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Marshall Islands ‐ Food and Nutrition Security Profiles Key Indicators Marshall Islands has made significant improvements in health and child survival; nevertheless, it will not achieve the Millennium Development Goal (MDG) on child mortality. A contributing factor for this may be found in an elevated prevalence of infants with Low Birth Weight and in the high level of Vitamin A deficiencies among pre‐ schoolers. Sanitary conditions have improved over the years but remain far from internationally acceptable levels, and significant disparities exist between urban and rural settings. Figure 1.1 Food Availability Figure 1.2 Undernourishment and Economic Growth From 1990 to 2012: • GDP increased 21% GDP per person, PPP (constant 2011 dollars) Undernourished in total population Figure 1.4 Child Mortality From 1990 to 2012: • Under‐5 mortality reduced 23%, and will not achieve the MDG target • Infant mortality reduced 20% • Neonatal mortality reduced 17% 49 41.4 38.8 25 3900 MDG Target 16 37.9 38.8 3700 3526 3500 19 3300 31.5 16.9 16.1 30.9 15.8 10 2922 2700 5 Source: GDP: WDI 2014 / Undernourished: FAO FSI_2013 Figure 1.3 Child Malnutrition 2012 2010 2008 2006 2004 2002 2000 1998 1996 1994 1992 1990 2500 Infant Neonatal 2015 2012 2010 2005 2000 1990 2900 1995 15 3100 No Data 33.4 20 Under fives Source: Inter‐agency Group for CME (2013) Figure 1.5 Anaemia • Anaemia is a moderate public health issue among non‐pregnant women (24%) and under‐5 children (30%), while bordering on severe among pregnant women (38%) • Deworming and iron supplementation can be effective for reducing anaemia in pregnant women as Total <2 yr well as children. Children <5 years 30 Non ‐ pregnant women of reproductive age 24 Pregnant women 38 0 20 40 60 80 Prevalence of Anaemia (%) 100 Source: WHO Worldwide prevalence of Anaemia (1993‐2005) Anthropometry (Table 1.1) No Data Underweight women (BMI < 18.5 kg/m2) ‐ ‐ Overweight adults (BMI >= 25 kg/m2) ‐ ‐ 18 % 2007 Proportion of infants with low birth weight Source: SOWC 2014 Marshall Islands ‐ Food and Nutrition Security Profiles Food Availability / Food Access Access to food Figure 2.2 Economic access to food General and food inflation Percent General inflation Food inflation 25 20 18.6 15 Food Availability 10 Figure 2.1 Food supply by food group 5 2008 2007 2006 2005 2004 2003 2002 2001 0 2000 0 ‐5 Source: LABORSTA Labour Statistics Database, ILO (2013) No Data • Food inflation and general inflation are correlated, with no major gaps in past years. • During the 2008 food price crisis, food inflation and general inflation increased significantly, from roughly 1% and 3% respectively in 2007 to nearly 17% and 18% respectively in 2008 Figure 2.3 Share of food expenditure No Data Marshall Islands ‐ Food and Nutrition Security Profiles Food Utilization Water and Sanitation Figure 3.2 Open Defecation • Overall, 7% of the population practices open defecation, mostly in rural areas (21%) Figure 3.3 Access to Improved Water Sources From 1990 to 2012: • Access to improved water sources remained high, at 93%. 100 30 100 25 20 2 Rural Urban Total Rural 2011 2008 2005 2002 1999 2011 2008 2005 2002 1999 1996 1993 1990 Total Source: WHO‐UNICEF Joint Monitoring Programme, 2014 1996 0 0 0 Total Urban Source: WHO‐UNICEF Joint Monitoring Programme, 2014 Rural 2011 2 2008 5 40 7 2005 20 9 2002 10 60 1999 58 41 1993 40 15 1996 60 21 21 20 93 91 1990 76 80 % Population 77 65 1990 80 % Population % Population 85 98 94 1993 Figure 3.1 Access to Improved Sanitation From 1990 to 2012: • Access to improved sanitation increased 18% in 22 years • Disparities between rural and urban areas remained, although improvements in rural areas were significantly higher • 24% of people do not have access to improved sanitation Urban Source: WHO‐UNICEF Joint Monitoring Programme, 2014 Food Safety Figure 3.4 Diarrhoea Management of Diarrhoea (Table 3.1) Zinc No Data Share of children under age 5 with diarrhoea receiving zinc treatment ‐ Existing policy framework Zinc Supplementation and Reformulated Oral Rehydration Salt in the Management of Diarrhea Source: Marshall Islands ‐ Food and Nutrition Security Profiles Food Utilization Nutrition and Health Figure 3.5 Exclusive Breastfeeding • Exclusive breastfeeding in 2007 stood at only 31%, although early initiation of breastfeeding is high, at 73% Figure 3.6 Complementary Feeding • Introduction of complementary feeding is timely for 87% of children • 84% of