Menu ENN Search

Regional Perspective: East Asia and Pacific

Jessica Blankenship is a Regional Nutrition Specialist in UNICEF’s East Asia and Pacific Regional Office (EAPRO), specialising in maternal, infant and young child nutrition

Roland Kupka is the Regional Nutrition Advisor at UNICEF EAPRO

Despite substantial economic growth in Southeast Asia, the triple burden of malnutrition – undernutrition, hidden hunger (due to vitamin and mineral deficiencies) and overweight – continues to threaten the survival, growth and development of young children. At least one in four children under the age of five in Southeast Asia suffers from one or more of the most visible forms of malnutrition, with 27.4% being stunted, 8.2% wasted and 7.5% overweight (UNICEF et al., 2021).

A major driver of child malnutrition in Southeast Asia is inadequate child complementary feeding practices. UNICEF EAPRO conducted a landscape analysis on complementary feeding in Cambodia, Indonesia, Lao PDR, Myanmar, the Philippines and Vietnam 2018–2019 (UNICEF EAPRO, 2021). This showed that, while complementary feeding is included in national nutrition policies, practices are inadequate across the region. Specifically, children’s diets lack diversity and they are not fed frequently enough to meet their growth and development requirements (Table 1).

Table 1. Complementary feeding practices in children aged 6–23 months in Southeast Asia (ANSS, 2022)

N/A: data not available. Many of the values presented were reanalysed by UNICEF to reflect the recently updated definitions for complementary feeding indicators published in 2021. As a result, they may differ slightly from previous indicator estimates printed in older reports.

The barriers to meeting the nutrient needs of young children are uniquely challenging in Southeast Asia as the context is changing dynamically. More families are moving to cities and their diets are constrained due to poverty, inequities and the increasing cost of nutritious foods. More women are participating in the workforce, often while continuing to carry the greatest burden of caregiving and household duties, restricting the time they have to prepare healthy homemade foods for their children (and for themselves). Families are shifting from traditional diets towards convenient processed foods, which are usually higher in salt, sugar and fat and low in essential nutrients (UNICEF, 2019).

From 2018 to 2019, UNICEF EAPRO hosted a series of regional and country-level technical consultations to identify priority actions. Regional frameworks (Figure 1) were developed to outline a comprehensive set of overarching and multi-sector strategic actions across the health, food, education, social protection, and water, sanitation and hygiene (WASH) systems to improve complementary feeding.

Figure 1. Southeast Asia Regional Action Framework for Complementary Feeding

UNICEF EAPRO supported countries to adapt the regional Action Frameworks through the development of the Association of Southeast Asian Nations (ASEAN) Food and Nutrition Security Report in 2021 (ASEAN et al., 2022). This provided an overview of the food and nutrition security profiles of countries in ASEAN member states, detailed the progress made over the previous five years and made recommendations on the way forward. UNICEF EAPRO also supported the development of a series of six ASEAN guidelines and documents on minimum standards – including one on the protection, promotion and support of breastfeeding and complementary feeding (ASEAN et al., 2022) – and the ASEAN Nutrition Surveillance System (ANSS) to annually monitor and report against 104 nutrition-specific and nutrition-sensitive indicators.1

Three research and knowledge gaps were also identified from the priority actions, as follows.

The role of nutrition-sensitive social protection: UNICEF EAPRO has developed a policy working paper documenting opportunities to expand social protection pathways to nutrition (UNICEF, 2020). A series of surveys have also been conducted on the status and determinants of food insecurity and undernutrition in the urban poor in Indonesia (UNICEF, FAO, WFP, & WHO, 2021a), the Philippines (UNICEF, FAO, WFP, & WHO, 2021b) and Myanmar (UNICEF, FAO, WFP, & WHO, 2021c), with the Food and Agricultural Organization (FAO) and World Food Programme (WFP), particularly focused on the impact of the COVID-19 pandemic.

Strengthening capacity for the development and implementation of social behaviour change (SBC) strategies: Despite being a priority overarching action in the region, there has been limited at-scale and sustained delivery of SBC strategies to improve nutrition. In 2021, UNICEF EAPRO conducted a capacity assessment in Cambodia, Lao PDR and the Philippines, which led to the development of a training curriculum on nutrition SBC for government staff to support planning, budgeting, management and monitoring of strategies and programmes at the national and sub-national levels.

