NUTRITION, FOR EVERY CHILD

PREFACEEvery child has the right to nutrition. Andtoday, the need for diets, services and practicesthat protect, promote and support good nutritionhas never been greater. Since 2000, the world hasreduced the proportion of children under 5 sufferingfrom undernutrition by one third and the number ofundernourished children by 55 million. This remarkableachievement proves that positive change for nutrition ispossible and is happening at scale – but there is morework to be done. In 2020, at least one in three childrenis not growing well because of malnutrition, and at leasttwo in three are not fed the minimum diet they need togrow, develop and learn to their full potential. That hurtsnot just children – it hurts us all.Our data indicate that the burden of undernutrition andmicronutrient deficiencies remains unsolved, particularlyin low- and middle-income countries, where about 200million children are affected by stunting or wastingand almost twice as many suffer from deficiencies invitamins and other essential nutrients. The added strainof the COVID-19 pandemic could throw an additional 140million children into poverty in 2020 and increase thenumber of undernourished children by 7 million. At thesame time, overweight and obesity are rising, includingin low- and middle-income countries.With 10 years remaining in the pursuit of the SustainableDevelopment Goals, it is time for renewed action onending child malnutrition in all its forms, everywhere.The COVID-19 pandemic should be a catalyst forprogress, so that no child is left behind: this is not atime to lower our collective ambition. The UNICEFNutrition Strategy 2020–2030: Nutrition, for Every Child,sets forth our vision, goal and priorities to supportgovernments – primary duty bearers of children’s right tonutrition – and partners, in scaling up policies, strategiesand programmes to end child malnutrition in bothdevelopment and humanitarian settings.Nutrition has long been at the core of UNICEF’s work.In 1990, our malnutrition framework broke new groundin setting out the multiple causes of poor nutrition,with a focus on child undernutrition. In 2020, we haverethought our framework to acknowledge the evolvingface of child malnutrition – including overweight andobesity. We emphasize the determinants of goodnutrition – from the diets of children and women, to thecare from which they benefit, the food environments inwhich they live, and the ways in which governments andsocieties underpin children’s right to nutrition throughpolitical commitment and societal values.All UNICEF nutrition programmes across regions andcountries share a universal premise: prevention comesfirst, in all contexts; if prevention fails, treatment isa must. This means that the primary objective ofour nutrition programmes is to prevent maternal andchild malnutrition in all its forms across the life cycle.When efforts to prevent malnutrition fall short, ourprogrammes aim to ensure the early detection andtreatment of children suffering from life-threateningmalnutrition.The Strategy recommits to rights-based and contextspecific programmes that are informed by evidence andinnovation. We expand our traditional focus on earlychildhood to middle childhood and adolescence. Werenew our focus on preventing stunting, wasting andmicronutrient deficiencies while increasingly respondingto the challenge of childhood overweight and obesity.And we propose a systems approach to nutrition thatstrengthens the ability of five key systems – food,health, water and sanitation, education, and socialprotection – to deliver diets, services and practicesthat support adequate maternal and child nutrition,making these systems more accountable for sustainablenutrition results.As Executive Director of UNICEF, I want to emphasizemy commitment, and the commitment of UNICEF,to use all opportunities to work for better nutritionin all programming contexts. I am underscoring thiscommitment by launching the UNICEF Nutrition Strategy2020–2030: Nutrition, for Every Child. In a world livingwith COVID-19 and increasing inequities, we lookforward to working with governments and other partnersto put children’s right to nutrition first and pave the wayto a more equitable and sustainable future in the decadeto come.Henrietta Fore, Executive DirectorUNICEF NUTRITION STRATEGY 2020 –2030vii

