DECISION

PROMULGATING PROGRAM FOR NUTRITION CARE IN THE FIRST 1.000 DAYS OF LIFE FOR PREVENTION OF MATERNAL AND CHILD UNDERNUTRITION AND IMPROVEMENT OF VIETNAMESE PEOPLE’S HEIGHT

PRIME MINISTER

Pursuant to the Law on Government Organization dated June 19, 2015;

Pursuant to the Government’s Resolution No. 139/NQ-CP dated December 31, 2017 promulgating action program for implementation of Resolution No. 20-NQ/TW dated October 25, 2017 by the 6th Meeting of the 12th Central Committee on enhancement of citizens’ health protection, improvement, and care in new situation;

At the request of the Minister of Health,

HEREBY DECIDES:

Article 1. The program for nutrition in the first 1.000 days of life for prevention of maternal and child undernutrition and improvement of Vietnamese people’s height, with the following content, is promulgated:

1. Objectives: improve nutritional status of pregnant women and children under 2 years of age to improve Vietnamese people’s strength and height. To be specific:

a) Improve nutritional status of pregnant women and children

- By 2025: prevalence of stunting among children under 5 years of age is under 20%; prevalence of wasting among children under 5 years of age is under 11%, and under 15% in ethnic minority and mountainous areas; prevalence of low birth weight (under 2.500 gram) is under 8%; and prevalence of anemia in pregnant women is under 23%, and under 25,5% in mountainous areas.

- By 2030: prevalence of stunting among children under 5 years of age is under 19%; prevalence of wasting among children under 5 years of age is under 10,5%; prevalence of low birth weight (under 2.500 gram) is under 7%; and prevalence of anemia in pregnant women is under 20%, and under 23,5% in mountainous areas.

b) Increase rate of practice in first 1000 days nutrition care for child caregivers

- By 2025: 80% of mothers initiate breastfeeding early and 25% of mothers breastfeed exclusively for the first 6 months; 60% of mothers continue to breastfeed up to 24 months of age or beyond; and 70% of mothers give complementary foods to children of from 6 to 24 months of age properly.

- By 2030: 85% of mothers initiate breastfeeding early and 30% of mothers breastfeed exclusively for the first 6 months; 70% of mothers continue to breastfeed up to 24 months of age or beyond; and 80% of mothers give complementary foods to children of from 6 to 24 months of age properly.

2. Main tasks and solutions:

a) Regarding institutions, policies and direction

- Review, research and complete policies and laws on nutrition care in the first 1000 days of life, including assistance for pregnant women, breastfeeding mothers and children under 24 months of age in areas with socio-economic difficulties, remote and isolated areas and ethnic minority areas.

- Set and add targets for first 1000 days nutrition to the socio-economic development targets of each locality; create healthy meal plans for each target group and each region. Incorporate nutrition targets of this program into nutrition targets of relevant programs of each locality.

- Further inspect and supervise planning, target setting, funding allocation and adoption of policies providing assistance for pregnant women, breastfeeding mothers and children under 24 months of age; implementation of the Government’s Decree No. 100/2014/ND-CP dated November 06, 2014 on trade and use of nutritious products for infants, feeding bottles and teats.

- Promote and improve interdisciplinary cooperation in nutrition care in the first 1000 days of life; focus on cooperation with Vietnam Women's Union in launching this program.

b) Regarding communications activities and encouraging change in acts of first 1000 days nutrition care

- Further raise the awareness of the benefits of periodical prenatal checkups, nutrition care for pregnant women, exclusive breastfeeding for the first 6 months, appropriate complementary feeding and micronutrient supplementing.

- Focus on raising the awareness of pregnant women, mothers with young children, child caregivers and families, especially those living in remote and isolated areas and ethnic minority areas.

- Apply suitable communication methods for each target group. Focus on raising awareness via grassroots systems, grassroots health officials, women unions and information systems of villages located in remote and isolated areas.

- Disseminate skills and knowledge for raising awareness of first 1000 days nutrition care to health officials and officials of women unions at all levels, especially grassroots level.

- Organize activities commending organizations and individuals with great achievements and effective implementation models (such as hospitals initiating breastfeeding excellently, breast milk bank establishment and operation) as appropriate.

c) Regarding technical aspect:

- Make all interventions in nutrition care in the first 1000 days of life, including proper nutrition and healthcare for mothers before, during and after childbirth; exclusive breastfeeding for the first 6 months; appropriate complementary feeding for children under 2 years of age; and periodical monitoring of child growth and development.

- Guidelines on proper nutrition for each target group and locality.

- Identify priority groups and areas needing intervention based on criteria for stunting, nutritional status of pregnant women and mothers with young children, and socio-economic situation of each locality, starting with communes with exceptional socio-economic difficulties located in mountainous areas, remote and isolated areas and ethnic minority areas.

- Provide training and refresher courses in proper nutrition and healthcare, advising on exclusive breastfeeding for the first 6 months; instructions on appropriate complementary feeding for children under 2 years of age; and monitoring of growth and development of children under 2 years of age for grassroots-level health officials, village health workers and village midwives.

