9.4 Deprived (bipanna) infant nutrition pro-gramme grant for women cooperatives.

OUTPUT 2.10: COMMUNITIES EMPOWERED

TO ADDRESS HARMFUL PRACTICES

The women and children sector will be respon-sible to coordinate and carry out the following activities: 2.10.1 Conduct behavioural change communi-

cation activities to prevent harmful tradi-tional practices.

2.10.2 Run campaigns to prevent child mar-riage.

2.10.3 Carry out programmes to shift social norms and harmful practices on food taboos preventing adequate nutrition for adolescents, menstrual seclusion, etc.

OUTPUT 2.11: ENHANCED ENROLMENT OF

CHILDREN IN BASIC EDUCATION

The education sector will be responsible to attain this result and carry out the following activities:2.11.1 Run welcome to school campaigns for

basic education students.2.11.2 Provide adequate resources to all schools

to have ECED/pre-primary education (PPE).

2.11.3 Provide diversified and nutritious mid-day meals and other nutrition services to children in basic education.

2.11.4 Increase knowledge of ECED facilita-tors, community learning centre (CLC) facilitators, focal teacher, health teach-ers and food management committees in coordination with FCHVs to activate them on health, hygiene and nutrition.

2.11.5 Carry out nutrition monitoring of basic education children.

2.11.6 Build nutrition capacity of ECD facili-tators, CLC facilitators, health teachers and food management committees.

2.11.7 Prepare study materials and demonstrate them to CLC facilitators, focal teachers, health teachers and food management committees on regular dietary (food, vegetable and fruits) calendar.


38

OUTPUT 2.12: INCREASED ADOLESCENT

GIRLS’ AWARENESS AND BEHAVIOURS IN

NUTRITION

The education sector will be responsible to carry out the following activities.2.12.1 Run campaigns for girls education to in-

crease their enrolment in schools in tar-geted areas.

2.12.2 Create priority minimum enabling con-ditions (class room, teacher, text book, WASH, book corners) in schools.

2.12.3 Construct separate toilets with group hand wash facility especially for girls in schools.

2.12.4 Provide safe drinking water in schools.2.12.5 Promote healthy behaviours through

skills-based health education in schools.2.12.6 Revise health and nutrition curriculum.2.12.7 Establish food management committees

in all schools providing midday meals.2.12.8 Develop educational training packages

on DRR for students, teachers and school management committees (SMCs).

OUTPUT 2.13 PROMOTE ACCESS TO HEALTH

AND REPRODUCTIVE HEALTH SERVICES

The health sector will be responsible to acarry out the following activities:2.13.1 Provide reproductive health and nutri-

tion information services at schools and health facilities to provide access to boys and girls.

2.13.2 Provide knowledge on the importance of delayed first pregnancy after marriage (if married before 20 years).

2.13.3 Raise knowledge of students at commu-nity schools on benefits of family plan-ning methods.

2.13.4 Run behaviour change communication programmes for improving routine mea-sles and rubella immunization.

Outcome 3: Improved policies, plans and multi-sectoral coordination at federal, provincial and local government levels to create enabling environment to improve nutrition statusOutcome 3 is the enabling environment out-

come. This outcome aims to increase multi-sec-toral commitment and resources for nutrition, strengthen nutritional information management and data analysis and establish protocol for nu-trition profiles (as the basis for planning) at fed-eral, provincial and local government levels. The NPC, NPC, MoFALD and other sector minis-tries will be responsible for the accomplishment of the following 5 outputs and 31 key activities (see Figure 2.4).

OUTPUT 3.1: MSNP INCLUDED IN LOCAL,

PROVINCIAL AND FEDERAL GOVERNMENTS’

POLICIES AND PLANS

The NPC, MoFALD, MoF and other sectoral ministries will be responsible for the accomplish-ment of the following key activities:3.1.1 Incorporate MSNP-II in federal sectoral

plans and polices. a) Update MSNP in the policy, long-term

plan and strategies of federal level sector ministries in line with MSNP-II.

b) Provide guidelines from NPC to incor-porate MSNP-II activities in the annual programme and budget of sectoral minis-tries.

c) Monitor to ensure incorporation of MSNP -II activities in the annual pro-grammes and budgets of sectoral minis-tries.

3.1.2 Incorporate MSNP-II in province level plans and policies.a) Organise workshops at provincial level

to provide advocacy and counselling on MSNP-II.

b) Send circular to all provicncial govern-ments to incorporate nutrition in their relevant policies, long-term plans and strategies in line with MSNP-II.

3.1.3 Incorporate MSNP-II in local govern-ments’ plans and planning processes.

3.1.4 Organize joint annual review meeting among MSNP-II sectoral ministries at fed-eral level.

3.1.5 Advocacy meeting for budget increment at federal, province and local government level.a) Conduct advocacy meetings with fed-

eral and provincial level parliamentar-ians to arrange resources and allocation of adequate budget for the implementa-tion of MSNP-II.


39

b) Conduct advocacy meetings with MoF at federal and provincial levels to ar-range resources and allocation of ade-quate budget for implementing MSNP-II.

c) Conduct advocacy and counselling with educational agencies, private sec-tor, entrepreneurs etc. to arrange ade-quate resources for the implementation of MSNP-II.

d) Conduct advocacy and counselling with NGOs and civil society organisa-tions to arrange adequate resources for the implementation of MSNP-II.

3.1.6 Develop a nutrition budget code.

OUTPUT 3.2: MSNP GOVERNANCE MECHA-

NISM STRENGTHENED AT FEDERAL, PROVIN-

CIAL, AND LOCAL LEVEL

The NPC, MoFALD and other sectoral min-istries will be responsible for implementing the folllowing activities:3.2.1 Organise High Level Nutrition and Food

Security Steering Committee (HLNFSS) meeting twice a year.

3.2.2 Organise Nutrition and Food Security Coordination Committee meetings in every trimester.

3.2.3 Send circular and facilitate formation of nutrition and food security steering com-mittees at province level.

3.2.4 Form nutrition and food security steering committees at provincial level.

3.2.5 Organise nutrition and food security steering committee meetings at provin-cial level twice a year.

3.2.6 Form nutrition and food security coordi-nation committee at provincial level.

3.2.7 Organise nutrition and food security co-ordination committee meetings in every trimester.

3.2.8 Assign a focal person for MSNP-II in provincial level sectoral ministries.

3.2.9 Organise thematic technical working group meetings at federal level each quar-ter.

3.2.10 Ensure formation of nutrition and food security steering committees and their

regular meetings at local government level.

3.2.11 Ensure formation of nutrition and food security steering committees and regular meeting at ward level in MSNP imple-mented local government areas.

3.2.12 Assign coordinators (from existing staff or outsourced) in local governments.

OUTPUT 3.3: MSNP INSTITUTIONAL MECHA-

NISMS FUNCTIONAL AT FEDERAL GOVERN-

MENT LEVEL.

NPC will be responsible to attain this result and carry out the following activities:3.3.1 Strengthen the National Nutrition and

Food Security Secretariat at NPC.3.3.2 Conduct O&M survey to establish

NNFSSC within NPC.3.3.3 Establish NNFSSC within NPC and re-

cruit staff as per approved organogram.

OUTPUT 3.4: STRENGTHENED INTEGRATED

INFORMATION MANAGEMENT SYSTEM

ACROSS THE SECTORS IN LINE WITH MSNP-II.

NPC, MoFALD and other sector ministries will be responsible to attain this result and carry out the following activities:3.4.1 Update the MSNP information portal

(www.nnfssp.gov.np) and all relevant sec-tor ministries information on the portal.

3.4.2 Link and update the nutrition information management system of sectoral ministries with the MSNP information portal at the central level.

3.4.3 Provide training on web-based MSNP re-porting system to MSNP related staff at federal and province levels.

3.4.4 Document and disseminate good practic-es, lessons learned and case studies through the MSNP portal.

3.4.5 Update the existing MSNP M&E frame-work used at federal level.

3.4.6 Facilitate preparation of MSNP M&E framework development and implementa-tion at the provincial level.

3.4.7 Facilitate MSNP M&E framework devel-opment at local level and ensure its imple-mentation.


40

OUTPUT 3.5: ENHANCED CAPACITY OF FED-

ERAL, PROVINCE AND LOCAL LEVEL GOVERN-

MENT TO PLAN AND IMPLEMENT NUTRITION

PROGRAMME.

NPC and all MSNP-II sectors will be responsible to attain this output and carry out the following activities:3.5.1 Develop capacity building master plan for

the implementation of MSNP-II3.5.2 Build capacity of relevant staff at federal,

provincial and local government level as per the capacity development master plan.

a) Prepare training manual for the imple-mentation of MSNP-II.

b) Provide ToT to implement MSNP-II at federal level.

The full MSNP-II results framework is given in Annex 1 including the goal and outcome level in-dicators with annual targets for 2018 to 2022, the means of verification and the responsible sectors; the output level indicators and the key activities. The outcomes, outputs and key activities are also presented graphically in Figures 2.2, 2.3 and 2.4.


41

IMPLEMENTATION OF MSNP-II (2018–2022)

Chapter 3

41


4242


43

3.1 Implementation ArrangementsThe key sectors for implementing MSNP-II are health, education, agriculture, livestock, water and sanitation, women, children and social wel-fare and federal affairs and local development. The finance, communication, commerce and supply sectors are also partners. NPC will lead the coordination with and between these sectors and facilitate the implementation of MSNP-II.

MSNP-II will be scaled up across the country to address malnutrition and will be rolled out to all local governments. It will initially be rolled out in the areas of greatest need — the remote and severe food deficit areas in the Mid-West and Far Western hills and mountains and in the mid-Tarai. The Local Government Operation Act, 2074 (GoN 2017) gives additional guidelines on implementing this plan at the local level.

The arrangements for implementing MSNP-II will be as follows: a) Planning and budgeting — MSNP-II will be

incorporated in provincial and local govern-ment policies and plans. Annual programmes and budget will be prepared in line with MSNP-II in all seven provinces and all local governments. Budgetary arrangements will be ensured for this purpose.

b) Institutional strengthening and human re-sources management — Necessary human resources will be assigned for managing nu-trition programmes at all levels of involved ministries and focal persons will be assigned at all levels to strengthen institutional, organ-isational and human resource capacities for implementing the plan at all levels and sectors linked to nutrition. The capacity of these of-ficials will be developed.

c) Coordination and management — The co-ordination and management of MSNP-II will

be the responsibility of NPC at the federal level and the entities responsible for planning at provincial and municipality levels. Com-mittees will be formed and made functional to give technical guidance on MSNP-II related functions (see Section 3.6). These commit-tees will coordinate vertically and horizontally with the line agencies to implement MSNP-II.

d) Information and Communication — Be-haviour change communication will be organ-ised to raise civic awareness about the major problem of chronic malnutrition and the ac-tions needed to improve maternal and child nutrition, thus ensuring equity, and facilitat-ing access to information, to promoting be-haviour change, with a focus on reaching the most marginalized and poorest segments of the population, and taking into account gen-der related factors. The mobilization of civil society organisations, parliamentarians, other elected representatives, and decision making authorities for advocacy activities will acceler-ate this process.

3.2 Target Groups and PrioritizationAs already mentioned, MSNP-II will initially be rolled out in the areas of greatest need — the remote and severe food deficit areas in the Mid-West and Far Western hills and mountains and in the mid-Tarai.

Although MSNP-II will benefit a wide range of people, it’s main focus will be on the following two groups:• Nutritional investments are most effective and

yield the greatest returns in the window of opportunity of the 1,000 days from concep-tion. Therefore, women of reproductive age, adolescent girls and under-3-year olds will re-ceive greater attention. Mothers, adolescents, infants’ grandmothers and husbands of preg-nant women will also be targeted.

3. implementation of MSNP-ii (2018–2022)

Chapter 3

MSNP-II will be scaled up across the country to address malnutrition and will be rolled out to all local governments.MSNP-II will initially be rolled out in the areas of greatest need.


44

• Pocket areas and communities that suffer higher levels of deprivation or are vulnerable to undernutrition will be prioritised. As many of the causes of undernutrition are related with feeding and care practices and socio-cultural traditions, MSNP-II will address the needs of all citizens including males and fe-males of all ages, castes, ethnicities, religions and geographical areas.

Information, communication and education pro-grammes will target all people nationwide. Other interventions will gradually be geared up to meet the needs of all citizens.

3.3 Financial ManagementAt the beginning of MSNP-II, in coordination with the Ministry of Finance, the NPC will de-velop a programme and financial planning frame-work with well-defined budget lines. The NPC will coordinate, facilitate, guide and monitor implementation.

The huge amount needed to scale up nutrition programmes nationally will be provided by the government and development partners. Imple-mentation will follow the financial administra-tion rules and regulations with auditing carried out by the Office of the Auditor General. The Ministry of Finance will maintain updated re-cords of off-budget grants received from develop-ment partners.

Donors and international agencies who wish to channel their support through development partners should first get endorsement from the HLNFSSC. Donors should submit proposals to the NPC stating total amounts, budget code and mode (lump sum or instalments).

All support received to implement MSNP-II, in-cluding from the government, foreign grants and the private sector will be entered into the govern-ment’s Budget Management Information System and Financial Management Information System.

MSNP-II grants will be allocated to local gov-ernments based on fixed criteria including per-centage of children with malnutrition, causes of malnutrition, status of nutrition and food secu-rity, geographical remoteness and availability of local resources. Nutrition analysis in local govern-

ments will also cover the nutrition status of preg-nant women, mothers and adolescents.

Also, provincial and local governments will con-tribute at least 15 percent of their internal re-sources (revenue) and grants for improving the nutrition of women and children.

NPC will assess the funds spent on implement-ing MSNP-II separately for nutrition specific, nutrition sensitive and enabling environment activities. It will coordinate the ratio of expendi-ture and issue guidance and directives for needed changes.

Various government ministries and agencies and non-government agencies were involved in im-plementing MSNP (2013–17). It was difficult to assess the financial investments made as budget and programme codes differed. The NPC will thus coordinate with the Ministry of Finance to implement a separate nutrition budget code. This will help in the preparation of the Medium Term Expenditure Framework, and the monitoring and evaluation of expenditure on nutrition in-cluding the allocation of budgets for MSNP-II’s programme, and budget preparation by provinces and local governments.

3.4 Estimated CostsThe estimated cost of implementing MSNP-II is NPR 48,901 million ($470 million at exchange rate of NPR 104.04). The budget is segregated thus:• By seven sectors plus NPC ,with the Ministry

of Education needing the most funds (35% of total) followed by the Ministry of Health (25%) (Table 3.1).

• By nutrition specific and nutrition sensitive programming with nutrition sensitive pro-gramming accounting for 76 percent of esti-mated costs (Table 3.2).

• The proportion of funding provided by the government is planned to increase from 47 percent in 2018 to 69 percent in the final year of MSNP-II, with the government providing 59 percent of funds and development partners 41 percent (Table 3.3).

These estimates are based on 2017/18 fixed cost prices, the present or past unit cost of planned activities, existing fixed rates of the government,

The huge amount needed to scale

up nutrition programmes

nationally will be provided by

the government and development

partners.

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45

TABLE 3.1: ESTIMATED NPC AND SECTORAL MINISTRY COSTS OF IMPLEMENTING MNSP-II (NPR MILLION)

NPC/sectoral ministries 2018 2019 2020 2021 2022 Total %

Health 2,223 2,403 2,615 2,497 2,464 12,202 25%

Education 3,428 3,434 3,444 3,455 3,467 17,228 35%

Agricultural development 1,652 1,728 1,812 1,900 2,006 9,098 19

Livestock development 101 87 108 96 118 510 1%

Drinking water and sanitation 568 1,021 1,865 2151 2,431 8,036 16%

Women, children and social welfare 188 196 211 223 235 1,053 2%

Local governance 42 78 91 97 104 412 1%

NPC 55 76 75 79 77 362 1%

Total 6,937 7,704 8,900 9,178 9,559 48,901 100%

TABLE 3.2: ESTIMATED NUTRITION-SPECIFIC AND NUTRITION-SENSITIVE COSTS OF IMPLEMENTING MNSP-2 (NPR MILLION)

Programmes 2018 2019 2020 2021 2022 Total

Nutrition sensitive 6,111 6,709 7,717 8,122 8,562 37,211 76%

Nutrition specific 2,146 2,314 2,504 2,376 2,340 11,680 24%

Total 8,256 9,023 10,221 10,498 10,902 48,901 100%

TABLE 3.3: ESTIMATED COSTS OF MSNP-II BY SOURCES OF FUNDS

GoN Development partners Total

2018


Percentage 47% 53% 100%

2019



2020



2021



2022



Total



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national and international costs and discussions with the concerned line ministries.

The annual financial tracking of nutrition-related expenditure carried out by the NPC covers all of the nutrition-related programmes in the govern-ment’s AWPB. The programmes proposed under MSNP-II do not necessarily cover all nutrition-related programmes and therefore the proposed above budget is less than the figures in NPC’s an-nual financial tracking exercises.

3.5 Duration of MSNP-IIMSNP-II will be implemented from Nepali FY 2075/76 to 2079/80 (mid-July 2018 to mid-July 2022).

3.6 MSNP CommitteesTwo existing high-level committees will govern the implementation of MSNP-II at the national level. The High Level Nutrition and Food Secu-rity Steering Committee (HLNFSSC) (see com-position in Table 3.4) is the highest level govern-ing body and will provide high level guidance and endorse policies and programmes. Its roles and responsibilities are as follows: a) Formulate and endorse macro level policies

and strategies on nutrition and food security.b) Ensure necessary resources for MSNP-II.c) Make policy decisions on foreign grant needs

and development partner support for MSNP-II.

d) Advocate and counsel on nutrition and food security related issues at national and interna-tional conferences, workshops, and meetings on behalf of the country.

e) Review MSNP-II’s progress and evaluate its performance and effects.

f ) Coordinate about MSNP-II with sectoral ministries at federal level.

g) Provide guidelines and directives to the Fed-eral Level Nutrition and Food Security Steer-ing Committee.

The National Nutrition and Food Security Co-ordination Committee (NNFSCC) (Table 3.5) will be responsible for national level coordination of the implementation of MSNP-II. Its roles and responsibilities oare as follows:a) Implement MSNP-II related national policies

and strategies

b) Arrange budget for federal level sectoral min-istries to implement MSNP-II.

c) Implement decisions of the HLNFSSC.d) Provide guidelines and directives to provincial

level NFSSCs.e) Facilitate the formation and operation of pro-

vincial and local government nutrition and food security steering committees.

f ) Form federal level technical groups and deter-mine their roles and responsibilities for imple-menting MSNP-II.

g) Review progress of MSNP-II at province and local government levels.

h) Form technical working groups for MSNP-II at the federal level.

i) Coordinate and perform other functions to implement, monitor, review and evaluate MS-NP-II at the federal level.

j) Provide guidelines to NNFSS and responsible NPC divisions.

