At a cost of USD$3 per child, the package includes deworming tablets and vitamin A capsules, multi-micronutrient supplements for household fortification of food, and enough oral rehydration salts to treat one episode of diarrhoea.
The Child Health Day is also an opportunity to pass important messages on handwashing and to make sure that children are reaching the correct developmental milestones. They are particularly screened for acute malnutrition and if needed, children will be referred for further treatment.
(...) They queued quietly, registered with a nurse and were then ushered into a room where young children received their vitamin A capsules and were screened for malnutrition.
Language:English
Score: 1292840.6
-
https://www.unicef.org/dprk/st...alth-day-jongju-city-dpr-korea
Data Source: un
This will provide the machinery for correcting entries and keeping the data base current by adding and deleting foods and modifying those nutrients whose data have changed. (...) Maintenance
The maintenance of a food composition data base consists, at minimum, of correcting mistakes. Additionally, there may be a need to modify data or add or delete foods. (...) Users should identify a particular edition of a data base that is used, so that possible or necessary corrections can be made when
18
a newer edition is available.
Language:English
Score: 1240337.8
-
https://www.fao.org/uploads/me..._Composition_Data_Bases_02.pdf
Data Source: un
DEFICIENCIES OF MICRONUTRIENTS
MOZAMBIQUE (MISAU, 2002, 2004)
Deficiencies of micronutrients like Vitamin
A, Iron and Iodine are very common and
have High prevalence in children under- five
years of age and women.
Iron aproximatelly 89% of children 6-24
months of age
Vitamin A about 69% of children 6-59
months of age
Iodine about 68% of children under 5 years
Nutrition Situation in Mozambique
55%
53%
45%
47%
44%
42%
36%
36%
27%
23%
23%
Chronic Malnutrition 43% (IDS, 2011)
Nampula
C Delgado
Zambézia
Niassa
Tete
Manica
Sofala
Inhambane
Gaza
Maputo P
Maputo C
Magnitude and impact of micronutrient
deficiencies in Mozambique
Source: Mozambique "Vitamin and Mineral Deficiency - UNICEF / MI 2003"
1,470 maternal deaths occur due to severe
anemia
14,000 child deaths are precipitated by
vitamin A deficiency
subclinical deficiency in children <6 years
estimated at 26%.
1,500 children are born with diseases
resulting from defects in the neural tube.
1 in 2 children suffer from chronic
malnutrition in Mozambique (MICS, 2008)
Geografic Distribution of Chronic Malnutrion & Food Insecurity & Agricultural Production
7
Food Insecurity Agricultural Production Chronic Malnutrition
Gaza
Manica
Tete
Niassa C. (...) Strategies against, control and prevention of the
Deficiencies of Micronutrients
Integrated Interventions
Supplementation
Public Health
Measures
Fortification
Dietary improvement
2000 2005 2010
R el
at iv
e co
nt ri
bu tio
n of
in te
rv en
tio ns
to e
lim in
at e
M N
D
INTEGRATED INTERVENTIONS
Suplementation
Public Health
Measures Fortification ̸
Biofortification
Dietary Improvement
•High Cost
•Short –medium
period
•Low Costs
•Long period -sustainables
Food Fortification:
Simple Process their success depends on the
correct selection of food to be used as a
vehicle for fortification and the type of
compound or micronutrient to be added.
Strategy more cost-effective and sustainable
prevention of multiple micronutrient
deficiencies
Being the food industry the focus of
activities for adding micro nutrients
Biofortification:
Biofortification: breeding crops to increase their nutritional value.
Develop basic rich crops (staple) in order to achieve
micronutrient is the provitamin A, and the
concentrations of iron and zinc, from deficiency of
these micronutrients and with a view to improving
the nutritional status of the population.
Easy reach rural populations in situations of
malnutrition
- Intervention low cost
- No recurring costs beyond the cost of maintenance
of varieties
Mozambique Interventions for
prevention of micronutrient
deficiencies
Prevention of macrounient deficiencies
Salt Iodization
Industrial Food
Fortification
Bio fortification
The home Food Fortification (nutritional
supplements)
Food and nutrition Education
Promotion of breastfeeding
Nutritional Supplementation
(Health Week)
FOOD FORTIFICATION IN
MOZAMBIQUE:
The National Committee for Food
Fortification in Mozambique (CONFAM)
was created in April 2010 and Official
launched in March 2012, and is fully
operational.
