Nutrition: What’s Working, What Does It Take, & What’s On the Horizon 2002 AFR SOTA Meeting Thursday, June 13

Nutrition & Child Survival Pelletier et al, 1994

Benefits & Costs of Interventions DALYs = Disability adjusted life years

Essential Nutrition Actions Vitamin A Iodized salt Breast Feeding Maternal nutrition Complementary feeding Mgmt of Sick Children

Essential Maternal Nutrition Actions Adequate food intake during pregnancy & lactation Adequate micronutrient intake during pregnancy Reduction of malaria infection in pregnant women in women in endemic areas Birth spacing of 3 years or longer

 Monitor monthly weight gain of children under 2  Focus on preventive nutrition & basic health services/ practices at community level Community-Based Growth Promotion (CBGP)

Country Implementation Zambia Madagascar Senegal Benin Ghana DR Congo Uganda Guinea Nigeria Mali

Madagascar Achieving national policy and community nutrition results through partnerships

DELIVERY: DELIVERY: safe delivery, EBF, vitamin A, iron/folic acid, diet, FP, STI prevention PREGNANCY : PREGNANCY : TT, antenatal visits, iron/folic acid, de- worming, anti-malarial, diet, EBF, risk signs, FP, STI prevention, safe delivery, iodized salt POSTNATAL AND FAMILY PLANNING: POSTNATAL AND FAMILY PLANNING: EBF, diet, iron/folic acid, diet, FP, STI prevention, child’s vaccination WELL CHILD & GM/P: WELL CHILD & GM/P: monitor growth, assess and counsel on feeding, iodized salt, check and complete vaccination/ vitamin A /de-worming SICK CHILD: monitor growth, assess and treat per IMCI, counsel on feeding, assess & treat for anemia, check and complete vitamin A/immunization/de-worming IMMUNIZATION: IMMUNIZATION: vaccinations, vitamin A, de-worming, assess and treat infant’s anemia, FP, and STI referral Essential Nutrition Actions: Promoted at 6 Key Contacts

Prevalence Exclusive Breast Feeding

Impact of Improved BF on Diarrhea  early BF 34% to 73%  EBF 45% to 68%  incidence of diarrhea 15% to 3%  EBF  risk of diarrhea 8.5X

Increased Feeding of Children (0-23 mo) Following Illness Breastfeeding Complementary feeding

Proportion of Children (6-23 mo) Receiving VA Capsule in the Past 6 mo

Proportion of Women Receiving Postpartum VA Capsule

On the Horizon Global Alliance for Improved Nutrition (GAIN) VA Supplementation: Beyond NIDs Postpartum Infant VA Dosing NNIPS3: Antenatal Fe/FA vs Multi-MNs Preventative & Therapeutic Zn Strengthening Links among Ag, Food Security, Nutrition, & HIV/AIDS

Regional Center for Infant Feeding & PMTCT Zambia