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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.