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  • 1. 30 years of Nutrition program in Vietnam: Implementation, progress and challenges Ha Huy Khoi, MD, DSc Vietnam Nutrition Association- National Institute of Nutrition
  • 2. 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)
  • 3. Period 1980 - 1995
    • In 1980 : The National Institute of Nutrition VN was established
  • 4. 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
  • 5. 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).
  • 6.
    • Nutrition Policy
    • and
    • Strategy in Vietnam
  • 7. 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.
  • 8. 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…
  • 9. Period 2001-2010
    • In 2001: The NNS 2001- 2010 was approved by the Government.
  • 10. 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.
  • 11.
    • How to implement the nutrition activities/programs in Vietnam?
  • 12. 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
  • 13. 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…
  • 14. 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 …
  • 15. Intervention Strategies
    • Preventive Orientation: Nutrition throughout the lifecycle
    • Prioritizing: High risk groups; Provinces with high malnutrition rate
    • Community-based and Multi-sectoral Approach
  • 16.
    • Nutrition Capacity Building from Central to local level
  • 17. 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
  • 18. Implementation Mechanism/System MOH NIN Preventive Medicine /Maternal and Child Care Centers Commune Health Center 104,000 Nutrition Collaborators
  • 19. NATIOAL cHILD MALNUTRITION CONTROL PROGRAM National Conference for Nutrition Collaborators
  • 20. Food preparation demonstration/practices
  • 21. Mother’s club Nutrition contest Growth monitoring
  • 22. 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…)
  • 23. 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
  • 24. 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
  • 25. 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
  • 26. 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”
  • 27. - Nutrition Training and Education - Credit programs - Providing new seeds and breeds World Mission projects
  • 28. Progress and sustainability
  • 29.
    • 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
  • 30. 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.
  • 31. Trend of underweight among under 5 children in Vietnam 1985-2008 (%)
  • 32. 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
  • 33. Trend of Stunting among children under 5 years of age in Vietnam from 1985 -2008 (%)
  • 34.  
  • 35. Secular trend in growth of Vietnamese children during 1875-2003 periods
  • 36. Prevalence of vitamin A deficiency (serum retinol <0.7umol/L) among <5 (VDD/UNICEF, 2006) Vietnam: xerophthalmia free since 1994
  • 37. Anaemia prevalence (in 1995 and 2000)
  • 38. Overweight and obesity (BMI ≥25) in 2005
  • 39. Overweight and Obesity of adults (2005) Nguån: Tổng điều tra BÐo ph× toµn quèc 2005
  • 40. Challenges
    • High rate of stunting among <5
    • Problems of Micronutrient deficiencies
    • Increasing overweight/obesity and NCD…
    • Problems of nutrition in transition
  • 41. 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…
  • 42. 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
  • 43. Thank you !