- Build and pilot implementation models in some communes with exceptional socio-economic difficulties.

d) Regarding funding

- This program shall be funded by state budget based on budget balancing capacity and applicable budget decentralization. This funding amount shall be added to recurrent expenditure estimate of regulatory bodies/units assigned healthcare and population tasks and funding for relevant programs and projects according to regulations of the Law on State Budget.

- Funding for this program shall also be allocated from funding for the project on taking care of public health, and improving the physical condition and height of ethnic minority people; preventing and controlling child undernutrition of the national target program on socio-economic development in ethnic minority and mountainous areas for the 2021-2030 period per the National Assembly’s Resolution No. 88/2019/QH14 dated November 18, 2019.

- Mobilize participation, contribution and assistance from domestic and foreign organizations, especially for production and provision of micronutrients to pregnant women and children.

dd) Regarding monitoring, supervision and assessment

- Develop indicators for supervision and assessment of this program’s results.

- Establish a system for monitoring and collecting information used for assessment and supervision of this program’s results.

- Inspect this program’s launching in localities.

Article 2. Implementing organization

1. Ministry of Health shall:

- Take charge and cooperate with the Committee for Ethnic Minority Affairs and Ministry of Finance in reviewing, researching and proposing that the Prime Minister considers and provides assistance allocated from central government budget for some localities with high stunting prevalence and budgetary difficulty; cooperate with the People’s Committees of relevant provinces in building and adopting some models of nutrition care in the first 1000 days of life in communes with exceptional socio-economic difficulties in the northern highlands, central coasts and central highlands.

- Take charge and cooperate with the Ministry of Finance in researching and reporting on free-of-charge provision of some essential micronutrients to pregnant women and micronutrient supplementing for undernourished children under 2 years of age living in remote and isolated areas and ethnic minority areas to the Prime Minister.

- Formulate technical guidelines and documents on nutrition care in the first 1.000 days of life for communication bodies; build capacity of provincial-level health officials and officials of central- and provincial-level women unions.

- Cooperate with Vietnam Television and Voice of Vietnam in developing broadcasting and radio segments that raise the awareness of and encourage nutrition care in the first 1.000 days of life.

- Promote international cooperation in researching, training, developing and enhancing quality of the workforce in charge of this program; implement this program together with international cooperation projects; share international experience in program launching to achieve objectives of nutrition care in the first 1.000 days of life.

- Take charge and cooperate with ministries and central authorities in inspecting, supervising, assessing, preparing periodical preliminary reports and summary reports, and drawing lessons.

- Report on this program’s results to the Prime Minister before December 20 of every year.

2. Ministry of Finance shall:

- Take charge and cooperate with the Ministry of Health in allocating funding for this program as per the law.

- Cooperate with the Ministry of Health in reviewing, researching and proposing that the Prime Minister considers and provides assistance allocated from central government budget for some localities with high stunting prevalence and budgetary difficulty to provide some essential micronutrients for pregnant women free-of-charge and micronutrients for undernourished children under 2 years of age living in remote and isolated areas and ethnic minority areas.

3. Committee for Ethnic Minority Affairs shall:

- Take charge in encouraging ethnic minorities to provide nutrition care in the first 1.000 days of life and replace outdated practices with acts beneficial to maternal and child health.

- Cooperate with the Ministry of Health and People's Committees of relevant provinces in building and piloting implementation models in communes with exceptional socio-economic difficulties located in the northern highlands, central coasts and central highlands.

4. Ministry of Information and Communications shall:

- Take charge and cooperate with the Ministry of Health and relevant ministries and central authorities in directing press agencies to further promote nutrition care in the first 1.000 days of life.

- Manage mass media advertising for nutritious products for children as per the law.

5. Vietnam Television and Voice of Vietnam shall:

- Increase segments and topics about nutrition and nutrition care in the first 1.000 days of life.

- Take charge and cooperate with the healthcare sector in regularly holding talk shows and segments providing answers and instructions, dialogues and radio and television programs about nutrition care in the first 1.000 days of life.

6. People’s Committees of provinces and central-affiliated cities shall:

- Set specific targets for improvement of nutritional status of pregnant women and children under 2 years of age as appropriate to this program’s targets and add them to the socio-economic development targets of their provinces/cities;

- Allocate funding from local government budget for this program; launch this program in their provinces/cities and inspect such launching; report this program’s results to the Ministry of Health, which will submit a consolidated report to the Prime Minister.

- Direct activities raising awareness of this program and encouraging launching of this program in their provinces/cities.

- People's Committees of provinces in the northern highlands, central coasts and central highlands shall cooperate with the Ministry of Health in building and piloting some models of nutrition care in the first 1.000 days of life.

7. Vietnam Women's Union shall encourage its members and their families to provide nutrition care for pregnant women and children under 2 years of age, focusing on prenatal care, provision of advice and instructions on breastfeeding, micronutrient supplementing and proper nutrition.

Article 3. This Decision takes effect from the date on which it is signed.

Article 4. Ministers, heads of ministerial-level agencies, heads of Governmental agencies, heads of relevant regulatory bodies, and Chairpersons of People’s Committees of provinces and central-affiliated cities shall implement this Decision./.