Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Advancing The food system for growth , Job
creation and better Nutrition
Prof. Gihan Fouad
Consultant of Pediatrics
Consul...
Outline
 Introduction to Food System and food security.
 How do peoplein Egypt get access food?
 OVERLAPS OF DIFFERENT ...
Introduction
 Food system is defined as:
-i) All the activities related to the
production, processing, distribution,
cons...
introduction
 Food security has been acknowledged internationally as
a basic human right and governments are obliged to
w...
Egyptian food insecurity levels
Environmental drivers
Socio-economic drivers
Managerial drivers
“FOOD SECURITY:
At what cost?”
Dietary and behavioural coping strategies
of low-income households in Cairo and
implication...
Population and Food system
 Egypt has one of the world’s fastest growing populations.
The Egyptian Central Agency for Pub...
Young consumers increasingly demand processed
products and snack foods
Since the mid-1990s, Egypt has been
among the top three wheat-importing
countries ,the largest importers of
many bulk com...
Basic Commodity Prices
(Dec 2011-Oct 2013)
0
10
20
30
40
50
60
70
Dec-11
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
...
Protein Prices
(Dec 2011-Oct 2013)
0
10
20
30
40
50
60
70
80
Dec-11
Jan-12
Feb-12
Mar-12
Apr-12
May-12
Jun-12
Jul-12
Aug-1...
How do people access food?
 The majority of the city’s food is purchased on
frequent visits to small shops, markets and i...
Street food
 Street foods provide cheap sources of often nutritious food and are a
good source of income for informal foo...
OVERLAPS OF DIFFERENT FORMS
OF MALNUTRITION
Healthy eating Pattern in
Egypt
The majority of energy supply for Egyptians is derived
from carbohydrates, fats and protei...
Healthy eating Index
 In Egypt National Survey conducted by NNI 2005
Report That Heathy Eating Index Indicate Poor
Nutrit...
 Unfortunately Egypt Off –Course for achieving six
global World Health Assembly (WHA) nutrition
targets Which are :
 (1)...
Cost of hunger
The Potential of Agricultural Value Chains
to Improve Nutrition
 In the past, the development of agricultural value chain...
The Potential of Agricultural Value Chains
to Improve Nutrition
Apart from availability and accessibility of
foods, dieta...
Is Nutrition intervention
is enough?
 In the last 25 years, many nutritional and disease control
interventions have targe...
Nutrition-sensitive intervention to be hand
in hand with Nutrition specific intervention
Toxins
 The toxins aflatoxin, fumonisin and deoxynivaenol, which arise from
moulds contaminating foods such as maize and ...
 However, average intestinal absorptive capacity by country
also correlated very closely with national Gross Domestic
Pro...
The economic benefits of improving
nutrition levels
 Prior to 2008, economists estimated that undernutrition reduced a
na...
 In 2008 a team of Nobel laureate economist, as part of the
Copenhagen Consensus project, identified that nutrition-speci...
The Egyptian Nutrition
intervention
Food Subsidization Program In
Egypt
 Social safety nets provide cash and food transfers to a billion poor
people and redu...
Cash transfer Programs
At the International Conference on Financing for
Development held in 2002, FAO, the International
...
UNICEF And MOH
 Strengthening the capacity of communities to raise
awareness of mothers on maternal and child
malnutritio...
 Supporting the national vitamin A, iron and folic acid
supplementation programme for women and children
within the prima...
Flour fortification
 Given the increased prevalence of anemia in Egypt, the Ministry of
Social Solidarity in cooperation ...
School feeding program
 The idea of the establishment of SFP in Egypt is considered as a
policy instrument for achieving ...
Go home messages
Marketing of food for children
 In spite that WHA63-14 Resolution to reduce the impact
on children of the marketing of fo...
The causes of nutrition problems in Egypt are a
function of many factors
 Most households are food insecure because of lo...
Recomendation
 One type of integrated nutrition- agriculture program is
homestead food production (HFP). The standard HFP...
Universal Salt iodization
 MOH, NNI and UNICEF designed social marketing plans
to increase the awareness of the populatio...
Dietary quality among men and
women in 187 countries in
1990 and 2010
 Imported food products in the Egyptian retail market
face heavy competition from domestic and imported
products. Egyptia...
 fresh or further processed product. Similarly, Egyptian
production of meat meets approximately 60 percent
while about 40...
The Evidence of nutritional challenges in Egypt
to 1 2 to 3 4 to 5 6 to 8 9 to 11 12 to 17 18 to 23 24 to 35
1
20.7
15.8 1...
This has driven Egyptian households to apply
severe coping strategies to their food
consumption that led to further deter...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation ...
Upcoming SlideShare
Loading in …5
×

Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation and Better Nutrition in Egypt”

24 views

Published on

as part of the IFPRI-Egypt Seminar Series- funded by the United States Agency for International Development (USAID) project called “Evaluating Impact and Building Capacity” (EIBC) that is implemented by IFPRI.

Published in: Government & Nonprofit
  • Be the first to comment

  • Be the first to like this

Gihan Fouad (National Nutrition Institute)• 2018 IFPRI Egypt Seminar: “Advancing the Food System for Growth, Job Creation and Better Nutrition in Egypt”

  1. 1. Advancing The food system for growth , Job creation and better Nutrition Prof. Gihan Fouad Consultant of Pediatrics Consultant of Clinical Nutrition National Institute of Nutrition
  2. 2. Outline  Introduction to Food System and food security.  How do peoplein Egypt get access food?  OVERLAPS OF DIFFERENT FORMS OF MALNUTRITION.  The Potential of Agricultural Value Chains to Improve Nutrition.  Is Nutrition specific intervention is enough?  Importance of Nutrition sensitive intervention.  Go home messages.
  3. 3. Introduction  Food system is defined as: -i) All the activities related to the production, processing, distribution, consumption and disposal of food, ii)All the factors affecting its activities: the environment, actors, infrastructures and institutions, iii) The outcomes of these activities that contribute to food security and a range of socio-economic and environmental issues
  4. 4. introduction  Food security has been acknowledged internationally as a basic human right and governments are obliged to work on asserting this right for every individual.  A joint report by the WFP and CAPMAS in 2011 on the status of poverty and food security in Egypt highlighted an increase in food insecurity levels to reach 17.2% (13.7 million) of the Egyptian population and the numbers have been in continuous increase since then.
  5. 5. Egyptian food insecurity levels Environmental drivers Socio-economic drivers Managerial drivers
  6. 6. “FOOD SECURITY: At what cost?” Dietary and behavioural coping strategies of low-income households in Cairo and implications on children’s food security By Radwa Saad Spring 2014 The American University in Cairo School of Global Affairs & Public Policy In partial fulfilment of the requirements for the degree of Master of Public Administration
  7. 7. Population and Food system  Egypt has one of the world’s fastest growing populations. The Egyptian Central Agency for Public Mobilization and Statistics (CAPMAS) estimates Egypt’s population at 92 million (December 2016), with a growth rate of 2.2 percent.  At current rates, the population grows by close to 1 million people every six months.. The population is also quite young, with a median age of 25.3.
  8. 8. Young consumers increasingly demand processed products and snack foods
  9. 9. Since the mid-1990s, Egypt has been among the top three wheat-importing countries ,the largest importers of many bulk commodities (wheat, sugar, oils), as well as an important vendor of subsidized food products.  This reliance on wheat and cereal imports to feed an ever-growing population makes Egypt especially vulnerable to international price volatility and supply shocks
  10. 10. Basic Commodity Prices (Dec 2011-Oct 2013) 0 10 20 30 40 50 60 70 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 PricePerUnit Date Corn Oil White Rice White Cheese Milk Eggs Potatoes Lentils
  11. 11. Protein Prices (Dec 2011-Oct 2013) 0 10 20 30 40 50 60 70 80 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 PriceperKg Date Beef Chicken Tilapia Fish
  12. 12. How do people access food?  The majority of the city’s food is purchased on frequent visits to small shops, markets and informal vendors. This reflects the income insecurity of much of the population, with many people finding it difficult to purchase significant quantities of food at one time. Where food is purchased from varies by food type
  13. 13. Street food  Street foods provide cheap sources of often nutritious food and are a good source of income for informal food sector workers, most of whom are women and more likely than men to invest that income in the wellbeing of their children.  With rising costs for food and cooking fuel, the use of street foods tends to increase as prices in this informal sector are inclined to rise slower due to the economies of scale of production. Lack of infrastructure (i.e. water, sanitation), lack of basic training in food hygiene of vendors and weak or arbitrary enforcement of the legal framework (if street foods-specific regulations do exist at all) are all factors contributing to the variable and sometimes poor safety of these foods.
