EMS 2014 - Findings and Recommendations

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Report on EMS2014 on Maternal and Child Health and Nutrition in Emerging Markets

Summary and Conclusions

Since the early 1980s sustained economic growth and targeted interventions have produced substantial improvements in maternal and child health and nutrition in emerging markets. Yet millions of mothers and children in these countries remain trapped in vicious cycles of poverty, ignorance, poor health and under-nutrition - meaning they do not have enough to eat and/or cannot absorb nutrients. Under-nutrition inhibits physical and cognitive development, stifles human potential, limits earning capacity and curbs productivity. This age old problem co-exists with the fact that, as the disposable incomes of some of the undernourished have risen with economic growth, their food regimes have increasingly consisted of empty calories, fructose and saturated fats associated with obesity and chronic non-communicable diseases.

Few emerging markets have given due recognition to the needs of mothers and children who do not get enough to eat or the problems of those who eat the wrong things. Even fewer have crafted or implemented national strategies to address these needs and to manage the constraints that have impeded solutions.

Having considered the underlying causes and the economic, social and political consequences of malnutrition, the symposium concluded that each emerging market has unique problems and potential solutions, and recommended that:

Emerging Market Governments should:
(1). Improve (or if they do not exist create) national nutrition strategies that emphasize balanced nutrient composition, take account of food traditions, incorporate high return interventions and are linked to sectoral policies that influence nutrition outcomes.

(2). Improve (or create) health strategies for women, babies and children incorporating: (i) Advice on contraception and child-spacing; (ii) Reproductive education; (iii) Ante-natal care, safe abortion, safe childbirth and post-natal care; (iv) Pre-conception care for all women (with equal treatment for women who do not wish to become mothers); (v) A multidimensional index of maternal and child health including morbidity and maternal and child mortality; (vi)  Policies that reconcile the capacity to preserve fetal and infant life with the anticipated consequences of lifetime disabilities; (vii) Special attention to fetal and infant development in the 1000 days after conception; and (viii) Universal growth and development standards as defined by INTERGROWTH-21st (see below).

(3). Ensure maternal and child health and nutrition strategies: (i) Harness the comparative advantages of the private and voluntary sectors; (ii) Incorporate: (a) Mechanisms to enforce cooperation between government departments responsible for aspects of maternal and child health and nutrition; (b) Comprehensive metrics including morbidity and mortality, relative vulnerability and the costs and benefits of interventions; (iii) Emphasize the need to incorporate nutrition in medical education; (iv) Improve understanding of health and nutrition in the public at large and in special interest groups; (v) Promote action by multilateral and international organizations; (vi) Leverage new research, including the results of INTERGROWTH-21st, which show that: (a) If mothers are healthy at the start of pregnancy, live in environments free from external constraints on growth, have access to regular evidence-based healthcare and breast feed, their children have similar linear growth patterns from conception to age five irrespective of nationality and ethnicity; (b) Ethnic and national stereotypes of physical and cognitive attributes are invalid; (c) Optimized conditions for fetal, infant and child development can change height, weight, growth and cognitive potential within a generation; (d) Universal measures of optimal growth, new standards for fetal and newborn growth and standardized methods for comparing length/height and head circumference for gestational age, which will shortly become available, are the best way to compare populations.

Other Governments should:
(1) Urge multilateral institutions, multinational corporations and global NGOs to provide financial, technical and administrative support to emerging markets seeking solutions to problems of maternal and child health and nutrition; (2) Emphasize maternal and child health and nutrition in bilateral financial and technical assistance programmes in emerging markets; (3) Promote research on those problems.

Institutions of Global Governance should:
(1) Prioritize improved maternal and child health and nutrition in the 2015 Millennium Development Goals (MDG15) and the post-2015 Sustainable Development Goals; (2) Develop a comprehensive global index of fetal and child development (including potential life years lost) for monitoring programme effectiveness; (3) Help emerging markets create optimal conditions for fetal and child development in a single generation.

The Private Sector should:
(1) Urge governments to improve maternal and child health and nutrition to ensure long term supplies of employable adults with the capacity to learn new skills; (2) Expand production of foods fortified with micro-nutrients; (3) Develop public-private partnerships for food fortification; (4) Use their marketing skills to support public sector nutrition campaigns; (5) Collaborate with government and civil society to develop multi-sectoral programmes; (6) Launch in-house nutrition and healthcare programmes.

Civil Society should:
(1) Increase efforts to: (a) Persuade governments to act and (b) Monitor the effectiveness of government policies and programmes; (2) Publish inventories of voluntary sector strategies, policies, plans, policies and programmes to improve maternal and child health and nutrition.