The terms of reference and the Fortification
Program are approved by the Ministers
The Committee was Official approved by the
Ministerial Diplom
Ministry of Industry and Commerce
Production & Industry
Legislation &Quality Control
/ Assurance
Advocacy, Social Marketing &
Communication
Performance Monitoring &
Evaluation
Ministry of Health
Ministry of Industry
and Trade
MoAgriculture
Customs, WFP,
UNIDO, WV,
Industry
Association,
Confederation of
Economic
Associations
Costums, Economic Activities Institute,
INNOQ, MoH (LNHAA), MoA, WFP, USAID, UNICEF, HKI
SETSAN, MoH, MoIndustry and
Commerce, USAID, UNICEF, HKI, PSI, WV, Consumers Defence
Association
One focal point from each one of
the 3 working group
National Committee for Food
Fortification (CONFAM)
FOOD FORTIFICATION IN
MOZAMBIQUE:
Mozambique is benefit by the GAIN funding for
a four year fortification Program (2011-2015),
two new donors, Danida and Irish Aid
The Program was draft and adopted by
CONFAM
The project was approved in February/2011
HKI is the Executy Agency
Vehicles (wheat flour, edible oils) and
micronutrients have been identified for 1st phase
– Oil (vit A); wheat (NaFeEDTA, Zn, B12,
Folic Acid)
Successes :
CONFAM membership is growing and now counts
regular participation by line Ministries, private
sector, agencies, development partners and
producers.
Food Fortification is part of Multisectorial Action
Plan for the Reduction of Chronic Undernutrition
in Mozambique 2011 – 2014(20) Approved by
Ministers Council
Additional donors have shown interest in
contributing to the program
Successes :
The commitment to fortification among key
stakeholders, including millers and oil producers,
is still growing strongly
Development of the Mozambican standards for
fortification ( Wheat Flour, Wheat maize and
edible oils) in line with the WHO recommendations
and harmonized in the region.
Language:English
Score: 1235873.6
-
https://www.who.int/pmnch/abou...ce/partnersforum/2e_mungoi.pdf
Data Source: un
PowerPoint Presentation
Update on the Codex RUTF Guideline
Alison Fleet RUTF Pre-tender Industry Consultation
UNICEF SUPPLY DIVISION, COPENHAGEN 11-13 JUNE 2018
Codex Alimentarius
• International standards for traded foods
Ready to Use Therapeutic Food (RUTF)
Codex Guideline
Summary
RUTF has been scaled up since 2007 and the volumes of both production and coverage have increased dramatically over 10 years
o Lack of a suitable regulatory framework for these products makes it challenging to justify funding procurement through the national budgets.
o In 2015 the UNICEF proposal was accepted for the Codex Committee for Nutrition and Foods for Special Dietary Uses (CCFSDU) to develop a commodity guideline for RUTF
The anticipated
benefits of a CODEX
guideline are:
• Provides the International regulatory framework for RUTF, by clarifying its regulatory status as a food for special medical purposes
• The Guideline will be an essential tool to assist in building regulatory capacity within national governments to establish their own regulatory framework for RUTF
The anticipated
benefits of a CODEX
guideline are:
• Provide an official reference for RUTF so the products are safe, efficacious and of good quality
• Provide an opportunity for advocacy for children’s rights to good nutrition and right to survival
• The process of the development provides an opportunity to clarify and improve the formulation e.g. contaminants, sugar level, proteins – which may allow for different formulations.
2018 Q1-Q2
• Preamble of the guideline: this is where the background on SAM and also the proper use of RUTF will be described
• Vitamin and minerals: the forms of minerals should be as per the WHO Management of severe malnutrition: A manual for physicians and other senior health workers (1999), Appendix 4
• Recommended mineral forms : Potassium chloride, tripotassium phosphate, magnesium chloride, zinc acetate, copper sulphate, sodium selenite, potassium iodide
2018 (Q-4)
• Contaminants : risk assessment including all possible ingredients in RUTF (cereals, legumes)
• Proteins : an expert meeting has been coordinated by FAO to provide a recommended Protein digestibility-corrected amino acid score (PDCAAS) for RUTF.
Language:English
Score: 1214691
-
https://www.unicef.org/supply/...ting-Codex-update-June2018.pdf
Data Source: un
Adolescence provides an opportunity to correct nutritional deficiencies that may have occurred in early life and to catch-up on growth, and to establish good dietary behaviours. (...) Food fortification plays an essential role in preventing vitamin and mineral deficiencies including iron, folic acid, vitamin A, and iodine.
