Nutrition Intervention strategy

1. NUTRITION STRATEGIES AND APPROACHES
(Alleviation of malnutrition)

2. Basis for interventions
Diet
 Reduce morbidity and mortality

3. Nutrition interventions
Can be Targeted at levels
1. National
Education campaigns
Supplementation/fortification
Collaboration/food manufacturers
2. Local
Workplace initiatives
Education and skills trainings
3. Individual
Counselling/follow up

4. Community Nutrition Programs/
Growth monitoring – for identification/early warning
Breastfeeding promotion – ideal nutrients
Nutrition education – information/empowerment
Promotion of better weaning practices – nutritious
weaning foods
Micronutrient intervention programs
De-worming
supplementary feeding
immunization
family planning,
nutritional surveillance

5. Community Nutrition Programs
 For Success Key features needing consideration
Responds to priority felt needs
Involves the community as key player
Integrates others sectors of development
Located close to beneficiaries
Uses community resources
Affects community as a whole
Reinforces capacities of community – management
and finances
Impacts directly or indirectly on nutritional status

6. Models of community nutrition interventions:
Example
Triple-A cycles

7. Figure 2. The Triple A Cycle
Source: UNICEF (1990)

8. Triple-A Cycle cont….
Assessment
Identify nutrition problems:
Nature
Extent
Severity
Distribution
Affected groups
Analysis
Major causes
Prioritize problems
Identify beneficiaries
Identify resources

9. Triple-A Cycle cont……
Action (implementation stage)
Set objectives
List activities
community mobilization
training
resource mobilization
organizational structure
monitoring and evaluation

10. Success/sustainability
Community participation
Political will
Located within the community
Uses local resources
Evaluation

11. Important interventions: Combating
Micronutrient Deficiencies
1. Dietary Improvement
 Improve the year round availability of
micronutrient rich foods
 Ensure access of households to these
foods
 Change feeding/ food practices to favour
these foods
 Cooking, Fermentation, Germination

12. 2. Dietary diversification: represents a
sustainable, economically feasible, and
culturally acceptable approach that may
be used to improve the adequacy of
dietary intakes of several micronutrients
simultaneously
Encouraging the consumption of
micronutrient rich foods - red palm oil, dark
green leafy vegetables, mangoes and
other carotene rich fruits – animal rich
sources

13.  Include kitchen gardening and keeping of
small livestock (Fishery, poultry, rabbit)
 Education and behavior change strategies
to promote greater intake of micronutrient
rich foods.
3. Food fortification – addition of nutrients
into food during food processing. e.g salt
is fortified with iodine, Margarine is
fortified with vitamins and breakfast
cereals are fortified with some B vitamins

14. Cont. . . .
4. Immunization – especially for
measles because of the connection
between Measles and depletion of
vitamin A stores in the body
5. Breastfeeding of infants and young
babies

15. 6. Supplementation – refers to the provision
of additional nutrients, usually in the form
of some chemical (or pharmaceutical)
compound, rather than in food. e.g. iron or
calcium for expectant mothers
 Used in preventive and therapeutic
measures
 Useful for targeting vulnerable population
subgroups whose nutritional status needs
to be improved within a relatively short time
period.

16. For early warning and planning
Growth Monitoring – programme that has
been used at the community level
The practice of following a child’s physical
development, by regular measurement of
certain indicators (usually weight and
sometimes length) in order to maintain good
health by detecting growth faltering and
intervening in a timely manner.

17. Aims of growth monitoring:
The main aims of growth monitoring, as originally
conceived, are to:
1. Provide a diagnostic tool for health and nutrition
surveillance of individual children and to instigate
effective action in response to growth faltering.
2. Teach mothers, families and health workers how diet and
illness can affect child growth and thereby stimulate
individual initiative and improved practices.
3. Provide regular contact with primary health-care services,
and so facilitate their utilization.

18. 4. Community mobilization: Growth
monitoring can serve as an entry point for
community mobilization and social action,
especially when growth monitoring data are
aggregated and used for community-level
assessment and analysis of child
malnutrition.
5. Targeting supplementary feeding: The
weight chart is widely used to determine
eligibility for entry to supplementary feeding
programmes.

