Person:
Mbuya, Nkosinathi V.N.

East Asia and Pacific, The World Bank

Fields of Specialization

Nutrition

Departments

East Asia and Pacific, The World Bank

Last updated January 31, 2023

Biography

Nkosinathi Mbuya is a Senior Nutrition Specialist in the East Asia and Pacific Region of the World Bank. He has led the World Bank’s nutrition engagement in Lao PDR, the Philippines and Vietnam as well as other regional initiatives. Prior to joining the East Asia Region, Nkosi was the HQ-based nutrition focal person for the South Asia Region. For the Africa Region, he has supported the Madagascar, Burundi, Sierra Leone and Zambia Health teams in their nutrition engagement. Nkosi led the preparation of the East Asia and Pacific Region Multisectoral Strategy and Action Plan to Reduce the Double Burden of Malnutrition (2015-2020) and also the South Asia Regional Assistance Strategy for Nutrition (2011-2016) as well as a wide range of analytical work in Afghanistan, Bangladesh, and Sri Lanka. Before joining the World Bank, he was the Impact assessment Advisor for Save the Children UK’s Hunger Reduction Team based in London. He has also worked for the Ministry of Health and Child Welfare in Zimbabwe as a Provincial Nutritionist and as a Nutrition Lecturer at the Institute of Food, Nutrition and Family Sciences at the University of Zimbabwe.

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Publication Search Results

Now showing 1 - 10 of 11

Bangladesh National Nutrition Services: Assessment of Implementation Status

(Washington, DC: World Bank, 2015-08-11) Saha, Kuntal K. ; Billah, Masum ; Menon, Purnima ; El Arifeen, Shams ; Mbuya, Nkosinathi V.N.

This report presents the findings of an operations research study conducted to assess the implementation of the Government of Bangladesh’s National Nutrition Services Program (NNS) and to identify the achievements, determine the bottlenecks that adversely impact these achievements, and highlight potential solutions to ensure smooth delivery of the program. A mixed methods research approach was used to evaluate five major domains of the program: management and support services; training and capacity development; service delivery; monitoring and evaluation, and; exposure to interventions. The study found that the overall NNS effort is an ambitious, but valuable approach to support nutrition actions through an existing health system with diverse platforms. The results indicate that although the maintenance of strong and stable leadership of NNS is an essential element to ensure integrated and well-coordinated comprehensive service delivery for the line directorate, the current arrangement is unable to ensure effective implementation and coordination of NNS. Focusing on some of the critical challenges related to leadership and coordination in the first instance, and on embedding a small core set of interventions into well-matched (for scale, target populations, and potential for impact) health system delivery platforms is most likely to help achieve scale and impact. Strategic investments in ensuring transparency, engaging available technical partners for monitoring and implementation support, and not shying away from other potential high coverage outreach platforms like some NGO platforms also could prove fruitful. Moreover, although the Government of Bangladesh, and the health system in particular, must lead the effort to deliver for nutrition, it is clear that development partners who have expressed a commitment to nutrition must coordinate their own activities and provide the support that can deliver on nutrition’s potential for Bangladesh.
Water, Sanitation, Hygiene, and Nutrition in Bangladesh: Can Building Toilets Affect Children's Growth?

(Washington, DC: World Bank, 2016) Mahmud, Iffat ; Mbuya, Nkosinathi

This report provides a systematic review of the evidence to date, both published and grey literature, on the relationship between water and sanitation and nutrition. We also survey the potential impact of improved water, sanitation, and hygiene (WASH) on undernutrition. This is the first report that undertakes a thorough review and discussion of WASH and nutrition in Bangladesh. The report is meant to serve two purposes. First, it synthesizes the results/evidence evolving on the pathway of WASH and undernutrition for use by practitioners working in the nutrition and water and sanitation sectors to stimulate technical discussions and effective collaboration among stakeholders. Second, this report serves as an advocacy tool, primarily for policy makers, to assist them in formulating a multisectoral approach to tackling the undernutrition problem.
Malnutrition in Afghanistan : Scale, Scope, Causes, and Potential Response

(World Bank, 2011) Levitt, Emily ; Kostermans, Kees ; Laviolette, Luc ; Mbuya, Nkosinathi