EXECUTIVESUMMARYviiiUNICEF NUTRITION STRATEGY 2020 –2030

Since 2000, the world has reduced the proportion of children under 5 suffering fromstunting by one third and the number of children who are stunted by 55 million.This remarkable achievement proves that positive change for nutrition is possibleand is happening at scale – but there is more work to be done.A triple burdenIn 2020, the burden of malnutrition remains unsolved,particularly in low- and middle-income countries,where about 200 million children are affected bystunting or wasting and almost twice as many sufferfrom deficiencies in vitamins and other essentialmicronutrients. At the same time the number ofchildren with overweight and obesity continues to rise,increasingly affecting children from poorer households.Together, these problems can be characterized as atriple burden of malnutrition facing the world’s children:undernutrition, in the form of stunting and wasting,widespread micronutrient deficiencies, and a growingprevalence of overweight and obesity.The backdrop of nutrition has changed, and new forcesdrive the nutrition situation of children globalization,urbanization, inequities, environmental crises, healthepidemics and humanitarian emergencies posingcritical challenges to feeding children sustainably todayand for generations to come. The added strain of theCOVID-19 pandemic could throw an additional 140million children into poverty in 2020 and increase thenumber of undernourished children by 7 million.Vision and goalThe evolving nature of child malnutrition demands aglobal multifaceted response that supports optimalnutrition at every stage of life. The UNICEF NutritionStrategy 2020–2030 sets forth UNICEF’s strategicintent to support national governments and partners inupholding children’s right to nutrition and ending childmalnutrition in all its forms.Our vision is “a world where all children, adolescentsand women realize their right to nutrition”. This visionis guided by the Convention on the Rights of the Child,which recognizes the right of every child to adequatenutrition.The goal of the Strategy is “to protect and promotediets, services and practices that support optimalnutrition, growth and development for all children,adolescents and women”. This goal aims to contributeto the goal of the 2030 Agenda for SustainableDevelopment to ensure children’s access to nutritiousdiets and to end child malnutrition in all its forms.Results areasThe vision and goals of the Strategy are realizedthrough programmes that share a universal premise:prevention comes first, in all contexts; if preventionfails, treatment is a must. UNICEF nutritionprogrammes aim to prevent child malnutrition in all itsforms across the life cycle. When efforts to preventmalnutrition fall short, our programmes aim to ensurethe early detection and treatment of children sufferingfrom life-threatening malnutrition, both in developmentand humanitarian contexts. UNICEF organizes itsprogramming for maternal and child nutrition into sixresults areas:Results Area 1: Early childhood nutrition –encompasses UNICEF’s programming for theprevention of all forms of malnutrition in the firstfive years of life, including undernutrition – bothstunting and wasting – micronutrient deficiencies, andoverweight and obesity.Results Area 2: Nutrition in middle childhood andadolescence – encompasses UNICEF’s programmingfor the prevention of all forms of malnutrition inmiddle childhood (ages 5–9 years) and adolescence(ages 10–19 years), including through school-basedprogrammes.Results Area 3: Maternal nutrition – encompassesUNICEF’s programming for the prevention ofmalnutrition in women during pregnancy andbreastfeeding two stages of nutritional vulnerabilityfor women and the prevention of low birthweightin newborns.UNICEF NUTRITION STRATEGY 2020 –2030ix

Results Area 4: Nutrition and care for childrenwith wasting – encompasses UNICEF’s programmingfor the early detection and treatment of childrenwith wasting through facility- and community-basedapproaches, in all contexts.Results Area 5: Maternal and child nutrition inhumanitarian action – encompasses UNICEF’snutrition programming in emergencies and is guidedby UNICEF’s Core Commitments for Children inHumanitarian Action and our commitments as ClusterLead Agency for Nutrition.Results Area 6: Partnerships and governance fornutrition – encompasses UNICEF’s programming tostrengthen the enabling environment for maternal andchild nutrition through improved partnerships, data,knowledge, advocacy and financing at global, regionaland country levels.For each Results Area, the Strategy outlines theintended results and the programmatic prioritiesguiding their achievement between 2020 and 2030.It is important to highlight that UNICEF countryprogrammes are not expected to implement allcomponents of the Nutrition Strategy. A guidingprinciple of the Strategy is context-specificprogramming, which is informed by an analysis of thenutrition situation of children and women in a givencontext determinants, drivers, and potential impactpathways and the human and financial resourcesand partnerships available.The triangulation of needs, resources andpartnerships allows UNICEF to identify the resultsareas and programmatic priorities of the Strategythat are relevant to a given context. The Strategykeeps UNICEF nutrition programmes coherent acrossregions, countries and programming contexts.A systems approachTo support this vision and goal, our Strategy calls fora systems approach to improving nutrition outcomes.This approach aims to activate the five systems –food, health, water and sanitation, education,and social protection – with the greatest potential todeliver nutritious diets, essential nutrition services andpositive nutrition practices for children, adolescentsand women. This approach captures the interactionsand interconnections across these five systems,avoiding the simplistic thinking that malnutrition hasstraightforward determinant

Results Area 4: Nutrition and care for children with wasting 48 Results Area 5: Maternal and child nutrition in humanitarian action 50 Results Area 6: Partnerships and governance for nutrition 52 6. A SYSTEMS APPROACH TO NUTRITION 56 Working with the food system 60 Working with the health system 62 Working with the water and sanitation system 64