Presentation on theme: "NUTRITION PROGRAMMES AND INTERVENTIONS"— Presentation transcript:
1NUTRITION PROGRAMMES AND INTERVENTIONS PHD annual review meetingHeld at: Erata Hotel8th -9th March 2007.
2PREVALENCE OF MALNUTRITION The major nutritional problems areunder nutrition mostly PEM,Micro nutrient deficiencies(Emerging) diet related non communicable diseases such as obesity, overweight, diabetes, hypertension, etc. with their attendant consequencesWomen and children are mostly affected
3Prevalence of Protein Energy Malnutrition-PEM PEM levels in children generally highAbout 30% of children under five are stunted i.e. too short for their age7% are wasted i.e. too thin22% are underweight i.e. have low weight for their age
4PEMMalnutrition is generally higher in rural than urban areas.
5PEM -Nutritional Status of Children by Region (DHS 2003) UnderwtWastingStuntingASH20.86.729.1BA20.45.729.4CEN22.03.031.6EAS22.214.171.124GAR126.96.36.199NOR35.56.648.8UER32.412.931.7UWR25.911.034.1VOL25.723.3WES16.55.328.4Except for GAR, stunting is generally high but highest in NR, UWR, UER & CRVR, UER,UWR recorded wasting levels above the national average of 7%NR, UER, UWR, VR & CR had underweight levels above the national average of 22%PEM HIGHLY PREVALENT IN 3 NORTHERN REGIONS + VR + CR
6Malnutrition in WomenPEM in WomenMaternal malnutrition measured by BMI<18.5declined slightly from 11% (’93 & ‘98)to 9% (2003)Over nutrition among women25% of women in Ghana are overweight, one-third of these are obese.Greater Accra has the highest prevalence - 46% of women overweight with more than half obese.
7Micronutrient Malnutrition Iron Deficiency/AnaemiaPreschool children – 76%pregnant women – 65%women years - 45% (DHS 2003)Vitamin A Deficiency (VAD)U5s had severe VAD - 72%Children aged 12 – 24 mon. & those in rural areas most at riskBreastmilk retinol showed low prevalence- 6.7% (VAD – breast milk retinol < 30 ug / dl)Iodine Deficiency9 districts out of 27 (33%) surveyed had serious IDD problems
8Goal and Areas of focus Areas of Focus: Goal: To ensure that all persons living in Ghana are well nourished.Areas of Focus:improving awareness, knowledge in nutritional issues including infant and young child feeding practices and maternal nutritionpromoting improved management of malnourished children / persons andpreventing /controlling micronutrient deficiencies due to iodine, iron and vitamin A
9INTERVENTIONS Promoting Healthy Eating and Healthy Lifestyle Infant and Young Child feedingCommunity Based Growth PromotionSupplementary FeedingMicronutrient Deficiency ControlVitamin A deficiency ControlIodine Deficiency DisordersIron Deficiency Anaemia
10Interventions Control of Micronutrient Deficiencies. Micronutrient deficiencies of importance are:iodine deficiency,vitamin A deficiency andiron deficiency/anaemia.Strategies adopted for control of these deficiencies are:Education on diversifying the diet through promoting the production and consumption of micronutrient rich foods.Micronutrient Supplementation. Fortification of selected foods.Other public health interventions done in collaboration with other stakeholders e.g. promoting good hygiene and sanitation and deworming, malaria control and immunization.
11Achievements Imagine Ghana Free of Malnutrition Strategy A Director-General initiative which enjoins the various stakeholders to prevent and control malnutrition in an integrated manner covering all intervention areas.A roll out plan was developed for advocacy and dissemination to policy makers at all levels and development partners.Six episodes on child feeding, growth promotion and food hygiene were prepared for TV under the theme ‘Healthy child, every child counts’.
12Achievements Healthy Eating and Lifestyle New Health Paradigm-Regenerative NutritionThe new health paradigm is promoting healthy lifestyles among people living in Ghana.In 2006, a draft training manual was revised and training piloted. There are plans to scale up training of health workers community based change agents and other extension agents nationwide.
13AchievementsInfant and Young Child feeding StrategyThe strategy seeks to promote appropriate feeding for different stages of infancy and early childhood.In 2006 Wall Charts on Essential Nutrition Actions (ENAs) were printed, distributed and training organized for health workers to operationalise use of ENAs.The ENAs are actions taken at any health contact with the child or the mother covering breastfeeding, complementary feeding, feeding the sick child, women’s nutrition, control of iron, vitamin A and iodine deficiencies.
