Introduction:
The Essential Nutrition Actions (ENA) framework was recommended by the world health organization (WHO) in Asia and Africa. It ensures the coverage of maternal and child health nutrition needs during the 1,000-day window period. This article discusses the need for nutrition welfare, and the purpose, scope, and strategies of ENA, which are helpful in combating the increasing mortality rates for pregnant, lactating mothers, and young children.
What Is the Need for Global Nutrition Welfare?
Globally, nearly two billion people suffer from a lack of daily dietary needs, leading to a frugal diet that lacks essential nutrients. This deficiency is a major cause of global malnutrition. Access to proper dietary needs is not only crucial for individuals but also a basic right to live a healthy and productive life, According to global research and surveys, more than 200 million children under the age of five still suffer from chronic diseases caused by undernutrition, stunting, and severe wasting. When this vicious cycle of malnutrition and undernutrition affects the 1,000-day window (the period from conception to a child's second birthday), it can result in multiple detrimental consequences for the developing infant. One of the highlighted causes for which global nutritional remedies are being implemented is mental impairment. If the nutritional demands of breastfed infants, especially during this 1,000-day window, are not met correctly, mental impairment becomes a common consequence. As these infants grow into children, they will continue to be susceptible to various health issues including growth disorders, stunting, susceptibility to general infections, and non-communicable diseases.
Similarly, young adolescents who do not meet their daily nutrient intake commonly suffer from malnutrition-related diseases. Therefore, global nutrition welfare should address malnutrition, by providing nutritious food and by encouraging proper dietary practices, especially among pregnant women, mothers, lactating women, infants, and children. Proper health and well-being are important in the development, growth, and functioning of individuals. Hence, addressing malnutrition can reduce mortality rates, especially among pregnant women and children who are below five, and can increase socioeconomic development by improving their physical and mental health. This can improve academic performance and eventually lead to increased productivity.
What Is the ENA (Essential Nutrition Actions)?
The Essential Nutrition Actions (ENA) is a comprehensive nutrition intervention introduced in 1997 under the USAID (United States Agency for International Development)-funded Basic Support for Institutionalizing Child Survival (BASICS) project, which was publicized by the World Health Organization (WHO). It is a global initiative and a novel approach to addressing the nutrition and health needs of individuals. The ENA framework aims to provide solutions to major public health issues, particularly regarding the basic dietary needs of individuals. It represents a perspective of achieving 90 percent global coverage with high-impact nutrition-based solutions that should be accessible to all individuals worldwide. The implementation of the ENA framework has been carried out in Africa and Asia, involving public health facilities and community groups. One of the primary objectives of the ENA is to promote health services that support maternal and child nutrition. This framework addresses the nutrition needs of infants from conception to the age of two years, which is the crucial 1,000-day period. ENA has been proven effective in improving global nutritional status and reducing infant mortality rates in the public health sector.
What Is the Aim of ENA?
The scope of these actions is to primarily address the following concerns, apart from preventing maternal and child mortality rates which includes:
- Nutrition for adolescents and women during pregnancy and lactation phases.
- Promoting healthy breastfeeding during the first six months of life.
- Introducing complementary feeding, starting from six months of age, while continuing breastfeeding up to two years of age and beyond.
- Arranging nutritional care for sick or malnourished children and young adolescents.
- Preventing vitamin A-related deficiencies in both women and children.
- Preventing and controlling nutrition deficiency-related anemia, such as vitamin B12 deficiency, in women and children.
- Encouraging the consumption of iodized or fortified salt for all household members.
What Are the Strategies and Management of ENA?
The ENA framework works by promoting the basic lifestyle needs of individuals and addressing women's nutrition during adolescence, pregnancy, and lactation. ENA also determines the specific requirements for different age groups. For example, optimal infant and young child feeding requirements differ from the care required for elderly or sick individuals, malnourished individuals with deficiencies in zinc, vitamin A, vitamin D, or anemia. The project includes the use of ready-to-use therapeutic foods (RUTF) and fortified or iodized salt to counteract iodine deficiencies. Therefore, the integration of the ENA framework is required in nearly all existing health sector programs. Integration entails various campaigns aimed at preventing global mortality rates (currently implemented in Asia and Africa), such as:
- Awareness and campaigns for maternal health and prenatal care.
- Postpartum care awareness for mothers and infants.
- Family planning awareness.
- Timed immunizations for children, including vaccination, growth monitoring, counseling, and others.
- Outpatient therapeutic care for mothers and children as part of community-based management.
ENA programs, through partnerships with maternal and child welfare schemes and programs, focus on the need for interpersonal communication in society. They promote awareness through mass media, community festivals, nutrition programs, and even schools at national and international levels. Health agents are also trained within this framework to raise awareness about the importance of dietary needs, food security, nutrition requirements, and behavior patterns, maximizing the benefits for women and children. Additionally, ENA community volunteer training provides education and equips semi-literate or illiterate individuals to become volunteers who can spread basic awareness and provide counseling to support pregnant women and lactating mothers with children below two years of age.
Conclusion:
According to WHO guidelines, the implementation of essential nutrition actions, which is a comprehensive nutrition intervention in Asia and Africa has been effective in combating global disease patterns addressing the nutrition and health needs of individuals especially among both mothers and infants during the 1,000-day window period. Furthermore, social and economic development also depends on nutrition-based welfare and awareness within the society.
