National Multisectoral Nutrition Action Plan (NMNAP) 2021/22 – 2025/26.

This second National Multisectoral Nutrition Action Plan (NMNAP II) is a nationwide 5-year document that seeks to address malnutrition in all its forms and for all ages with the overall expected result by 2026 of a country where "Women, Men, Children, and Adolescents are better nourished and living healthier and more productive lives". The purpose is to fight against the triple burden of malnutrition – undernutrition, micronutrient deficiencies, overweight, and obesity indicated as Key Result Areas (KRAs), to which is added another KRA aiming at strengthening the enabling environment. The Action Plan includes other areas and actions, such as (i) increasing financial investment, especially in proven low-cost and high-impact nutrition interventions; (ii) research, development, and innovation; and (iii) further strengthening nutrition coordination. The factors that led to the persistent and sometimes worsening of some forms of malnutrition were identified during the mid-term review of NMNAP 2016–2021 and have been addressed in this NMNAP II. Through the lessons learned, the NMNAP II emphasizes scaling-up multisectoral interventions and community-based initiatives that have been proven to yield cost-effective results and target areas and groups with the highest levels of malnutrition, considering that investing in the fight against malnutrition will save lives and yield high economic returns. The Plan, adopting the Theory of Change (ToC) outlines the following five different conditions for change (outcomes) to achieve the desired change (1) children, adolescents, women, and men have increased utilization of adequate, equitable, and quality services at the community and facility levels; (2) women, men, children, and adolescents increase adoption and practice appropriate nutrition behaviors; (3) food systems must be enhanced, sustainable, resilient and responsive to the nutritional needs of children, adolescents, women and men; (4) multisectoral and private sector engagement in nutrition must be strengthened; (5) the enabling environment must be strengthened and supportive of adequate human and financial resources for nutrition.
To improve the nutrition standards the Plan invites to intervene on production, and in particular to (i) advocate with the ministries of agriculture, industry and trade, livestock and fisheries, and other partners, to diversify food production by adding nutrient-rich foods; (ii) conduct training of agricultural extension workers on the production of nutritious food; (iii) promote the use of appropriate technologies to support the availability of nutritious foods (urban agriculture, sack gardens, aquaponics, agroponics, plastic fishponds, small animal keeping); (iv) promote the development and adoption of culturally acceptable smart technologies in agriculture.
The main intervention in the field of improved nutrition and food security, the document accommodates interventions for all age groups, including those with special health and nutritional needs. Specifically, this includes a special focus on nutrition-specific and nutrition-sensitive interventions in the first 1,000 days which promote nutrition and early childhood development, adolescent health and nutrition, and also those interventions which target people with special nutritional needs such as the elderly and those with chronic illnesses. Other measures are (i) promote local production of nutrition commodities and supplies; (ii) strengthen availability of nutrition services during emergencies; (iii) increase nutrition knowledge; (iv) strengthen delivery of nutrition-sensitive interventions at all levels (WASH, deworming, food system); (v) strengthen food quality and safety standards; (vi) address micronutrient deficiencies with particular regard to iron, folate, zinc, iodine, and vitamin A; (vii) address overweight and obesity involving health-care infrastructures, workplaces and communities, and public–private sector.
To promote an inclusive social and economic growth, the suggested strategies are (i) empower women, men and adolescents to make necessary nutrition decisions; (ii) develop improved market and trade system to ensure affordable, safe and nutritious foods; (iii) strengthen consumer education and information; (iv) strengthen private sector engagement in the implementation of undernutrition interventions; (v) address gender issues in each stage and deliver the interventions through the existing systems, namely, through the food, health, education, social protection and WASH systems.
As for Governance, Chapter VI illustrates the roles and responsibilities of the key actors, calling for strengthening multisectoral nutrition governance, considering an efficient and effective multisectoral coordination at all levels should through ensuring accountability, user-friendly policies, legal and regulatory frameworks, political leadership, and commitment for nutrition.