  14. 14. OVERLAPS OF DIFFERENT FORMS OF MALNUTRITION
  15. 15. Healthy eating Pattern in Egypt The majority of energy supply for Egyptians is derived from carbohydrates, fats and protein.  Cereals represent the main source of energy, providing about 64% percent of the total energy Relatively little is consumed in terms of vegetables and fruits, and meat and dairy products.  This is partly explained by the relative easy access to staples via the subsidy programme but the consumption of vegetables fruits and animal protein is improving. (FAO 2014)
  16. 16. Healthy eating Index  In Egypt National Survey conducted by NNI 2005 Report That Heathy Eating Index Indicate Poor Nutrition Habit and this confirmed by Small Scale study show that HEI-2010.48% had a poor diet and 49% had a diet that needs improvement while 3% had a good diet.  Lower percent subgroup scores were found for whole grains, total fruits, whole fruits and sea food and plant protein.(Fouad et al 2014)
  17. 17.  Unfortunately Egypt Off –Course for achieving six global World Health Assembly (WHA) nutrition targets Which are :  (1) Reducing child stunting by 40 percent,  (2) Reducing anemia in women of reproductive age by 50 percent,  (3) Reducing low birth weight by 30 percent,  (4) Preventing an increase in child overweight,  (5) Increasing exclusive breastfeeding of infants up to at least 50 percent,  (6) Reducing and Maintaining child wasting to less than 5 percent.
  18. 18. Cost of hunger
  19. 19. The Potential of Agricultural Value Chains to Improve Nutrition  In the past, the development of agricultural value chains mainly focused on the promotion of cash crops in developing countries. With the global food price crisis in 2008/2009 the focus shifted towards staple crops.  More recently, the professional discourse has once again shifted, highlighting the importance of the production and supply of nutritious foods. The aim thereby is to not only increase income and contribute to increased local availability of nutrient-dense foods to reduce the prevalence of food insecurity but also to reduce the burden of malnutrition.  However, there is mounting evidence that neither the availability of nutritious foods nor increased incomes necessarily lead to improved nutrition and food security [LANSA 2015, Galli 2015].
  20. 20. The Potential of Agricultural Value Chains to Improve Nutrition Apart from availability and accessibility of foods, dietary behavior is influenced by food preferences and traditions on the one hand and nutrition knowledge and awareness on the other [Contento 2008]. Though agricultural value chain projects do have the potential to include components of nutrition education and awareness communication for improving food and nutrition security,
  21. 21. Is Nutrition intervention is enough?  In the last 25 years, many nutritional and disease control interventions have targeted linear growth deficits acquired in early life with disappointing results .  The smaller-than-expected effect sizes associated with these interventions have been attributed to the complex relationships between infection and undernutrition .  In Evidence shows that children who live without adequate sanitation, hygiene, and clean drinking water don’t grow as well as children who do.
  22. 22. Nutrition-sensitive intervention to be hand in hand with Nutrition specific intervention
  23. 23. Toxins  The toxins aflatoxin, fumonisin and deoxynivaenol, which arise from moulds contaminating foods such as maize and peanuts, have been linked to impaired growth and gut inflammation in children but have not yet been studied in the specific context of EED  Infants and children are especially vulnerable to mycotoxin exposure,  Mostly because of a lower detoxification capacity, rapid growth and high intake of food and water per kg body weight.  Eg:aflatoxin (AF), fumonisin (FB), deoxynivalenol (DON) and zearalenone (ZEA)]
