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Presentation Icn Vn
 

Presentation Icn Vn

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    Presentation Icn Vn Presentation Icn Vn Presentation Transcript

    • 30 years of Nutrition program in Vietnam: Implementation, progress and challenges Ha Huy Khoi, MD, DSc Vietnam Nutrition Association- National Institute of Nutrition
    • Nutrition in Vietnam before 1980
      • Food shortage. No sector responsible for nutrition.
      • Nutrition and Food safety Dep. (NIHE): Nutrition Research
      • Nutrition Section at Hanoi Medical University : Nutrition Module and Medical doctors nutrition oriented (42 persons)
    • Period 1980 - 1995
      • In 1980 : The National Institute of Nutrition VN was established
    • Nutrition Program/activities 1980-1995
      • Conducting nutrition epidemiological researches  Nutrition problems and causes
      • Introduction of VAC Eco-System  to alleviate the Household Food Insecurity (V-garden, A-fish pond, C-animal husbandry)
      • Nutrition Education and Training  to Set –up the Network of Nutrition in the whole country
    • Nutrition Program/activities 1980-1995
      • WFP project 2651 (1983-1988): supplementary feeding for vulnerable groups (pregnant and lactating mothers, under five children)
      • Since 1989: Nationwide Vit. A capsule distribution to children 6-60 mo  in 1994 Vietnam was Xerophthalmia free
      • Iron-folic acid tablets supplementation to pregnant women (pilot UNICEF project).
      • Nutrition Policy
      • and
      • Strategy in Vietnam
    • Period 1995-2000
      • In 1995: The NPAN 1995-2000 was ratified by the Prime Minister; the Government asked authorities at all levels to integrate nutrition goals, reduction of malnutrition into their SE development plan.
    • NPAN 1995-2000
      • Development of PEMC program (Government allocated budget to 63 provinces)
      • Since 1996: 1-2 of June – “National Vit.A distribution Day”  “Micronutrient Day ”.
      • Iron supplementation project for pregnant women (Supported by UNICEF)
      • Providing In-service training for nutrition staff at provincial and district level…
    • Period 2001-2010
      • In 2001: The NNS 2001- 2010 was approved by the Government.
    • General objective
      • By the year 2010, this strategy aims to ensure the significant improvement of nutritional status of the country’s population; primarily children and mothers . In addition, it will attempt to minimize emerging nutrition-related health problems.
      • How to implement the nutrition activities/programs in Vietnam?
    • NNS 2001-2010
      • Development of Nutrition project/programs:
      • National PEMC Program (Increased the Gov. Budget and mobilized resources from local)
      • National Vitamin A distribution program:
        • <2005: Supported by UNICEF
        • > 2005: partly by Gov. and ADB, other sources
      • Iron supplementation:
        • < 2005 supported by UNICEF in selected districts
        • > 2005: Pregnant women paid for Fe tablets
      • Pilot project on Multi-Micronutrient supplementation
    • NNS 2001-2010
      • How to implement Nutrition program/activities?
      • Advocacy for stakeholders in nutrition
      • Multi-sectoral approach in implementation of NNS activities: Health, Agricultural, Training & Education…
      • Involvement of social organizations: Women Union, Farmer Union, Youth Union…
    • NNS 2001-2010
      • How to implement Nutrition program/activities?
      • Strengthening International cooperation:
        • Program/projects of UN organizations (UNICEF, WHO, FAO)
        • Capacity Building Project (the Netherlands government)
        • GAIN (Fe Fortified Fish Sauce)
        • ADB project (Vit, A + De-worming)
        • Community- based projects of the WM, SCUS, IRD, ILSI, JICA, GRET …
    • Intervention Strategies
      • Preventive Orientation: Nutrition throughout the lifecycle
      • Prioritizing: High risk groups; Provinces with high malnutrition rate
      • Community-based and Multi-sectoral Approach
      • Nutrition Capacity Building from Central to local level
    • Nutrition Training in Vietnam
      • In 1990 : Nutrition, Food hygiene and Safety Dep-t at Hanoi Medical University was established.
