Are data available for tracking progress on nutrition policies, programs, and outcomes in Sri Lanka?

Book excerpt: The World Health Organization (WHO) and other global nutrition and health agencies recommend nutrition actions throughout the life-course to address malnutrition in all its forms. In this report, we examined how Sri Lanka’s nutrition policies and programs addressed the recommended nutrition actions, determinants, and outcomes. We reviewed population-based surveys to assess the availability of data on nutrition actions, nutrition outcomes, and determinants of these outcomes; we also assessed the data availability in administrative data systems for selected nutrition actions. Our policy review identified a total of 53 recommended evidence-based nutrition actions, of which 47 nutrition actions were applicable in Sri Lanka; of these, 44 were addressed in the country’s nutrition policies and programs. Nutrition actions not included in current policies and programs were food supplementation during adolescence and food supplementation for complementary feeding during early childhood. Although policies addressed daily or intermittent iron and folic acid (IFA) supplementation during preconception, the country’s preconception care program has not yet implemented it. Sri Lanka’s multisectoral nutrition plan recognized and addressed all key determinants of nutrition except women’s status; the country’s multisectoral nutrition plan and its national nutrition policy were found to also express an intent to track the progress of all Sustainable Development Goal (SDG) nutrition targets for maternal, infant, and young child nutrition and also the indicators related to non-communicable diseases (NCDs). Our data review found that out of 44 actions that were addressed by Sri Lanka’s policies and programs, the population-based surveys we reviewed contained data on only 22 actions; similarly, out of 15 selected actions we reviewed in the administrative data system, data was available on only five actions. Data was not available in either of the surveys on the following interventions: various types of counseling during pregnancy, optimal timing (delayed) of umbilical cord clamping, indicators related to newborn care and care of low-birth-weight infants, postpartum IFA supplementation and breastfeeding counseling and around delivery and in the postpartum period, counseling on infant and young child feeding (IYCF), growth monitoring and identification and treatment of severe acute malnutrition (SAM) and moderate acute malnutrition (MAM) during early childhood. In the administrative data source data was not available on IFA supplementation, nutrition counseling and advice on consuming IFA during pregnancy, IFA supplementation during lactation, micronutrient powders (MNPs) and zinc supplementation and on identification and management of SAM and MAM during early childhood. Population-based surveys contained data on most of the indicators on determinants and on all indicators on outcomes. In conclusion, Sri Lanka’s policy landscape for nutrition is robust; however, the gaps in data availability for tracking progress on nutrition are much greater than are the gaps in policies and programs for addressing recommended actions. Future population-based surveys and future modifications of other data systems should aim to fill the identified data gaps for nutrition actions.