children aged 6‐23 months meet the minimum dietary diversity • 81% of children achieve the desired meal frequency • 72% of children do not meet the minimum acceptable diet Early initiation of breastfeeding Exclusive breast feeding rate (0‐5 months) 100 73 Percent 80 60 40 31 20 0 Introduction of solid, semi‐solid or soft food (breastfed children… Minimum dietary diversity (breastfed children 6‐23 months) Minimum meal frequency (breastfed children 6‐23 months) Minimum acceptable diet (breastfed children 6‐23 months) Percent 2007 Source: DHS 2007, Final report 87 84 81 72 0 20 40 60 80 100 Source: MHL_Marshall Islands Demographic and Health Survey 2007_2008 Figure 3.7 Duration of Breastfeeding No Data Micronutrient Status Figure 3.8 Child Malnutrition and Poverty Figure 3.9 Vitamin A •Vitamin A deficiencies are severely high (61% of pre‐schoolers), indicating that Vitamin A is lacking in the daily diet and that supplementation efforts may be necessary. Vitamin A deficiency is the leading cause of preventable paediatric blindness and also contributes to the mortality risk of infections and episodes of 100 Vitamin A Supplementation Coverage ‐ full – children 6‐59 months Percent 75 50 60.7 25 0 No Data Vitamin A Deficiency (Pre‐School Aged Children) <0.7umoL /a 0 * VAD is a severe public health problem if >20% of preschool children (6‐71 months) have low serum retinol (<0.7µmol/L) Source: a/ WHO Global prevalence of vitamin A deficiency in population at risk 1995‐2005 report. Iodine (Table 3.2) Households consuming iodized salt ‐ Iodine deficiency (Urinary Iodine Concentration <100ug/L) among school‐age children ‐ *Optimal UIE 100 ‐ 199ug/L Source: Marshall Islands ‐ Food and Nutrition Security Profiles Policy Table ‐ 1 Enabling environment for Nutrition and Food security ‐ Policy documents addressing nutrition issues Nutrition related issues covered in these policies Maternal and Child Undernutrition Child undernutrition Low Birth Weight Maternal undernutrition Child obesity Obesity and diet related Adult obesity NCDs Diet related NCDs Infant and Young Child Source: Nutrition Covered Comments Breastfeeding Complementary feeding Int’l Code of Marketing of BMS Supplementation: Vitamin A children/women Vitamins and Minerals Underlying and contextual factors Iron Folate children/women Zinc children Other vitamins & min child/women Food fortification Food Safety Food security Food Aid Nutrition and Infection Gender Maternal leave Social Protection policies or legislation including food or nutrition component Marshall Islands ‐ Food and Nutrition Security Profiles Policy Table ‐ 2 Demographic Indicators (Table ‐ 5.1) Population size (thousands) /a Average annual population growth Proportion of population urbanised Year Economic Indicators (Table ‐ 5.3) Year 53 2012 GDP annual growth rate /c 1.9 % 2012 0.11 % 2012 GDP per capita (PPP) (constant 2011 international dollars) /c 3,526.3 2012 ‐ ‐ ‐ ‐ 30.9 % 1999 Population below US $ 1.25 (PPP) per day /c (%) ‐ ‐ ‐ ‐ Poorest 20% ‐ ‐ Richest 20% ‐ ‐ 72.15 % 2012 Number of children <5 years (thousand) 5 2012 Education level of mothers of under‐fives: None (%) ‐ ‐ Gini index /c (100= complete inequality; 0= complete equality) Male ‐ ‐ Unemployment rate /c Female ‐ ‐ Agriculture population density(people/ ha of arable land /b) 1.4 2006‐2008 Employment in agriculture sector (% of total employment) /c 20.8 % 1999 Poverty gap ratio /e Women employed in agriculture sector (% of total female employment) /c) 6.5 % 1999 Income share held by households /c Life expectancy at birth (Years) /a Adolescents (Table ‐ 5.2) Adolescent birth rate (number of births per 1,000 adolescent girls aged 15‐19) /a Adolescent girls aged 15‐19 currently married or in union /d Women aged 20‐24 who gave birth before age 18 /d (%) Year 105 2006 21.1 % 2005‐2012 21 Sources: a/ World Bank, Health Nutrition and Population Statistics Database 2014 Update b/ FAOSTAT 2013 Update; c/ World Bank, World Development Indicators Database, 2014 Update; d/ UNICEF, State of the World Children 2014 (data refer to the most recent year available during the period specified) 2008‐2012 The information inlcuded in this Food Security and Nutrition profile, is backed by recognized, validated and properlty published information available untill June 2014. Although updated information might be available at national level form different sources, until requirements of quality, validity and proper publication are met, it has not been inlcuded in this profile.