SOMALI NUTRITION STRATEGY 2011 – 2013 - ReliefWeb

62 The advantages of LNS pertinent to the Somali context include: LNS are high quality fortified
foods that can be used at home without the need for water or premixing or cooking; they are stable
and resistant to spoilage, the micronutrients do not interact; they provide additional energy and
increase energy density of complementary foods; they have been proven to improve linear growth
of young children and proven more effective than CSB in supplementary feeding of moderately
malnourished children (Nackers et al 2010). LNS in the form of the product ‘Plumpy Doz’ has been
used in Somalia under operational research conditions. However with high prevalence of acute
malnutrition and limited contacts with beneficiaries, evaluating and documenting impacts have
proved difficult. Thus cost compared to nutritional benefit is as yet undetermined in the context.
Outcome 2 Sustained availability of timely and quality nutrition information and
operational research into effective responses to the causes of undernutrition
Quality and timely nutrition information is essential to defining appropriate & feasible nutrition
response options. Whilst more is known about the underlying causes of undernutrition throughout
Somalia from KAPs 2007, the national micronutrient and Anthropometric Survey 2009, FSNAU
data, less is known about the types of interventions that can impact on the problem, particularly
in the Somali context. Operational research is therefore key to providing the evidence base on
which appropriate programmes can be planned.
Outcome 3 Increased appropriate knowledge, attitudes and practices regarding infant,
young child and maternal nutrition
KAPS 2007 and Micronutrient survey
2009 reveal the extent of inappropriate
knowledge, attitudes and practices
regarding infant, young child and maternal
nutrition throughout Somalia. Rates of
exclusive breastfeeding are extremely low
at around 5% (National Micronutrient and
Anthropometric Nutrition survey 2009).
According to KAPS 2007, the practice
of discarding colostrum is widespread.
Infant formulas are vigorously promoted
in a context of widespread poor water,
sanitation and hygiene conditions. In
contrast, the Lancet series on Maternal
and Child Undernutrition 2008 identifies
that exclusive breastfeeding in the first
six months of life is particularly beneficial
while infants who are not breastfed in the
Poor infant and young child feeding practices, including
bottle-feeding in deplorable conditions is a predisposing
factor to diarrhoea and malnutrition, FSNAU, Dec, 2009
first month of life may be as much as 25 times more likely to die than infants who are exclusively
breastfed. Continued breastfeeding is also very critical to improve feeding in children 6-23 months
of age, as breast milk is an important source of energy and nutrients in the child’s diet.
The Lancet series on Maternal and Child Undernutrition 2008 shows that both individual and
group counselling have been demonstrated to extend the duration of exclusive breastfeeding. In
Somalia individual counselling of mothers on appropriate breastfeeding practices and improving
family and community understanding and support for early initiation and exclusive breastfeeding to
six months are important. However, the other key priority is to address the vigorous advertising of
breast milk substitutes by engaging with importers and traders. While the absence of a legislative
framework is appreciated, it is important that a longer term consultative process on adoption of
the International code for marketing of Breast milk substitutes is initiated.