14IYCF - AchievementsTwenty-six agents from FDB. Environmental Health and GHS trained on monitoring of BF Regulation 2000.12 Health Workers from Central, Western and Volta regions trained on infant feeding counseling.
15Achievements Community Based Growth Promotion Community Participation in child growth monitoring and promotion implemented through the District Assemblies.After running the project for 2 years, some positive impact was realized e.g. project contributed to increases in exclusive breastfeeding rate in project communities.In 2006 programme was planned for expansion into 500 communities in 50 districts.
16Achievements Supplementary Feeding Programme A programme that provides health and nutrition education, growth monitoring, deworming, vitamin A supplementation, immunisation and food to children under five, pregnant and lactating women in 26 districts in the 3 Northern regions.After running programme for a number of years, mean birth weight has increased from 2.2 to 2.8kgProportion of lactating women with low Body mass index(BMI) ie underweight, has reduced.In 2006, programme scaled up to 170 communities covering14,000 children 6-24 months,60,000 children 2-5years10,000 pregnant and lactating women.
17Achievements Nutrition and HIV/AIDS Adequate nutrition is a co-therapy for HIV-AIDS. Good nutrition is required to boost the compromised immune system in HIV/AIDS patientsDietary guidelines have been developed for people living with HIV/AIDS.
18Achievements Iodine Deficiency The main control strategy is Universal Salt Iodisation and the target set was to increase household coverage from 74.4% (in 2005) to at least 90% or more by end of 2006.(50%-2002; 44.4%-2003)In 2006, IEC activities included development of a TV documentary with Miss Ghana 2006 as main star.
19Achievements Iron deficiency/Anaemia control Aims at reducing anemia among women and children by 25% over a 5-year periodRadio spots on anaemia control in pregnancy translated in local languages and aired on 16 radio/Fm stations nationwideGuidelines for school aged children were developed and piloted in collaboration with stakeholders and partnersNational School age Deworming was undertaken by Nutrition Unit, RCH, Disease Control Unit in February in collaboration with GES.
20Achievements Vitamin A deficiency control The programme aims to eliminate vitamin A deficiency.Promoting the consumption of vitamin A rich foods is on-going.2 rounds of vitamin A capsules were distributed to children 6-59 months. National coverage of 81% was achieved in Nov 2006.Distribution of capsules to lactating women within 8 weeks after delivery is on-going. National coverage from the Demographic and Health Survey, 2003 was 43%.
21AchievementsFood fortificationProgramme aimed at fortifying vegetable oil with vitamin A and wheat flour with vitamin A iron, B-vitamins and zinc.Last year a proposal submitted by a multisectoral committee, the National food fortification Alliance won approval for award of a grant to kick start the programmeA legislative instrument developed for the amendment of the food law was submitted for approval of cabinet.Fortification of commercially processed vegetable oil and wheat flour is expected to start in April 2007.
22CHALLENGES Key Challenges faced: (Large) Funding Gaps for implementation of Programmes / planned activitiesNeed for a comprehensive and integrated nutrition communication strategyInadequate staff at district level in particular and also at national levelSecuring District Assembly support for program activities at community levelInadequate commitment by collaborators
23STRATEGIC PLANBuild capacity for growth promotion at regional, district/sub-district and community levels.Implement the new W.H.O. growth standards.Intensify nutrition BCC/IEC in all program areas especially complementary feeding.Increase awareness and knowledge on ENAs.
24STRATEGIC PLANImplement a roll out plan on guidelines for nutrition care and support for PLWHIV.Initiate development of Nutrition guidelines in the management of TB.Mobilize support to provide Vitamin A capsules to children aged 6 to 59 months and lactating women and strengthen data capture.Support Micronutrient Food Fortification in collaboration with Global Alliance for Improved Nutrition (GAIN) & FDB.
25STRATEGIC PLANConduct survey to appraise the Vit. A supplementation program and impact of consumption of iodated salt.Ensure effective enforcement of LIs on salt iodation, fortified wheat flour/vegetable oil and the breastfeeding regulations.Disseminate, sensitize and roll out IGFM.Intensify Monitoring/Supportive visits to regions and districts