Public health nutrition in Afghanistan-policies, strategies and capacity-building: current scenario and initiatives

Background: Afghanistan is grappling with high burden of malnutrition in women and children and a rising burden of noncommunicable diseases. Aims: A narrative review was conducted with the aim of mapping current nutrition policies and capacity development initiatives to assess policy and the institutional environment and identify gaps and opportunities. Methods: A comprehensive, broad based search was conducted, including databases and websites and policy and programme documents. Results: The policy focuses on multisectoral efforts to address nutrition challenges; however; implementation of nutrition-specific and nutrition-sensitive interventions is not delivered uniformly at the community level due to continued conflic situations and geographic inaccessibility, lack of availability of trained human resources and weak institutions. There is limited evidence on the effectiveness of nutrition programmes in Afghanistan. Limited policy provisions are available to address nutrition issues due to the rising burden of noncommunicable diseases, urbanization and changing dietary patterns. The shortage of skilled nutritional professionals is a critical issue. Lack of institutional capacity, educational standards and accreditation mechanism poses major challenges. Ongoing training programmes are fragmented and fail to meet the requirements of a professional nutrition workforce. Conclusion: The findings highlight that well-structured policies and strategies focusing on maternal and child nutrition provide an enabling policy environment to scale up nutrition interventions. Evidence on the implementation of programmes is needed to aid policy recommendations. The lack of an institutional mechanism for professional nutrition education highlights the great need for action in Afghanistan for public health nutrition and education.