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Nutrition: nutrition of women in the preconception period, during pregnancy and the breastfeeding period

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This report argues that taking a life cycle approach and securing good nutritional status for women across the life course will in the long term reduce child underweight and stunting. It argues that around 30% of all women aged 15 to 49 years are thought to be anaemic, and the highest proportions of these anaemic women live in Africa and South East Asia. The prevalence of anaemia in adolescent girls is thought to be even higher. The report notes that women often play a major role in planning and preparing food for their households, and points out that in countries affected by disasters and crises women are often already chronically undernourished, so access to food and the maintenance of an adequate nutritional status are crucial for women’s survival in a disaster. The report outlines the links between women’s nutrition prior to conception and the health outcomes of babies, covering, for example, iodine and folic acid deficiencies, and low body mass index. It goes on to discuss the importance of women’s nutrition during pregnancy, covering micronutrient deficiencies as well as obesity. The importance of good nutrition while breastfeeding is then explained, before an overview of the types of nutrition interventions that target women before conception and while pregnant and breastfeeding, including: • Health interventions such as pregnancy spacing, and prevention and treatment of communicable and non-communicable diseases • Social and economic interventions such as universal women’s education, preferential treatment for minority groups, redistribution of resources through welfare systems or cash transfers, and microcredit for women • Actions around agriculture, such as improving the nutritional quality of crops, investing in smallholders’ agriculture and developing technologies to increase productivity while safeguarding women’s time for child care • Efforts to reduce environmental hazards, such as provision of sanitation and clean water, and improved housing to prevent crowding and control indoor pollution • Maternity protection laws, such as the ILO Maternity Protection Convention • Interventions to reduce inequities in micronutrient status such as legislation for food fortification, and delivery of supplements with vaccinations • Education about infant and young child feeding, and training for health and community workers on nutrition counselling In the final section on ‘future directions’ the report argues that a series of actions to raise the quality and increase the coverage of services is needed, as well as more information about nutrition related conditions, and the formulation of evidence-based policy and programme guidance. Member states could consider the following: • Expanding proven interventions targeting women’s nutrition in the health, agriculture, social protection, education and environmental sectors • Raising the quality and increasing the coverage of antenatal and postnatal care services • Improving access to antenatal care of women with low socioeconomic status and other disadvantaged groups • Monitoring low birth weight, maternal under nutrition and obesity, weight gain in obese pregnant women, and those infected with HIV, maternal iron and folate status • Developing and disseminating dietary guidelines for pregnant women • Making healthy diets and access to facilities for physical activity available and affordable • Providing nutritional support to pregnant and lactating women living with HIV • Mounting social marketing campaigns to advocate healthy nutrition in the preconception period and for adolescents • Running educational programmes and awareness campaigns to prevent adolescent pregnancy • Including specific provisions for women in preparedness plans for emergencies

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