ASEANRegionalGuideline

onMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

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ASEANRegionalGuideline

onMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

TheASEANSecretariatJakarta

TheAssociationofSoutheastAsianNations(ASEAN)wasestablishedon8August1967.TheMemberStatesareBruneiDarussalam,

Cambodia,Indonesia,LaoPeople'sDemocraticRepublic,Malaysia,Myanmar,Philippines,Singapore,ThailandandVietNam.

TheASEANSecretariatisbasedinJakarta,Indonesia.

Forinquiries,contact:TheASEANSecretariat

CommunityRelationsDivision(CRD)70AJalanSisingamangaraja

Jakarta12110,Indonesia

Phone:(6221)724-3372,726-2991Fax:(6221)739-8234,724-3504

E-mail:public@

Catalogue-in-PublicationData

ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems,June2024.

1.ASEAN–ChildWasting–Treatment

2.HealthSystemStrengthening–CapacityBuilding–Integration

ASEAN:ACommunityofOpportunitiesforAll.

Thetextofthispublicationmaybefreelyquotedorreprinted,providedproperacknowledgmentisgiven,andacopycontainingthereprintedmaterialissenttotheCommunityRelationsDivision(CRD)oftheASEANSecretariat,Jakarta.

GeneralinformationonASEANappearsonlineattheASEANWebsite:.

CopyrightAssociationofSoutheastAsianNations(ASEAN)2024.Allrightsreserved.

ThisdocumentwaspreparedbyUNICEFinconsultationandcoordinationwithASEANmemberstatesthroughtheASEANHealthCluster1.

AllreasonableprecautionshavebeentakenbyASEANandUNICEFtoverifytheinformationcontainedinthispublication.However,thepublishedmaterialisbeingdistributedwithoutwarrantyofanykind,eitherexpressedorimplied.Theresponsibilityfortheinterpretationanduseofthemateriallieswiththereader.InnoeventshallASEANorUNICEFbeliablefordamagesarisingfromitsuse.

Theboundaries,colors,denominations,andotherinformationshownonanymapinthisworkdonotimplyanyjudgmentonthepartofASEANorUNICEFconcerningthelegalstatusofanyterritoryortheendorsementoracceptanceofsuch

boundaries.

Financialsupport

ThisdocumenthasbeenproducedwiththefinancialassistanceofUNICEF.UNICEFrecognizesthesupportbytheBill&MelindaGatesFoundation.TheviewsexpressedhereincaninnowaybetakentoreflecttheofficialopinionofUNICEF.

Rightsandpermissions

Thematerialinthisworkissubjecttocopyright.BecauseASEANandUNICEFencouragethedisseminationofthisknowledge,thisworkmaybefreelyquotedorreprinted,inwholeorinpart,fornon-commercialpurposesaslongasfullattributiontothisworkisgiven.Thetextofthispublicationmaybefreelyquotedorreprinted,providedproperacknowledgmentisgiven,andacopycontainingthereprintedmaterialissenttotheCommunityRelationsDivision(CRD)oftheASEANSecretariat,Jakarta.Requestsforpermissiontoreproduceortranslatepublications,andanyqueriesonrightsandlicences,includingsubsidiaryrights,shouldbeaddressedtoOfficeofthePublisher,ASEANSecretariat,70AJalanSisingamangarajaJakarta12110Indonesia,Telephone:+62-21-724-3372.

Suggestedcitation

AssociationofSoutheastAsianNations(ASEAN)andtheUnitedNationsChildren’sFund(UNICEF).2024.ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems.Jakarta.

Photographycredits

Coverpage:?UNICEF/UN0540117/Philippines/2021Pagex:?UNICEF/Philippines/2022

Page1:?UNICEF/Cambodia/2021

Page7:?UNICEF/UN0556776/Htet

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ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

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TableofContents

CHAPTER1:INTRODUCTION2

CHAPTER2:COREPRINCIPLESFORTHEMANAGEMENTOFCHILDWASTING7

2.1Preventionfirst:Increaseaccesstoservicesforthepreventionofwasting7

2.2Understandthelocaldriversofchildwastingandaddressthem

9

2.3Prioritizethemostvulnerablechildreninthedeliveryofpreventiveandtreatmentservicesforwasting

