National Plan of Action for Nutrition 2021 – 2025.

The present National Plan of Action on Nutrition (NPAN) envisages a prosperous country, with a healthy, food-secure population, with reduced malnutrition and poverty. The overall goal of this Plan is to reduce malnutrition among women and children and improve the nutritional status of all Lao people so that they are healthy and have a high quality of life, and thus contribute to the achievement of national socio-economic development targets by 2025. There are 8 Indicators for the Overall Goal: (1) stunting in children under 5 years of age, (2) wasting in children under 5 years of age, (3) underweight in children under 5 years of age, (4) anemia in children aged 6-59 months, (5) anemia in women of reproductive age (15-49 years), (6) infants born with low birth weight, (7) overweight in children under 5 years of age, and (8) infants under 6 months of age who are exclusively breastfed. Nutrition contributes to broader national health indicators. The Strategic Framwork comprises 3 Components, 13 Strategic Objectives, 22 Interventions, and 36 Indicators at outcome- and output-level. The Components are to (1) address direct (immediate) causes of malnutrition, (2) address indirect (underlying) causes of malnutrition, and (3) address basic causes of malnutrition, create an enabling environment, and promote multisectoral action. The Strategic Objectives are: (1) improve nutrient intake, (2) improve water and sanitation, promote hygiene, prevent and control diseases, (3) increase availability of and access to nutritious food, (4) improve child and adolescent knowledge and behavior about nutritious diets, (5) improve mother and child health and care, (6) strengthen institutional capacity, governmance, management, and coordination, (7) strengthen human resources, (8) improvehealth service delivery system for communities, (9) improve information management and use of evidence for decision-making, (10) improve financial management and increase investment, (11) ensure effective preparedness and response to disasters and emergencies, and social protection, (12) scale up social and behavior change communication (SBCC) for nutrition, and (13) promote gender equity.
As for the direct and immediate causes of malnutrition (component 1), the actions are oriented to: SO1: Improve nutrient intake (Health); and SO2: Improve water and sanitation, promote hygiene, prevent and control diseases(Health/WASH). The SO1 focuses on maternal, infant, and young child nutrition (MIYCN) in the first 1000 days (during pregnancy up to 2 years of age). This SO emphasizes early breastfeeding within an hour of birth and exclusive breastfeeding for the first 6 months, followed by supplementary feeding from 6 months to 2 years and later. This SO also emphasizes consumption of safe, adequate, varied, and healthy diets for children under 5 years of age; during the first 8000 days (up to 21 years of age); for pregnant, postpartum, and breastfeeding women; and throughout the course of life. In addition to dietary counseling and promotion of nutritious and healthy food, this SO also includes promotion of healthy diets and provision of micronutrient supplementation, including Vitamin A and iron-folic acid, and food fortification. As for SO2, it covers environmental health and hygiene; focuses on construction, renovation, provision, access to and maintenance of systems for clean water sources for drinking, handwashing stations, and latrines, for use in the home, community, health facilities, and schools; and emphasizes hygiene and sanitation behaviors and practices to prevent and control diseases, and includes provision of deworming in the community.
Under component 2, the policy addresses indirect (underlying) causes of malnutrition, namely: SO3: Increase availability of and access to nutritious food. (Agriculture) SO4: Improve child and adolescent knowledge and behaviors about nutritious diets. (Education) SO5: Improve mother and child health and care. (Health). This Component includes Strategic Objectives that enable the promotion of health and nutrition and the reduction of malnutrition. It focuses on increasing production of safe, nutrient-rich crops, vegetables, fruit, small livestock, fish, frogs, and other protein sources, for diet diversification and consumption in the home. This SO includes maximizing opportunities to add nutritional value at every step of the agriculture value chain, such as planning, production, post-harvest processing, preservation, storage, marketing, and distribution. This includes attention to gender dynamics of agricultural production, ensuring balance between women’s empowerment, women’s involvement in production, and women’s roles for child raising, and is related to gender equity. In addition, the component also focuses on increasing knowledge and awareness about nutrition, for students, parents, communities, and teachers.
Finally, component 3 includes Strategic Objectives that address the basic causes of malnutrition, including poverty; insufficient institutional capacity and coordination; inadequate human resources; inadequate information, monitoring and evaluation systems; and insufficient effectiveness of aid and public investment. In this Component, the SOs are about well-functioning institutions which create an enabling environment, including law, policy, strategy, good governance, and effective management. In addition, this NPAN includes a greater emphasis on cross-cutting issues, such as nutrition in disasters and emergencies, including those brought about by climate change, social and behavior change communication (SBCC), and gender equality.