  24. 24.  However, average intestinal absorptive capacity by country also correlated very closely with national Gross Domestic Product (GDP) per capita, independent of climate, suggesting that at the individual level, poverty or environment may play a more significant role.
  25. 25. The economic benefits of improving nutrition levels  Prior to 2008, economists estimated that undernutrition reduced a nation’s economic growth by between 2 and 3% of GDP.  In The Lancet 2013 series, a figure of up to 8% is given owing to reasons such as the reduction in a child’s ability to attend and learn in school, loss of long- term cognitive functions owing to chronic lack of essential vitamins and productivity losses due to in- creased mortality rates.  Children who not undernourished have been shown to earn 20% more in labor market and are 10% more likely to own their own business. .
  26. 26.  In 2008 a team of Nobel laureate economist, as part of the Copenhagen Consensus project, identified that nutrition-specific had the potential to save one million lives, reduce stunting by one third and halve the number who are wasted; all at a benefit to cost ratio of 16-1. These benefit-cost ratios are competitive with the benefit- cost ratios generated by overall investments in health as reported in( Stenberg et al. 2014).
  27. 27. The Egyptian Nutrition intervention
  28. 28. Food Subsidization Program In Egypt  Social safety nets provide cash and food transfers to a billion poor people and reduce poverty. They also have an important role in mitigation of the negative effects of global changes, conflicts, and shocks by protecting income, food security, and diet quality. When targeted to women, they enhance several aspects of women’s empowerment. Pooled evidence, however, shows limited effects of these programmes on child nutrition, although some individual studies showed effects in younger and poorer children exposed for longer durations (Lancet).
  29. 29. Cash transfer Programs At the International Conference on Financing for Development held in 2002, FAO, the International Fund for Agricultural Development (IFAD) and the World Food Program (WFP) agreed upon a “twin- track approach” for combating hunger and poverty: strengthening the productivity and incomes of hungry and poor people, targeting the rural areas; and direct and immediate access to food by hungry people and social safety nets.
  30. 30. UNICEF And MOH  Strengthening the capacity of communities to raise awareness of mothers on maternal and child malnutrition.  supports community-based nutrition programmes for improving community awareness, mainly in Upper Egypt rural areas, with a focus on the most deprived and vulnerable populations. Awareness activities include building the capacity of community health workers to support in-community awareness and counselling for nutrition,
  31. 31.  Supporting the national vitamin A, iron and folic acid supplementation programme for women and children within the primary health care sector to strengthen prevention and treatment of malnutrition,  Supporting the national Iodine Deficiency Disorder programme to promote universal salt iodization and household consumption of iodized salt and implementing community awareness and social mobilization campaigns to address low iodized salt consumption in seven governorates.
  32. 32. Flour fortification  Given the increased prevalence of anemia in Egypt, the Ministry of Social Solidarity in cooperation with the National Institute of Nutrition (NNI), started a project for the fortification of subsidized wheat flour used in the production of Baladi bread with iron and folic acid through assistance from the World Food Programme (WFP) funded by the Global Alliance for Improved Nutrition (GAIN).  This National Program started to fortify flour in 2008 in Aswan governorate and reached complete national coverage by early 2010. The program continues to provide fortified subsidized Baladi bread to almost 56 million citizens Till It face some Funding Problem in 2014.
  33. 33. School feeding program  The idea of the establishment of SFP in Egypt is considered as a policy instrument for achieving the Millennium Development Goals of universal primary education and the reduction of hunger for Egyptian children in the school age group.  The school snack in the form of pie provided by the program usually provides from one fifth, one-fourth, one third and one-half of the recommended daily allowance for energy, protein, folate and iron for the school-age group targeted by the program respectively.
