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Building Tomorrow Through Better Nutrition. Tamer Rabie Senior Health Specialist. The World Bank Europe & Central Asia. Irrefutable Evidence for Nutrition. Impact of Undernutrition Interventions on the MDGs. Impact of Undernutrition Interventions on the MDGs cont’d.

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building tomorrow through better nutrition
Building Tomorrow Through Better Nutrition

Tamer Rabie

Senior Health Specialist

The World Bank Europe & Central Asia

background for kg nutrition report
Background for KG Nutrition Report
  • Joint World Bank/UNICEF report
  • to calculate the potential human & economic benefits from increasing nutrition investments
  • Objective

Epidemiology of undernutrition

Physical & economic consequences

  • Situational Analysis

Systems for delivering nutrition interventions

Coverage of nutrition interventions

Economic gains



  • Economic Burden of Undernutrition

Iodine Sufficient Brain

Iodine Deficient Brain

Source: From Legrand, 1967



Benefitsfrom Scaling Up

Nutrition Interventions



Choosing Priorities

prioritization method
Prioritization Method

Three criteria used to rank interventions

  • Deaths averted
  • Economic return on investments
  • Feasibility of implementation at scale

Two ranking systems developed

  • Operational priority -- weight to feasibility of implementation at scale
  • Evidence for interventions – weight to the “evidence base” set out in The Lancetseries
highest priority interventions
Highest Priority Interventions
  • Early initiation of breastfeeding, exclusive breastfeeding until six months of age, and timely and appropriate complementary feeding
  • Supplementing pregnant women with iron folic acid or multiple micronutrients
  • Expand salt iodization and flour fortification programs
second priority interventions
Second Priority Interventions
  • Maintain twice-annually vitamin A supplementation
  • Expand deworming program
  • Zinc for the management of diarrhea
  • Severe acute malnutrition treatment
  • Address underlying and basic causes of undernutrition through other sectors
  • Promoting handwashing and hygiene
  • Undernutrition costs the Kyrgyz Republic more than US$ 32 million annually
  • Scaling up proven interventions could save over US$ 6 million annually
  • SUN Framework brings global consensus on implementing two complementary approaches addressing:
    • Immediate causes: a set of direct public health interventions focusing on the minus 9 to 24-month window of opportunity
    • Underlying causes: a broader set of longer-route interventions in agriculture & social protection