New committees will be formed as the main bod-ies for overseeing the implementation of MSNP-II in provinces, local governments and wards. District coordination committees will also be formed.

Provincial nutrition and food security steering committees (PLNFSSC) (Table 3.6) will have the following responsibilities:a) Formulate provincial level policies and strate-

gies on nutrition and food security that com-ply with HLNFSSC and NNFSCC federal level policies.

b) Identify available resources for MSNP-II and ensure necessary resources for its implementa-tion at provincial and local government levels.

c) Advocate and guide on nutrition and food security at national level conferences, work-shops and meetings on behalf of provinces

d) Review MSNP-II progress and evaluate its performances and effects at the local level.

e) Provide guidelines and directives to provin-cial level sectoral ministries and agencies on implementing MSNP-II.

f ) Facilitate the formation and operation of local government nutrition and food security steer-ing committees.

g) Review performance of local nutrition and food security steering committees.

MSNP-II will be implemented from

Nepali FY 2075/76 to 2079/80 (mid-July 2018 to mid-

July 2022).


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TABLE 3.4: COMPOSITION OF HIGH LEVEL NUTRITION AND FOOD SECURITY STEERING COMMITTEE (HLNFSSC)

Office holders Position on committee

Hon. Vice Chairman, National Planning Commission (NPC) Chairperson

Hon. Member, Health and Nutrition, NPC Co-chair

Hon. members NPC (agriculture, livestock development, WASH, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies)

Members

Secretaries of federal ministries of health, agriculture development, livestock development, drinking water and sanitation, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies

Members

Nutrition and food security experts (4, nominated by the Chair) Members

Member Secretary, National Planning Commission Member Secretary

Joint Secretary, Social Development Division, NPC Joint Member Secretary

TABLE 3.5: COMPOSITION OF NATIONAL NUTRITION AND FOOD SECURITY COORDINATION COMMITTEE (NNFSCC)


Hon. Member, Health and Nutrition Sector, NPC Coordinator

Hon. NPC members responsible for health, agriculture, livestock, WASH, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies. Members

Chiefs of the Policy Planning and International Cooperation Division, the Budget and Programme Division and Nutrition Division from the federal ministries of health, agriculture, livestock, drinking water and sanitation, women, children and social welfare, education, federal affairs and local development, communication, commerce and supplies.

Members

Director generals of federal departments of health, agriculture development, livestock development, drinking water and sanitation, women, children and social welfare, education, federal affairs and local development

Members

Executive Director, Nepal Health Research Council Member

Two nutrition and food security experts (nominated by the Coordinator) Members

Representative of civil society network working on nutrition and food security Member

Representative responsible for health and nutrition from FNCCI or other representative body Member

Joint Secretary, Social Development Division, NPC Member Secretary

TABLE 3.6: COMPOSITION OF PROVINCIAL NUTRITION AND FOOD SECURITY STEERING COMMITTEES (PLNFSSC)


Chief of body responsible for provincial level planning Chair

Chief of agencies responsible for health, agriculture development, livestock development, drinking water and sanitation, women children and social welfare, education, federal affairs and local development, finance, communication, commerce and supplies in the province

Members

Two local nutrition and food security experts Members

Development partners working in the nutrition and food security sector in the province. Can be invited to meetings as per need


48

h) Regularly submit MSNP progress report to National Nutrition and Food Security Coor-dination Committee.

District coordination committees will carry out monitoring and coordination within provinces by carrying out the following responsibilities: a) Conduct MSNP-II monitoring in local gov-

ernments where it is implemented.b) Coordinate with provinces and between local

governments.c) Facilitate the incorporation of MSNP-II in lo-

cal governments’ long-term, periodic and an-nual programmes.

d) Advocacy and guidance on nutrition and food security at local conferences, workshops, and meetings on behalf of provincial governments.

e) Review MSNP-II progress and evaluate its performance and effects at the local level.

Local government nutrition and food security steering committees will be formed in metropoli-tan cities, sub-metropolitan cities, urban munici-palities and rural municipalities (Table 3.7). They will have the following responsibilities:a) Formulate local government policies and

strategies on nutrition and food security that comply with federal and provincial policies.

b) Identify resources for MSNP-II and ensure necessary resources for its implementation.

c) Incorporate MSNP-II activities in long-term, periodic and annual programmes of local gov-ernments.

d) Advocate and counsel on nutrition and food security at national conferences, workshops, and meetings.

e) Facilitate the formation of ward level nutri-tion and food security steering committees, review their progress and provide guidelines and directives.

f ) Review MSNP-II related performance of ward level nutrition and food security steer-ing committees and provide directions for im-provement.

g) Regularly submit MSNP-II progress reports to district coordination committee and prov-ince level nutrition and food security coordi-nation committees.

Ward-level nutrition and food security steering committees (Table 3.8) will have the following responsibilities:

a) Identify nutrition programmes in a participa-tory way and submit for support to local gov-ernment councils.

b) Identify local nutrition deficient communities.c) Assess needs of nutrition deficient communi-

ties and support prioritization of programmes for them with their participation.

d) Mobilise communities to run nutrition spe-cific and sensitive campaigns.

e) Assign NGOs and other agencies to monitor local nutrition programmes and report find-ings to the committee.

3.7 Power to Frame Guidelines The NPC may frame guidelines and issue direc-tives to provincial and local levels to implement MSNP-II.

3.8 National Nutrition and Food Security Secretariat A National Nutrition and Food Security Secre-tariat (NNFSS) will be established under the NPC Secretariat to provide technical and mana-gerial support to the national committees (HL-NFSSC and NNFSCC) for the smooth operation of MSNP-II. The organogram and staffing of the secretariat will be as assigned by NPC.

3.9 Responsibilities of Private, Non-government and Academic SectorsMSNP-II will be implemented by government agencies, national and international NGOs, pri-vate sector agencies and community and civil so-ciety organisations. The plan will be implemented through the coordinated efforts of national and international agencies, professional bodies, civil society and academia. At the local level, the range of stakeholders will be involved in formulating policies, and planning, implementing and moni-toring nutrition and food security programmes.

Civil society organisations, the private sector and other stakeholders will participate in nutrition and food security-related advocacy and commu-nication. Their cooperation will also be sought for the organisation of nutrition-related public hearings and grievance handling. Public-private-partnerships will help implement MSNP-II with NPC responsible for coordinating this process.

MSNP-II will be implemented

by government agencies, national and international

NGOs, private sector agencies

and community and civil society

organisations.


49

TABLE 3.7: COMPOSITION OF LOCAL GOVERNMENT NUTRITION AND FOOD SECURITY STEERING COMMITTEES


Chief of local government authority Chair

Deputy chief of local government Deputy chair

All ward chairpersons of local government Members

Woman member of local government designated by the chair Member

Dalit woman member of local government designated by the chair Member

Coordinator designated for planning and implementation of nutrition and food security programmes Member

Section chiefs of health, agriculture, livestock development, WASH, women, children and social welfare, education, federal affairs and local development, communication, finance, commerce and supplies and documentation and information section of local government

Members

Programme officer of social development section of local government Member

President of local chambers of commerce and industry Member

President of local NGO federation Member

Executive officer of local government or a designated officer Member Secretary

Executive member who looks after the social sector or executive woman member Coordinator

Nutrition and food security experts from local government and development partners. Can be invited as per need

TABLE 3.8: COMPOSITION OF WARD-LEVEL NUTRITION AND FOOD SECURITY STEERING COMMITTEES


Ward chair Chair

Female ward member Member

Unit chiefs of health, agriculture, livestock development, WASH, women children and social welfare, education, federal affairs and local development, communication, commerce and supplies unit in the ward (if any)

Members

Local female teacher Member

Representative of an NGO working in the ward Member

Coordinator of ward citizens forum Member

One local female community health volunteer (FCHV) Member

Representative of a local school management committee Member

Representative of a local health service management committee Member

Ward secretary Member Secretary


50

3.10 Capacity Development The capacity of staff and officials involved in implementing MSNP-II will be developed in-cluding their knowledge and skills on nutrition and food security, documentation and reporting, information dissemination and training skills.

3.11 Review, Monitoring and EvaluationA) NEED AND PROCESS

The review, monitoring and evaluation of MSNP-II will assess progress of MSNP-II pro-grammes principally in terms of the attainment of outcomes and outputs and impact on target groups. Annex 1 lists the indicators for measuring progress against the annual targets.

A monitoring and evaluation framework will be prepared as per the National Monitoring and Evaluation Guidelines to measure programme delivery and sectoral performance. Information will be collected on all indicators. The capacity of stakeholders will be developed at all levels to monitor the achievement of results.

Nutrition improvements will indirectly help to achieve all 17 SDGs, particularly SDGs 2 and 3.

B) REGULAR MONITORING AND REVIEW

Much of the data for measuring the indicators will come from regular national surveys including the Nepal Demographic and Health Survey, the Nepal Multiple Indicators Cluster Survey, and Nepal Living Standards Surveys. The periodic reports of government agencies will be another important source of information and means of verification. Further surveys may be carried out to gather data not available from existing surveys. Capacity will be built to carry out monitoring.

C) STUDIES, RESEARCH AND EVALUATION

Applied and action research will be carried out to identify and address bottlenecks to implementing MSNP-II.

Status and progress information will be regu-larly posted on the nutrition and food security web portal (http://www.nnfsp.gov.np). Relevant policy making-related information will also be posted here.

Consultations will be held with NPC’s Monitor-ing and Evaluation Division to guide decisions on monitoring, review and evaluation. A Tech-nical Working Group for monitoring and evalu-ating MSNP-II will be formed under the joint secretary of NPC’s Social Development Division to supervise MSNP-II’s management informa-tion system. Each involved sectoral ministry will nominate an M&E focal person to this TWG who will be responsible for updating their min-istry’s progress.

3.12 Documentation and ReportingLocal governments will be responsible for report-ing on the physical and financial progress of MS-NP-II to district coordination committees, pro-vincial level and federal level sectoral ministries. Local governments will submit four monthly and annual physical progress reports and statements of expenditure to their district coordination com-mittees and sectoral ministries at provincial and national levels. The sectoral ministries will pre-pare integrated reports for submission to NPC and will document the implementation status of MSNP-II and update physical and financial progress reports in the prescribed format.

Status and progress information will be regularly posted on

the nutrition and food security

web portal (http://www.nnfsp.

gov.np)

50


51

Annexes

51


5252


53

ann

ex 1

: Mul

ti-se

ctor

Nut

ritio

n Pl

an-ii

(20

18-2

022)

Re

sults

Fra

mew

ork

Resu

lts

chai

nRe

sult

indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

Goa

l (Im

pact

)

Impr

oved

m

ater

nal,

adol

esce

nt a

nd

child

nut

ritio

n by

sc

alin

g up

ess

entia

l nu

triti

on-s

peci

fic

and

sens

itive

in

terv

entio

ns

and

crea

ting

an e

nabl

ing

envi

ronm

ent f

or

nutr

ition

1. P

reva

lenc

e of

stu

ntin

g am

ong

unde

r 5 y

ears

chi

ldre

n re

duce

d 35

.8

ND

HS

2016

3431

3129

28N

DH

S, N

MIC

SH

ealth

2. P

reva

lenc

e of

was

ting

amon

g un

der

5-ye

ar-o

ld c

hild

ren

redu

ced

9.7

N

DH

S 20

169.

58

87

7N

DH

S, N

MIC

SH

ealth

3. P

reva

lenc

e of

low

birt

h w

eigh

t re

duce

d24

N

MIC

S 20

1420

1713

1110

ND

HS,

NM

ICS

Hea

lth

4. %

redu

ctio

n in

chi

ldre

n un

der-

5 w

ith o

verw

eigh

t and

obe

sity

2.1

N

DH

S 20

162

1.9

1.7

1.6

1.4

ND

HS,

NM

ICS

Hea

lth

5. %

redu

ctio

n in

ove

rwei

ght a

nd

obes

e w

omen

of r

epro

duct

ive

age

(WRA

)

22

ND

HSS

201

622

2120

1918

ND

HS,

NM

ICS

Hea

lth

6. %

of w

omen

with

chr

onic

ene

rgy

defic

ienc

y (m

easu

red

as b

ody

mas

s in

dex)

redu

ced

17

ND

HS

2016

12N

DH

S, N

MIC

SH

ealth

Out

com

es

1: N

utri

tion

spe

cific

out

com

e

Out

com

e 1:

Im

prov

ed a

cces

s to

and

equ

itabl

e us

e of

nut

ritio

n-sp

ecifi

c se

rvic

es

1.1.

Incr

ease

d %

of c

hild

ren

aged

6-

23 m

onth

s hav

ing

min

imum

ac

cept

able

die

t

35

ND

HS

2016

4045

5055

60N

DH

S, N

MIC

SH

ealth

1.2.

Incr

ease

d %

of c

hild

ren

unde

r 6

mon

ths

with

exc

lusi

ve

brea

stfe

edin

g

66

ND

HS

2016

6870

7477

80N

DH

S, N

MIC

SH

ealth

1.3.

Red

uced

% o

f ana

emia

am

ong

child

ren

aged

6-5

9 m

onth

s 52

.7

ND

HS

2016

4037

3330

28N

DH

S, N

MIC

SH

ealth

1.4.

Red

uced

% o

f ana

emia

am

ong

adol

esce

nt g

irls

(10-

19 y

ears

)39

N

DH

S 20

1620

25N

DH

S, N

MIC

SH

ealth

Goa

l and

Out

com

e in

dica

tors


54

Resu

lts

chai

nRe

sult

indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

Out

com

e 1:

Im

prov

ed a

cces

s to

and

equ

itabl

e us

e of

nut

ritio

n-sp

ecifi

c se

rvic

es

1.5.

Red

uced

% o

f ana

emia

am

ong

WRA

(15-

49 y

ears

)40

.8

ND

HS

2016

2624

ND

HS,

NM

ICS

Hea

lth

1.6.

Red

uced

pre

vale

nce

of u

nder

5-

year

s ol

d ch

ildre

n w

ith d

iarr

hoea

in

last

two

wee

ks

14%

N

DH

S 20

1610

%7%

ND

HS,

NM

ICS

Hea

lth

1.7.

Mea

n di

etar

y di

vers

ity s

core

am

ong

WRA

(15-

49 y

ears

) TB

D

ND

HS

2016

TBD

ND

HS,

NM

ICS

Hea

lth

2: N

utri

tion

-sen

siti

ve o

utco

me

Out

com

e 2:

Im

prov

ed a

cces

s to

an

d th

e eq

uita

ble

use

of n

utrit

ion-

sens

itive

ser

vice

s an

d im

prov

ed

heal

thy

habi

ts a

nd

prac

tices

2.1.

Red

uced

pro

port

ion

of p

opul

atio

n be

low

min

imum

leve

l of d

ieta

ry

ener

gy c

onsu

mpt

ion

22.8

N

MIC

S 20

14

1715

.514

12.5

11SD

G s

tatu

s re

port

s, N

MIC

SAg

ricul

ture

an

d liv

esto

ck

2.2.

Incr

ease

d %

peo

ple

usin

g sa

fe

drin

king

wat

er

15

JMP

2017

33.7

38.4

43.1

47.8

52.5

Join

t Mon

itorin

g Pr

ogra

mm

e (J

MP)

WA

SH

2.3.

Incr

ease

d %

peo

ple

usin

g im

prov

ed s

anita

tion

faci

litie

s th

at

are

not s

hare

d

92.6

to

ilet

cove

rage

: 20

17

NM

IP-D

WSS

, 20

17

9598

100

100

100

NM

ICS

& N

MIP

-D

WSS

W

ater

and

sa

nita

tion

2.4.

Incr

ease

d %

of p

eopl

e pr

actis

ing

hand

was

hing

with

soa

p an

d w

ater

be

fore

feed

ing

baby

(0-2

yrs

) and

af

ter c

lean

ing

babi

es’ b

otto

ms

Know

ledg

e 6

and

5.5

NM

ICS

2014

1520

3040

50

NM

ICS

Wat

er a

nd

sani

tatio

n

2.5.

Per

cent

age

of w

omen

age

d 20

-24

year

s w

ho w

ere

mar

ried

or in

un

ion

befo

re a

ge 1

8

40.7

%

ND

HS

2011

5% re

duct

ion

per y

ear

ND

HS

Wom

en,

Child

ren

and

Soci

al W

elfa

re

and

Hea

lth

2.6.

Incr

ease

d gr

oss

enro

lmen

t rat

e (G

ER) (

boys

and

girl

s) in

ear

ly

child

edu

catio

n an

d de

velo

pmen

t (E

CED

)/pr

e-pr

imar

y ed

ucat

ion

(PPE

)

81

(81.

2, 8

0.9)

82.6

(8

2.8,

82.

5)84

.3

(84.

5, 8

4.2)

86

(86.

2, 8

5.9)

87.7

(8

7.9,

87.

6)89

.4

(89.

4, 8

9.5)

Educ

atio

n M

anag

emen

t In

form

atio

n Sy

stem

(EM

IS)

Educ

atio

n

2.7.

Dec

reas

ed %

of o

ut-o

f-sch

ool

child

ren

(boy

s an

d gi

rls) i

n ba

sic

educ

atio

n

10.6

(1

0.8,

10.

4)

9.06

(9

.2, 9

.8)

7.5

(7.6

, 7.3

)6.

0 (6

.1, 5

.8)

4.5

(4

.6, 4

.6)

3.0

(3.1

, 2.0

)EM

ISEd

ucat

ion

2.8.

Incr

ease

d ba

sic

educ

atio

n cy

cle

com

plet

ion

rate

(boy

s an

d gi

rls)

69.6

(6

8.8,

70.

5)72

.4

(71.

6,73

.4)

75.4

(7

4.5,

76.

4)78

.5

(77.

6, 7

9.5)

81.7

(80.

8,

82.8

)85

.0

(84.

1, 8

6.1)

EMIS

Educ

atio

n


55

Resu

lts

chai

nRe

sult

indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

3: E

nabl

ing

envi

ronm

ent o

utco

me

Out

com

e 3:

Im

prov

ed

polic

ies,

plan

s an

d m

ulti-

sect

oral

co

ordi

natio

n at

fe

dera

l, pr

ovin

cial

an

d lo

cal

gove

rnm

ent l

evel

s to

enh

ance

the

nutr

ition

sta

tus

of a

ll po

pula

tion

grou

ps

3.1.

% o

f far

m la

nd o

wne

d by

wom

en

or in

join

t ow

ners

hip

10

(201

0)12

1315

1821

AD

SAg

ricul

ture

an

d Li

vest

ock

3.2.

