How can we realise the full potential of health systems for nutrition?

Abstract

Poor nutrition contributes substantially to global disease, diminishing the wellbeing of women and children in low and middle income countries, and better nutrition must be part of the universal health coverage agenda, say Rebecca Heidkamp and colleagues

Missed opportunities for delivering nutrition interventions in first 1000 days of life in India: insights from the National Family Health Survey, 2006 and 2016

“…Investing in data systems can help to close gaps in the data available to analyse coverage and opportunity gaps. 4 …”

“…[24][25][26] Our findings are aligned with evidence from analyses of 50 countries showing that global movements to scale BMJ Global Health up effective nutrition interventions and achieve universal health coverage have not been connected to reach their full potential. 4 Overall review of 36 studies also showed large gaps between contact coverage and quality-adjusted coverage levels (10-38 pp) across the continuum of care for reproductive, maternal, newborn and child health. 27 Therefore, closing the opportunity gap by increasing nutrition intervention coverage among those already reached by other platforms should be an immediate priority.…”

“…Investing in data systems can help to close gaps in the data available to analyse coverage and opportunity gaps. 4 CONCLUSION India's progress in coverage of health and nutrition interventions in the last decade is promising, but both opportunity and equality gaps must be closed by assessing and tracking policy, fiscal and programmatic health systems bottlenecks to achieve universal coverage for both health and nutrition. The community-based platforms of India's health and ICDS programmes offer tremendous potential and opportunity but seizing these opportunities will require careful investments in strategy and implementation.…”

“… 3 Among these, health systems are the most effective platform to reach women and children in the first 1000 days and along the continuum of care. 4 Within health systems, nutrition interventions can be delivered during antenatal care (ANC) (eg, micronutrient and food supplementation, deworming, nutrition counselling), during intrapartum care (eg, delayed cord clamping and support for early initiation of breastfeeding (EIBF)) and during postnatal care and childhood (eg, counselling for breast feeding and complementary feeding, micronutrient and food supplementation, and management of child illness). 5 6 Missing the opportunity to deliver nutrition interventions through its associated health platforms has been defined as ‘opportunity gaps’ 4 and examining these gaps can help to identify opportunities to influence health systems for nutrition more effectively.…”

“… 4 Within health systems, nutrition interventions can be delivered during antenatal care (ANC) (eg, micronutrient and food supplementation, deworming, nutrition counselling), during intrapartum care (eg, delayed cord clamping and support for early initiation of breastfeeding (EIBF)) and during postnatal care and childhood (eg, counselling for breast feeding and complementary feeding, micronutrient and food supplementation, and management of child illness). 5 6 Missing the opportunity to deliver nutrition interventions through its associated health platforms has been defined as ‘opportunity gaps’ 4 and examining these gaps can help to identify opportunities to influence health systems for nutrition more effectively. A recent study from 81 low-income and middle-income countries suggested that improvement in quality of care among health systems to effectively deliver a core subset of 19 maternal and child interventions could reduce maternal and neonatal mortality by 28% and reduce stillbirth by 22%.…”