Development of standards and a nutrient profile and labelling model for the promotion of commercially available complementary foods (CACFs) for children aged 6–36 months: Families in Southeast Asia increasingly rely on CACFs due to convenience and time constraints. CACFs vary widely in nutritional quality (Bassetti et al., 2022): they may either provide critical micronutrients that are limited in the diets of infants and young children, or they may lack fortification and/or contain high levels of added salt, sugar or unhealthy fats. While both the World Health Organization (WHO) and UNICEF recommend the use of fortified CACF in some circumstances, the regional and national standards regulating their promotion in Southeast Asia are insufficient. The Southeast Asia Consortium for Improving Complementary Foods (COMMIT) was formed by regional nutrition partners to fill evidence gaps on nutrient composition and labelling of CACFs in Cambodia, Indonesia, Laos PDR, Malaysia, the Philippines, Thailand and Vietnam, and to develop recommendations to strengthen national standards and guide the adaptation of a nutrient profile and labelling model at the national level.

Next steps

UNICEF EAPRO continues to support a systems-based, holistic approach to improving the diets of infants and young children through assisting governments to identify and implement evidence-based priority actions for complementary feeding. Technical assistance will be provided to strengthen national capacity for nutrition-sensitive social protection and development and the implementation of SBC strategies for nutrition, as well as the adaptation of the COMMIT regional framework to guide national CACF standards.

For more information, please contact Jessica Blankenship at jblankenship@unicef.org.

References

ANSS (2022) ASEAN Nutrition Surveillance System (ANSS). ASEAN. https://asean-anss.org/

ASEAN, UNICEF, & Alive & Thrive (2022). Guidelines and Minimum Standards for the Protection, Promotion and Support of Breastfeeding and Complementary Feeding. ASEAN, UNICEF, & Alive & Thrive https://www.unicef.org/eap/reports/guidelines-and-minimum-standards-breastfeeding

ASEAN, UNICEF, & WFP (2022) ASEAN Food and Nutrition Security Report 2021, Vols 1 & 2. United Nations Children’s Fund https://www.unicef.org/eap/reports/asean-food-and-nutrition-security-report-2021

Bassetti E , Zehner E, Mayhew S et al (2022) Nutrient profiles of commercially produced complementary foods available in Cambodia, Indonesia, and the Philippines. Public Health Nutrition, 25, 10, 1–28.

Blankenship J, Rudert C & Aguayo V (2021) Triple trouble: Understanding the burden of child undernutrition, micronutrient deficiencies and overweight in East Asia and the Pacific. Maternal & Child Nutrition, 16(S2), e12950. https://doi.org/10.1111/mcn.12950

UNICEF (2019) The State of the World’s Children 2019. Children, Food and Nutrition: Growing Well in a Changing World. United Nations Children’s Fund.

UNICEF (2020) The Social Protection Pathways to Nutrition: A Stocktaking of Evidence in Asia and the Pacific. United Nations Children’s Fund https://socialprotection.org/discover/publications/social-protection-pathways-nutrition-stocktaking-evidence-asia-and-pacific

UNICEF EAPRO (2021) Southeast Asia Regional Report on Maternal Nutrition and Complementary Feeding. United Nations Children’s Fund https://www.unicef.org/eap/reports/maternal-nutrition-and-complementary-feeding

UNICEF, FAO, WFP, & WHO (2021a) Food Security and Nutrition in Urban Indonesia: Evidence from a Remote COVID-19 Survey. UNICEF, FAO, WFP, & WHO

UNICEF, FAO, WFP, & WHO (2021b) Food Security and Nutrition in Urban Philippines: Evidence from a Remote Follow-Up Survey. UNICEF, FAO, WFP, & WHO

UNICEF, FAO, WFP, & WHO (2021c) Food Security and Nutrition in Urban Yangon: Evidence from a Remote Follow-Up Survey. UNICEF, FAO, WFP, & WHO

UNICEF, WHO, & IBRD/World Bank (2021) Levels and Trends in Child Malnutrition: Key Findings of the 2021 Edition of the Joint Child Malnutrition Estimates. UNICEF, WHO, & IBRD/World Bank

Read more...

More like this

FEX: Complementary feeding in emergencies programming – Myanmar case study

This is the one of four case studies in this special section of FEX to highlight the importance of a strong contextual analysis to guide the appropriate design, implementation...

FEX: Regional Perspective: South Asia

Zivai Murira is the Regional Advisor for Nutrition at the UNICEF Regional Office for South Asia (ROSA), Kathmandu, Nepal All forms of malnutrition - stunting, wasting and...

FEX: Postscript - Progress on monitoring and enforcing the Code in Cambodia: New developments to ban digital marketing

View this article as a pdf Lisez cet article en français ici Grana Pu Selvi Gnanaraj is the Technical Lead for integrated nutrition for World Vision International in...