This book has the potential to contribute to a reversing of this trend, whereby activities in not only the health sector but also in other sectors relevant to nutrition will gain increased support and prominence in national development planning. South Asia has by far the largest number of malnourished women and children, and no other region of the world has higher rates of malnutrition. Malnutrition in childhood is the biggest contributor to child mortality; a third of child deaths have malnutrition as an underlying cause. For the surviving children, malnutrition has lifelong implications because it severely reduces a child's ability to learn and to grow to his or her full potential. Malnutrition thus leads to less productive adults and weaker national economic performance. Therefore, the impact of malnutrition on a society's productivity and well being and a nation's long-term development is hard to underestimate. For the South Asia region of the World Bank, malnutrition is a key development priority, and in the coming years, the Bank intends to enhance dramatically its response to this challenge. As a first step, a series of country assessments such as this one are being carried out. These assessments will be used to reinforce the dialogue with governments and other development partners to scale up an evidence-based response against malnutrition. To succeed, we will need to address the problem comprehensively, which will require engaging several sectors. This assessment of malnutrition in Afghanistan lays out the scale, scope, and causes of the problem. The assessment also indicates key elements of a potential response.
Data Utilization and Evidence-Based Decision Making in the Health Sector : Survey of Three Indian States

(World Bank, 2009-04-01) Belay, Tekabe ; Mbuya, Nkosinathi ; Rajan, Vikram

Recently, there has been increased attention to data use in the international public health community. At the global level there have been major investments in data collection for public health programs. However, there is concern that such data are not being used. Data and information lack value unless they are used to inform decisions. Interventions that increase local demand for information and facilitate its use enhance evidence-based decision making. Data use therefore, is critical to improving the effectiveness and sustainability of the health system. Data quality is poor and use of available data is low in India's health sector. The current study focuses on issues of data use. It aims to shed light on how data are used for decision-making at different levels of the health sector in India and to highlight impediments to improved data utilization. This report is organized in five sections. The survey design, instruments and the data collection process will be described in the next section. Findings including measurement of data use, perceived data use issues, skills assessment of respondents and ranges of actual decision making are presented in section three. Section four presents a number of hypotheses and discusses their implications. The last section provides conclusions and recommendations.
Malnutrition in Timor-Leste: A Review of the Burden, Drivers, and Potential Response

(World Bank, Washington, DC, 2017-04-01) Provo, Anne ; Atwood, Steve ; Sullivan, Eileen Brainne ; Mbuya, Nkosinathi

This report presents the findings of nutrition assessment, gap analysis, and donor mapping exercise in the Democratic Republic of Timor-Leste (RDTL). Timor-Leste, though as a young and fragile state, has the preconditions for successful development. However, persistent high levels of malnutrition threaten to impede efforts to reduce poverty, capitalize on gains in human and skills development, increase productivity, and stimulate economic growth. Though progress has been in other areas of human development, malnutrition – particularly maternal and Child undernutrition – is the single greatest contributor to premature death and disability in the country and presents an unparalleled development challenge. In 2013, over half (50.2 percent) of all children under-five were stunted in their physical and cognitive development. Timor-Leste has the third highest stunting prevalence in the world, higher than all other g7+ countries and a significant outlier relative to its level of economic development. In 2013, nearly one in three (63.2 percent) children (6-59 months) and 2 in 5 women age 14-60 (39.5 percent) were anemic. Although the country is no longer in an emergency situation, the prevalence of wasting (11 percent) – an indicator of acute malnutrition and a prominent risk factor for child mortality – exceeds the WHO threshold for high public health significance, with emergency levels of wasting experienced in Covalima and Oecusse districts. Overweight prevalence is low relative to global averages, but has risen more than five-fold among adult women over the past decade. Though Timor-Leste does not yet suffer from the double burden of malnutrition, it will soon emerge if the problem continues unaddressed.
The Double Burden of Malnutrition in East Asia and the Pacific: Evidence and Lessons for a Multisectoral Response

(World Bank, Washington, DC, 2016-12) Shrimpton, Roger ; Mbuya, Nkosinathi Vusizihlobo ; Provo, Anne Marie

