Nepal Set to Launch Crucial Micronutrient Survey with US Funding
A vital nationwide micronutrient survey in Nepal, initially planned for 2025 but postponed due to funding shortages, is now on track to commence shortly. The United States government has allocated $3 million to support this critical study, which aims to provide an updated understanding of the nutritional status and health indicators of the Nepali population.
The survey will meticulously assess the levels of essential micronutrients, including vitamin A, iron, folic acid, iodine, and zinc. Furthermore, it will investigate breastfeeding practices and the prevalence of anaemia across the country. The findings are expected to be instrumental in shaping public health policies and guiding decisions on the continuation and effectiveness of long-standing health programmes.
Lila Bikram Thapa, chief of the Nutrition Section at the Family Welfare Division under the Department of Health Services, highlighted the significance of the study. “This is a very crucial study, which was suspended last year due to a funding crunch,” Thapa stated. “Without an updated report, we would not have an accurate picture of the disease status. Now, the US government is funding the study through the United Nations Children’s Fund (UNICEF).”
This nationwide survey, traditionally conducted every decade, was initially envisioned with financial backing from the United States Agency for International Development (USAID). However, its implementation was indefinitely delayed following a global freeze on nearly all US assistance after Donald Trump began his second term in January of the previous year. Reports indicate that Health Minister Dr. Sudha Gautam made personal appeals to secure the necessary funding for the survey.
“We will hold a formal meeting next week and conclude the remaining procedure to start the study,” Thapa confirmed. “Earlier, it was agreed that the US Centres for Disease Control and Prevention would provide technical help for the survey and New Era would conduct the study.” New Era, a reputable non-governmental research agency, has a history of conducting significant national-level research in Nepal, including previous Nepal Demographic Health Surveys.
Expanding Scope: Addressing Lead Contamination
A notable addition to the survey’s objectives this year is the assessment of lead levels in the general population. Lead contamination has emerged as a pressing public health concern in Nepal. Exposure to this toxic heavy metal is linked to a range of severe health issues, including decreased IQ and behavioural problems in children, impaired growth, kidney damage, hypertension, infertility, and adverse pregnancy outcomes. The World Health Organisation (WHO) emphasizes that there is no safe level of lead exposure, particularly for children, who absorb lead at a significantly higher rate than adults.
Recent research by the Centre for Public Health and Environmental Development (CEPHED) revealed high concentrations of lead in approximately one-third of cosmetic products, such as gajal (eyeliner) and sindoor (vermilion powder), as well as toothpaste available in Nepal. This indicates that millions of individuals, including women and children, are potentially exposed to this harmful metal.
A Decade of Progress and New Challenges
It has been over ten years since the last comprehensive micronutrient survey was conducted in Nepal. The 2016 survey provided valuable insights into various aspects of public health, including:
- The condition of drinking water and sanitation facilities.
- Child feeding practices and dietary diversity.
- The impact and coverage of vitamin A supplementation and deworming programmes for children.
- Iron supplementation and vitamin A and deworming initiatives for women.
- The prevalence of blood disorders.
- The nutritional status of adolescent girls.
- Rates of anaemia, iron deficiency, and zinc deficiency.
- Salt consumption patterns and iodine levels among the Nepali populace.
Informing Policy and Public Health Interventions
The forthcoming survey is expected to evaluate the effectiveness of ongoing vitamin A supplementation and fortification programmes. These programmes have been credited with significant public health achievements, such as the virtual elimination of night blindness among children and a 23 percent reduction in under-five mortality. The data generated will empower the government and policymakers to develop evidence-based strategies for these interventions.
Furthermore, the survey’s findings will inform decisions regarding the optimal amount of iodine to be added to salt. The 2016 survey indicated that a substantial portion of the population, 68 percent, consumed iodine in excess of recommended levels, contributing to a high prevalence of hyperthyroidism. Nepal currently fortifies salt with 50 parts per million (ppm) of iodine per kilogram, a level higher than the WHO’s recommendation of 15 to 40 ppm per kg.
Physicians express concern that the elevated iodine content in Nepali salt might be a contributing factor to the high incidence of non-communicable diseases, including thyroid disorders and hypertension. They also point to evolving dietary habits, characterized by increased consumption of processed foods, as a factor in the rising rates of hypertension and cardiovascular diseases. Conversely, insufficient iodine intake can lead to hypothyroidism, a condition where the thyroid gland produces inadequate thyroxine, potentially causing goitres.
The Imperative for Independent Data
Officials have noted a persistent challenge in securing government investment for data generation and independent research, with some perceiving such initiatives as a wasteful allocation of national resources. Moreover, data collected through official government channels are often viewed with skepticism by international agencies, as they can be susceptible to manipulation to portray progress artificially. Therefore, the current independent study, facilitated by UNICEF, is deemed essential for obtaining reliable and internationally recognized data crucial for effective public health planning and intervention in Nepal.
