New Impetus To Curb Malaysia’s Childhood Growth & Nutrition Issues?
The Malaysian Paediatric Association commends Dr Milton Lum on his article, Malaysia Fares Worst In ASEAN For Nutrition (The Star, December 2, 2018). We wish to add our thoughts and perspectives to the discussion.
Ownership, Partnership and Accountability
Dr Lum referred to the Global Nutrition Report 2018 which highlighted Malaysia as the only country in ASEAN exhibiting high prevalence rates of all three states of malnutrition ie stunting, anaemia and overweight.
We would all do well to react constructively and urgently to our “growing public health emergency”. In this vein, we applaud the Malaysian government for initiating the National Children’s Well-being Roadmap (NCWR).
We are encouraged by the NCWR as it appears to meet the six key recommendations in Time To Deliver: Report of the WHO Independent High-level Commission on Non-Communicable Diseases, released on June 1, 2018.
- “Start at the top”. The NCWR is directed by the Deputy Prime Minister herself. We hope the NCWR will be realised by resolute leadership to tackle the enormous challenges of battling childhood obesity.
- “Prioritise and scale up”. The NCWR gives childhood growth and nutrition the high priority it deserves within the overall NCD agenda; preventing obesity in children helps prevent them from becoming obese adults.
- “Embed and expand”. With the NCWR, we hope childhood obesity prevention and management will receive more emphasis in the health system, as part of universal health coverage.
- “Collaborate and regulate”. A whole-of-society approach is required to protect our children from obesity. We believe the NCWR can galvanise all stakeholders – not just government ministries and selected NGOs, but also medical and allied health professional bodies, academia, the private sector, civil society, and communities – into a concerted force for change.
- “Finance”. The fight against childhood obesity calls for greater investment in training for multi-disciplinary healthcare professionals, public health promotion, and interventions. We hope the NCWR will be instrumental in increasing the availability of funding for such activities.
- “Act for accountability”. Time To Deliver states that governments should strengthen accountability to their citizens for action. Appropriate tools and transparent reporting under the NCWR is necessary and welcomed.
MPA’s Commitment to Childhood Growth and Nutrition
Malaysian Paediatric Association (MPA) embraces our responsibility to help combat childhood malnutrition (stunting and obesity) as a professional body of paediatricians, through the following initiatives:
- Positive Parenting was launched in 2000. Activities today include a magazine, a website (mypositiveparenting.org), and public talks. MPA collaborates with the Nutrition Society of Malaysia to promote healthy eating and nutrition for children as one of the core pillars of the programme.
- IMFeD For Growth is MPA’s comprehensive programme on childhood growth, feeding and nutrition. Since 2012, it has conducted over 33 training events for paediatricians and GPs across the country. In 2018, it mobilised 200 private paediatricians in a three-month, nationwide childhood growth screening and counselling campaign. About 22% of the 23,000 under-5 year olds screened exhibited growth risk factors, including poor dietary choices, feeding difficulties, frequent illness, and chronic health conditions. In a subset of 10,386 children aged 2-5, stunting was found at 15.5%; however, the figure fell to 10.1% after factoring their parents’ height. This shows that many Malaysian children are short because their parents are short. It also underscores the need for caution when interpreting growth among children above 2 years old as Malaysia does not have its own growth chart. IMFeD is a collaboration between MPA with Abbott Malaysia.
- ProtFit Clinic aimed at supporting healthcare professionals in preventing childhood obesity among children aged 6 months to 6 years. The programme promoted healthy and active lifestyle, instead of focusing on weight reduction. A total of 157 paediatricians, general practitioners, medical officers and dietitians from the government and private sectors attended the workshops. ProtFit, which ran in 2016 and 2017, was a collaboration between MPA with Nestlé Nutrition Institute.
- MPA and its members also actively participate in programmes, training workshops, dialogues and campaigns organised by the Ministry of Health, Ministry of Education, academia and the media. Examples over the last 2 years included NCD Advocacy in Action Workshop organised by MPA, MOH & American Academy of Pediatrics; Food-Environment Policy Index Expert Rating Workshop to Benchmark Food Environment Policies for Malaysia organised by UKM; Workshop on Addressing the Global Health Challenge of Obesity in Malaysia and Beyond organised by Academy of Sciences Malaysia and The Academy of Medical Sciences Britain; Health and Living Forum by BFM; and Counselling Kit Harmonisation Meeting for Childhood Obesity Prevention Among Children Under 5 by Ministry of Health.
Currently, MPA is holding discussions with stakeholders including government ministries, state governments, related expert bodies and potential private sector partners, to develop a new childhood obesity prevention programme. It will integrate screening, face-to-face counselling & customised online intervention, targeting parents during the pre-conception, antenatal, newborn and infancy, and 2 to 6 years old stages. Impact assessment will be incorporated to enable continuous improvement.
Despite our efforts, the “growing public health emergency” continues to loom large over our children’s future. We believe the whole-of-society approach is ever more crucial to make any impact. As a key stakeholder, MPA embraces the need for ownership, partnership and accountability. We also welcome the opportunity to collaborate with other like-minded parties in the areas of community-wide healthy lifestyle promotion, parent education, clinical intervention as well as research. Together, we will be able to achieve the reach, depth, effectiveness and sustainability required to curb childhood obesity in Malaysia.
Muhammad Yazid Jalaludin
President, Malaysian Paediatric Association