10

2.4Adoptevidence-basednationalguidelines

11

2.5Simplifyprotocolsforthemanagementofwastingtofacilitatescale-up

andintegrationofwastingservicesintonationalhealthprogrammes

15

2.6Decentralizeservicesforthemanagementofwasting,bringingthemasclose

tothepopulationaspossibletomaximizeaccess16

2.7Engagecommunities16

2.8Increasethesupplyofessentialcommoditiesandequipment17

2.9Monitorservicereachandqualityservices18

2.10Linktoothersupportservices19

2.11Buildcapacitytorapidlyexpandservicesduringemergencies19

CHAPTER3:PROVIDINGSERVICESFORTHEMANAGEMENT

OFCHILDWASTINGTHROUGHNATIONALHEALTHSYSTEMS23

3.1Governanceandleadership23

3.2Financing24

3.3Servicedelivery25

3.4Healthworkforce26

3.5Healthinformationsystem27

3.6Medicalproducts,vaccines,andtechnologies28

CHAPTER4:PLANNINGFORTHEINTEGRATIONOFWASTINGTREATMENT

SERVICESINTONATIONALHEALTHSYSTEMS30

4.1Keyconsiderationsforintegratingwastingservicesintohealthsystems30

4.2Guidingprinciplesinplanningforintegration32

4.3Planningforintegratingthetreatmentofwastingintonationalhealthsystems32

References42

ASEANRegionalGuidelineonMinimumStandards

fortheManagementofChildWastinginNationalHealthSystems

vi

ListofFigures

Figure1:PrevalenceofwastinginASEANcountries2

Figure2:Modelpackageofessentialmaternalandchildactionsforthepreventionofwasting8

Figure3:UNICEFconceptualframeworkonmaternalandchildnutrition9

Figure4:Interventionsforthemanagementofchildwasting13

Figure5:Rolesofmicro,meso,andmacrolevelsofthehealthsystem31

Figure6:Afive-stageprocessfortheintegrationofwastingintothehealthsystem32

ListofTables

Table1:Modelpackageofessentialnutritionactionsfortheprevention,

earlydetection,andtreatmentofchildwasting8

Table2:SampleroutinewastingindicatorsforintegrationintothenationalHMIS18

Table3:Minimumpreparednessactionsforscalingupofservicesfortheprevention

andtreatmentofwastingduringemergencies20

Table4:Governanceandleadershipbenchmarks24

Table5:Financingbenchmarks24

Table6:Servicedeliverybenchmarks25

Table7:Healthworkforce26

Table8:Healthinformationsystembenchmarks27

Table9:Medicalproducts,vaccines,andtechnologiesbenchmarks28

Table10:Proposedstrategicobjectivesfortheintegrationofservices

forthetreatmentofwastingintothehealthsystem34

Table11:Mappingfactorsinfluencingintegrationacrossthehealthbuildingblocks37

ListofBoxes

Box1:SummaryofprogressinaddressingwastingintheASEANregion4

Box2:WHO(2023)updatedguideline:Infantsunder6months10

Box3:WHO(2023)updatedguideline:Managementofmoderatewasting14

Box4:KeyreportinganddataconsiderationsforASEANmemberstates18

ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

vii

ListofAbbreviations

AMS

ASEANCHW

HMISF75

F100

GAP

IMCI

MAMI

MUAC

PHC

ReSoMalRUTF

SDG

UHC

UNICEFWHO

WHZ

ASEANMemberStates

AssociationofSoutheastAsianNationsCommunityHealthWorker

HealthManagementInformationSystemFormula75

Formula100

GlobalActionPlan

IntegratedManagementofChildhoodIllness

ManagementofSmallandNutritionallyAt-RiskInfantsUnderSixMonthsandtheirMothers

Mid-UpperArmCircumferencePrimaryHealthCare

RehydrationSolutionforMalnutrition

Ready-To-UseTherapeuticFoodSustainableDevelopmentGoalUniversalHealthCoverage

UnitedNationsChildren’sFundWorldHealthOrganization

Weight-For-HeightZ-Score

ASEANRegionalMinimumStandards

fortheManagementSystems

viii

ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

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Acknowlegments

TheASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystemswasdevelopedamongdesignatedrepresentativesfromASEANMemberStates,UNICEF,WHO,WFP,andHellenKellerInternational.

