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Regional Perspective: Middle East and North Africa (MENA)

Aashima Garg is a Regional Nutrition Advisor at the UNICEF MENA Regional Office (MENARO), Amman

Wigdan Madani is a Regional Nutrition Specialist at UNICEF MENARO, Amman

High burdens of malnutrition in all its forms remain a challenge in the MENA region, with inequities between and within countries regarding the number of children under the age of five who are affected. According to the latest estimates, in 2020, 15.6% of the region’s children under the age of five were stunted, 6.3% were wasted and 12% were overweight (UNICEF, 2021). Regional estimates mask the alarming prevalence of malnutrition; over the last decade, some countries have experienced persistently high levels of stunting (Djibouti, Libya, Sudan, Syria and Yemen) and wasting (Djibouti, Sudan and Yemen). At the same time, trends of childhood overweight are comparatively high, and worsening, in Egypt, Libya, Syria and Tunisia. While data on childhood anaemia in the region are scarce, national surveys conducted in selected countries show a very high (>40%) prevalence of childhood anaemia.

Poor diets for young children are a critical determinant of malnutrition in the region, with only one in four children (23%) aged 6–23 months receiving MAD. About half of young children are fed egg and/or flesh foods (53%), and a fourth are not fed fruits and vegetables. This lack of dietary diversity is driven by constrained access to nutritious and diverse foods as a result of food insecurity, limited access to markets due to conflict and instability, low purchasing power and high food prices due to ongoing global food and nutrition crises. Inadequate complementary feeding practices, coupled with limited access to essential nutrition-sensitive services, also contribute to the poor diets of young children in the region.

In 2019, UNICEF MENARO assessed complementary feeding practices and their determinants in six MENA countries (Shaker-Berbari et al, 2021). This analysis recommended that interventions to improve complementary feeding practices should include actions tailored to the population’s needs at the caregiver, household, community, service use and policy level.

The MENA region presents a diverse programming context, including countries across different income categories (from lower-income to high-income), stability levels (from unstable/conflict-affected countries to countries with long-standing development/humanitarian challenges, as well as stable countries) and levels of food security. Climatic shocks and the global food and nutrition crisis further impact access to nutritious, safe and affordable diets in the region. This is compounded by country-level programmatic challenges/bottlenecks related to nutrition data gaps, low prioritisation of (and funding for) maternal and child nutrition agendas and weak technical capacities to design, implement and monitor nutrition programmes. Improving the quality of young children’s diets is often missing or minimal in the programming agendas of these countries, with a heavy focus placed on the treatment of wasting as part of humanitarian responses over the last decade.

The way forward: Improving the quality of young children’s diets is a key priority for UNICEF MENARO under the current strategic plan (2022–2025). Prior investment from the Government of the Netherlands has supported initial work to improve children’s diets in eight of the region’s countries: Djibouti, Egypt, Lebanon, Libya, Oman, the State of Palestine, Sudan and Syria.

Building on this, UNICEF MENARO is working to strengthen the design and delivery of programmes across the following five strategic pillars:

• Reinforcing the importance of situation analysis to understand the determinants and drivers of young children’s diets: This will involve a regional and country-level analysis to fill data gaps using quantitative and qualitative methods
• Setting the narrative and advocating for actions to improve young children’s diets at the country level: UNICEF MENARO has led the adaptation of UNICEF’s global Action Framework for improving young children’s diets¹ to the MENA context. The MENA regional Action Framework serves as a tool to guide a systematic analysis and prioritisation of strategic actions to improve children’s diets through a multi-systems response
• Strengthening partnerships and coordination with other United Nations agencies, academia, international NGOs, NGOs, etc. to deliver coordinated and synergistic interventions to improve young children’s diets at the regional and country level
• Leveraging the wasting agenda to address all forms of malnutrition: The focus of donor investment in the region is on addressing high levels of wasting in priority countries. UNICEF MENARO is leveraging this focus and past achievements in wasting treatment, to position a more holistic programming narrative that delivers a continuum of across prevention, early detection and treatment of all forms of malnutrition
• Knowledge generation, dissemination and exchange will form a critical pillar of UNICEF’s regional nutrition programming approach to document and share lessons learnt, bridge evidence gaps and build the capacity of the UNICEF workforce and partners to improve young children’s diets in MENA

For more information, please contact Aashima Garg at agarg@unicef.org.

References

Shaker-Berbari L, Qahoush Tyler V, Akiki C et al (2021) Predictors of complementary feeding practices among children aged 6–23 months in five countries in the Middle East and North Africa region. Maternal & Child Nutrition, 17, 4, e13223 https://doi.org/10.1111/mcn.13223

UNICEF (2021) Fed to Fail? The Crisis of Children’s Diets in Early Life. 2021 Child Nutrition Report. United Nations Children’s Fund https://www.unicef.org/reports/fed-to-fail-child-nutrition

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Reference this page

Aashima Garg, Wigdan Madani (). Regional Perspective: Middle East and North Africa (MENA). Field Exchange 68 , November 2022. www.ennonline.net/fex/68/unicefmiddleeastandnorthafrica

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