1. Advocacy in Micronutrient Programs Dr. Azza Gohar Training Unit National Nutrition Institute Egypt

2. Micronutrient Deficiencies Among the Most Prevalent Health Problems Worldwide Yet Programs may have the least Success achieved Success achieved Enthusiasm directed at solutions Enthusiasm directed at solutions

3. Micronutrient deficiencies  Don’t always have easily noticeable symptoms & warning signs  May remain unrecognized despite their devastating impact  May not be viewed as a priority Why ?

4. Common Communication Goals Most Health/Nutrition Programs  Build Concern for Problem  Motivate Action  Sustain the Solution

5. Who? Who? Not Only End Beneficiaries But Also Government Decision/policy-makers Government Decision/policy-makers NGO Partners NGO Partners Medical Community Medical Community Religious Leaders Religious Leaders Industry Industry Mass Media Mass Media Other Professional groups Other Professional groups

6. We Need Them To Be….  Aware there is a problem  Know how to solve it  Convinced there is a benefit in doing so  Convinced that it is feasible

7. Communication Strategy In order To Succeed & have Sustained impact Needs more Positive reinforcement byAdvocacy

8. General Steps for Advocacy in Health Programs  Confirm that the problem exists (prevalence)  Define the Impact of the problem (individual/national)  Show that the Chosen approach is a proven and tested solution for this problem (experiences)  Describe the potential benefits and cost-effectiveness (Communicate the cost/benefit (problem/solution)  Alleviate the fears and concerns of targets (identified by research eg. FGD…..)

9. Remember……..When Advocating Focus on ways to present the problem Most Simply and Dramatically Tailored According to Target Group

10. Lack of Effective Advocacy Strategies Leads to Lack of Priority & Awareness Lack of Support Increased Fears and Suspicions Reflecting itself as program problems

11. Thank You

12. Advocacy Guidelines Dr. Azza Gohar Training Unit National Nutrition Institute Egypt

13. Advocacy Presentation to Medical Community

14. What to Tell Medical Community According to the level/type Magnitude of the problem Magnitude of the problem Impact on health Impact on health Safety of fortified foods/Other countries successes Safety of fortified foods/Other countries successes Impact of food fortification on health Impact of food fortification on health No Impact on Clinical Conditions (Thalassemia) No Impact on Clinical Conditions (Thalassemia) Role in Patient Information Role in Patient Information

15. Research, ……..Research,….. Research………

16. Define the Problem & its Magnitude Define & describe the problem & its causes Define & describe the problem & its causes Confirm the problem exists in quantity (prevalence by age –sex- geographical..) Confirm the problem exists in quantity (prevalence by age –sex- geographical..) Mention actual facts on biological, Dietary & consumption indicators Mention actual facts on biological, Dietary & consumption indicators

17. Define & Clarify Impact of the Problem on health Clinical Impacts: Mortality rates, Morbidity rates, maternal deaths, still births, LBW, immunity, childhood development, disabilities/impairments Clinical Impacts: Mortality rates, Morbidity rates, maternal deaths, still births, LBW, immunity, childhood development, disabilities/impairments Social Impacts: IQ/intelligence, mental capacity, school performance, work performance Social Impacts: IQ/intelligence, mental capacity, school performance, work performance

18. Impact of Food Fortification on Health Problem Give examples for comparisons Other rich food sources (food tables) in numbers Other rich food sources (food tables) in numbers Other Countries that solved the problem by food fortification (names & numbers) Other Countries that solved the problem by food fortification (names & numbers)

19. Give Evidence of Safety of Fortified Foods Safety of Level (type of fortificant) Safety of Level (type of fortificant) Evidence that Evidence that Individuals not at risk can consume the fortified food safely Individuals not at risk can consume the fortified food safely Fortification process has a very good QC & QA system Fortification process has a very good QC & QA system Successful Examples of Industrialized & Similar Countries Successful Examples of Industrialized & Similar Countries

20. Describe Possible Side Effects Describe clearly any side effects from consumption of Fortified food if any and how to handle Describe clearly any side effects from consumption of Fortified food if any and how to handle Describe proper management and what to say to their patients in that case Describe proper management and what to say to their patients in that case Describe clearly any changes expected in color, taste, appearance, odor, texture of fortified food Describe clearly any changes expected in color, taste, appearance, odor, texture of fortified food

21. Remember…. Involve them as part of the solution Involve them as part of the solution Motivate them to share Motivate them to share

22. Thank You

23. What to Tell Decision -Makers Magnitude of the problem (According to Sector) Magnitude of the problem (According to Sector) National Cost of neglecting it National Cost of neglecting it Cost- effectiveness & efficacy of fortification Cost- effectiveness & efficacy of fortification Safety of fortification Safety of fortification Experiences in other countries Experiences in other countries

24. General population (Consumers) Define the problem simply Define the problem simply Impact of problem on health, well being, productivity, intelligence….. Impact of problem on health, well being, productivity, intelligence….. Safety of fortificant Safety of fortificant Expected changes in taste or color Expected changes in taste or color Expected side effects Expected side effects Expected cost Expected cost

25. Food producers (Millers) / Food distributors (Bakers) Cost of new technology Cost of new technology Technical Feasibility & Know how Technical Feasibility & Know how Marketing Benefits & Profits Marketing Benefits & Profits Other countries successful experiences Other countries successful experiences Types, level & Safety of fortificant Types, level & Safety of fortificant Expected extra work load Expected extra work load Shelf life and storage Shelf life and storage