NUTRITION FOR GROWTH: SIERRA LEONE’S PROGRESS ON ITS COMMITMENTS 3 YEARS LATER

Ranking 181/188 in the Human Development Index, Sierra Leone remains one of the countries with the highest maternal and infant mortality rates. According to the 2014 National Nutrition Survey, the Global Acute Malnutrition, Severe Acute Malnutrition and stunting (chronic malnutrition) rates in Sierra Leone stand at 4.7%, 1.0% and 28.8% respectively. The Government of Sierra Leone (GoSL) signed up to various commitments in the context of regional and global movements. As part of the Nutrition for Growth Summit (N4G, London, 2013), the GoSL committed to reduce stunting in children under 2 to 11.7% and global acute malnutrition in children under 5 to 2% by 2020 while increasing exclusive breastfeeding to 70%. They also committed to increase funding for nutrition; create budget lines under Ministries of Health and Agriculture; and to ratify the Code of Marketing of Breast-milk substitutes (CMBS).

In May 2016 ACF in Sierra Leone conducted, in cooperation with the local NGO Focus 1000 and the SUN Movement Civil Society Platform, an analysis on progress made so far in Sierra Leone regarding the commitments taken at the Nutrition for Growth (N4G) summit in London in 2013. This advocacy report summarises the findings of this study and comprises our recommendations to strengthen the efforts and results in achieving these commitments by 2020.

Main findings:

• While some efforts and progress have been made between 2013 and 2016, a lot still needs to be done to achieve the objectives by 2020;
• Important lack of data on nutritional status in Sierra Leone (National Nutrition Surveys not conducted regularly enough);
• For nutritional status  commitment: between 2010 and 2014, acute malnutrition (under 5) decreased from 6.9% to 4.7%; severe acute malnutrition (under 5) increased from 0.9% to 1%; chronic malnutrition in (children under 2) increased from 25.7% to 26.7%; exclusive breastfeeding increased from 32% to 58.8%;
• For policy commitment: while a Core Code Committee for the Code of Marketing of Breast-milk Substitutes (CMBS) was created in 2011 to advocate for the endorsement of the CMBS, as of 2016 the process was still pending at the Ministry of Health Permanent Secretary office level;
• For financial commitment: while the GoSL expenditure for nutrition increased both for nutrition specific and nutrition sensitive interventions between 2012 and 2015, in 2015 it still represented 0.98% of the country’s GDP only and 32% of the estimated cost for the implementation of the 2015 activities comprised in the Food and Nutrition Security Implementation Plan;
• For community commitment:   community support networks for nutrition and agriculture have been scaled up throughout the country.

Main recommendations:

1. Conduct annual National Nutrition Surveys, using alternatively SMART and SQUEAC methodologies;
2. Align nutrition targets on the World Health Assembly timeline;
3. Consider means of mainstreaming nutrition within line ministries, such as the development of nutrition-sensitive policies;
4. Restart the discussions on the creation of budget lines for nutrition;
5. Give specific attention to mainstreaming nutrition within the Ministry of Water resources;
6. Restart the Core Code Committee meetings to engage with the Permanent Secretary office and obtain the Cabinet Minister’s authorisation to draft the law;
7. Take more SMART commitments at the next Nutrition for Growth Summit.

This publication was presented to nutrition stakeholders in Sierra Leone (ministries’ representatives, parliamentarians, UN agencies, donors, civil society) during a workshop organised by ACF for the N4G media event in Rio that took place in Rio (Brazil) on 4th August.

You can consult the technical report and advocacy paper dedicated to the budget tracking here and   here. For more information please contact Laetitia Battisti (advocacyexpert@sl.missions-acf.org), advocacy officer for ACF in Sierra Leone.