Presentation Icn Vn


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Presentation Icn Vn

  1. 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. 2. Nutrition in Vietnam before 1980 <ul><li>Food shortage. No sector responsible for nutrition. </li></ul><ul><li>Nutrition and Food safety Dep. (NIHE): Nutrition Research </li></ul><ul><li>Nutrition Section at Hanoi Medical University : Nutrition Module and Medical doctors nutrition oriented (42 persons) </li></ul>
  3. 3. Period 1980 - 1995 <ul><li>In 1980 : The National Institute of Nutrition VN was established </li></ul>
  4. 4. Nutrition Program/activities 1980-1995 <ul><li>Conducting nutrition epidemiological researches  Nutrition problems and causes </li></ul><ul><li>Introduction of VAC Eco-System  to alleviate the Household Food Insecurity (V-garden, A-fish pond, C-animal husbandry) </li></ul><ul><li>Nutrition Education and Training  to Set –up the Network of Nutrition in the whole country </li></ul>
  5. 5. Nutrition Program/activities 1980-1995 <ul><li>WFP project 2651 (1983-1988): supplementary feeding for vulnerable groups (pregnant and lactating mothers, under five children) </li></ul><ul><li>Since 1989: Nationwide Vit. A capsule distribution to children 6-60 mo  in 1994 Vietnam was Xerophthalmia free </li></ul><ul><li>Iron-folic acid tablets supplementation to pregnant women (pilot UNICEF project). </li></ul>
  6. 6. <ul><li>Nutrition Policy </li></ul><ul><li>and </li></ul><ul><li>Strategy in Vietnam </li></ul>
  7. 7. Period 1995-2000 <ul><li>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. </li></ul>
  8. 8. NPAN 1995-2000 <ul><li>Development of PEMC program (Government allocated budget to 63 provinces) </li></ul><ul><li>Since 1996: 1-2 of June – “National Vit.A distribution Day”  “Micronutrient Day ”. </li></ul><ul><li>Iron supplementation project for pregnant women (Supported by UNICEF) </li></ul><ul><li>Providing In-service training for nutrition staff at provincial and district level… </li></ul>
  9. 9. Period 2001-2010 <ul><li>In 2001: The NNS 2001- 2010 was approved by the Government. </li></ul>
  10. 10. General objective <ul><li>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. </li></ul>
  11. 11. <ul><li>How to implement the nutrition activities/programs in Vietnam? </li></ul>
  12. 12. NNS 2001-2010 <ul><li>Development of Nutrition project/programs: </li></ul><ul><li>National PEMC Program (Increased the Gov. Budget and mobilized resources from local) </li></ul><ul><li>National Vitamin A distribution program: </li></ul><ul><ul><li><2005: Supported by UNICEF </li></ul></ul><ul><ul><li>> 2005: partly by Gov. and ADB, other sources </li></ul></ul><ul><li>Iron supplementation: </li></ul><ul><ul><li>< 2005 supported by UNICEF in selected districts </li></ul></ul><ul><ul><li>> 2005: Pregnant women paid for Fe tablets </li></ul></ul><ul><li>Pilot project on Multi-Micronutrient supplementation </li></ul>
  13. 13. NNS 2001-2010 <ul><li>How to implement Nutrition program/activities? </li></ul><ul><li>Advocacy for stakeholders in nutrition </li></ul><ul><li>Multi-sectoral approach in implementation of NNS activities: Health, Agricultural, Training & Education… </li></ul><ul><li>Involvement of social organizations: Women Union, Farmer Union, Youth Union… </li></ul>
  14. 14. NNS 2001-2010 <ul><li>How to implement Nutrition program/activities? </li></ul><ul><li>Strengthening International cooperation: </li></ul><ul><ul><li>Program/projects of UN organizations (UNICEF, WHO, FAO) </li></ul></ul><ul><ul><li>Capacity Building Project (the Netherlands government) </li></ul></ul><ul><ul><li>GAIN (Fe Fortified Fish Sauce) </li></ul></ul><ul><ul><li>ADB project (Vit, A + De-worming) </li></ul></ul><ul><ul><li>Community- based projects of the WM, SCUS, IRD, ILSI, JICA, GRET … </li></ul></ul>
  15. 15. Intervention Strategies <ul><li>Preventive Orientation: Nutrition throughout the lifecycle </li></ul><ul><li>Prioritizing: High risk groups; Provinces with high malnutrition rate </li></ul><ul><li>Community-based and Multi-sectoral Approach </li></ul>
  16. 16. <ul><li>Nutrition Capacity Building from Central to local level </li></ul>
  17. 17. Nutrition Training in Vietnam <ul><li>In 1990 : Nutrition, Food hygiene and Safety Dep-t at Hanoi Medical University was established. </li></ul><ul><li>In 2005 : Nutrition Dep-t was established in other Medical Universities, Agricultural Universities… </li></ul><ul><li>Since 1994 : Carrying out the M.Sc in Community Nutrition Training </li></ul><ul><li>Since 2005: PhD in Nutrition Training at NIN </li></ul>