TheconsultationprocesswiththeASEANMemberStatesincludeddevelopingandfinalizingtheconceptnoteandoutlineoftheGuidelinesandMinimumStandards,drafting,reviewing,andfinalizingthedraftGuidelinesandMinimumStandards.Theseprocesseswerecarriedoutundertheoveralldirectionoftheleadcountry,Cambodia,throughtheMinistryofHealth,togetherwiththeco-leadcountry,thePhilippines,throughtheDepartmentofHealthandNationalNutritionCouncil,andsecondtheco-leadcountry,LaoPDR,throughtheCentreofNutrition,withoverallcoordinationbytheHealthDivisionoftheASEANSecretariat.

TheGuidelinesandMinimumStandardshavebeenapprovedbytheASEANHealthCluster1(AHC1)onPromotingHealthyLifestylesandendorsedbytheASEANSeniorOfficialsMeetingonHealthDevelopment(SOMHD)andadoptedbytheASEANHealthMinisterMeeting(AHMM).

Thedrafting,content,andtechnicalassistanceforthedevelopmentoftheGuidelineswasledbyMs.Anne-DominiqueIsraelandAlexandraRutishauserfromActionAgainstHungerUK(ConsultantsofUNICEFEAPRO),underthesupervisionofMsMueniMutunga(RegionalNutritionSpecialistofUNICEFEAPRO)andDrRolandKupka(RegionalNutritionAdvisorofUNICEFEAPRO).TheyweresupportedbyDr.AngeladeSilva(Regionaladvisernutritionandhealthfordevelopment)oftheWHORegionalOfficeforSoutheastAsia,Dr.JuliawatiUntoro(TechnicalleadnutritionoftheWHORegionalOfficefortheWesternPacific),FilippoDibari(Nutritionteamleader,WorldFoodProgramme),AnusaraSinghkumarwong(RegionalNutritionist,WorldFoodProgramme)andMaiA.Hoang(RegionalTechnicalAdvisorandTechnicalCoordinator,HellenKellerInternational).

TheguidelinedocumentwaseditedbyMs.JuliaD’Aloisio.

Thedesign,layout,andgraphicsforthisdocumentwerepreparedbyMr.TanatSupichayangkun.

ACoreTechnicalWorkingGroupwasestablishedtodevelopandreviewtheGuidelines,consistingoftheleadandco-leadcountries,partners,andASEANSecretariat.

ContributorsfromASEANMemberStates

Cambodia

(Leadcountry)

Dr.CheaMary

Manager,NationalNutritionProgram,NationalMaternalandChildHealthCenter,MinistryofHealth,Cambodia

WathnaChhuon

NutritionOfficer,HealthandNutrition,UNICEFCambodia

SelamawitNegashBelayneh

NutritionSpecialist,UNICEFCambodia

Ms.ChinSedtha

ProgramManager,Alive&Thrive/FHI360,Cambodia

Mr.HouKroeun

CountryDirector,HelenKellerInternational,Cambodia

Philippines

(Co-leadcountry)

AzucenaM.Dayanghirang,MD,MCH,CESOIII

AssistantSecretaryandExecutiveDirectorIVNationalNutritionCouncil

AnnaMarieCelinaG.Garfin,MD,MM

DirectorIV

DepartmentofHealth

ASEANRegionalGuidelineonMinimumStandards

fortheManagementofChildWastinginNationalHealthSystems

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ContributorsfromASEANMemberStates

Philippines

(Co-leadcountry)

EllenRuthF.Abella

NutritionOfficerIVandOfficer-in-ChargeNationalNutritionCouncil

LuzB.Tagunicar

SupervisingHealthProgramOfficerDepartmentofHealth

JasmineAnneDF.Tandingan

NutritionOfficerIII

NationalNutritionCouncil

Lao–PDR

(Co-leadcountry)