      • In 2005 : Nutrition Dep-t was established in other Medical Universities, Agricultural Universities…
      • Since 1994 : Carrying out the M.Sc in Community Nutrition Training
      • Since 2005: PhD in Nutrition Training at NIN
    • Implementation Mechanism/System MOH NIN Preventive Medicine /Maternal and Child Care Centers Commune Health Center 104,000 Nutrition Collaborators
    • NATIOAL cHILD MALNUTRITION CONTROL PROGRAM National Conference for Nutrition Collaborators
    • Food preparation demonstration/practices
    • Mother’s club Nutrition contest Growth monitoring
    • A comprehensive Package of Interventions in 3 provinces ( UNICEF/NIN Vietnam)
      • Adding new items in the existing PEMC program to make it more comprehensive and target more on pre-pregnancy
      • Strengthening partnership among health and with social sectors (Women Union, Youth Union…)
    • Additional Interventions
      • Before pregnant
        • De-worming every 6 months
        • Weekly dose of MMN
        • IEC activities
      • During pregnant
        • Multiple micronutrients daily dose
        • IEC activities
      • Infancy
        • Ensured vitamin A supplementation high coverage
        • Quality of the growth monitoring activity
        • Communication for nutrition behavior change at the household level
    • IEC activities
      • IEC center has been set up at NIN in 1995
      • IEC campaign:
            • 1-2 Jun Micronutrient Days
            • 16-23 Oct Nutrition Week
      • Education materials: Booklets :To be mother. Nutrition: questions and answers..
      • RDA: approved in 1996, revised in 2007
      • FBDG: ten recommendation for healthy nutrition, revised in 2006
    • Provision of healthy foods
      • A food workshop has been set up at NIN in 1985
      • Products: balanced food mixtures, micronutrient fortified cakes, multiple micronutrient sprinkles, functional foods
    • The Netherlands Project
      • “ Local capacity building for effective and sustainable implementation of community-based nutrition activities for improving nutritional status of women and children in 10 disadvantaged provinces in Vietnam”
      • GAIN project
      • “ Iron fortified fish sauce for control iron deficiency anemia in Vietnam 2006-2008”
    • - Nutrition Training and Education - Credit programs - Providing new seeds and breeds World Mission projects
    • Progress and sustainability
      • Malnutrition Reduction is 1 of the National criteria of the SE development.
      • Increasing Gov. Budget year by year + Mobilizing the local resources  Socialization of nutrition activities
      Progress and Sustainability
    • Progress and Sustainability
      • Building up a strong nutrition network from central to grassroots levels
      • High level political awareness and support of the stakeholders/local leaders.
    • Trend of underweight among under 5 children in Vietnam 1985-2008 (%)
    • Underweight (W/A) 2008: 19.9% Suy dinh d­ìng trÎ em n¨m 2008: 19,9% Suy dinh d­ìng trÎ em n¨m 1999: 36,7% 1999 2008 % SDD
    • Trend of Stunting among children under 5 years of age in Vietnam from 1985 -2008 (%)
    •  
    • Secular trend in growth of Vietnamese children during 1875-2003 periods
    • Prevalence of vitamin A deficiency (serum retinol <0.7umol/L) among <5 (VDD/UNICEF, 2006) Vietnam: xerophthalmia free since 1994
    • Anaemia prevalence (in 1995 and 2000)
    • Overweight and obesity (BMI ≥25) in 2005
    • Overweight and Obesity of adults (2005) Nguån: Tổng điều tra BÐo ph× toµn quèc 2005
    • Challenges
      • High rate of stunting among <5
      • Problems of Micronutrient deficiencies
      • Increasing overweight/obesity and NCD…
      • Problems of nutrition in transition
    • Nutrition Plan
      • Conducting the National Nutrition Survey 2009  Development of NNS 2011-2020.
      • Development of Stunting Reduction Plan
      • Strengthening the Inter. Cooperation in nutrition research and training…
    • Vietnam nutrition association ( VINUTAS)
      • Set up in 2001, represent the nutrition community of the whole country, member of IUNS
      • Work closely with NIN in implementing nutrition program
      • Scientific seminars, biannual national Nutrition scientific meeting
      • Quarterly journal “Nutrition and food science” since 2005
    • Thank you !