No.

of l

ocal

, pro

vinc

ial a

nd fe

dera

l go

vern

men

t pla

ns th

at in

clud

e nu

triti

on a

nd fo

od s

ecur

ity

prog

ram

s in

line

with

MSN

P-II

30 d

istr

icts

29

9 lo

cal

gove

rnm

ents

60 d

istr

icts

75

3 lo

cal

gove

rnm

ents

753

loca

l go

vern

men

ts75

3 lo

cal

gove

rnm

ents

Gov

ernm

ent

plan

s an

d M

SNP-

II an

nual

pr

ogre

ss re

port

s

Loca

l G

over

nanc

e

3.3.

Ava

ilabi

lity

of n

atio

nal M

SNP-

II do

cum

ent

MSN

P-I

1-

--

-M

SNP-

II do

cN

PC

3.4.

Ava

ilabi

lity

of n

atio

nal b

udge

t co

de fo

r nut

ritio

n an

d fo

od

secu

rity

01

--

--

MoF

bud

get

code

NPC

, MoF

3.5.

Nat

iona

l Cap

acity

Dev

elop

men

t M

aste

r Pla

n fo

r im

plem

enta

tion

of

MSN

P-II

Prod

uced

01

--

--

Capa

city

D

evel

opm

ent

Plan

NPC

, all

sect

ors

3.6.

Mul

ti-se

ctor

com

mitm

ent a

nd

reso

urce

s fo

r nut

ritio

n in

crea

se to

at

leas

t 3.5

% o

f tot

al g

over

nmen

t bu

dget

1.08

1.5

22.

53

3.5

MoF

red

Book

NPC

3.7.

Fin

anci

al re

sour

ce tr

acki

ng in

pla

ce1

11

11

1Fi

nanc

ial

reso

urce

tr

acki

ng to

ols

NPC

, MoF


56

Out

put

indi

cato

rsRe

sult

sIn

dica

tors

Base

line

Targ

ets

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

2018

2019

2020

2021

2022

Nut

riti

on s

peci

fic o

utpu

ts

Out

com

e 1:

Impr

oved

acc

ess

to a

nd e

quit

able

use

of n

utri

tion

-spe

cific

ser

vice

s

Out

put 1

.1:

Enha

nced

nut

ritio

n st

atus

of W

RA

incl

udin

g ad

oles

cent

s

Med

ian

age

at fi

rst b

irth

amon

g W

RA (1

5-49

yea

rs)

17

ND

HS

2016

20

ND

HS

Hea

lth

% o

f ins

titut

iona

l del

iver

y 57

N

DH

S 20

1665

70N

DH

S, N

MIC

SH

ealth

% g

ettin

g a

post

nata

l che

ck-u

p fo

r ess

entia

l new

born

car

e an

d se

rvic

es w

ithin

24

hour

s of

de

liver

y

57

ND

HS

2016

75N

DH

SH

ealth

Out

put 1

.2:

Impr

oved

infa

nt a

nd

youn

g ch

ild n

utrit

ion

and

care

pra

ctic

es

% o

f new

born

s in

itiat

ing

brea

stfe

edin

g w

ithin

one

hou

r of

birt

h

55

ND

HS

2016

80N

DH

S, N

MIC

SH

ealth

Prop

ortio

n of

infa

nts

6–8

mon

ths

of a

ge re

ceiv

ing

solid

, sem

i-sol

id

or s

oft f

oods

73.5

N

MIC

S 20

1495

ND

HS,

NM

ICS

Hea

lth

% o

f chi

ldre

n ag

ed 0

-59

mon

ths

who

rece

ived

mor

e fr

eque

nt

feed

ing

(bre

ast m

ilk a

nd

appr

opria

te fo

od) d

urin

g ep

isod

es

of d

iarr

hoea

29 N

DH

S 20

1650

ND

HS,

NM

ICS

Hea

lth

Out

put 1

.3:

Impr

oved

mat

erna

l, in

fant

and

you

ng c

hild

(M

IYC)

mic

ronu

trie

nt

stat

us

% o

f chi

ldre

n ag

ed 6

–59

mon

ths

who

rece

ived

Vita

min

A c

apsu

le in

la

st s

ix m

onth

s

86

ND

HS

2016

95N

DH

S, N

MIC

SH

ealth

% o

f chi

ldre

n ag

ed 1

2-59

mon

ths

who

rece

ived

dew

orm

ing

tabl

et

in la

st s

ix m

onth

s

83

ND

HS

2016

90N

DH

S, N

MIC

SH

ealth

% o

f pre

gnan

t and

lact

atin

g w

omen

who

took

180

+ IF

A

tabl

ets

42

ND

HS

2016

65>8

0N

DH

S, N

MIC

SH

ealth

% o

f pre

gnan

t wom

en w

ho

rece

ived

dew

orm

ing

tabl

ets

55

ND

HS

2016

80N

DH

SH

MIS

Hea

lth


57

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

% o

f sch

ool a

ge c

hild

ren

who

re

ceiv

ed d

ewor

min

g ta

blet

in

crea

sed

65

HM

IS80

HM

ISH

ealth

% o

f hou

seho

lds u

sing

ade

quat

ely

iodi

zed

salt

82

NM

ICS

2014

>90

ND

HS,

NM

ICS

Hea

lth

% o

f ado

lesc

ent g

irls

(10-

19 y

ears

) w

ho re

ceiv

ed w

eekl

y IF

A ta

blet

su

pple

men

ts

550

HM

ISH

ealth

% o

f chi

ldre

n ag

ed 6

-23

mon

ths

who

rece

ived

mic

ronu

trie

nt

pow

der (

MN

P)

5

HM

IS20

HM

ISH

ealth

% o

f chi

ldre

n w

ho re

ceiv

ed O

RS

and

zinc

dur

ing

diar

rhoe

a 18

N

MIC

S 20

1450

ND

HS,

NM

ICS

Hea

lth

Out

put 1

.4:

Impr

oved

m

anag

emen

t of

seve

re a

nd m

oder

ate

acut

e m

alnu

triti

on

No.

of l

ocal

gov

ernm

ents

with

in

tegr

ated

man

agem

ent o

f acu

te

malnu

trition

(IM

AM

) pro

gram

me

35 d

istr

icts

520

loca

l go

vern

men

tsH

MIS

Hea

lth

Perc

enta

ge o

f chi

ldre

n ag

ed 6

-59

mon

ths

iden

tified

with

sev

ere

acut

e m

alnu

triti

on (S

AM

) aga

inst

to

tal e

stim

atio

n of

SA

M

NA

>90

ND

HS

Hea

lth

% o

f chi

ldre

n ag

ed 6

-59

mon

ths

with

acu

te m

alnu

triti

on tr

eate

d am

ong

iden

tified

cas

es

70

90H

MIS

Hea

lth

No.

of l

ocal

gov

ernm

ent

bodi

es w

ith IM

NCI

pro

gram

me

impl

emen

ted

55 d

istr

icts

753

loca

l go

vern

men

ts

HM

ISH

ealth

Out

put 1

.5:

Enha

nced

pr

epar

edne

ss

for n

utrit

ion

in

emer

genc

y re

spon

ses

No.

of l

ocal

gov

ernm

ents

w

ith n

utrit

ion

emer

genc

y pr

epar

edne

ss a

nd re

spon

se o

r co

ntin

genc

y pl

an

5050

0 lo

cal

gove

rnm

ents

Cont

inge

ncy

plan

s an

d pr

epar

edne

ss

plan

Hea

lth

Out

put 1

.6:

Capa

city

bui

lt of

nu

triti

on s

peci

fic

sect

ors

No.

of c

apac

ity d

evel

opm

ent

mea

sure

s re

com

men

ded

in

the

capa

city

dev

elop

men

t pla

n im

plem

ente

d by

nut

ritio

n sp

ecifi

c se

ctor

NA

>90

HM

ISH

ealth


58

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

NU

TRIT

ION

SEN

SITI

VE

OU

TPU

TS

Out

com

e 2:

Impr

oved

acc

ess

to a

nd th

e eq

uita

ble

use

of n

utri

tion

-sen

siti

ve s

ervi

ces

and

impr

oved

hea

lthy

hab

its

and

prac

tice

s

Agr

icul

ture

and

live

stoc

k

Out

put 2

.1:

Incr

ease

d av

aila

bilit

y an

d co

nsum

ptio

n of

sa

fe a

nd n

utrit

ious

fo

ods

% o

f pro

duct

ion

and

prod

uctiv

ity

of c

rops

and

live

stoc

k:

1. C

erea

ls: a

rea

(1,0

00 h

a)33

06

3405

3371

3303

3270

3188

Ann

ual r

epor

t of

MoA

D

Agric

ultu

re

2. C

erea

ls: p

rodu

ctio

n (1

,000

to

nnes

)86

1495

1597

5094

1496

9799

87Ag

ricul

ture

3. P

ulse

s: a

rea

(1,0

00 h

a)34

234

935

335

636

036

3Ag

ricul

ture

4. P

ulse

s: p

rodu

ctio

n (1

,000

to

nnes

)31

632

933

534

234

935

6Ag

ricul

ture

5. V

eget

able

s: a

rea

(1,0

00 h

a)28

031

532

834

135

436

9Ag

ricul

ture

6. V

eget

able

s : p

rodu

ctio

n (1

,000

to

nnes

)38

1944

1346

7849

5952

5655

72Ag

ricul

ture

7. P

otat

oes:

are

a (1

,000

ha)

190

210

218

227

236

246

Agric

ultu

re

8. P

otat

o: p

rodu

ctio

n (1

,000

to

nnes

)25

5129

7632

1434

7137

4940

49Ag

ricul

ture

9. F

ish:

pro

duct

ion

(1,0

00 to

nnes

) 48

5760

6366

69Ag

ricul

ture

10. F

ruits

: pro

duct

ion

(1,0

00

tonn

es)

992

(2

014)

1181

1252

1327

1407

1492

Agric

ultu

re

Year

roun

d irr

igat

ion

(%)

18

(201

0)22

2530

3545

ADS

annu

al

repo

rtsAg

ricul

ture

Per c

apita

food

gra

in p

rodu

ctio

n (k

g)34

1

(201

4)38

139

140

141

142

2SD

G p

rogr

ess

repo

rtAg

ricul

ture

Dec

reas

ed in

cide

nce

of su

b-

stan

dard

food

in th

e m

arke

t (%

)12

D

FTQ

C11

109

87

Ann

ual r

epor

t of

DFT

QC

Agric

ultu

re

and

Live

stoc

k

Hou

seho

lds

with

min

imum

di

etar

y di

vers

ity (%

)10

.5

AHSI

II 201

4/15

1315

1820

23A

nnua

l ho

useh

old

surv

ey (C

BS)

Agric

ultu

re

and

Live

stoc

k

% o

f pro

duct

ion

and

prod

uctiv

ity

of c

rops

and

live

stoc

k:

Milk

(1,0

00 to

nnes

)1,

954

2031

2296

2594

2776

2942

Ann

ual r

epor

t of

MoL

D

Live

stoc

k

Mea

t (1,

000

tonn

es)

332

344

379

417

438

460

Live

stoc

k

Eggs

(1,0

00 to

nnes

)13

513

514

515

716

817

8Li

vest

ock


59

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

Out

put 2

.2:

Incr

ease

d ph

ysic

al a

nd

econ

omic

acc

ess

to

dive

rse

type

s of

food

s

Impr

oved

acc

ess

to u

pdat

ed

agric

ultu

re m

arke

ting

info

rmat

ion

ABP

MD

D re

port

Publ

ish

agric

ultu

re m

arke

ting

info

rmat

ion

bulle

tin1

11

11

1Ag

ricul

ture

Upd

ate

web

site

and

app

re

late

d to

agr

icul

ture

mar

ketin

g in

form

atio

n sy

stem

11

11

11

Agric

ultu

re

Hou

seho

lds

rais

ing

lives

tock

NA

Wat

er, S

uppl

y an

d Sa

nita

tion

Out

put 2

.3:

Incr

ease

d ac

cess

to

safe

drin

king

wat

er

% h

ouse

hold

s us

ing

impr

oved

dr

inki

ng w

ater

faci

litie

s93

.3N

MIP

201

795

9810

010

010

0N

MIP

-DW

SSW

ater

Su

pply

and

Sa

nita

tion

% h

ouse

hold

s w

ith p

iped

wat

er

supp

ly in

dw

ellin

g ya

rd26

NM

IP 2

017

2532

4045

50N

MIP

-DW

SSW

ater

Su

pply

and

Sa

nita

tion

% h

ouse

hold

s ad

opte

d w

ater

tr

eatm

ent o

ptio

n22

.4

NM

ICS

2014

3052

.15

58.1

64.0

570

NM

ICS

Wat

er

Supp

ly a

nd

Sani

tatio

n

% h

ouse

hold

s w

ith E

sche

richi

a co

li (E

. col

i) ris

k le

vel i

n ho

useh

old

wat

er o

f ≥ 1

col

ony

form

ing

unit

(cfu

)/10

0ml

82.2

N

MIP

201

760

5030

2010

NM

IP-D

WSS

Wat

er

Supp

ly a

nd

Sani

tatio

n

Out

put 2

.4:

Incr

ease

d ac

cess

to

safe

and

sus

tain

able

sa

nita

tion

serv

ices

% h

ouse

hold

s ha

ving

toile

ts

(san

itatio

n co

vera

ge)

87.2

7N

MIP

-DW

SS

2016

9899

100

100

100

NM

IP/D

WSS

Wat

er

Supp

ly a

nd

Sani

tatio

n

% o

f chi

ldre

n ag

ed 0

–2 y

ears

w

hose

last

sto

ols

wer

e di

spos

ed

of s

afel

y (u

se o

f toi

let,

or fa

eces

di

spos

ed in

toile

t)

48

NM

ICS

2014

5256

6266

70N

MIC

SW

ater

Su

pply

and

Sa

nita

tion

Num

ber o

f dis

tric

ts d

ecla

red

open

de

feca

tion

free

(OD

F)42

dis

tric

ts

NM

IP-2

017

6577

(7

53 lo

cal

gove

rnm

ents)

77

(753

loca

l go

vern

men

ts)

77

(753

loca

l go

vern

men

ts)

77

(753

loca

l go

vern

men

ts)

NM

IP-D

WSS

Wat

er

Supp

ly a

nd

Sani

tatio

n


60

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

Out

put 2

.5:

Impr

oved

kno

wle

dge

of c

hild

ren,

and

m

othe

rs a

nd

care

take

rs o

f und

er

5-ye

ar-o

lds

on h

ealth

an

d hy

gien

e

% o

f mot

hers

and

car

etak

ers

of u

nder

-5 y

ear-

old

child

ren

(hou

seho

lds)

with

kno

wle

dge

of

hand

was

hing

bef

ore

eatin

g

92.2

NM

ICS

2014

9596

9798

100

NM

ICS

Wat

er

Supp

ly a

nd

Sani

tatio

n

% o

f mot

hers

and

car

etak

ers

of u

nder

5-y

ear-

old

child

ren

(hou

seho

lds)

with

kno

wle

dge

of

hand

was

hing

bef

ore

prep

arin

g fo

od

22.2

NM

ICS

2014

3040

5060

70N

MIC

SW

ater

Su

pply

and

Sa

nita

tion

% o

f mot

hers

and

car

etak

ers o

f un

der-

5 ye

ar-o

lds (

hous

ehol

ds)

with

kno

wle

dge

of h

andw

ashi

ng

befo

re b

reas

tfeed

ing

or fe

edin

g ba

bies

6N

MIC

S 20

1420

3040

5060

NM

ICS

Wat

er

Supp

ly a

nd

Sani

tatio

n

% o

f mot

her a

nd c

aret

aker

s of

un

der 5

-yea

r-ol

ds (h

ouse

hold

s)

with

kno

wle

dge

of h

andw

ashi

ng

afte

r def

ecat

ion

and

urin

atin

g

86.6

NM

ICS

2014

8890

9396

99N

MIC

SW

ater

Su

pply

and

Sa

nita

tion

% o

f mot

hers

and

car

etak

ers

of

unde

r 5 y

ear-

olds

(hou

seho

lds)

w

ith k

now

ledg

e of

han

dwas

hing

af

ter c

lean

ing

child

ren’

s bo

ttom

s

5.5

NM

ICS

2014

1520

5070

90N

MIC

SW

ater

Su

pply

and

Sa

nita

tion

% o

f mot

hers

and

car

etak

ers

of

unde

r 5 y

ear-

olds

(hou

seho

lds)

w

ith k

now

ledg

e of

han

dwas

hing

af

ter c

lean

ing

toile

ts a

nd p

ottie

s (a

fter

man

agin

g w

aste

)

7.7

NM

ICS

2014

2030

4560

75N

MIC

SW

ater

Su

pply

and

Sa

nita

tion

% o

f peo

ple

who

was

h ra

w fo

od,

vege

tabl

es, c

over

s co

oked

food

an

d su

ffici

ently

hea

t sta

le fo

od

befo

re e

atin

g

NA

Soci

al P

rote

ctio

n

Out

put 2

.6:

Targ

eted

gro

ups

have

ac

cess

to re

sour

ces

and

oppo

rtun

ities

that

m

ake

them

sel

f-rel

iant

No.

of w

omen

gro

up c

oope

rativ

es

rece

ived

gra

nts

and

cred

it41

188

9010

011

012

0A

nnua

l rep

ort o

f D

ept o

f Wom

en

and

Child

ren

(DW

C)

Wom

en,

Child

ren

and

Soci

al W

elfa

re

No.

of c

omm

unity

leve

l aw

aren

ess

prog

ram

mes

hel

d on

redu

cing

ch

ild m

arria

ge

900

1,00

01,

050

1125

1,20

0A

nnua

l rep

ort o

f D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re

No.

of w

omen

gro

up, c

omm

ittee

, co

oper

ativ

e m

embe

rs w

ith

esta

blis

hed

self-

entr

epre

neur

ship

(s

tart

-up

gran

ts)

49,3

8515

,000

12,0

0010

,000

15,0

0017

,000

Ann

ual

econ

omic

su

rvey

Wom

en,

Child

ren

and

Soci

al W

elfa

re


61

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

No.

of l

ocal

gov

ernm

ents

pr

ovid

ing

child

gra

nts

to c

hild

ren

unde

r 5-y

ears

-old

203

203

299

323

347

372

Repo

rt o

f D

ept o

f Civ

il Re

gist

ratio

n (D

oCR)

Loca

l G

over

nanc

e se

ctor

Mat

erna

l Hea

lth

and

Wom

en E

mpo

wer

men

t

Out

put 2

.7:

Nut

ritio

n co

mpo

nent

in

corp

orat

ed in

w

omen

, ado

lesc

ent

girls

and

chi

ld

deve

lopm

ent t

rain

ing

pack

ages

No.