Dr.PhonesavanhKEONAKHONE

DirectorGeneralCentreofNutrition,MinistryofHealth

VilasithMIKHASITH.MPH

DeputyHeadTrainingUnitCentreOfNutrition,MinistryofHealth

Brunei

Darussalam

RoseyatiYaakub

SeniorDietitian,HealthPromotionCentre,MinistryofHealth

IlhamHajiMdAli

Dietician,CommunityNutritionDivision,Dept.OfHealthServices,MinistryofHealth

NurhaimeSuhaimi

CommunityNutritionist,Community

NutritionDivision,Dept.ofHealthServices,MinistryofHealth

Indonesia

Dr.RivaniNoor.,MKM

StaffofDirectorateofNutritionandMotherandChildHealth,MinistryofHealth

DewiAstuti,S.Gz.,MKM

NutritionistatDirectorateofNutritionandMotherandChildHealth,MinistryofHealth

SitiMasruroh,S.Gz.,MKM

NutritionistatDirectorateofNutritionandMotherandChildHealth,MinistryofHealth

Malaysia

MsRusidahSelamat

Director,NutritionDivision,MinistryofHealth

MsZaitonDaud

DeputyDirector(FamilyNutrition),NutritionDivision,MinistryofHealth

MrNazliSuhardiIbrahim

DeputyDirector(CommunityNutritionandInter-agency)NutritionDivision,MinistryofHealth

MsRashadibaIbrahim@Rahman

SeniorPrincipleAssistantDirector,

InfantandYoungChildNutritionSector,NutritionDivision,MinistryofHealth

MsNorizaZakaria

SeniorPrincipleAssistantDirector,PolicyandGlobalNutritionSector,NutritionDivision,MinistryofHealth

MsSitiShuhailahShaikhAbdRahim

SeniorPrincipleAssistantDirector,

NutritionServiceandAdvocacySector,NutritionDivision,MinistryofHealth

MsJunidahRaib

SeniorPrincipleAssistantDirector,

MaternalandWomenofReproductiveAgeNutritionSector,NutritionDivision,MinistryofHealth

MsTehWaiSiew

PrincipleAssistantDirector,SurveillanceSector,NutritionDivision,MinistryofHealth

Ms.NorHanisahZaini

SeniorAssistantDirector,

PolicyandGlobalNutritionSector,NutritionDivision,MinistryofHealth

Dr.RozitaAbRahman

PublicHealthMedicineSpecialist

HeadofSector,ChildHealthSector,FamilyHealthDevelopmentDivision,MinistryofHealth

Dr.AmyNurDiyanaMohamedNasir

SeniorPrincipleAssistantDirector,

ChildHealthSector,FamilyHealthDevelopmentDivision,MinistryofHealth

Myanmar

Dr.AyeMyaMyaKyaw

DeputyDirector(Nutrition)

DepartmentofPublicHealthMinistryofHealth,Myanmar

Dr.HninDarliWin

AssistantDirector(Nutrition)DepartmentofPublicHealthMinistryofHealth,Myanmar

ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

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ContributorsfromASEANMemberStates

Singapore

DrChowWaiLeng

Director,DiseasePolicy&StrategyDivision,MinistryofHealth

MsGuoSiqi

SeniorAssistantDirector(Non-CommunicableDiseases),DiseasePolicy&StrategyDivision,MinistryofHealth

MrBrandonNg

SeniorManager(Non-CommunicableDiseases),DiseasePolicy&StrategyDivision,MinistryofHealth

Ms.JamaicaTan

Manager(Non-CommunicableDiseases),DiseasePolicy&StrategyDivision,MinistryofHealth

Thailand

SaipinChotivichienMD.,PhD

Director,BureauofNutrition,DepartmentofHealth,MinistryofPublicHealth

VisaratanaTherakomenMD.

DeputyDirector,AcademicAffairs,BureauofNutrition,DepartmentofHealth,MinistryofPublicHealth

TitipornTuangratananonMD.,MSc

DeputyDirector,DivisionofMaternalandInfantHealth,DepartmentofHealth,MinistryofPublicHealth

Miss.NarttayaUngkanavin

Nutritionist,ProfessionalLevel,BureauofNutrition,DepartmentofHealth,MinistryofPublicHealth

Miss.NattanitInkhum

Nutritionist,PractitionerLevel,BureauofNutrition,DepartmentofHealth,MinistryofPublicHealth