Global trends indicate that overlapping burdens of undernutrition and overnutrition—the double burden of malnutrition (DBM)—are the new normal (IFPRI 2014); indeed, most East Asia and Pacific (EAP) countries now have a DBM problem. This report explores the nature of nutrition problems affecting EAP countries to understand the sectoral and system-wide actions necessary for a coordinated approach to improving nutrition. The report (i) synthesizes evidence related to the burden of malnutrition in EAP, (ii) identifies the rationale for a multisectoral approach to DBM practitioners working across sectors in EAP, and (iii) provides an overview of the types of actions and interventions needed to address the DBM in a coordinated fashion across the life course. Actions across health and nonhealth sectors—ranging from implementation of national-level policy measures and complemented by interventions at the community and individual levels to support behavior change—are needed to prevent escalation of overweight and obesity. Among sectoral priority actions, the health sector plays an important role in monitoring health and nutrition outcomes, preventing and treating infectious and noncommunicable diseases associated with malnutrition, and providing interventions that affect individuals’ nutrient intakes. Similarly, nonhealth sectors have expertise and resources to deliver interventions related to the underlying causes of malnutrition. Further, systems-strengthening efforts are needed to support an environment that addresses the DBM across the life course, including increasing DBM-sensitivity of policy frameworks; leadership, coordination, and accountability; workforce capacity; and knowledge and evidence. Reducing the DBM is fundamental to sustainable development in EAP. EAP countries must shift from dichotomized policies addressing either undernutrition or overnutrition and develop coherent frameworks to address malnutrition in all forms for all life stages. Integrated preventive and curative interventions for undernutrition and overnutrition—implemented across the life course by multiple sectors—can forestall massive economic and human development consequences for future generations.
Addressing the Double Burden of Malnutrition in ASEAN

(World Bank, Bangkok, 2019-12-01) Mbuya, Nkosinathi Vusizihlobo ; Osornprasop, Sutayut ; David, Clarissa

Malnutrition, which encompasses both undernutrition and overnutrition, presents a significanthuman capital as well as economic development challenge across most ASEAN Member States.A healthy, well-nourished, well-educated and skillful population provides the foundation for aproductive life and enables future workers to compete in the dynamic labor markets of digitaleconomies. However, most of ASEAN's lower-income countries face an unfinished agenda withregard to undernutrition. Undernutrition elevates the risk of infant and child morbidity andmortality, increases expenditure on health care and social safety nets, lowers the efficiency ofinvestments in education, and decreases lifelong income-earning potential and labor forceproductivity, with the potential to be transmitted across generations. Estimates for some ASEANmember states show undernutrition resulting in annual losses of between 2.4 percent - 4.4 percent of GDP Overnutrition compounds the challenges. Overnutrition is posing an increasing challenge to ASEAN, with some countries having high prevalence of obesity and overweight. In the last 35 years obesity prevalence across ASEAN increased over 7-fold, most rapidly in Cambodia, Indonesia, and Lao PDR, where obesity rates have risen more than 10-fold. Childhood overweight and obesity is likewise a growing problem, especially in Brunei, Malaysia, and Thailand where childhood overweight prevalence exceeds 25 percent. Overweight and obesity among ASEAN member states have high direct costs for some countries, for example in Brunei it is 16. Direct health care costs related to treatment of obesity and associated chronic diseases due to obesity as well as indirect costs, particularly from the loss of labor productivity, are expected to increase in many ASEAN countries.
Media and Messages for Nutrition and Health: Assessing Media Appropriateness for Nutrition and Health-Related Social and Behavior Change Communication in Four High Stunting-Burden Provinces of Lao PDR

(World Bank, Washington, DC, 2020-06) Mbuya, Nkosinathi V.N. ; Calleja, Ramon V., Jr. ; Morimoto, Tomo ; Thitsy, Sophavanh