of t

rain

ing

pack

ages

with

he

alth

and

nut

ritio

n m

odul

e in

tegr

ated

23

21

--

Ann

ual r

epor

ts

of D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re

Out

put 2

:8:

Wom

en, c

hild

ren

and

out o

f sch

ool

adol

esce

nt g

irls

reac

hed

with

hea

lth

and

nutr

ition

car

e pr

actic

es

No.

of o

ut-o

f-sch

ool a

dole

scen

t gi

rls re

ache

d w

ith h

ealth

an

d nu

triti

on c

are

prac

tices

in

form

atio

n th

roug

h lif

e sk

ills

trai

ning

NA

3,70

03,

750

3,80

03,

825

3,90

0A

nnua

l rep

orts

of

DW

CW

omen

, Ch

ildre

n an

d So

cial

Wel

fare

No.

of w

omen

gro

up, c

omm

ittee

, co

oper

ativ

e m

embe

rs re

ache

d w

ith h

ealth

and

nut

ritio

n ca

re

info

rmat

ion

thro

ugh

wom

en

soci

al a

nd e

cono

mic

dev

elop

men

t tr

aini

ng

NA

15,0

0012

,000

10,0

0015

,000

17,0

00A

nnua

l rep

orts

of

DW

CW

omen

, Ch

ildre

n an

d So

cial

Wel

fare

Out

put 2

.9:

Child

car

e ho

mes

co

mpl

y w

ith m

inim

um

stan

dard

s of

nut

ritio

n ca

re

No.

of c

hild

car

e ho

mes

that

co

mpl

y w

ith m

inim

um n

utrit

ion

care

ser

vice

s

103

4725

3035

40A

nnua

l rep

orts

of

DW

CW

omen

, Ch

ildre

n an

d So

cial

Wel

fare

Out

put 2

.10:

Co

mm

uniti

es

empo

wer

ed to

pr

even

t har

mfu

l pr

actic

es

No.

of c

omm

uniti

es a

nd

rura

l mun

icip

aliti

es d

ecla

red

chha

upad

i fre

e

15 V

DCs

(d

ecla

red

as

men

stru

al

secl

usio

n sh

ed

[chh

aupa

di

goth

] fre

e)

67

89

10A

nnua

l rep

orts

of

DW

CW

omen

, Ch

ildre

n an

d So

cial

Wel

fare


62

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

Earl

y Ch

ildho

od D

evel

opm

ent a

nd C

lass

room

Edu

cati

on

Out

put 2

.11:

En

hanc

ed e

nrol

men

t of

chi

ldre

n in

bas

ic

educ

atio

n

Num

ber o

f chi

ldre

n in

bas

ic

educ

atio

n re

ceiv

ing

mid

day

mea

ls

612,

000

stud

ent

612,

000

612,

000

612,

000

612,

000

612,

000

EMIS

Educ

atio

n

Out

put 2

.12:

In

crea

sed

adol

esce

nt

girls

’ aw

aren

ess

and

impr

oved

beh

avio

ur

on n

utrit

ion

Num

ber o

f sch

ools

usi

ng

nutr

ition

-sen

sitiv

e lit

erac

y m

ater

ials

Ann

ual r

epor

t of

Dep

artm

ent o

f Ed

ucat

ion

(DoE

)

Educ

atio

n

Hea

lth

and

Fam

ily P

lann

ing

Serv

ices

Out

put 2

.13:

En

hanc

ed a

cces

s to

hea

lth a

nd

repr

oduc

tive

heal

th

serv

ices

Prop

ortio

n of

wom

en (1

5-49

ye

ars)

usi

ng a

ny c

ontr

acep

tive

met

hod

53

ND

HS

2016

60N

DH

SH

ealth

% o

f chi

ldre

n re

ceiv

ing

com

plet

e im

mun

izat

ion

with

in o

ne y

ear

78

ND

HS

2016

≥ 90

ND

HS,

NM

ICS

Hea

lth

Enab

ling

envi

ronm

ent o

utpu

ts

Out

com

e 3:

Im

prov

ed p

olic

ies,

pla

ns a

nd m

ulti

-sec

tora

l co

ordi

nati

on a

t fe

dera

l, pr

ovin

cial

and

loc

al g

over

nmen

t le

vels

to

enha

nce

the

nutr

itio

n st

atus

of

all

popu

lati

on g

roup

s

Out

put 3

.1:

MSN

P-II

incl

uded

in

loca

l, pr

ovin

cial

and

fe

dera

l gov

ernm

ent

polic

ies

and

plan

s

No.

of s

ecto

ral m

inis

trie

s’ pl

ans

that

incl

ude

nutr

ition

and

food

se

curit

y in

line

with

MSN

P-II

77

77

77

AWPB

of

Sect

oral

M

inis

trie

s

NPC

, Sec

tora

l M

inis

trie

s

No.

of p

rovi

ncia

l gov

ernm

ent’s

pl

ans

incl

udin

g nu

triti

on a

nd fo

od

secu

rity

in li

ne w

ith M

SNP-

II

Not

app

licab

le

77

77

7AW

PB o

f pr

ovin

ce

gove

rnm

ent

NPC

, Sec

tora

l M

inis

trie

s

No.

of l

ocal

gov

ernm

ents

in

corp

orat

ed n

utrit

ion

rela

ted

targ

ets

and

indi

cato

rs in

thei

r pl

ans

and

prog

ram

mes

30 d

istr

icts

(s

elec

ted

war

ds o

f 19

4 lo

cal

gove

rnm

ents

)

308

(30

dist

ricts

)30

8 (3

0 di

stric

ts)

332

(33

dist

ricts

356

(37

dist

ricts

)38

1 (3

9 di

stric

ts)

AWPB

s of

loca

l go

vern

men

tsLo

cal

Gov

erna

nce

No.

of p

rovi

nces

with

MSN

P-II

inst

itutio

nal a

rran

gem

ent s

et u

p an

d fu

nctio

nal

Not

app

licab

le

5 6

7 7

7M

eetin

g m

inut

esLo

cal

Gov

erna

nce

No.

of p

rovi

nces

allo

cate

d re

sour

ces

as re

quire

d fo

r MSN

P-II

Not

app

licab

le

77

77

7A

nnua

l bud

gets

an

d pl

ans

at

prov

ince

Loca

l G

over

nanc

e

No.

of l

ocal

gov

ernm

ents

al

loca

ted

reso

urce

s as

requ

ired

for

MSN

P-II

Not

app

licab

le

308

308

332

356

381

Ann

ual

budg

ets

and

plan

s of

loca

l go

vern

men

ts

Loca

l G

over

nanc

e


63

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

Out

put 3

.2:

MSN

P go

vern

ance

m

echa

nism

inst

itute

d an

d st

reng

then

ed a

t fe

dera

l, pr

ovin

cial

, and

lo

cal l

evel

s

No.

of m

eetin

gs o

f Hig

h Le

vel

Nut

ritio

n an

d Fo

od S

ecur

ity

Stee

ring

Com

mitt

ee c

ondu

cted

a

year

at f

eder

al le

vel

12

22

22

Mee

ting

min

utes

N

PC

No.

of q

uart

erly

Nut

ritio

n an

d Fo

od S

ecur

ity C

oord

inat

ion

Com

mitt

ee m

eetin

gs c

ondu

cted

at

fede

ral l

evel

14

44

44

Mee

ting

min

utes

N

PC

Nut

ritio

n an

d fo

od s

ecur

ity

stee

ring

com

mitt

ees

form

ed a

t pr

ovin

ce le

vel

Not

app

licab

le

7-

--

-M

eetin

g m

inut

es

NPC

, Loc

al

gove

rnan

ce

No.

pro

vinc

es h

oldi

ng n

utrit

ion

and

food

sec

urity

ste

erin

g co

mm

ittee

mee

tings

twic

e a

year

Not

app

licab

le

77

77

7M

eetin

g m

inut

es

NPC

, Loc

al

gove

rnan

ce

No.

pro

vinc

es fo

rmin

g nu

triti

on

and

food

sec

urity

coo

rdin

atio

n co

mm

ittee

s

Not

app

licab

le

7-

--

-M

eetin

g m

inut

es

NPC

, Loc

al

gove

rnan

ce

No.

of p

rovi

nces

con

duct

ed

nutr

ition

and

food

sec

urity

co

ordi

natio

n co

mm

ittee

mee

tings

qu

arte

rly

Not

app

licab

le

77

77

7M

eetin

g m

inut

es

NPC

, Loc

al

gove

rnan

ce

MSN

P-II

foca

l poi

nt/u

nit i

dent

ified

in

all

rele

vant

sec

tors

at p

rovi

nce

leve

l

Not

app

licab

le

77

77

7D

ecis

ion

lett

er

for M

SNP

foca

l po

int/

unit

Loca

l G

over

nanc

e

No.

of l

ocal

uni

ts (d

istr

icts

and

lo

cal g

over

nmen

ts) w

ith M

SNP

inst

itutio

nal a

rran

gem

ents

30 d

istr

icts

(3

08 lo

cal

gove

rnm

ents

)

308

loca

l go

vern

men

ts

(30

dist

ricts

)

308

(3

0 di

stric

ts

332

(33

dist

ricts

)35

6

(37

dist

ricts

)38

1 (3

9 di

stric

ts)

Mee

ting

min

utes

Loca

l G

over

nanc

e

No.

of l

ocal

gov

ernm

ents

co

nduc

ted

nutr

ition

and

food

se

curit

y st

eerin

g co

mm

ittee

m

eetin

g at

leas

t tw

ice

a ye

ar

30 d

istr

icts

(3

08 lo

cal

gove

rnm

ents

)

308

(30

dist

ricts

)30

8 (3

0 di

stric

ts)

332

(3

3 di

stric

ts)

356

(3

7 di

stric

ts)

381

(3

9 di

stric

ts)

30 d

istr

icts

(3

08 lo

cal

gove

rnm

ents

)

Loca

l G

over

nanc

e

No.

of l

ocal

gov

ernm

ents

ass

igne

d a

coor

dina

tor (

from

exi

stin

g st

aff

or o

utso

urce

d) to

ove

rsee

MSN

P-II

inte

rven

tions

30 d

istr

icts

(3

08 lo

cal

gove

rnm

ents

)

308

(30

dist

ricts

)30

8 (3

0 di

stric

ts)

332

(33

dist

ricts

)35

6 (3

7 di

stric

ts)

381

(3

9 di

stric

ts)

Lett

ers

Loca

l G

over

nanc

e

No.

of w

ards

with

war

d le

vel

nutr

ition

and

food

sec

urity

st

eerin

g co

mm

ittee

s

2,74

92,

749

2749

2,94

13,

133

3,51

4M

eetin

g m

inut

esLo

cal

Gov

ernm

ent


64

Resu

lts

Indi

cato

rsBa

selin

e Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

or20

1820

1920

2020

2120

22

No.

war

ds c

ondu

cted

war

d le

vel

nutr

ition

and

food

secu

rity

stee

ring

com

mitt

ee a

t lea

st tw

ice

a ye

ar

2,74

92,

749

2,74

92,

941

3,13

33,

514

Mee

ting

min

utes

Loca

l G

over

nmen

t

Out

put 3

.3:

MSN

P in

stitu

tiona

l m

echa

nism

s fu

nctio

nal a

t fed

eral

go

vern

men

t lev

el

Nat

iona

l Nut

ritio

n an

d Fo

od

Secu

rity

Secr

etar

iat (

NN

FSS)

in

stitu

tiona

lized

and

func

tiona

l at

NPC

11

11

11

FN

PC

Org

aniz

atio

n an

d m

anag

emen

t su

rvey

for N

NFS

S co

mpl

eted

and

ap

prov

ed b

y N

PC B

oard

01

--

--

NPC

or

gano

gram

NPC

Num

ber o

f san

ctio

ned

staff

po

sitio

ns fi

lled

at N

NFS

S1

(Ful

fille

d fr

om e

xter

nal

sour

ces)

-1

--

-Co

ntra

ct le

tter

sN

PC

Out

put 3

.4:

Func

tiona

l upd

ated

in

form

atio

n sy

stem

ac

ross

all

MSN

P-II

sect

ors

MSN

P-II

M&

E fr

amew

ork

deve

lope

d or

upd

ated

for a

ll se

ctor

s an

d im

plem

ente

d at

fe

dera

l, pr

ovin

cial

and

loca

l lev

els

11

11

11

M&

E fr

amew

ork

for M

SNP-

IIN

PC, s

ecto

rs,

Loca

l G

over

nanc

e

Web

-bas

ed re

port

ing

syst

em

linke

d w

ith M

SNP-

II M

&E

plan

at

all l

evel

s

7 se

ctor

s7

77

77

NPC

’s w

eb

base

d sy

stem

NPC

& s

ecto

rs

NN

FSS

port

al u

pdat

ed e

ach

quar

ter

44

44

44

NN

FSS

port

al

NPC

No.

of s

ecto

ral r

epor

ts u

pdat

ed

on N

NFS

S po

rtal

as

per M

&E

plan

ea

ch q

uart

er

04

44

44

NN

FSS

port

alN

PC, a

ll se

ctor

s

Out

put 3

.5:

Enha

nced

cap

acity

of

fede

ral,

prov

inci

al a

nd

loca

l lev

el g

over

nmen

t to

pla

n an

d im

plem

ent

nutr

ition

pro

gram

mes

Nat

iona

l Cap

acity

Dev

elop

men

t M

aste

r Pla

n fo

r im

plem

enta

tion

of

MSN

P-II

deve

lope

d

01

11

11

Capa

city

de

velo

pmen

t pl

an

NPC

, all

sect

ors

MSN

P-II

Capa

city

Dev

elop

men

t M

aste

r Pla

n im

plem

ente

d at

fe

dera

l lev

el

01

11

11

Sect

oral

trai

ning

re

port

sN

PC, a

ll se

ctor

s

MSN

P-II

Capa

city

Dev

elop

men

t M

aste

r Pla

n im

plem

ente

d at

pr

ovin

cial

leve

l

07

77

77

Sect

oral

trai

ning

re

port

sN

PC, a

ll se

ctor

s


65

Key

act

iviti

es

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

OU

TPU

T 1

Nut

riti

on s

ensi

tive

act

ivit

ies

Out

put 1

.1: E

nhan

ced

nutr

itio

n st

atus

of W

RA in

clud

ing

adol

esce

nts

1.1.

1 O

rgan

ize

and

impl

emen

t ful

ly-n

ouris

hed

villa

ges/

war

ds in

clud

ing

Gol

den

1000

D

ays

com

mun

icat

ion

cam

paig

n

Villa

geN

A

300

villa

ges

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.1.

2 Re

vita

lize

Scho

ol H

ealth

and

Nut

ritio

n Pr

ogra

mm

e in

clud

ing

prom

otio

n of

he

alth

y di

etar

y ha

bits

and

phy

sica

l act

ivity

Loca

l go

vern

men

ts77

dis

tric

ts

350

loca

l go

vern

men

ts

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.1.

3 Ra

ise

awar

enes

s an

d se

rvic

es fo

r hea

lthy

timin

g an

d sp

acin

g of

pre

gnan

cy.

Loca

l go

vern

men

ts77

dis

tric

ts75

3 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.1.

4 Co

nduc

t bar

rier a

naly

sis

for i

ncre

asin

g A

NC

serv

ice

utili

zatio

nPr

ovin

ceN

A7

(1 in

eac

h pr

ovin

ce)

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.1.

5 In

tegr

ate

and

expa

nd a

dole

scen

t-fr

iend

ly

heal

th a

nd n

utrit

ion

serv

ices

Loca

l go

vern

men

tsN

A37

2 lo

cal

gove

rnm

ents

A

nnua

l rep

orts

of

DoH

SH

ealth

Out

put 1

.2: I

mpr

oved

mat

erna

l, in

fant

and

you

ng c

hild

nut

riti

on a

nd c

are

prac

tice

s

1.2.

1 Co

nduc

t mat

erna

l, in

fant

and

you

ng

child

nut

ritio

n (M

IYCN

) cou

nsel

ling

on a

ll he

alth

sec

tor p

latf

orm

s vi

z. h

ealth

mot

her’s

gr

oup

mee

tings

, im

mun

izat

ion,

AN

C, P

NC,

gr

owth

mon

itorin

g (G

MP)

, PH

C-O

RC, I

MN

CI

and

OPD

Loca

l go

vern

men

tsN

A37

2 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.2.

2 Co

nduc

t reg

ular

gro

wth

mon

itorin

g co

unse

lling

at P

HC-

ORC

s an

d he

alth

fa

cilit

ies

Loca

l go

vern

men

tsN

A37

2 lo

cal

gove

rnm

ents

Ann

ual r

epor

t of

DoH

SH

ealth

1.2.

3 D

isse

min

ate

IEC

and

BCC

mat

eria

ls in

lin

e w

ith F

ood

Base

d D

ieta

ry G

uide

lines

th

roug

h he

alth

faci

litie

s, FC

HVs

to

com

mun

ities

and

hou

seho

lds

regu

larly

.

Loca

l go

vern

men

tsN

A75

3 lo

cal

gove

rnm

ents

A

nnua

l rep

ort

of D

oHS

Hea

lth

1.2.

4 Co

nduc

t foo

d pr

epar

atio

n an

d co

okin

g de

mon

stra

tions

to p

repa

re lo

cal n

utrit

ious

fo

ods

(e.g

. nut

ritio

us fl

our/

porr

idge

(lito

), ja

ulo

and

khic

hadi

usi

ng lo

cal f

oods

tuffs

Loca

l go

vern

men

ts N

A75

3 lo

cal

gove

rnm

ents

Ann

ual r

epor

t of

DoH

SH

ealth


66

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

1.2.

5 En

gage

med

ia fo

r doc

umen

tatio

n an

d di

ssem

inat

ion

of M

IYCN

pro

gram

me

Even

tN

A7

(1 in

all

7)A

nnua

l rep

ort

of D

oHS

Hea

lth

1.2.

6 Ra

ise

awar

enes

s on

nut

ritio

n in

clud

ing

esse

ntia

l new

born

car

eLo

cal

gove

rnm

ents

NA

753

loca

l go

vern

men

tsA

nnua

l rep

ort

of D

oHS

Hea

lth

Out

put 1

.3: I

mpr

oved

MIY

C m

icro

nutr

ient

sta

tus

1.3.

1 M

aint

ain

and

sust

ain

rout

ine

dist

ribut

ion

of V

itam

in A

cap

sule

s an

d de

wor

min

g ta

blet

s to

chi

ldre

n un

der 5

Loca

l go

vern

men

ts77

dis

tric

ts75

3 lo

cal

gove

rnm

ents

Ann

ual r

epor

t of

DoH

SH

ealth

1.3.