19. 6. Reporting prevalence of underweight:
Governments and agencies may require
health workers to provide information on
the extent of underweight in their locality,
or the number of children failing to grow in
a given month.

20. Other complementary public health
efforts:
Hookworm Disease Control
Malaria prophylaxis
Immunization
Community –based primary health care

21. END

22. FOOD SECURITY

23. Food security
Food security exists when all people, at all
times, have physical and economic
access to sufficient, safe and nutritious
food that meets their dietary needs and
food preferences for an active and healthy
life.
1996 World Food Summit held in Rome

24. Dimensions of food security
Physical availability of food
Economic and physical access to food
Food utilization
Stability/sustainability of the other three
dimensions over time

25. Dimensions
1. Availability – actual supply of food from
own production, markets and at the
national level as domestic food production
and commercial food imports

26. 2. Access is ensured when all the
households and individuals within the
households have sufficient resources to
obtain appropriate foods
Access is also a function of the physical,
social and policy environment which
determines how effectively food is
obtained

27. Dimensions of food security…
 3.Use/utelization – refers to the way the body
makes use of the various nutrients in the food
as determined by people’s health status aspects
of households.
 General hygiene and sanitation, water quality,
health care practices
and food safety and
quality are determinants
of good food utilization
by the body.

28. Utilization may also mean that food is
properly used: existence of proper food
processing and storage practices
4.Stablility/sustainability – the time over
which food security is being considered

29. Types of food insecurity
1. Chronic food insecurity: long term and
deep-rooted food insecurity is largely
driven by endemic poverty.

30. People are subject to a continual problem
of poor diet through an inability to acquire
their basic food requirements, either
because they are unable to buy it or to
produce it for themselves.
Chronic food insecurity is often the result
of extended periods of poverty, lack of
assets and inadequate access to
productive or financial resources.

31. Chronic food insecurity can be overcome
with typical long term development
measures also used to address poverty,
such as education or access to productive
resources, such as credit.

32. 2.Transitory food insecurity –is primarily
caused by short-term shocks and
fluctuations in food availability and food
access, including year-to-year variations in
domestic food production, food prices and
household incomes.

33. May result from extreme cases of famine
caused by war, flooding, drought, crop
failure, pest infestations, and loss of
purchasing power in farming communities
and market failures through high food
prices.

34. Transitory food insecurity is relatively
unpredictable and can emerge suddenly.
This unpredictability makes planning and
programming more difficult and requires
different capacities and types of
intervention including early warning
systems and preparedness

35. 3. Seasonal food insecurity
This occurs when there is a cyclical
pattern of inadequate availability and
access to food. This is associated with
seasonal fluctuations in the climate,
cropping patterns, work opportunities
(labor demand) and/or prevalence of
diseases.

36. Seasonal food insecurity
Seasonality
highlights and
times of the
year when food
gaps are likely
to be greatest.
Time
Availability
/access to
food

37.  Characterized by hungry periods _ eg, pre-
harvest period
 This concept of seasonal food security falls
between chronic and transitory food insecurity. It
is similar to chronic food insecurity as it is
usually predictable and follows a sequence of
known events.
 However, as seasonal food insecurity is of
limited duration it can also be seen as a
recurrent, transitory food insecurity.

38. Measuring food security
1.Food Balance Sheet is A key tool used to
look at food availability at a national level.
It describes all the factors which constitute
the total availability of food in a specific
country over a selected twelve month
period.
Food
Available
Food
needed

39. Cont. . . .
2. Estimating crop and livestock
production
 Forecast of crop/livestock production can
be based on meteorological data, farm
size and arm inputs and reference data
from past yields

40. 3. household stocks.
It consists in estimating what each
household has in stock of the main
foods. That includes what they may have
in a storage hut, bin or shed, but also what
they may maintain in the ground as stocks
(as with cassava).

41. Methods for assessing household stocks
a). Household production and consumption
surveys
 The production minus estimated consumption
can be used to estimate projected stocks.
b) Rapid appraisals
 Research teams are sent out to talk with
community leaders, groups of farmers and local
experts.

42. 3. Market surveys