  18. 18. Implementation Mechanism/System MOH NIN Preventive Medicine /Maternal and Child Care Centers Commune Health Center 104,000 Nutrition Collaborators
  19. 19. NATIOAL cHILD MALNUTRITION CONTROL PROGRAM National Conference for Nutrition Collaborators
  20. 20. Food preparation demonstration/practices
  21. 21. Mother’s club Nutrition contest Growth monitoring
  22. 22. A comprehensive Package of Interventions in 3 provinces ( UNICEF/NIN Vietnam) <ul><li>Adding new items in the existing PEMC program to make it more comprehensive and target more on pre-pregnancy </li></ul><ul><li>Strengthening partnership among health and with social sectors (Women Union, Youth Union…) </li></ul>
  23. 23. Additional Interventions <ul><li>Before pregnant </li></ul><ul><ul><li>De-worming every 6 months </li></ul></ul><ul><ul><li>Weekly dose of MMN </li></ul></ul><ul><ul><li>IEC activities </li></ul></ul><ul><li>During pregnant </li></ul><ul><ul><li>Multiple micronutrients daily dose </li></ul></ul><ul><ul><li>IEC activities </li></ul></ul><ul><li>Infancy </li></ul><ul><ul><li>Ensured vitamin A supplementation high coverage </li></ul></ul><ul><ul><li>Quality of the growth monitoring activity </li></ul></ul><ul><ul><li>Communication for nutrition behavior change at the household level </li></ul></ul>
  24. 24. IEC activities <ul><li>IEC center has been set up at NIN in 1995 </li></ul><ul><li>IEC campaign: </li></ul><ul><ul><ul><ul><li>1-2 Jun Micronutrient Days </li></ul></ul></ul></ul><ul><ul><ul><ul><li>16-23 Oct Nutrition Week </li></ul></ul></ul></ul><ul><li>Education materials: Booklets :To be mother. Nutrition: questions and answers.. </li></ul><ul><li>RDA: approved in 1996, revised in 2007 </li></ul><ul><li>FBDG: ten recommendation for healthy nutrition, revised in 2006 </li></ul>
  25. 25. Provision of healthy foods <ul><li>A food workshop has been set up at NIN in 1985 </li></ul><ul><li>Products: balanced food mixtures, micronutrient fortified cakes, multiple micronutrient sprinkles, functional foods </li></ul>
  26. 26. The Netherlands Project <ul><li>“ 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” </li></ul><ul><li>GAIN project </li></ul><ul><li>“ Iron fortified fish sauce for control iron deficiency anemia in Vietnam 2006-2008” </li></ul>
  27. 27. - Nutrition Training and Education - Credit programs - Providing new seeds and breeds World Mission projects
  28. 28. Progress and sustainability
  29. 29. <ul><li>Malnutrition Reduction is 1 of the National criteria of the SE development. </li></ul><ul><li>Increasing Gov. Budget year by year + Mobilizing the local resources  Socialization of nutrition activities </li></ul>Progress and Sustainability
  30. 30. Progress and Sustainability <ul><li>Building up a strong nutrition network from central to grassroots levels </li></ul><ul><li>High level political awareness and support of the stakeholders/local leaders. </li></ul>
  31. 31. Trend of underweight among under 5 children in Vietnam 1985-2008 (%)
  32. 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. 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
  35. 36. Prevalence of vitamin A deficiency (serum retinol <0.7umol/L) among <5 (VDD/UNICEF, 2006) Vietnam: xerophthalmia free since 1994
  36. 37. Anaemia prevalence (in 1995 and 2000)
  37. 38. Overweight and obesity (BMI ≥25) in 2005
  38. 39. Overweight and Obesity of adults (2005) Nguån: Tổng điều tra BÐo ph× toµn quèc 2005
  39. 40. Challenges <ul><li>High rate of stunting among <5 </li></ul><ul><li>Problems of Micronutrient deficiencies </li></ul><ul><li>Increasing overweight/obesity and NCD… </li></ul><ul><li>Problems of nutrition in transition </li></ul>
  40. 41. Nutrition Plan <ul><li>Conducting the National Nutrition Survey 2009  Development of NNS 2011-2020. </li></ul><ul><li>Development of Stunting Reduction Plan </li></ul><ul><li>Strengthening the Inter. Cooperation in nutrition research and training… </li></ul>
  41. 42. Vietnam nutrition association ( VINUTAS) <ul><li>Set up in 2001, represent the nutrition community of the whole country, member of IUNS </li></ul><ul><li>Work closely with NIN in implementing nutrition program </li></ul><ul><li>Scientific seminars, biannual national Nutrition scientific meeting </li></ul><ul><li>Quarterly journal “Nutrition and food science” since 2005 </li></ul>
  42. 43. Thank you !