2 In

crea

se c

over

age

and

com

plia

nce

of ir

on

folic

aci

d an

d de

wor

min

g am

ong

preg

nant

and

po

st-p

artu

m w

omen

Loca

l go

vern

men

ts77

dis

tric

ts75

3 lo

cal

gove

rnm

ents

Ann

ual r

epor

t of

DoH

SH

ealth

1.3.

3 Sc

ale-

up h

ome

food

fort

ifica

tion

with

m

ultip

le m

icro

nutr

ient

pow

der (

MN

P) in

ta

rget

ed a

reas

Loca

l go

vern

men

ts30

dis

tric

ts34

di

stric

ts45

di

stric

ts55

di

stric

ts75

3 lo

cal

gove

rnm

ents

753

loca

l go

vern

men

tsA

nnua

l rep

orts

of

DoH

SH

ealth

1.3.

4 Ra

ise

awar

enes

s to

pro

mot

e ho

useh

old

use

of tw

o-ch

ild-lo

go io

dize

d sa

ltLo

cal

gove

rnm

ents

77 d

istr

icts

753

loca

l go

vern

men

tsA

nnua

l rep

orts

of

DoH

SH

ealth

1.3.

5 Ra

ise

awar

enes

s to

pro

mot

e co

nsum

ptio

n of

nat

iona

l rol

ler-

mill

fort

ified

flou

r and

rice

Lo

cal

gove

rnm

ents

NA

372

loca

l go

vern

men

tsA

nnua

l rep

orts

of

DoH

SH

ealth

and

ag

ricul

ture

1.3.

6 In

itiat

e ric

e fo

rtifi

catio

n in

gov

ernm

ent

(NFC

) and

sel

ecte

d bi

g ric

e pr

oduc

ing

mill

sRo

ller m

ills

NA

1 2

22

Ann

ual r

epor

ts

of D

FTQ

CAg

ricul

ture

, he

alth

, su

pplie

s

1.3.

7 Co

nduc

t res

earc

h to

impr

ove

use

of ir

on-

folic

aci

d (IF

A) s

uppl

emen

tatio

nPr

ovin

ce7

Ann

ual r

epor

ts

1.3.

8 Co

nduc

t bar

rier a

naly

sis

on lo

w c

over

age/

com

plia

nce

of M

NP

Even

t per

pr

ovin

ceN

A7

(1 in

all

7 pr

ovin

ce)

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.3.

9 Pr

ocur

e an

d su

pply

nut

ritio

n co

mm

oditi

es

for r

egul

ar a

nd e

mer

genc

y pr

ogra

ms

(VAC

, IFA

, de

wor

min

g ta

blet

s, M

NPs

, RU

TF, t

hera

peut

ic

milk

, ReS

oMal

)

Perc

enta

ge10

010

0A

nnua

l rep

orts

of

DoH

SH

ealth


67

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

1.3.

10 S

cale

-up

fort

ified

sup

er c

erea

l flou

r di

strib

utio

n in

sel

ecte

d di

stric

ts w

ith h

igh

prev

alen

ce o

f acu

te m

alnu

triti

on to

pre

gnan

t an

d la

ctat

ing

wom

en a

nd 6

-23

mon

ths

child

ren

unde

r MCH

N p

rogr

amm

e

Dis

tric

ts6

66

89

9A

nnua

l rep

orts

of

DoH

SH

ealth

Out

put 1

.4: I

mpr

oved

man

agem

ent o

f sev

ere

and

mod

erat

e ac

ute

mal

nutr

itio

n

1.4.

1 Ex

pand

and

est

ablis

h O

TC a

nd IT

C ce

ntre

s fo

r man

agem

ent o

f sev

ere

acut

e m

alnu

triti

on

in c

hild

ren

unde

r 5 y

ears

Loca

l go

vern

men

ts32

dis

tric

ts75

3 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.4.

2 Sc

ale-

up n

utrit

ion

reha

bilit

atio

n ho

mes

(N

RH) i

n 50

+ be

d ho

spita

lsLo

cal

gove

rnm

ents

43

hosp

itals

37

2 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.4.

3 Co

nduc

t per

iodi

c nu

triti

on a

sses

smen

ts

and

coun

selli

ng a

t com

mun

ity le

vel

Loca

l go

vern

men

tsN

A37

2 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.4.

4 Co

nduc

t bar

rier a

naly

sis

on s

ervi

ces

rela

ted

to S

AM

man

agem

ent

Prov

ince

NA

7 pr

ovin

ce

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.4.

5 Sc

ale-

up a

nd s

tren

gthe

n IM

NCI

pr

ogra

mm

eLo

cal

gove

rnm

ents

77 d

istr

icts

753

loca

l go

vern

men

tsA

nnua

l rep

orts

of

DoH

SH

ealth

1.4.

6 Es

tabl

ish

and

stre

ngth

en n

utrit

ion

info

rmat

ion

and

surv

eilla

nce

syst

em in

nor

mal

an

d hu

man

itaria

n si

tuat

ions

Prov

ince

2

dist

ricts

7 pr

ovin

ces

Ann

ual r

epor

ts

of D

oHS

Hea

lth

Out

put 1

.5: E

nhan

ced

prep

ared

ness

for n

utri

tion

in e

mer

genc

y re

spon

ses

1.5.

1 Es

tabl

ish

loca

l nut

ritio

n cl

uste

rs a

nd

cond

uct q

uart

erly

coo

rdin

atio

n m

eetin

g at

lo

cal l

evel

s

Prov

ince

77 d

istr

icts

7 pr

ovin

ces

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.5.

2 U

pdat

e an

d de

velo

p nu

triti

on in

em

erge

ncy

prep

ared

ness

for r

espo

nse

and

cont

inge

ncy

plan

ning

at l

ocal

leve

ls

Prov

ince

s an

d lo

cal

gove

rnm

ents

77 d

istr

icts

7

prov

ince

s an

d 37

2 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

Out

put 1

.6: B

uilt

cap

acit

y of

nut

riti

on s

peci

fic s

ecto

r

1.6.

1 Co

nduc

t ref

resh

er tr

aini

ng to

hea

lth

wor

kers

and

FCH

Vs a

t all

leve

ls o

n M

IYCN

pa

ckag

e

Loca

l go

vern

men

ts77

dis

tric

ts

753

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.6.

2 O

rgan

ize

basi

c tr

aini

ng o

n M

IYCN

pac

kage

to

new

ly re

crui

ted

nutr

ition

sup

ervi

sors

and

nu

triti

on o

ffice

rs

Loca

l go

vern

men

tsN

A75

3 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth


68

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

1.6.

3 O

rgan

ize

nutr

ition

cha

mpi

on le

ader

ship

de

velo

pmen

t eve

nts

Prov

ince

NA

7 pr

ovin

ces

Ann

ual r

epor

ts

of D

oHS

Hea

lth

1.6.

4 Co

nduc

t rou

tine

data

qua

lity

asse

ssm

ent

(RD

QA

) usi

ng n

utrit

ion

prog

ram

me-

rela

ted

HM

IS to

ols

Loca

l go

vern

men

tsN

A37

2 lo

cal

gove

rnm

ents

Ann

ual r

epor

ts

of D

oHS

Hea

lth

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

OU

TPU

T 2

Agr

icul

ture

and

Liv

esto

ck

Out

put 2

.1: I

ncre

ased

ava

ilabi

lity

and

cons

umpt

ion

of s

afe

and

nutr

itio

us fo

od

2.1.

1 M

ake

avai

labl

e ag

ricul

ture

and

live

stoc

k in

puts

(i.e

. see

ds, f

ertil

izer

s, br

eeds

) at

hous

ehol

d an

d co

mm

unity

leve

ls

Impr

oved

see

ds (i

ncre

ase

by 1

0%) (

in 1

,000

to

nnes

) 1,

000

tonn

es9,

540

(201

4)12

,698

13,9

6815

,364

16,9

0118

,591

MoA

D’s

annu

al

repo

rts

Agric

ultu

re

Fert

ilize

rs (i

ncre

ase

use

by 5

% a

nnua

lly) (

in

1,00

0 to

nnes

) 1,

000

tonn

es29

8,67

7

(201

4)34

5,75

636

3,04

438

1,19

640

0,25

642

0,26

9M

oAD

’s an

nual

re

port

sAg

ricul

ture

Bree

ds (n

o. o

f art

ifici

al in

sem

inat

ions

)Br

eeds

450,

000

500,

000

525,

000

550,

000

600,

000

650,

000

MoA

D’s

annu

al

repo

rts

Live

stoc

k

2.1.

2 Pr

ovid

e te

chni

cal s

uppo

rt (t

rain

ing,

de

mon

stra

tion)

to p

rom

ote

prod

uctio

n of

frui

ts,

vege

tabl

es, n

utrit

ious

root

s, ce

real

s an

d pu

lses

to

incr

ease

con

sum

ptio

n of

div

ersi

fied

food

s in

ho

useh

olds

Agric

ultu

re

Cere

als

(1,0

00 to

nnes

)1,

000

tonn

es8,

614

(201

4)9,

515

9,70

59,

414

9,69

79,

987

MoA

D’s

annu

al

repo

rts

Puls

es (1

,000

tonn

es)

1,00

0 to

nnes

316

(201

4)32

933

534

234

935

6

Frui

ts (1

,000

tonn

es)

1,00

0 to

nnes

992

(201

4)11

811,

252

1,32

71,

407

1,49

2

Vege

tabl

es (1

,000

tonn

es)

1,00

0 to

nnes

3,81

9 (2

014)

4413

4,67

84,

959

5,25

65,

572

Pota

to (1

,000

tonn

es)

1,00

0 to

nnes

190

210

218

227

236

246


69

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

2.1.

3 In

crea

se p

rodu

ctio

n an

d pr

omot

e co

nsum

ptio

n of

fres

h fr

uits

and

gre

en le

afy

vege

tabl

es

Refe

r to

c.

and

d. o

f ac

tivity

2.1

.2

MoA

D’s

annu

al

repo

rts

Agric

ultu

re

2.1.

4 Bu

ild c

apac

ity o

f liv

esto

ck fa

rmer

s an

d en

trep

rene

urs

to in

crea

se m

ilk, m

eat a

nd e

gg

prod

uctio

n

Pers

on13

,000

15,0

0017

,000

19,0

0022

,000

25,0

00A

nnua

l rep

orts

of

MoL

D

Live

stoc

k

2.1.

5 Te

chni

cal s

uppo

rt fo

r mic

ro a

nd a

ltern

ativ

e sm

all i

rrig

atio

n to

pro

duce

div

ersi

fied

and

mic

ronu

trie

nt ri

ch fo

ods

% o

f cro

p la

nd

in y

ear r

ound

irr

igat

ion

18

(201

0)22

2530

3545

AD

SAg

ricul

ture

2.1.

6 Su

ppor

t foo

d pr

oduc

ing

indu

strie

s to

ad

opt g

ood

man

ufac

turin

g pr

actic

es a

nd

rela

ted

syst

ems

Indu

stry

N

A

1010

1010

10Re

port

s of

D

FTQ

CAg

ricul

ture

and

Li

vest

ock

2.1.

7 Tr

ain

agric

ultu

re a

nd li

vest

ock

exte

nsio

n offi

cers

and

sta

ff on

food

saf

ety,

food

pro

cess

ing

and

nutr

ition

Even

tN

A

100

100

100

100

100

Repo

rts

of

DFT

QC

Agric

ultu

re a

nd

Live

stoc

k

2.1.

8 Tr

ain

farm

ers

on fo

od s

afet

y, fo

od

proc

essi

ng a

nd n

utrit

ion

Pers

onN

A1,

000

1,00

01,

000

1,00

01,

000

Repo

rts

of D

oA

& D

oLS

Agric

ultu

re a

nd

Live

stoc

k

.9 S

tudy

and

impr

ove

loca

l foo

d re

cipe

sEv

ent

NA

55

55

5Re

port

s of

D

FTQ

CAg

ricul

ture

and

Li

vest

ock

2.1.

10 U

pdat

e an

d di

ssem

inat

e fo

od

com

posi

tion

tabl

esa)

Ana

lyse

food

sam

ples

b) D

ata

com

pila

tion

and

publ

icat

ion

of

upda

ted

food

com

posi

tion

tabl

e

Piec

e Ex

istin

g 30

0 30

0 30

030

0 30

0Re

port

s of

D

FTQ

CAg

ricul

ture

and

Li

vest

ock

2.1.

11 D

isse

min

ate

food

bas

ed d

ieta

ry

guid

elin

es to

loca

l gov

ernm

ents

Piec

e N

A30

030

030

030

030

0Re

port

s of

D

FTQ

CAg

ricul

ture

and

Li

vest

ock

2.1.

12 D

evel

op a

nd m

ultip

ly B

CC m

ater

ials

in

clud

ing

audi

o vi

sual

s on

food

saf

ety,

food

pr

oces

sing

and

nut

ritio

n

Piec

e N

A5

55

55

Repo

rts

of

DFT

QC

Agric

ultu

re a

nd

Live

stoc

k

Out

put 2

.2: I

ncre

ased

phy

sica

l and

eco

nom

ic a

cces

s to

div

ersi

fied

food

2.2.

1 En

hanc

e ac

cess

and

util

izat

ion

of a

nim

al

sour

ce fo

ods

a) O

pen

mar

ket e

stab

lishm

ents

No.

of m

arke

ts3

56

77

7

Ann

ual r

epor

ts

of M

oLD

Live

stoc

k b)

Chi

lling

vat

dis

trib

utio

nN

umbe

r20

4060

7010

011

0

c) A

war

enes

s pr

ogra

mm

es to

use

saf

e an

imal

pr

oduc

ts (e

vent

s)Ev

ent

2040

5070

9012

0


70

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

2.2.

2 Pr

omot

e an

d su

ppor

t pro

duct

ion

and

cons

umpt

ion

of fi

sh in

clud

ing

supp

ort t

o es

tabl

ish

com

mun

ity p

onds

for p

rodu

ctio

n an

d lo

cal c

onsu

mpt

ion

1,00

0 to

nnes

48

5760

6366

69A

nnua

l rep

orts

of

MoA

D

Agric

ultu

re

Wat

er S

uppl

y an

d Sa

nita

tion

Out

put 2

.3: I

ncre

ased

acc

ess

to s

afe

drin

king

wat

er

2.3.

1 Co

nstr

uct a

nd re

pair

wat

er s

uppl

y sc

hem

es

in c

omm

uniti

es a

nd in

stitu

tions

thro

ugh

wat

er

safe

ty p

lans

and

pro

ject

s

Perc

enta

ge

610

0 D

WSS

Wat

er S

uppl

y an

d Sa

nita

tion

2.3.

1 Pr

omot

e al

tern

ativ

e an

d in

nova

tive

tech

nolo

gies

for s

uppl

y w

ater

Perc

enta

ge

0.4

2.5

NM

IP-D

WSS

Wat

er S

uppl

y an

d Sa

nita

tion

2.3.

3 Pr

omot

e ho

useh

old

wat

er tr

eatm

ent

optio

nsPe

rcen

tage

N

A25

NM

IP-D

WSS

Wat

er S

uppl

y an

d Sa

nita

tion

Out

put 2

.4: I

ncre

ased

acc

ess

to s

afe

and

sust

aina

ble

sani

tati

on s

ervi

ces

2.4.

1 Ra

ise

com

mun

ity a

war

enes

s on

co

nstr

uctio

n, m

aint

enan

ce a

nd h

ygie

nic

use

of im

prov

ed h

ouse

hold

toile

ts in

clud

ing

safe

di

spos

al o

f chi

ld fa

eces

Perc

enta

geN

A10

0N

MIP

-DW

SSW

ater

Sup

ply

and

Sani

tatio

n

2.4.

2 Su

ppor

t and

str

engt

hen

WA

SH

coor

dina

tion

com

mitt

ees

and

loca

l gov

ernm

ent

to a

ccel

erat

e O

DF

cam

paig

ns.

Perc

enta

ge

100

NM

IP-D

WSS

Wat

er S

uppl

y an

d Sa

nita

tion

2.4.

3 Su

ppor

t con

stru

ctio

n an

d m

anag

emen

t of

chi

ld, g

ende

r and

diff

eren

tly a

bled

fr

iend

ly to

ilets

incl

udin

g m

enst

rual

hyg

iene

m

anag

emen

t fac

ilitie

s at

inst

itutio

ns

Perc

enta

ge

NA

2035

WA

SH S

ecto

r D

evel

opm

ent

Plan

Wat

er S

uppl

y an

d Sa

nita

tion

22.4

.4 S

afe

and

hyge

nic

food

saf

ety

prac

tices

su

ch a

s co

verin

g st

one

mix

ture

, dry

ing

ut

ensi

ls e

tc

Perc

enta

ge

NA

2035

WA

SH S

ecto

r D

evel

opm

ent

Plan

Wat

er S

uppl

y an

d Sa

nita

tion

Out

put 2

.5: P

rom

oted

hyg

iene

beh

avio

ur p

ract

ices

and

its

man

agem

ent

2.5.

1 Co

nstr

uct,

esta

blis

h an

d pr

omot

e us

er

frie

ndly

han

d w

ashi

ng fa

cilit

ies

in h

ouse

hold

s an

d in

stitu

tions

Perc

enta

geN

A10

0D

WSS

Wat

er S

uppl

y an

d Sa

nita

tion

2.5.

2 Ra

ise

awar

enes

s on

han

d w

ashi

ng a

t cr

itica

l tim

es in

com

mun

ities

, sch

ool c

hild

ren

and

heal

th w

orke

rs

NA

Dat

a fr

om D

oE

and

DoH

SW

ater

Sup

ply

and

Sani

tatio

n

2.5.

3 Ra

ise

awar

enes

s on

men

stru

al h

ygie

ne

man

agem

ent i

n co

mm

uniti

es a

nd s

choo

lsPe

rcen

tage

NA

100

DW

SSW

ater

Sup

ply

and

Sani

tatio

n

2.5.

4 Ra

ise

awar

enes

s ab

out f

ood

hygi

ene

in

com

mun

ities

NA

DW

SSW

ater

Sup

ply

and

Sani

tatio

n


71

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

Soci

al P

rote

ctio

n

Out

put 2

.6: T

arge

ted

grou

ps h

ave

acce

ss to

reso

urce

s an

d op

port

unit

ies

that

are

ess

enti

al fo

r mak

ing

them

sel

f-re

liant

.

2.6.

1 Su

ppor

t com

mun

ity s

eed

bank

sSe

ed b

ank

15

(201

6)17

1921

2325

Ann

ual r

epor

t of

MoA

DAg

ricul

ture

2.6.

2 Su

ppor

t wom

en a

nd d

isad

vant

aged

gr

oups

to p

rodu

ce a

nd c

onsu

me

anim

al

lives

tock

pro

duct

s

Dis

tric

t N

A20

2530

3235

Ann

ual r

epor

t of

MoL

DLi

vest

ock

2.6.