The Lao People’s Democratic Republic (Lao PDR) has experienced rapid and significant economic growth over the past decade. However, poor nutritional outcomes remain a concern. Rates of childhood undernutrition are particularly high in remote, rural, and upland areas. Media have the potential to play an important role in shaping health and nutrition–related behaviors and practices as well as in promoting sociocultural and economic development that might contribute to improved nutritional outcomes. This report presents the results of a media audit (MA) that was conducted to inform the development and production of mass media advocacy and communication strategies and materials with a focus on maternal and child health and nutrition that would reach the most people from the poorest communities in northern Lao PDR. Making more people aware of useful information, essential services and products and influencing them to use these effectively is the ultimate goal of mass media campaigns, and the MA measures the potential effectiveness of media efforts to reach this goal. The effectiveness of communication channels to deliver health and nutrition messages to target beneficiaries to ensure maximum reach and uptake can be viewed in terms of preferences, satisfaction, and trust. Overall, the four most accessed media channels for receiving information among communities in the study areas were village announcements, mobile phones, television, and out-of-home (OOH) media. Of the accessed media channels, the top three most preferred channels were village announcements (40 percent), television (26 percent), and mobile phones (19 percent). In terms of trust, village announcements were the most trusted source of information (64 percent), followed by mobile phones (14 percent) and television (11 percent). Hence of all the media channels, village announcements are the most preferred, have the most satisfied users, and are the most trusted source of information in study communities from four provinces in Lao PDR with some of the highest burden of childhood undernutrition.
Qualitative Study on Nutrition- and Health-Related Knowledge Attitudes and Practices in Four High Stunting Regions of Lao PDR

(World Bank, Washington, DC, 2020-09) Mbuya, Nkosinathi V.N. ; Sychareun, Vanphanom ; Morimoto, Tomo ; Thikeo, Manivone ; Durham, Jo ; Thitsy, Sophavanh

Despite the Lao People’s Democratic Republic (Lao PDR)’s significant economic growth over the last decade, poor nutritional outcomes remain a concern. Rates of malnutrition are particularly high in remote, rural, and upland areas. Redressing these high rates of malnutrition is critical in reversing inequalities in mortality and ill-health throughout people’s lives. This report presents the results of a qualitative study to investigate the knowledge, attitudes, and practices related to maternal and child health and nutrition in local communities in four provinces of Lao PDR with high levels of childhood undernutrition. While study participants were aware of the importance and benefits of antenatal care, facility-based birthing, and postnatal care, they also reported significant barriers to accessing these services. These barriers included poor road conditions and lack of transportation, long distances to health facilities, language difficulties, and lack of spousal support. With regard to infant and young child feeding, many mothers were aware of the benefits of colostrum for the first 24 hours and exclusive breastfeeding for the first six months of life and tried to put this into practice. However, some ethnic minority women stated that at times it was hard to prevent grandmothers from giving the infant water or a little chewed rice. There were mixed results when it came to growth monitoring of children. Even though mothers did participate in growth monitoring and promotion activities, most did not fully understand the reasons behind those activities. Access to clean water and appropriate sanitation facilities depended on location, but few families had access to safe water. While messages regarding handwashing and desisting from open defecation were well known in most villages, poverty and lack of support for providing safe and sustainable sanitation systems diminished the ability of many families to practice safe hygienic practices.
Mind Over Matter in the Philippines: A Study of Key Stakeholders' Perceptions of Childhood Stunting

(World Bank, Washington, DC, 2020-06) Sen, Iman ; Mbuya, Nkosinathi ; Demombynes, Gabriel ; Gauri, Varun

Declines in rates of child stunting in the Philippines have decelerated, making it hard for the country to achieve its targets on nutritional outcomes. The knowledge base, beliefs, and practices of caregivers have been extensively researched, but little is known about how health workers and policy makers fare in comparison. The authors conduct qualitative interviews, striving to preclude bias as we capture these stakeholders’ views on factors that affect stunting, and go on to compare and contrast these perceptions. The authors subsequently investigate the importance of the different factors in detail through a large-scale quantitative survey with frontline health and nutrition workers. The findings suggest that while most workers’ knowledge and beliefs are consistent with accepted practices, important deviations from consensus views exist, and these are correlated with worse self-reported service delivery outcomes at local health centers. The findings suggest that in the Philippines any endeavor to further improve service delivery must take into consideration the beliefs of frontline workers.