Vietnam

PhuongHuynh,MD,PhD

Head,ScientificManagementDivision,NationalInstituteofNutrition

ContributionsfromtheUnitedNationsandInternationalOrganizations

Alive&Thrive

Dr.PaulZambrano

AssociateDirector(Technical),Alive&ThriveEastAsiaPacific

Dr.NguyenThanhTuan

RegionalTechnicalAdvisorinMeasurement,LearningandEvaluation,Alive&ThriveEastAsiaPacific

UNICEF

MueniMutunga

NutritionSpecialist

UNICEFEastAsia&PacificRegionalOffice

RolandKupka

RegionalNutritionAdviser,

UNICEFEastAsia&PacificRegionalOffice

HellenKellerInternational

MaiA.Hoang

RegionalTechnicalAdvisorandTechnicalCoordinator

WFP

FilippoDibari

RegionalNutritionAdvisor

RegionalBureauforAsiaandthePacific

AnusaraSinghkumarwong

RegionalNutritionist

RegionalBureauforAsiaandthePacific

WHO

Dr.AngeladeSilva

RegionalAdvisorNutritionandHealthforDevelopmentWHORegionalOfficeforSoutheastAsia

Dr.JuliawatiUntoro

TechnicalleadnutritionoftheWHORegionalOfficefortheWesternPacific

ASEANSecretariatcontributors

FerdinalFernando,MD,MDM

AssistantDirectorandHeadofHealthDivision,HumanDevelopmentDirectorate,ASEANSocio-CulturalCommunityDepartment

LinaRospita

ProgrammeCoordinatorforNutrition/SeniorNutritionConsultant,HealthDivision,HumanDevelopmentDirectorate,ASEANSocio-CulturalCommunityDepartment

ASEANRegionalGuidelineonMinimumStandards

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Aboutthisguidancedocument

01Thisdocumentprovidesguidanceonminimumrequirementsandstandards

addressingwastingandintegratingtheprovisionofwastingtreatmentservicesintoroutineprimaryhealthcareservices

?Theguidanceoutlinesthecoreprinciplesandminimumstandardsfortheprovisionofservicesfortheprevention,earlydetection,andtreatmentofchildwastingthroughnationalhealthsystems.Italsooutlinesessentialstepsforintegratingservicesforthemanagementofchildwastingintoroutineprimaryhealthcareservices.

?ThepurposeofthisguidelineistoprovidepracticalguidancetosupportAMSsinacceleratingprogresstowardtheprevention,earlydetection,andmanagementofchildwastingthroughnationalhealthsystems,includingintegratingthetreatmentofchildwastingintoroutinePHCservices.

?Thisguidelinedoesnotcoverclinicalprotocolsforthetreatmentofchildwasting.TheWorldHealthOrganization(WHO)hasdevelopedtheseprotocols,andeachAMShasdevelopednational

guidelinesthatoutlineclinicalprotocolsformanagementofwastingbasedonthelocalcontext.

?TheguidelinefocusesonlyonhealthsysteminterventionstopreventandmanagewastingwithafocusonSevereAcuteMalnutrition(SAM);othersystemsarebeyondthescopeofthisguideline.

02Intendedaudienceanduse

?Intendedaudience:ThetargetaudienceispolicymakersandhealthandnutritionexpertsfromAMSs.

?Intendeduse:Thisguidelineisintendedtoserveasareferenceforcommonregionalperspectivesonprovidingservicesforpreventingandtreatingchildwastingthroughnationalhealthsystems.Eachnationalhealthsystemisuniqueinitscharacteristicsandstructure;therefore,eachAMSwillneedtoadaptandaligntheseguidelinestoreflectitsownnationalcontext.

03Terminologyof“Wasting”and“Acutemalnutrition”

Inthisdocument,theterms“wasting”(moderateandsevere)and“acutemalnutrition”(Moderate/MAMandsevere/SAM)areusedinterchangeably.Theactionsandguidelinesdescribedhererefertochildrenwithwastingand/ornutritionaloedema.Likewise,IntegratedManagementofAcuteMalnutrition(IMAM)isusedtorefertotreatmentservicesforchildrenwithwastingand/ornutritionaloedema.