3 Pr

ovid

e st

art-

up e

ntre

pren

eurs

hip

gran

ts

to w

omen

coo

pera

tives

for s

ocia

l and

eco

nom

ic

empo

wer

men

t (N

PR 1

50,0

00 to

450

,000

)

Wom

en

coop

erat

ive

411

8890

100

110

120

Ann

ual r

epor

ts

of D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re

2.6.

4 Pr

ovid

e st

art-

up e

ntre

pren

eurs

hip

gran

ts

to w

omen

gro

up m

embe

rs fo

r soc

ial a

nd

econ

omic

em

pow

erm

ent (

NPR

350

0–75

00)

Mem

bers

of

wom

en

coop

erat

ives

49,3

85

15,0

0012

,000

10,0

0015

,000

17,0

00D

raft

73/

74

Ann

ual

Econ

omic

Su

rvey

Wom

en,

Child

ren

and

Soci

al W

elfa

re

2.6.

5 Tr

aini

ng a

nd o

rient

atio

ns fo

r inc

ome

gene

ratio

n an

d bu

sine

ss p

rom

otio

n (v

eget

able

&

frui

t pro

duct

ion,

ani

mal

hus

band

ry, l

ives

tock

, ta

ilorin

g, e

tc.)

Pers

ons/

no. o

f tr

aini

ngs

163,

959

1,50

01,

600

1,75

01,

900

2,00

0A

nnua

l rep

orts

of

DW

CW

omen

, Ch

ildre

n an

d So

cial

Wel

fare

2.6.

6 Li

nk th

e di

strib

utio

n of

chi

ld p

rote

ctio

n gr

ants

to n

utrit

ion

in a

ll di

stric

tsLo

cal

gove

rnm

ents

203

loca

l go

vern

men

ts20

3 29

9 32

3 34

7 37

2 Re

port

s of

D

oCR

Loca

l G

over

nanc

e

2.6.

7 In

clud

e nu

triti

on a

s a

maj

or o

bjec

tive

of

soci

al p

rote

ctio

n pr

ogra

mm

esLo

cal

gove

rnm

ents

203

loca

l go

vern

men

ts20

3 29

9 32

3 34

7 37

2 Re

port

s of

D

oCR

Loca

l G

over

nanc

e

Mat

erna

l Hea

lth a

nd W

omen

Em

pow

erm

ent

Out

put 2

.7: N

utri

tion

com

pone

nt in

corp

orat

ed in

wom

en, a

dole

scen

t gir

ls a

nd c

hild

dev

elop

men

t tra

inin

g pa

ckag

es

2.7.

1 In

tegr

ate

nutr

ition

mod

ules

in tr

aini

ng

pack

ages

incl

udin

g ge

nder

bas

ed v

iole

nce

prev

entio

n an

d re

spon

se tr

aini

ng, l

eade

rshi

p,

com

mun

ity p

rote

ctio

n, b

usin

ess

deve

lopm

ent

and

life

skill

s tr

aini

ng

Mod

ule

2 3

21

00

Ann

ual r

epor

ts

of D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re


72

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

Out

put 2

.8: W

omen

, chi

ldre

n an

d ou

t of s

choo

l ado

lesc

ent g

irls

reac

hed

wit

h he

alth

and

nut

riti

on c

are

prac

tice

s

2.8.

1 O

rgan

ize

trai

ning

s fo

r wom

en c

oope

rativ

es

and

child

clu

bs o

n nu

triti

on s

ensi

tive

serv

ices

:

Ann

ual r

epor

ts

of D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re

Lead

ersh

ip tr

aini

ngPe

rson

37,6

323,

760

3,80

03,

825

3,85

03,

900

Gen

der b

ased

vio

lenc

e pr

even

tion

and

resp

onse

trai

ning

Coop

erat

ive

3640

4245

50

Com

mun

ity p

rote

ctio

n tr

aini

ngCo

oper

ativ

e32

4042

4550

Busi

ness

dev

elop

men

t tra

inin

gsPe

rson

48,3

00

28,3

0038

,200

51,6

0062

,000

73,0

00

Repr

oduc

tive

heal

th tr

aini

ngPe

rson

121,

513

1980

2,00

02,

050

2,15

02,

200

Gen

der d

evel

opm

ent t

rain

ing

(c

o-de

velo

pmen

t)Pe

rson

2,85

02,

900

2,95

03,

000

3,10

03,

200

2.8.

2 Li

fe s

kill

deve

lopm

ent p

rogr

amm

es fo

r ou

t-of

-sch

ool a

dole

scen

t girl

s:

Men

stru

al h

ygie

ne tr

aini

ng

Pers

on24

050

070

090

01,

000

Ann

ual r

epor

ts

of D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re

Know

ledg

e an

d aw

aren

ess

rais

ing

initi

ativ

es

for a

dole

scen

t girl

s (v

ulne

rabl

e di

stric

ts fo

r ge

nder

-bas

ed v

iole

nce

and

girl

traffi

ckin

g)

Pers

on3,

700

3,85

04,

000

4,20

04,

500

Ann

ual r

epor

ts

of D

WC

Gen

eral

life

ski

ll de

velo

pmen

t tra

inin

gPe

rson

,5,

120

2,80

03,

000

3,20

03,

300

3,50

0A

nnua

l rep

orts

of

DW

C

Org

aniz

e tr

aini

ng to

chi

ld c

lubs

and

vill

age

child

pro

tect

ion

com

mitt

ees

(VCP

C) o

n nu

triti

on c

are

Ann

ual r

epor

ts

of D

WC

Out

put 2

.9: C

hild

car

e ho

mes

com

ply

wit

h m

inim

um s

tand

ards

of n

utri

tion

car

e se

rvic

es.

2.9.

1 M

onito

r chi

ld c

are

hom

es c

ompl

ianc

e w

ith

min

imum

sta

ndar

ds o

f pro

visi

on o

f nut

ritio

n se

nsiti

ve s

ervi

ces

Child

Car

e H

ome

103

4725

3540

45A

nnua

l rep

orts

of

DW

C

Wom

en,

Child

ren

and

Soci

al W

elfa

re

Child

Car

e H

ome

103

103

100

105

110

120

Ann

ual r

epor

t of

DW

C

2.9.

2 Pr

omot

e nu

triti

on s

ensi

tive

serv

ices

at

child

car

e ho

mes

Child

Car

e H

ome

NA

5010

010

010

010

0A

nnua

l rep

orts

of

DW

C

2.9.

3 In

tegr

ate

nutr

ition

com

pone

nt in

chi

ld

prot

ectio

n ca

se m

anag

emen

t tra

inin

g an

d se

rvic

es

Trai

ning

Pa

ckag

eN

A

1A

nnua

l rep

orts

of

DW

C

2.9.

4 D

epriv

ed (B

ipan

na) i

nfan

t nut

ritio

n pr

ogra

mm

e (N

PR 5

0,00

0 gr

ant f

or w

omen

co

oper

ativ

es)

Coop

erat

ive

3640

5055

6070

Ann

ual r

epor

ts

of D

WC


73

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

Out

put 2

.10:

Com

mun

itie

s em

pow

ered

to p

reve

nt h

arm

ful p

ract

ices

2.10

.1 R

un b

ehav

iour

cha

nge

com

mun

icat

ion

activ

ities

to e

nd h

arm

ful t

radi

tiona

l pra

ctic

esEv

ent

NA

90

01,

000

1,15

01,

200

1,50

0A

nnua

l rep

ort

of D

WC

Wom

en,

Child

ren

and

Soci

al W

elfa

re

2.10

.2 R

un c

ampa

igns

to p

reve

nt m

arria

ge u

ntil

age

20 (3

50 a

dole

scen

ts, 3

90 s

take

hold

ers,

840

dham

i-jha

kri i

n 39

inte

ract

ion

prog

ram

mes

)

Even

t5,

000

2750

3,00

03,

200

3,50

04,

000

Ann

ual r

epor

t of

DW

C

2.10

.3 P

rogr

amm

es to

shi

ft s

ocia

l nor

ms

and

harm

ful p

ract

ices

on

food

tabo

os th

at p

reve

nt

men

stru

al h

ygie

ne, a

dequ

ate

nutr

ition

for

adol

esce

nts,

etc.

Even

t30

030

040

045

050

055

0A

nnua

l rep

ort

of D

WC

Earl

y Ch

ildho

od D

evel

opm

ent a

nd C

lass

room

Edu

cati

on

Out

put 2

.11

Enha

nced

enr

olm

ent o

f chi

ldre

n in

bas

ic e

duca

tion

.

2.11

.1 R

un w

elco

me

to s

choo

l cam

paig

ns fo

r ba

sic

educ

atio

nSc

hool

29,2

07

29,3

0729

,407

29,5

0729

,607

29,7

07A

nnua

l rep

orts

of

DoE

Ed

ucat

ion

2.11

.2 P

rovi

de a

dequ

ate

reso

urce

s to

all

scho

ols

to h

ave

ECED

/PPE

Scho

ol25

,000

25

,500

26,0

0027

,000

28,0

0029

,000

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

2.11

.3 P

rovi

de d

iver

sifie

d an

d nu

triti

ous

mid

day

mea

ls to

chi

ldre

n in

bas

ic e

duca

tion

Stud

ent

612,

000

612,

000

612,

000

612,

000

612,

000

612,

000

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

2.11

.4 E

CED

faci

litat

ors,

com

mun

ity le

arni

ng

cent

res

(CLC

) fac

ilita

tors

, foc

al te

ache

r and

he

alth

teac

hers

and

food

man

agem

ent

com

mitt

ees

in c

oord

inat

ion

with

FCH

Vs e

ngag

e pa

rent

s to

impr

ove

thei

r kno

wle

dge

of h

ealth

, hy

gien

e an

d nu

triti

on

Dis

tric

t 12

12

1212

1212

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

2.11

.5 N

utrit

ion

mon

itorin

g of

bas

ic e

duca

tion

stud

ents

Dis

tric

t 12

57

5757

5757

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

2.11

.6 B

uild

nut

ritio

n ca

paci

ty o

f ECD

faci

litat

ors,

CLC

faci

litat

ors,

heal

th te

ache

rs a

nd fo

od

man

agem

ent c

omm

ittee

in s

choo

ls

Dis

tric

t 12

12

1212

1212

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

Out

put 2

.12:

Incr

ease

d ad

oles

cent

gir

ls’ a

war

enes

s an

d be

havi

ours

in n

utri

tion

2.12

.1 R

un c

ampa

igns

to in

crea

se g

irls’

enro

lmen

t in

scho

ols

in ta

rget

ed a

reas

Sc

hool

29,2

0729

,307

29,4

0729

,507

29,6

0729

,707

EMIS

Educ

atio

n

2.12

.2 C

reat

e pr

iorit

y m

inim

um e

nabl

ing

cond

ition

s (c

lass

room

s, te

ache

rs, t

ext b

ooks

, W

ASH

, boo

k co

rner

s) in

sch

ools

Scho

olN

A

All

scho

ols

All

scho

ols

All

scho

ols

All

scho

ols

All

scho

ols

EMIS

Educ

atio

n

2.12

.3 B

uild

sep

arat

e fu

nctio

nal t

oile

ts w

ith

grou

p ha

nd w

ash

faci

litie

s, es

peci

ally

for g

irls

in

scho

ols

Scho

ol67

7277

8287

92EM

ISEd

ucat

ion


74

Key

acti

viti

esU

nit

Situ

atio

n in

201

7Ta

rget

Mea

ns o

f ve

rific

atio

nRe

spon

sibl

e se

ctor

s20

1820

1920

2020

2120

22

2.12

.4 P

rovi

de s

afe

drin

king

wat

er in

sch

ools

Scho

ol80

8590

9510

010

0EM

ISEd

ucat

ion

2.12

.5 P

rom

ote

heal

thy

beha

viou

r thr

ough

sk

ills-

base

d he

alth

edu

catio

n in

sch

ools

Scho

olN

A

35,2

2235

,300

35,4

0035

,500

35,6

00EM

ISEd

ucat

ion

2.12

.6 R

evis

e he

alth

and

nut

ritio

n cu

rric

ulum

Clas

sN

A

Clas

s 1-

3Cl

asse

s 4-

5Cl

asse

s 6-

8Cl

asse

s 9-

10Cl

asse

s 11

-12

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

2.12

.7 E

stab

lish

food

man

agem

ent c

omm

ittee

s in

all

scho

ols

prov

idin

g m

idda

y m

eals

Dis

tric

t 12

57

5757

5757

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

2.12

.8 D

evel

op a

set

of e

duca

tiona

l tra

inin

g pa

ckag

es o

n di

sast

er ri

sk re

duct

ion

(DRR

) for

st

uden

ts, t

each

ers

and

scho

ol m

anag

emen

t co

mm

ittee

s

Trai

ning

pa

ckag

e N

A1

Ann

ual r

epor

ts

of D

oE

Educ

atio

n

Hea

lth

and

Fam

ily P

lann

ing

Serv

ices

Out

put 2

.13

Prom

ote

acce

ss to

hea

lth

and

repr

oduc

tive

hea

lth

serv

ices

.

2.13

.1 P

rovi

de re

prod

uctiv

e he

alth

info

rmat

ion

serv

ices

in s

choo

ls a

nd h

ealth

faci

litie

s fo

r boy

s an

d gi

rls

Publ

ic s

choo

l77

dis

tric

ts

>75%

of p

ublic

sc

hool

sA

nnua

l rep

orts

of

DoH

SH

ealth

2.13

.2 P

rovi

de k

now

ledg

e on

impo

rtan

ce o

f de

laye

d fir

st p

regn

ancy

aft

er m

arria

gePu

blic

sch

ool

77 d

istr

icts

>7

5% o

f pub

lic

scho

ols

Ann

ual r

epor

ts

of D

oHS

Hea

lth

2.13

.3 P

rovi

de in

form

atio

n to

sch

ool s

tude

nts

on b

enefi

ts o

f use

of f

amily

pla

nnin

g m

etho

ds

Publ

ic s

choo

l77

dis

tric

ts

>75%

of p

ublic

sc

hool

sA

nnua

l rep

orts

of

DoH

SH

ealth

2.13

.4 B

ehav

iour

cha

nge

com

mun

icat

ion

for

incr

easi

ng u

ptak

e of

rout

ine

mea

sles

and

ru

bella

imm

uniz

atio

n

Loca

l go

vern

men

ts

77 d

istr

icts

75

3 A

nnua

l rep

orts

of

DoH

SH

ealth


75

Key

acti

viti

esU

nit

Situ

atio

n in

20

17Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

ors

2018

2019

2020

2021

2022

OU

TPU

T 3

Enab

ling

envi

ronm

ent a

ctiv

itie

s

Out

put 3

.1:

MSN

P in

clud

ed in

loca

l, pr

ovin

cial

and

fede

ral g

over

nmen

t’s p

olic

ies

and

plan

s.3.

1.1

Inco

rpor

ate

MSN

P-II

in fe

dera

l pla

ns a

nd

polic

esSe

ctor

al

polic

ies

and

plan

s

NPC

, Sec

tors

a) D

evel

op a

nd u

pdat

e se

ctor

al p

olic

ies,

long

-te

rm p

lans

and

str

ateg

ies

at fe

dera

l lev

el

Min

istr

y7

77

77

7Se

ctor

al

polic

ies

and

plan

s

NPC

, Sec

tors

b) D

irect

ives

from

NPC

to s

ecto

rs a

t fed

eral

le

vel t

o in

corp

orat

e nu

triti

on s

peci

fic a

nd

sens

itive

act

iviti

es in

AW

PBs

in li

ne w

ith

MSN

P-II

Even

t 1

11

11

1D

irect

ives

NPC

c) E

nsur

e nu

triti

on s

peci

fic a

nd s

ensi

tive

activ

ities

are

inco

rpor

ated

in a

nnua

l wor

k pl

ans

and

budg

ets

of a

ll se

ctor

s at

fede

ral l

evel

in

line

with

MSN

P-II

Min

istr

y 7

77

77

7AW

PBs

of

sect

ors

NPC

3.1.

2 In

corp

orat

e M

SNP-

II in

pro

vinc

ial l

evel

pl

ans

and

polic

ies

a) A

dvoc

acy

wor

ksho

p on

MSN

P-II

in a

ll pr

ovin

ces

Even

tN

A7

77

77

Wor

ksho

p Re

port

sN

PC

b) S

end

circ

ular

to a

ll pr

ovin

cial

gov

ernm

ents

to

inco

rpor

ate

nutr

ition

in th

eir r

elev

ant

polic

ies,

long

-ter

m p

lans

and

str

ateg

ies

in li

ne

with

MSN

P

Even

tN

A1

11

11

Polic

es a

nd

plan

s of

pr

ovin

ces

NPC

, Loc

al

Gov

erna

nce,

Fi

nanc

e

c) C

oord

inat

e an

d fa

cilit

ate

with

loca

l go

vern

men

t sec

tor a

t fed

eral

leve

l (M

oFA

LD)

to d

evel

op M

SNP-

II po

licy,

long

-ter

m p

lan

and

stra

tegy

at l

ocal

leve

ls

Even

tN

A2

22

22

Coor

dina

tion

mee

tings

N

PC

3.1.

3 In

corp

orat

e M

SNP-

II in

loca

l gov

ernm

ent

plan

s an

d pl

anni

ng p

roce

sses

Loca

l go

vern

men

ts28

dis

tric

ts

(194

loca

l go

vern

men

ts)

203

299

323

347

372

AWPB

s of

loca

l go

vern

men

tsLo

cal

Gov

erna

nce

sect

or

3.1.

4 O

rgan

ize

join

t ann

ual r

evie

w m

eetin

gs

amon

g M

SNP-

II se

ctor

min

istr

ies

at fe

dera

l lev

elEv

ent

01

11

11

Repo

rts

of re

view

m

eetin

g

NPC

3.1.

5 Ad

voca

cy m

eetin

gs fo

r inc

reas

ing

nutr

ition

bu

dget

(at l

east

3.5

% o

f tot

al) a

t fed

eral

and

pr

ovin

ce le

vels

a) A

dvoc

acy

mee

tings

with

par

liam

enta

rian

at

fede

ral a

nd p

rovi

nce

leve

lsEv

ent

08

88

88

Mee

ting

repo

rts

NPC

, sec

tors

b) A

dvoc

acy

mee

tings

with

min

istr

y of

fin

ance

at f

eder

al a

nd p

rovi

nce

leve

lsEv

ent

02

22

22

Mee

ting

repo

rts

NPC

, sec

tors


76

Key

acti

viti

esU

nit

Situ

atio

n in

20

17Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

ors

2018

2019

2020

2021

2022

c) A

dvoc

acy

mee

tings

with

gro

ups,

educ

atio

nal i

nstit

utes

, priv

ate

sect

or a

nd

indu

strie

s

Even

t 0

22

22

2M

eetin

g re

port

sN

PC

d) A

dvoc

acy

mee

tings

with

civ

il so

ciet

y or

gani

zatio

ns a

nd N

GO

s Ev

ent

12

22

22

Mee

ting

repo

rts

NPC

3.1.