Language:English
Score: 1183154.6
-
https://www.unicef.org/rosa/wh...dolescent-and-womens-nutrition
Data Source: un
Many countries now use the opportunity to deliver other health interventions, such as vitamin A, long-lasting insecticide treated nets (LLINs), folic acid, health education, and others. (...) In these countries, growth monitoring, supplementary feeding, health education, vitamin supplementation and immunizations were all provided together in comprehensive child health campaigns. (...) Careful selection of the integration and addition of interventions, as well as close monitoring is warranted, so as not to overburden a weak system, and to identify and correct any unforeseen challenges that arise. Finally, integration of services can make the most efficient use of scarce resources, such as health workers, and respects the burden on families associated with travelling to health facilities.
Language:English
Score: 1182138.7
-
https://www.who.int/pmnch/know...ublications/summaries/ks25/en/
Data Source: un
Many countries now use the opportunity to deliver other health interventions, such as vitamin A, long-lasting insecticide treated nets (LLINs), folic acid, health education, and others. (...) In these countries, growth monitoring, supplementary feeding, health education, vitamin supplementation and immunizations were all provided together in comprehensive child health campaigns. (...) Careful selection of the integration and addition of interventions, as well as close monitoring is warranted, so as not to overburden a weak system, and to identify and correct any unforeseen challenges that arise. Finally, integration of services can make the most efficient use of scarce resources, such as health workers, and respects the burden on families associated with travelling to health facilities.
Language:English
Score: 1182138.7
-
https://www.who.int/pmnch/know...5_integrating_immunization/en/
Data Source: un
RECOMMENDATION FOR FUNDING FROM OTHER RESOURCES WITHOUT A RECOMMENDATION FOR FUNDING FROM REGULAR RESOURCES : MICRONUTRIENT PROGRAMME FOR THE ANDEAN SUBREGION AND PARAGUAY
Perhaps due to the easy access and abundant availability of food enriched with
vitamin A, the situation of vitamin A deficiency in Bolivia, Colombia and Ecuador
is only low to moderate among children under three years old. (...) Colombia did not provide vitamin A
supplementation since they decreed to fortify sugar with vitamin A in 1998.
(...) It is cost-effective, while
guaranteeing mass consumption if the correct commodities are fortified.
Fortification must be linked to a monitoring plan from the initial stage for quality
control and to permit effective adjustments.
18.
Language:English
Score: 1161892.8
-
daccess-ods.un.org/acce...n&DS=E/ICEF/2001/P/L.63&Lang=E
Data Source: ods
Identification of the root cause is still an issue
• Handling of corrective and preventive actions still needs improvement
• Complaint file do not always give a clear “audit trail” • Internal audit performed by properly trained internal
auditors
Facilities
• Dedicated areas are needed – F75 and F100 – infant formula standards – RUF – low moisture foods
• HVAC and a good zoning system needed • Logical flow of materials and staff • Surfaces smooth and easy to clean (with special focus on
dry cleaning). (...) Add random
sampling • Remember is for you – not the inspector/auditor • Pest control: corrective action in case of higher activity • Maintenance: clear procedure / formal assessment
before restart of production • Rework of filled sachets is not allowed.
(...) Complete information of the raw material manufacturer needs to be present
• Only approved suppliers should be used • Audit of key suppliers are needed (e.g. peanuts or
peanut paste, milk powders, vitamin and mineral premix, oil mixtures), but audit of all suppliers are highly recommended
Quality Control
• More analysis (number of nutrients and mixes) needed for RUTF and RUSF (companies can still improve their knowledge on compliance with the finished product specification). 1 tracer per shift / shift
• Trend analysis • Internal specifications e.g.
Language:English
Score: 1159719.9
-
https://www.unicef.org/supply/...ctions-trends-observations.pdf
Data Source: un
Iron deficiency is one of the most common nutrient deficiencies, affecting an estimated two billion people and causing almost a million deaths a year, and impairing the mental development of about half of the developing world's children. Vitamin A deficiency is compromising the immune systems of approximately 40% of the children in developing countries, leading to the deaths of approximately 1 million young children every year. (...) Zinc intakes are also commonly inadequate, affecting a half or more of the population in those developing countries with the highest mortality rates, and correcting this would have a dramatic impact on young child morbidity and mortality.
(...) Several micronutrient deficiencies (iron, vitamin A, folate, iodine, calcium) are associated with pregnancy complications.
Language:English
Score: 1156719.5
-
https://www.un.org/en/ecosoc/m.../2005/docs/nut.issue.paper.pdf
Data Source: un