  34. 34. Go home messages
  35. 35. Marketing of food for children  In spite that WHA63-14 Resolution to reduce the impact on children of the marketing of foods high in saturated fats, trans fatty acids, free sugars or salt by restricting marketing, including in settings where children gather, for example, at schools, But Egypt not comply to resolution and no active policy in place.
  36. 36. The causes of nutrition problems in Egypt are a function of many factors  Most households are food insecure because of low income, high food prices and low local agricultural production, in addition to poor dietary practices due to lack of awareness, and inadequate health service provision capacities.  There are also the problems of environmental pollution and food safety challenges due to lack of enforcement of existing laws. There is an overarching health system challenge that derives from uncoordinated and disjointed planning of nutrition activities; often leading to sub- optimal use of resources and impact on nutrition status.  The slow improvements in public health systems and community infrastructure in Egypt have been cited among the factors that contributed to the slow progress in reducing malnutrition.  On the other hand the adoption of Western diets high in refined carbohydrates, saturated fats and sugars, as well as a more sedentary lifestyle are commonly cited as the major contributors to the increase in overweight and chronic diseases
  37. 37. Recomendation  One type of integrated nutrition- agriculture program is homestead food production (HFP). The standard HFP model includes gardening and small animal production and a behavior-change communication strategy designed around the so-called essential nutrition actions. It is typically targeted to vulnerable households with children under five years of age.
  38. 38. Universal Salt iodization  MOH, NNI and UNICEF designed social marketing plans to increase the awareness of the population in the 7 governorates with the lowest rate of consumption of iodized salts (according to National IDD 2006 survey). At the same time IDDSSE was initiated to coordinate the effort of prevention of IDD in Egypt and to achieve the USI Goal. IDDSSE, with the support of UNICEF, conducted many activities to increase the collaboration between salt iodization industry partners and international organization to increase the quality of iodized salt and improve the usage of iodized salt at market and HH level. GAIN, UNICEF and ICCIDD support MOH to reach the USI Goal. Their technical teams support MOH activities to eliminate IDD in Egypt.
  39. 39. Dietary quality among men and women in 187 countries in 1990 and 2010
  40. 40.  Imported food products in the Egyptian retail market face heavy competition from domestic and imported products. Egyptian snack producers fill much of the domestic demand for chips, crackers and cookies, though imported brands are perceived as being of higher quality. Egypt produces a wide variety of horticulture products, most of which is sold on the domestic market .
  41. 41.  fresh or further processed product. Similarly, Egyptian production of meat meets approximately 60 percent while about 40 percent of consumption is met through imports. Despite growing fluid milk output, Egypt still imports close to $1 billion/year in dairy products. Domestic egg production covers almost all demand. In the case of poultry, domestic production meets about 90 percent of demand with the balance imported; however, US poultry parts remains unjustifiably blocked from the market. Egypt’s per capita consumption of chicken at about 11 kg./capita is low.
  42. 42. The Evidence of nutritional challenges in Egypt to 1 2 to 3 4 to 5 6 to 8 9 to 11 12 to 17 18 to 23 24 to 35 1 20.7 15.8 16.7 14.1 10 4.9 1.7 5.8 28.3 34.3 25.2 23.1 14 8.1 Bo le feeding 2008 2014 0 to 1 2 to 3 4 to 5 6 to 8 9 to 11 12 to 17 18 to 23 24 to 35 78.9 57.5 28.8 12.3 3.9 0.7 0.4 0.1 70.6 43 13.3 3.2 1.3 0.5 0.1 Exclusive breas eeding 2008 2014
  43. 43. This has driven Egyptian households to apply severe coping strategies to their food consumption that led to further deterioration in the nutritional and health status of the Egyptian community; having long-term negative effects, most notably in the aspects of health, education and productivity

×