6 D

evel

op n

utrit

ion

budg

et c

ode

Even

t 0

1-

--

-Re

d bo

okN

PC, M

oF

Out

put 3

.2: M

SNP

gove

rnan

ce m

echa

nism

str

engt

hene

d at

fede

ral,

prov

inci

al a

nd lo

cal l

evel

3.2.

1 O

rgan

ise

Hig

h Le

vel N

utrit

ion

and

Food

Se

curit

y St

eerin

g Co

mm

ittee

(HLN

FSS)

mee

tings

tw

ice

a ye

ar

Even

t 2

22

22

2M

eetin

g m

inut

esN

PC

3.2.

2 O

rgan

ise

Nat

iona

l Nut

ritio

n an

d Fo

od

Secu

rity

Coor

dina

tion

Com

mitt

ee m

eetin

gs

quar

terly

Even

t 4

44

44

4M

eetin

g m

inut

esN

PC

3.2.

3 Se

nd c

ircul

ar a

nd fa

cilit

ate

form

atio

n of

nu

triti

on a

nd fo

od s

ecur

ity s

teer

ing

com

mitt

ee

in p

rovi

nces

Even

t N

A7

--

--

Mee

ting

min

utes

NPC

3.2.

4 Fo

rm n

utrit

ion

and

food

sec

urity

ste

erin

g co

mm

ittee

s at

pro

vinc

e le

vel

Prov

ince

N

A7

--

--

Mee

ting

min

utes

NPC

, Loc

al

Gov

erna

nce

3.2.

5 O

rgan

ise

nutr

ition

and

food

sec

urity

st

eerin

g co

mm

ittee

mee

tings

twic

e a

year

at

prov

ince

leve

l

Even

t N

A14

1414

1414

Mee

ting

min

utes

NPC

, Loc

al

Gov

erna

nce

3.2.

8 A

ppoi

nt n

utrit

ion

foca

l per

sons

for a

ll se

ctor

al m

inis

trie

s at

pro

vinc

e le

vel

Prov

ince

NA

7-

--

-D

ecis

ion

lett

ers

Loca

l G

over

nanc

e

3.2.

9 O

rgan

ise

them

atic

tech

nica

l wor

king

gr

oup

(TW

G) m

eetin

gs a

t fed

eral

leve

l qua

rter

ly.

Them

atic

gro

ups:

a)

Cap

acity

Bui

ldin

gb)

Adv

ocac

y an

d co

mm

unic

atio

nc)

M&

E

Even

t 3

TWG

s12

1212

1212

Mee

ting

min

utes

NPC

3.2.

10 F

orm

nut

ritio

n an

d fo

od s

teer

ing

com

mitt

ees

at lo

cal g

over

nmen

ts le

vel a

nd

mee

t reg

ular

ly

Loca

l go

vern

men

ts30

dis

tric

t 20

3 29

932

334

7 37

2Re

port

s fr

om lo

cal

gove

rnm

ents

Loca

l G

over

nanc

e

3.2.

11 F

orm

nut

ritio

n an

d fo

od s

teer

ing

com

mitt

ee a

nd re

gula

r mee

tings

at w

ard

leve

l in

MSN

P lo

cal g

over

nmen

ts

War

dsVD

C le

vel

091

413

5014

5016

00Re

port

fr

om lo

cal

gove

rnm

ents

Loca

l G

over

nanc

e

3.2.

12 F

acili

tate

to a

ssig

n co

ordi

nato

rs (e

xist

ing

staff

or o

utso

urce

d) a

t loc

al g

over

nmen

ts to

ov

erse

e M

SNP-

II in

terv

entio

ns

Loca

l go

vern

men

ts30

dis

tric

t20

3 29

9 32

3 34

7 37

2 Re

port

s fr

om lo

cal

gove

rnm

ents

Loca

l G

over

nanc

e


77

Key

acti

viti

esU

nit

Situ

atio

n in

20

17Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

ors

2018

2019

2020

2021

2022

Out

put 3

.3 M

SNP

inst

itut

iona

l mec

hani

sms

func

tion

al a

t fed

eral

gov

ernm

ent l

evel

3.3.

1 St

reng

then

Nat

iona

l Nut

ritio

n an

d Fo

od

Secu

rity

Secr

etar

iat a

t NPC

Ev

ent

11

11

11

NN

FSS

NPC

3.3.

2 Ca

rry

out o

rgan

izat

ion

and

man

agem

ent

surv

ey o

n in

clud

ing

NN

FSS

with

in N

PC

Even

t0

1O

&M

sur

vey

repo

rt

NPC

3.3.

3 Fa

cilit

ate

endo

rsem

ent o

f the

O&

M s

urve

y re

port

Even

t0

1N

PC

orga

nogr

am

NPC

3.3.

4 Re

crui

t sta

ff fo

r NFS

S as

per

app

rove

d or

gano

gram

Even

t0

01

11

1A

nnua

l rep

orts

NPC

Out

put 3

.4: F

unct

iona

l upd

ated

info

rmat

ion

syst

em a

cros

s th

e se

ctor

s.3.

4.1

Upd

ate

MSN

P in

form

atio

n po

rtal

and

mak

e it

func

tiona

lEv

ent

11

11

11

Acce

ss to

up

date

d M

SNP

port

al

NPC

3.4.

2 Li

nk a

nd u

pdat

e nu

triti

on in

form

atio

n at

ce

ntra

l lev

el (H

MIS

, EM

IS, W

ASH

, agr

icul

ture

, liv

esto

ck a

nd lo

cal g

over

nanc

e)

Even

t1

11

11

1Li

nkag

e of

nu

triti

on

info

rmat

ion

with

all

sect

ors

NPC

All

sect

ors

3.4.

3 Pr

ovid

e tr

aini

ng o

n w

eb-b

ased

MSN

P re

port

ing

syst

em a

t fed

eral

and

pro

vinc

e le

vel

Even

t0

-1

-U

se o

f web

-ba

sed

MSN

P re

port

ing

syst

em

NPC

3.4.

4 D

ocum

ent a

nd d

isse

min

ate

good

pr

actic

es, l

esso

ns le

arne

d an

d ca

se s

tudi

esEv

ent

11

11

11

Repo

rtLo

cal

Gov

erna

nce

3.4.

5 D

evel

op a

nd re

view

mon

itorin

g an

d ev

alua

tion

fram

ewor

k fo

r all

MSN

P se

ctor

s at

fe

dera

l lev

el

Even

t1

11

11

1M

SNP-

II M

&E

fram

ewor

kN

PC, s

ecto

rs

3.4.

6 D

evel

op a

nd re

view

mon

itorin

g an

d ev

alua

tion

fram

ewor

k fo

r all

MSN

P se

ctor

s at

pr

ovin

ce le

vel

Prov

ince

N

A7

77

77

MSN

P-II

M&

E fr

amew

ork

NPC

, sec

tors

3.4.

7 D

evel

op m

onito

ring

and

eval

uatio

n fr

amew

ork

for a

ll M

SNP

sect

ors

at lo

cal l

evel

Loca

l go

vern

men

ts30

dis

tric

ts20

329

932

334

737

2M

SNP-

II M

&E

fram

ewor

kN

PC, l

ocal

go

vern

ance

, se

ctor

s

Out

put 3

.5:

Enha

nced

cap

acit

y of

fede

ral,

prov

ince

and

loca

l lev

el g

over

nmen

t to

plan

and

impl

emen

t nut

riti

on p

rogr

am3.

5.1

Dev

elop

nat

iona

l cap

acity

bui

ldin

g m

aste

r pl

an fo

r MSN

P-II

Even

t0

1-

--

-Ca

paci

ty

deve

lopm

ent

mas

ter p

lan

docu

men

t

NPC

, Sec

tors

3.5.

2 Im

plem

ent c

apac

ity d

evel

opm

ent m

aste

r pl

an a

t all

leve

ls.

a) D

evel

op tr

aini

ng p

acka

ge

Even

t0

1-

--

-Tr

aini

ng

pack

age

NPC

, sec

tors


78

Key

acti

viti

esU

nit

Situ

atio

n in

20

17Ta

rget

sM

eans

of

veri

ficat

ion

Resp

onsi

ble

sect

ors

2018

2019

2020

2021

2022

b) C

ondu

ct m

aste

r tra

inin

g of

trai

ners

(MTo

T)

on M

SNP-

IIEv

ent

11

11

1M

ToT

repo

rt

NPC

3.5.

2 (c

ontin

ued)

: Cap

acity

dev

elop

men

t mea

sure

s fr

om s

ecto

rs

Agr

icul

ture

and

Liv

esto

ck D

evel

opm

ent

Capa

city

dev

elop

men

t tra

inin

g, in

tera

ctio

ns,

expo

sure

vis

its:

a) C

entr

al le

vel —

10

pers

ons

b) P

rovi

ncia

l lev

el —

35

pers

ons

c) L

ocal

leve

l — 1

,488

(agr

icul

ture

and

liv

esto

ck s

ecto

r hum

an re

sour

ces)

Pers

onN

A1,

523

-1,

523

-1,

523

Trai

ning

re

port

sAg

ricul

ture

an

d Li

vest

ock

Sect

or

d) C

ondu

ct tr

aini

ng a

nd d

emon

stra

tions

on

impr

oved

reci

pes

Even

tN

A7

77

77

Trai

ning

re

port

sAg

ricul

ture

an

d Li

vest

ock

Sect

or

e) E

stab

lish

and

stre

ngth

en fo

od p

roce

ssin

g,

food

saf

ety

and

nutr

ition

regu

latio

n an

d ex

tens

ion

serv

ices

at l

ocal

leve

l

Loca

l go

vern

men

tsN

A75

375

375

375

375

3A

nnua

l rep

ort

of M

oAD

Agric

ultu

re

and

Live

stoc

k Se

ctor

Loca

l Gov

erna

nce

a) B

uild

cap

acity

for i

n-se

rvic

e nu

triti

on

spec

ific

and

nutr

ition

sen

sitiv

e tr

aini

ng to

nu

triti

on s

take

hold

ers

at fe

dera

l, pr

ovin

cial

, vi

llage

cou

ncil,

loca

l gov

ernm

ent a

nd

com

mun

ity le

vels

Loca

l go

vern

men

ts30

Dis

tric

ts1

fede

ral,

5 pr

ovin

ce,

203

Loca

l go

vern

men

ts

1 fe

dera

l, 5

prov

ince

, 29

9 Lo

cal

gove

rnm

ents

1 fe

dera

l, 7

prov

ince

, 32

3 Lo

cal

gove

rnm

ents

1 fe

dera

l, 7

prov

ince

, 34

7 Lo

cal

gove

rnm

ents

1 fe

dera

l, 7

prov

ince

, 37

2 Lo

cal

gove

rnm

ents

Perio

dic

repo

rt o

f loc

al

gove

rnm

ents

Loca

l G

over

nanc

e

b) D

evel

op in

tegr

ated

pac

kage

for G

olde

n 10

00

days

hou

seho

lds

— o

rient

atio

n, tr

aini

ngEv

ent

NA

1N

PC, L

ocal

G

over

nanc

e

c) S

ensi

tize

stak

ehol

ders

on

MSN

P-II

Pers

onN

/A4,

500

8,97

09,

780

10,5

0011

,400

Perio

dic

repo

rts

of lo

cal

gove

rnm

ents

Loca

l G

over

nanc

e

NPC a)

Pre

pare

MSN

P-II

capa

city

dev

elop

men

t pla

nEv

ent

01

--

--

Capa

city

de

velo

pmen

t m

aste

r pla

n

NPC

, sec

tors

b) P

repa

re a

dvoc

acy

and

com

mun

icat

ion

stra

tegy

Even

t1

1St

rate

gy

docu

men

tSe

ctor

s

c) T

rain

M&

E fo

cal p

erso

n on

info

rmat

ion

syst

emEv

ent

11

11

1Tr

aini

ng

Repo

rtN

PC


7979


8080


81

MSNP (2013–17) Related Programmes and Projects Supported by Development Partners

ANNEX 2:

Nepal’s development partners implemented the following programmes and projects under MSNP (2013–17) with some of them carrying on into the MSNP-II period:

Period Project Description

October 2012 to March 2017

Sunaula Hazar Din (Golden Thousand Days)

This project was funded by the World Bank and implemented by the Ministry of Federal Affairs and Local Development (MoFALD). Programmes were conducted in 15 districts to prevent malnutrition in the crucial first 1,000 days from conception until children’s second birthday (= 270 days + 365 days + 365 days = 1,000 days).

2011 to 2016 (Suaahara-1)

2016 to 2021 (Suaahara-2)

Suaahara Project This integrated nutrition programme is implemented with USAID funding in partnership with stakeholders to improve the nutritional status of women and children in 40 districts. The project is a major initiative under MSNP (2013–17) and MSNP-II. The second phase is being rolled out in coordination with the National Planning Commission and relevant federal ministries; and will be rolled out in coordination with provincial planning units, provincial ministries and local governments once they are established. Its activities address the first thousand days from conception to two years of age focussing on infants and women and adolescent girls as the people mainly responsible for caring for infants. It integrates health, nutrition, WASH, agriculture and food security activities.

2013 to 2018 Agriculture and Food Security Project

This World Bank funded project is being implemented by the Ministry of Agricultural Development and the Ministry of Livestock Development in coordination with the Ministry of Health in 18 districts. It aims to improve the nutritional status and food security of targeted groups by increasing the productivity of agriculture and livestock production and improving the availability of and access to nutritional food and nutrition-related behaviour.

2013 to 2016 KISAN: Knowledge-based Integrated Sustainable Agriculture and Nutrition

The KISAN project was implemented by the ministries of agricultural and livestock development and the health ministry with funding from USAID. It ran in 16 districts of the Mid-West and Far Western regions –the areas most severely affected by food insecurity, hunger and inadequate nutrition. The project improved food security and increased incomes through integrated agriculture activities and was implemented as part of USAID’s Feed the Future initiative.

2014–2019 SABAL: Sustainable Action for Resilience and Food Security

This project is being implemented in 11 hill and mountain districts of the eastern and central regions with support from USAID. It is being implemented by the Ministry of Agricultural Development, the Ministry of Federal Affairs and Local Development, the Ministry of Health and local NGO partners.

2016–2019 Partnership for Improved Nutrition (Poshan Ko Laagi Haatemalo)

With financial aid from the European Union channelled via UNICEF, and additional funding from UNICEF, this project is conducting nutrition specific programmes through the Ministry of Health and nutrition sensitive programmes through MoFALD in 28 districts in coordination with relevant ministries following MSNP (2013–17) guidelines.

Food for Education Supported by the World Food Programme and implemented by the Ministry of Education, this programme is improving the nutritional status of students in 10 hill and mountain districts of Far Western and Mid-Western Nepal. It aims to bring quantitative and qualitative improvements in primary education, increase school admission rates for girls, and achieve sustainable improvements in the food security of marginalized community, especially women and children.

2013–2016 Multi-partner Trust Fund

Nepal received a Multi-partner Trust Fund grant from the SUN Movement Secretariat to expand the availability of nutrition-related services. The Civil Society Alliance of Nepal allocated funds to its members to run advocacy and capacity building activities that facilitated the implementation of MSNP (2013–17).

2013–2016 REACH:Renewed Efforts Against Child Hunger and Undernutrition

The REACH project helped establish the National Nutrition and Food Security Secretariat in the initial phase of MSNP (2013–17) to coordinate capacity building at central and district levels. This project has also helped to manage information related to nutrition and food security by developing the Nepal Nutrition and Food Security Portal.

81

82

September 2012 Kathmandu Declaration of Commitments

For an accelerated improvement in maternal and child nutrition in Nepal

ANNEX 3:

We, the Nepal Government, UN agencies, de-velopment partners and members of civil soci-ety and the private sector, meeting today, the 17 September 2012, in the National Nutrition and Food Security Coordination Meeting, whose ob-jective is to achieve a national consensus on the scaling up of the multi-sector action plan for the reduction of chronic malnutrition in Nepal,

Recognizing that chronic malnutrition is the main problem affecting the nutrition of Nepali children especially during the first 1,000 days of life (from conception up to two year of age) and that its reso-lution requires a multi-sector approach,

Concerned that malnutrition is responsible for more than a third of child mortality, and for derailing socio-economic development of the af-fected families, communities, and ultimately the country, and impacting negatively on achieve-ment of the all the Millennium Development Goals,

Recalling and reaffirming the commitment dur-ing the World Food Summit, held in Rome in 1996, to reduce the number of undernourished people by 50 per cent by the year 2015,

Recognizing that poverty reduction is a Gov-ernment priority and that there is a strong link between poverty reduction, food insecurity and nutrition and chronic malnutrition,

Taking into account the opportunities that pres-ent themselves, notably: the national political engagement, cost effective interventions based on scientific evidence, global initiatives on Scal-ing Up of Nutrition (SUN) and Renewed Ef-forts Against Child Hunger and Under-nutrition (REACH), with Nepal having made commit-ment to be an ‘early riser’ SUN country under the leadership of His Excellency the Prime Minister of

Nepal as a member of the SUN Lead Group, and to introduce REACH in the country with the in-volvement of national and international partners,

Recognizing that the right to adequate food and nutrition is a fundamental human right,

We commit ourselves and strive to:• Contribute to the implementation of actions

defined in multi-sector nutrition plan of ac-tion for the improvement of maternal and child nutrition and the reduction of chronic malnutrition;

• Develop advocacy, communication, and social mobilization actions to raise awareness of the various sectors and the general public, about the significant problem of chronic malnutri-tion and actions needed to improve maternal and child nutrition, accessible to everyone, especially during the first 1,000 days of life, ensuring equity, and facilitating access to in-formation, to promoting behaviour change, with a focus to reach the most marginalized, poorest segments of the population, and tak-ing into account gender related factors;

• Strengthen the institutional, organization and human resource capacity for the implementa-tion of the plan at all levels and in different sectors linked to nutrition;

• Support the inter-sector coordination body at all the key levels (national, district, and VDC) in all its dimension so that through functional coordination mechanisms are implemented and effective action to improve the nutri-tional status of women and children, ensuring complementarity and strengthening synergies between the different actors;

• Enhance the multi-sector nutrition informa-tion, knowledge management, surveillance systems, monitoring and evaluation of prog-

Commitments For implementing MSNP


83

______________________________Mr. Deependra Bahadur Kshetry

Hon. Vice Chair, National Planning Commission

______________________________Mr. Krishna Hari BaskotaSecretary, Ministry of Finance

______________________________Mr. Balananda PaudelSecretary, Ministry of Women, Children, & Social Welfare

______________________________Mr. Suresh Man ShresthaSecretary, Ministry of Education

______________________________Dr. Praveen MishraSecretary, Ministry of Health and Population

______________________________Ms. Hanaa Singer, Representative UNICEFOn Behalf of UN REACH Partners (FAO, UNICEF, WFP, WHO)

______________________________Mr. Suraj VaidyaChair, Federation of Nepalese Chambers of Commerce and Industries (FNCCI)

______________________________Prof. Dr. Shiba Kumar RaiHon. Member, National Planning Commission, Country SUN Focal Point - Nepal

______________________________Dr. Ganesh Raj JoshiSecretary, Ministry of Agriculture Development

______________________________Mr. Kishor ThapaSecretary, Ministry of Urban Development

______________________________Mr. Sheetal Babu RegmiSecretary, Ministry of Federal Affairs and Local Development

______________________________Mr. Robert PiperUN Resident Coordinator

______________________________Dr. Lin Aung, WHO Representative Chair, External Development Partners-Health

______________________________Mr. Deepak Raj Sapkota, Country Director, Karuna FoundationAs a Chair, Association of International NGOs in Nepal

ress with links to existing early warning sys-tems; and

• Mobilize support nationally and internation-ally to ensure the large-scale implementation of interventions and nutrition programs to address both the immediate, underlying and basic social and economic determinants of maternal and under-nutrition.