FEX: Programmes d’alimentation de complément dans les situations d’urgence – Étude de cas au Myanmar

Ceci est l'une des quatre études de cas de cette section spéciale de FEX qui souligne l'importance d'une analyse contextuelle solide pour guider la...

FEX: Improving complementary feeding practices through a comprehensive health systems strengthening approach: experiences from Egypt

View this article as a pdf Naglaa Arafa is a Nutrition Officer for UNICEF in the Egypt Country Office. Moataz Saleh is a Nutrition Specialist for UNICEF in the Egypt Country...

FEX: National social assistance programmes to improve child nutrition: Lessons from Burundi, Ethiopia and Tanzania

View this article as a pdf Lisez cet article en français ici Chloe Angood is a Knowledge Management for Nutrition Consultant for UNICEF Eastern and Southern Africa...

FEX: Regional Perspective: Europe and Central Asia (ECA)

This article presents a summary of the findings of the ECA Regional Office (ECARO) landscape analysis report (UNICEF, 2020), drafted by the Emergency Nutrition Network (ENN)...

FEX: Regional Perspective: West and Central Africa

Simeon Nanama is the Regional Nutrition Advisor at the UNICEF West and Central Africa Regional Office (WCARO) Arnaud Laillou is a Regional Nutrition Specialist (prevention...

FEX: Regional Perspective: Eastern and Southern Africa (ESA)

Charity Zvandaziva is a Regional Nutrition Specialist for UNICEF ESA Regional Office (ESARO) Chloe Angood is a Knowledge Management Consultant working for UNICEF...

FEX: State of Palestine: Investing in assessment positively impacted programming for complementary feeding

Lisez cet article en français ici Amani Jouda is a Health and Nutrition Officer at UNICEF, State of Palestine. Fairooz Abuwarda is an Early Childhood Development...

FEX: Regional IFE Workshop held in Indonesia

The ENN, as co-ordinator of the IFE Core Group1, co-facilitated a regional strategy workshop on infant and young child feeding in emergencies on 10-13th March 2008 in Bali,...

FEX: Severe acute malnutrition: an unfinished agenda in East Asia and the Pacific

By Cecilia De Bustos, Cécile Basquin and Christiane Rudert Lisez cet article en français ici Cecilia De Bustos is a nutrition and public health specialist who...

FEX: A global perspective on improving the diets of infants and young children

View this article as a pdf Lisez cet article en français ici Grainne Moloney is Senior Nutrition Advisor at UNICEF headquarters, New York Linda Shaker Berbari is...

FEX: UN Global Action Plan (GAP) Framework for Child Wasting and the Asia and Pacific Region

View this article as a pdf Lisez cet article en français ici By Harriet Torlesse, Roland Kupka, Warren T K Lee, Britta Schumacher and Angela de Silva Harriet Torlesse...

FEX: Postface – Progrès accomplis en matière de suivi et d’application du Code au Cambodge : des avancées vers l’interdiction du marketing digital

Read an English version of this article here Grana Pu Selvi Gnanaraj est responsable technique pour la nutrition intégrée chez World Vision International au...

FEX: Conducting situation analysis as a first step to improve young children’s diets: examples from Ethiopia, Tanzania, and Zimbabwe

Lisez cet article en français ici Key messages: Context analysis is a crucial step in understanding the particular gaps faced by caregivers in providing young children...

FEX: Nutrition needs and best practices for formerly trafficked female children and adolescents

By Erin Lisemby Erin Lisemby is a registered dietitian/nutritionist currently working with the US Special Supplemental Nutrition Program for Women, Infants and Children (WIC)...

IYCF-E Events

IYCF-E Events Upcoming Events No events planned currently. Previous Events Wednesday 24th April 2024: Supporting Wet Nursing in Emergency Contexts This webinar provides...

Resources

View this article as a pdf Global guidance WHO & UNICEF (2003). Global Strategy for Infant and Young Child Feeding. Geneva: World Health Organization and United Nations...

NEX: Filling the Nutrient Gap in Pakistan: Insights to address malnutrition

Dr Aliahmad Khan is a nutritionist with the World Food Programme Pakistan Country Office in Islamabad. Muhammad Aslam Shaheen is Chief of Nutrition and SUN Focal Point in...

Close

Reference this page

Jessica Blankenship, Roland Kupka (). Regional Perspective: East Asia and Pacific. Field Exchange 68 , November 2022. www.ennonline.net/fex/68/unicefeastasiaandpacific

(ENN_7522)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.