ASEANLeaders’DeclarationonEndingAllFormsofMalnutrition

In2017,ASEANadoptedtheASEANLeadersDeclarationonEndingAllFormsofMalnutritionduringthe31stASEANSummit.Torealizethesecommitments,theASEANHealthMinistersMeetingadoptedtheASEANStrategicFrameworkandActionPlanonNutrition2018–2030,whichidentifiesactivitiesandoutputs.ThedevelopmentoftheASEANGuidelinesandMinimumStandardsfortheProtection,Promotion,andSupportofComplementaryFeedingisoneoftheseactivities.

ASEANRegionalGuidelineMinimum

ManagementofChildWastinginNationalHealthSystems

ASEANRegionalGuidelineonMinimumStandards

fortheManagementofChildWastinginNationalHealthSystems

2

CHAPTER1:

INTRODUCTION

Childwastingreferstoachildwhoistoothinforhisorherheightandistheresultofrecentrapidweightlossorthefailuretogainweight.Childrenwithwastinghaveweakenedimmunesystems,leavingthemvulnerabletodisease,developmentaldelays,andincreasedriskofdeath.Theyoungestchildren–thoseaged0-5months–areparticularlyvulnerable.Childwastingispreventable,butwhenpreventionfails,treatmentiscriticaltosavechildren’slivesandputsthembackonthepathtohealthygrowthanddevelopment.

Globally,anestimated45.4millionchildrensufferfromwasting,and13.6millionofthesechildrensufferfromseverewasting,themostlife-threateningformofchildmalnutrition.1Thesenumbershaveremainedstubbornlyhighovertime.2,3Anestimated8.5millionchildrenwithwastingareinfantsaged6monthsoryounger.4ThesocioeconomicimpactsoftheCOVID-19pandemichavealsoexacerbatedthenumberofmalnourishedchildrenglobally.5

ChildwastinginASEANcountries

WastingisapersistentprobleminSoutheastAsia,affectinganestimated4.5millionchildren.Thisnumberaccountsfor10percentofthetotalnumberofchildrenwithwastingglobally.1AsshowninFigure1,theprevalenceofwastingisconsidered“medium”inCambodia,Malaysia,LaoPeople’sDemocraticRepublic,Thailand,Indonesia,Myanmar,andthePhilippinesand“l(fā)ow”inVietNam.OfallMemberStatesintheAssociationofSoutheastAsianNations(ASEAN),onlytwo(BruneiDarussalamandSingapore)havealowprevalenceofwasting(<5percent);anddonottracknationaldataonstuntingandwastingduetoitslowprevalence.

WastinginSoutheastAsiaaffectschildrenatacriticalageoftheirdevelopment:about80percentofthechildrenwithwastingareyoungerthan2yearsofage.7Theperiodbeforetheageof2yearsisacriticalwindowofchilddevelopment;leftuntreated,childrenwithwastingfaceagreaterriskofdying,andthosewhosurvivecouldfailtoreachtheirfullpotentialofgrowthandbraindevelopment.

Figure1:PrevalenceofwastinginASEANcountries

Source:ASEANetal.6

≥15%

?

10%-<15%

?

5%-<10%

Malaysia

Cambodia

LaoPeople's

Democratic

9.79.69.0

7.77.46.75.85.2

RepublicThailand

IndonesiaMyanmarPhilippines

2.5%-<5%

VietNam4.2

<2.5%

?

VERYHIGH

HIGH

MEDIUM

LOW

VERYLOW

n.a.BruneiDarussalamSingapore

ASEANRegionalGuidelineonMinimumStandardsfortheManagementofChildWastinginNationalHealthSystems

3

Childwasting

Studieshaveshownthatwastingandstuntingaretwointerconnectedformsofundernutrition;globallyandintheASEANregion,manychildrensufferfrombothconditionssimultaneously.8Further,childhoodstuntingandwastingputchildrenatahigherriskofnon-communicablediseaseslaterinlife.9Addressingchildwastingcould,therefore,alsoplayaroleinpreventingstuntingandallformsofmalnutrition.

EvidenceshowsalinkbetweenlowbirthweightandwastinginSoutheastAsia,6,7underscoringtheimportanceofpreventiveservices,includingmaternalnutrition,antenatalcareservices,andearlychildhoodnutritionandhealthcare,particularlyinthefirstyearoflife.

Globaltargetsandrecentdevelopments

Childwastingis