We, the Nepal Government, UN agencies, de-velopment partners and members of civil society and the private sector, by this we approve the contents of this “Declaration of Commitment for an Accelerated Improvement in Maternal and Child Nutrition in Nepal.”

Kathmandu, September 2012

(For)

(For)

(For)

(AI)

(For)

(For)

84

CONTRiBUTORS TO MULTiSECTOR NUTRiTiON PLaN-ii (2018-2022)

ANNEX 4:

Officials from Government of NepalS.N. Name Position Organization/ Institute 1 Dr. Min Bahadur Shrestha Hon’ble Vice- Chair National Planning Commission, Singhadurbar2 Dr. Swarnim Wagle Hon’ble Vice- Chair National Planning Commission, Singhadurbar3 Dr. Usha Jha Hon’ble Member National Planning Commission, Singhadurbar4 Mr. Min Bahadur Shahi Hon’ble Member National Planning Commission, Singhadurbar5 Prof. Dr. Geeta Bhakta Joshi Hon’ble Member National Planning Commission, Singhadurbar6 Prof. Dr. Ramesh Kant

AdhikariExpert Member, High Level Nutrition and Food Security Steering Committee

National Planning Commission, Singhadurbar/KIST

7 Prof. Dr. Madhu Dixit Devkota

Expert Member, High Level Nutrition and Food Security Steering Committee

National Planning Commission, Singhadurbar/IOM

8 Mr. Chandra Kumar Ghimire Member Secretary National Planning Commission, Singhadurbar9 Mr. Madhu Kumar Marasini Joint Secretary National Planning Commission, Singhadurbar10 Mr. Radhakrishna Pradhan Joint Secretary National Planning Commission, Singhadurbar11 Mr. Khomraj Koirala Joint Secretary National Planning Commission, Singhadurbar12 Mr. Tritharaj Dhakal Joint Secretary National Planning Commission, Singhadurbar13 Dr. Kiran Rupakhetee Programme Director National Planning Commission, Singhadurbar14 Mr. Prakash Prasad Kharel Programme Director National Planning Commission, Singhadurbar15 Mr. Mahesh Kharel Programme Director National Planning Commission, Singhadurbar16 Mr. Krishna Murai Neupane Programme Director National Planning Commission, Singhadurbar17 Ms. Sita Devi Thapa Planning Officer National Planning Commission, Singhadurbar18 Mr. Chudamani Aryal Planning Officer National Planning Commission, Singhadurbar19 Ms. Sushila Kumari Panth Planning Officer National Planning Commission, Singhadurbar20 Ms. Gita Ghimire Planning Officer National Planning Commission, Singhadurbar21 Mr. Purushottam Nepal Joint Secretary MoFALD22 Mr. Kedarnath Sharma Joint Secretary MoFALD23 Mr. Bijaya Raj Subedi Under Secretary MoFALD24 Mr. Dila Ram Panthi Under Secretary MoFALD25 Mr. Janak Raj Sharma Section Officer MoFALD26 Mr. Dhananjaya Poudyal Nutrition Expert MoFALD/G1000D27 Mr. Manoj Pant M & E Officer MoFALD28 Dr. Khem Pokharel MSNP Coordinator MoFALD//HERD29 Mr. Indra Bhujel Information Manager MoFALD/HERD30 Mr. Mahendra Prasad Shrestha Chief, PPICD Ministry of Health and Population31 Dr. Bikash Lamichhane Director Child Health Division, DoHS, MoHP32 Ms. Yashoda Aryal PHA, PPICD Ministry of Health and Population33 Mr. Giri Raj Subedi Chief, Nutrition Section Child Health Division, DoHS, MoHP34 Mr. Raj Kumar Pokharel Chief, Nutrition Section Child Health Division, DoHS, MoHP35 Mr. Kapil Timalsena Chief, Planning Section Child Health Division, DoHS, MoHP36 Mr. Sharad Kumar Sr.Demo-Graph Family Health Division, DoHS, MoHP


85

37 Ms. Basundhara Sharma PHO Child Health Division, DoHS, MoHP38 Mr. Shanker Pandey Sr. AHWO Child Health Division, DoHS, MoHP39 Mr. Uttam Acharaya Technical Coordinator-

NUTECChild Health Division, DoHS, MoHP

40 Mr. Mahesh Karki L.V.D. NEEICC, Ministry of Health and Population41 Dr. Rashmina Manandhar MO NEEICC, Ministry of Health and Population42 Mr. Kunja Prasad Joshi HEA NEEICC, Ministry of Health and Population43 Ms. Rajani Gyawali Technical Coordinator-

NUTECChild Health Division, DoHS, MoHP

44 Mr. Chetnath Sharma Deputy Director General Department of Education, Ministry of Education45 Mr. Bedahari Dahal Deputy Director Department of Education, Ministry of Education46 Mr. Bishnu Bhandari Deputy Director Food for Education, Ministry of Education47 Mr. Chetnath Aryal Deputy Director Department of Education, Ministry of Education48 Mr. Khem Nanda Bhushal Deputy Director Department of Education, Ministry of Education49 Mr. Narendra Raj Paudel Under Secretary Ministry of Education50 Mr. Nava Raj Khatiwada Under Secretary Ministry of Education51 Mr. Anil Sharma Mishra Under Secretary Ministry of Education52 Mr. Karan Bdr. Bhuwagi Under Secretary Ministry of Education53 Mr Sunil K. Das Deputy Director General Department of Water Supply & Sanitation54 Mr. Hari Prasad Timilsina SDE Ministry of Water Supply & Sanitation55 Mr. Shekhar Khanal Engineer Ministry of Water Supply & Sanitation56 Ms. Sushma Kafle Engineer Ministry of Water Supply & Sanitation57 Mr. Kamal Adhikari Sociologist Department of Water Supply & Sanitation58 Ms. Bishwa Maya Neupane WDO Ministry of Women, Children and Social Welfare59 Ms. Shobha Kharel Women Development Of-

ficerMinistry of Women, Children and Social Welfare

60 Ms. Sabriti Poudel Section Officer Dept. of Women and Childern, MoWCSW61 Dr. Y.K. Karki Joint Secretary Ministry of Agriculture Development62 Dr. Sita Ram Aryal Director NARC, Ministry of Agriculture Development63 Ms. Jyotsna Shrestha Food Research Officer Ministry of Agriculture Development64 Mr. Kalash Ram Chaudhary Sr.Agri Economist Ministry of Agriculture Development65 Mr. Jeevan Acharaya Hrt. Dev Officer Department of Agriculture Development66 Mr. Santosh Kr. Singh Fisheries Dev. Officer Department of Agriculture Development67 Mr. Kishor Bista Sr. Agri. Economist Department of Agriculture Development68 Mr. Ram Krishna Regmi Statistcian Ministry of Agriculture Development69 Mr. Kalash Ram Chaudhary Sr. Agri. Economist Ministry of Agriculture Development70 Mr. Shiva Sundar Ghimire Sr.Agri Economist Department of Agriculture, Food Security Nutrition

Section71 Mr. Dinesh Bhattarai S.S.O Ministry of Agriculture Development72 Mr. Purna Chandra Wasti Sr.Food Researcher Officer

(SFRO)DFTQC, Ministry of Agriculture

73 Dr. K.P Premy Joint Secretary Ministry of Livestock Development74 Dr. Barun k . Sharma Senior VET Officer Ministry of Livestock Development75 Dr. Pradeep Bhattarai Sr. Live Stock Dev. Officer Ministry of Livestock Development76 Mr. Rajeev Kumar Agri. Economist Ministry of Livestock Development77 Mr. Jay Mangal Prasad SFO Ministry of Livestock Development78 Dr. Tej Bahadur Rijal SLDO Dept of Livestock, Ministry of Livestock

Development79 Mr. Atmaram Pandey Former Secretary GoN80 Ms. Savita Malla Advocacy & Communication

SpecialistNNFSS/NPC/UNICEF

81 Mr. Bishnu Paudel Program and Policy Specialist NNFSS/NPC/Suaahara82 Mr. Min Raj Gyawali Nutrition Advisior NNFSS/NPC/UNICEF83 Ms. Rohita Gauchan Thakali M & E Officer NNFSS/NPC/UNICEF


86

84 Ms. Manu Panthi Nutrition Officer NNFSS/NPC/UNICEF85 Ms. Shikha Basnet M & E and Documentation

ConsultantNNFSS/NPC/UNICEF

86 Mr. Sagar Shrestha Adim & Finance NNFSS/NPC/UNICEF

Contributors from Development Partners S.N. Name Position Organization/ Institute 1 H.E. Rensje Teerink Ambassador/Head of

DelegationDelegation of the EU to Nepal

2 Mr. Andreas Roettger Head of the Programs Delegation of the EU to Nepal3 Mr. Robert Hynderick Program Manager Delegation of the EU to Nepal4 Mr. Mim Hamal Program Manager Delegation of the EU to Nepal5 Mr. Tomoo Hozumi Country Representative UNICEF Nepal6 Mr. Stanley Chitekwe Chief, Nutrition Section UNICEF Nepal7 Mr. Pradiumna Dahal Nutrition Specialist UNICEF Nepal8 Mr. Anirudra Sharma Nutrition Specialist UNICEF Nepal9 Mr. Gyan Bahadur Bhujel Nutrition Officer UNICEF Nepal10 Mr. Sanjay Rijal M&E Officer UNICEF Nepal11 Mr. Naveen Paudyal Nutrition Officer UNICEF Nepal12 Mr. Mukunda Nepal Communication Officer UNICEF Nepal13 Mr. Yadav KC Information Management

OfficerUNICEF Nepal

14 Mr. Phulgendra Singh Nutrition Officer UNICEF Nepal15 Mr. Rudra Khadka Nurtition Officer UNICEF Nepal16 Mr. Prakash Chandra Joshi Nutrition Officer UNICEF Nepal17 Ms. Meena Thapa H & N Officer UNICEF Nepal18 Ms. Alisha Pradhan Consultant UNICEF Nepal19 Mr. Babu Ram Acharaya Nutrition Officer UNICEF Nepal20 Mr. Binod Nepal Program Associate UNICEF Nepal21 Ms. Dibya Manadhar Consultant CHD, DOHS/UNICEF Nepal22 Dr. Rajendra Kumar BC Consultant CHD, DOHS/UNICEF Nepal23 Ms. Pragya Rimal Consultant CHD, DOHS/UNICEF Nepal24 Mr. Sher Singh Dahit IMAM Officer CHD, DOHS/UNICEF Nepal25 Ms. Sophiya Uprety Nutrition Officer UNICEF Nepal26 Ms. Sumi Maskey Nutrition Officer UNICEF Nepal27 Ms. Chahana Singh Rana Programme Officer UNICEF Nepal28 Mr. Chandan Deo IMO UNICEF Nepal29 Mr. Dipu Shakya ECD Specialist UNICEF Nepal30 Mr. Ernest Lecomte Intern UNICEF Nepal31 Mr. Kapil Ghimire Consultant UNICEF Nepal32 Mr. Lokendra Shansher Thapa Logistic Officer UNICEF Nepal33 Mr. Siddhi Shrestha WASH Specialist UNICEF Nepal34 Ms. Satya Tamatta Progs. Assistance UNICEF Nepal35 Mr. Sher Singh Dahit IMAM Officer CHD, DOHS/UNICEF Nepal36 Ms. Sanju Bhattarai C4D UNICEF Nepal37 Mr. Sudip Pokharel Consultant UNICEF Nepal38 Mr. Ram Thapa Budget Asst. UNICEF Nepal39 Ms. Shanda Steimer Director USAID40 Mr. Debendra Adhikari Nutrition Specialist USAID41 Dr. Shilu Adhikari MNCH Advisor USAID42 Dr. Manav Bhattarai Health Specialist World Bank43 Ms. Pooja Pandey Rana Deputy Chief of Party Suahaara II44 Ms. Bishow Raman Neupane Sr. Manager Suahaara II


87

45 Mr. Harendra Chand M& E Co-ordinator Suahaara II46 Ms. Bhim Kumari Pun Sr. Program Manager Suahaara II47 Ms. Anita Shah Sr. Coordinator Suahaara II48 Mr. Bishnu Pd. Dulal Data Analysis Suahaara II49 Dr. Lonim Dixit National Professional Officer WHO50 Mr. Paridhi Pathak Programme Associate FAO51 Mr. Shrawan Adhikari Food Security Officer FAO52 Mr. Tej Bahadur Subedi Programme Director AFSP/FAO53 Mr. Kul Dip Ghimire Sr. Planning Officer AFSP/FAO54 Mr. Amrit Gurung Sr. Program Associate for

NutritionWFP

55 Ms. Mamta Gurung Head of Education WFP56 Mr. Puspa Shrestha NekSAP WFP57 Mr. Richard Nwandetar Nutrition WFP58 Mr.Nhukesh Maharjan Programme Associate WFP59 Mr. Umesh Chaudhary Programme Policy WFP60 Ms. Naomi Saville Nutrition Advisior WFP61 Mr. Chandra Br. Thapa VAM Officer WFP62 Mr. Sujay N Bhattacharaya Head Nutrition and Health ACF63 Mr. Deepak Paudel HoD Save the Children64 Dr. Jaganath Sharma Sr. Tech. Manager Health &

NutritionSABAL Program

65 Mr. Jeeban Ghimire Sr. Programme Coordinator SABAL Program66 Mr. Santosh Ghimire Sr. Manager SABAL Program67 Mr. Govinda Acharaya Goverance &Coordination

AdvisorPAHAL Program

68 Mr. Buddhi Devkota Quality Control Officer Pahal/ NTAG69 Ms. Shanti Upadhyaya Nutrition Specialist Pahal/ Plan Nepal70 Ms. Richa Uprety Communication Specialist Care Nepal71 Ms. Asha Basnyet Deputy Country Director Helen Keller International72 Ms. Dale Davis Country Director Helen Keller International73 Mr. Madhukar Shrestha Consultant Helen Keller International74 Ms. Sabina Hora IEC & Nutrition Specialist Helen Keller International75 Dr. Sushil Baral Managing Director HERD International76 Hom Nath Subedi Sr. Programme Manager HERD77 Ms. Shophika Regmi Programme Manager HERD International78 Mr. Deepak Joshi Sr.RM &E Officer HERD 79 Mr. Alok Shrestha National Facilitator HELVETAS80 Mr. Sunil Shrestha Board Member CSANN81 Ms. Prativa AC Communication Officer CSANN82 Dr. Purushottam Mainali Nutrition Advisor KISAN83 Mr. Kuber Adhikari National Health Coordinator World Vision84 Mr. Pranab Rajbhandari Deputy Chief of Party HC385 Ms. Seema Luitel Programme Manger WHH Nepal86 Ms. Nira Joshi Research Officer New Era87 Prof. Dr. Uma Koirala Chairperson Civil Society Alliances for Nutrition 88 Dr. Marina Vaidya Shrestha Doctor Kathmandu Medical College


88

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CBS (2011). Nepal - Nepal Living Standards Survey 2010-2011, NLSS Third. Kathmandu: Central Bureau of Statistics.

CBS (2015). Nepal Multiple Indicator Cluster Survey 2014, Final Report. Kathmandu: Central Bureau of Statistics and UNICEF Nepal.

CBS. (2011). National Population and Housing Census 2011 (National Report) (Vols. 01, NPHC 2011). Kathmandu, Nepal: Central Bureau of Statistics.

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CHD (2014). Strategy for Infant and Young Child Feeding: Nepal. Kathmandu: Child Health Division, Department of health Services. Accessed 23 November 2017 at https://www.humanitarianresponse.info/system/files/documents/files/iycf_strategy_final_draft_18th_sept_014_english.pdf

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GoN (2015). The Constitution of Nepal. Kathmandu: Government of Nepal

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HEART (2013). Nepal Health Sector Programme II (NHSP II) Mid-Term Review. Kathmandu: HEART.

IFPRI (2016). Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington DC: International Food Policy Research Institute.

MoAD (2015). Agriculture Development Strategy (ADS) 2015 to 2035. Kathmandu: Ministry of Ag-ricultural Development

MoH, New ERA and ICF (2017). Nepal Demographic and Health Survey 2016. Kathmandu: Ministry of Health.

MoH, New ERA, NHSSP and ICF (2017). Nepal Health Facility Survey, 2015. Kathmandu: Ministry of Health, New ERA, Nepal Health Sector Support Programme and ICF.

MoH, New ERA and ORC Macro (2002). Nepal Demographic and Health Survey 2001. Calverton, Maryland, USA: Family Health Division, Ministry of Health; New ERA; and ORC Macro.

MoHP (2015b). Nepal Health Sector Strategy (NHSS) 2015-2020, 2015. Kathmandu: Ministry of Health and Population.

MoHP, New ERA and ICF (2012). Nepal Demographic and Health Survey 2011. Kathmandu: Ministry of Health and Population, New ERA, and ICF International.

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NPC (2012). Multi-sector Nutrition Plan For Accelerating the Reduction of Maternal and Child Under-nutrition in Nepal: 2013-2017 (2023). Kathmandu: National Planning Commission

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www.nnfsp.gov.np

Documents

Multi-Sector Nutrition Plannnfsp.gov.np/PublicationFiles/b8aae359-15ea-40c4... · 1.9 Achievements of Multi-Sector Nutrition Plan (2013–17) 15 1.10 Analysis of Estimated Costs and