Workshop 3: The Agriculture Nutrition Nexus and the Way Forward at The Caribbean-Pacific Agri-Food Forum 2015 (CPAF2015) taking place 2-6 November in Barbados with support from the Intra-ACP Agricultural Policy programme, organized in partnership with the Barbados Agricultural Society (BAS) and the Inter-American Institute for Cooperation on Agriculture (IICA). http://www.cta.int/en/news/caribbean-pacific-agri-food-forum.html
National Food & Nutrition Policy: Balancing the Role of Research, Nutrition S...Corn Refiners Association
At Experimental Biology 2015, the Sponsored Satellite Program "National Food & Nutrition Policy: Balancing the Role of Research, Nutrition Science and Public Health" held in conjunction with the American Society for Nutrition's Scientific Session took place on April 1, 2015.
To watch the Dr. Lichtenstein video on slide 68 "Do Scripted Diets Work for Policy? What about Low-fat Diets?", please download the presentation first.
Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.
National Food & Nutrition Policy: Balancing the Role of Research, Nutrition S...Corn Refiners Association
At Experimental Biology 2015, the Sponsored Satellite Program "National Food & Nutrition Policy: Balancing the Role of Research, Nutrition Science and Public Health" held in conjunction with the American Society for Nutrition's Scientific Session took place on April 1, 2015.
To watch the Dr. Lichtenstein video on slide 68 "Do Scripted Diets Work for Policy? What about Low-fat Diets?", please download the presentation first.
Food security exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.
Food and nutrition are cornerstones that affect and define the health of all people, rich and poor. The right to food is one of the most consistently mentioned items in international human rights documents
Food and nutrition are cornerstones that affect and define the health of all people, rich and poor. The right to food is one of the most consistently mentioned items in international human rights documents
Black American women have higher rates of many risk factors for heart disease, including obesity, physical inactivity, metabolic syndrome, diabetes, and hypertension than white women
This presentation focuses on the unique healthcare issues that African Americans face. The presentation further explains steps that American Americans can take towards healthier lives.
Dr C. Dustin Becker, Leeroy Joshua and Dorothy Tavoa of the School of Natural Resources and Applied Sciences from the Solomon Islands National University undertook a rapid country scan on the agriculture-nutrition nexus in 2015. The scan was commissioned by CTA and provides a snapshot of the policies and programmes in the nation.
info4africa/MRC KZN Community Forum | 25 March 2014 | The Department of Healt...info4africa
Speaker: Ms Zamazulu Mtshali – Deputy Manager for the Integrated Nutrition Programme (INP), KwaZulu-Natal Department of Health
Ms Mtshali's presentation will highlight studies that show the presence of nutritional transition in KwaZulu-Natal, where both under and over-nutrition are prevalent. Within the context of the HIV and AIDS pandemic and food insecurity, the high prevalence of under-nutrition, micronutrient deficiencies and emergent over-nutrition presents a complex series of challenges.
Over the years, significant gains have been made with regards to scaling up nutrition, with the development of policies and guidelines for the implementation of nutrition strategies. There is now a renewed focus on specific priority groups for nutrition interventions to have a bigger impact.
Livestock-Climate Change CRSP Annual Meeting 2011: Integrating Human Nutritio...Colorado State University
Tips for integrating human nutrition into research on the interaction between livestock/agricultural production and climate change; overview of the Global Livestock CRSP's ENAM project in Ghana. Presentation given by G. Marquis (McGill University) at the Livestock-Climate Change CRSP Annual Meeting, Golden, CO, April 26-27, 2011.
Title: Navigating Obesity: Understanding, Impact, Solutions
In this presentation, we unravel obesity's complexity, exploring its subcategories and the significance of Body Mass Index. Key facts underscore its global urgency. We dissect causes, from genetics to sedentary lifestyles, and outline health risks like cardiovascular issues and diabetes. We address the challenge of "double burden of malnutrition." Solutions include balanced diets, activity, stress management, and professional guidance. Real-life success stories inspire, and a Q&A session fosters engagement. Our aim: empower individuals to grasp obesity's nuances, mitigate its impacts, and embrace healthier living.
Pendant les deux derniers jours du Forum, le Ministère a eu l'occasion d'écouter les recommandations faites par les dirigeants des coopératives et par les experts du développement des coopératives. Voici la présentation synthétisant les réponses fournies par le MIDSP au Forum. Pour plus d'info http://bit.ly/2mMLoo2
Le Dr. Nicola Francesconi, conseiller technique sénior au CTA, a coordiné l'organisation du Forum des coopératives malgaches, qui s'est tenu du 13 au 17 février 2017. Plus d'infos : http://bit.ly/2mMLoo2
Tovo Aina Andriamampionona et Nirina Razafimanantsoa, élus porte-paroles par les membres des coopératives participantes au Forum des coopératives malgaches, ont résumé les principaux problèmes auxquels les coopératives sont confrontées. Plus d'infos : http://bit.ly/2mMLoo2
This document outlines some of the key action points discussed at the workshop held in February 2017. More information about the workshop: http://bit.ly/2lt7Vbf More information about the impact of open data for agriculture and nutrition: http://bit.ly/2lyjJqW
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. Preventing disease, promoting and protecting health
Christine Bocage
Senior Technical Officer, Food Security and Nutrition
Caribbean Public Health Agency (CARPHA)
Presented at the Caribbean and Pacific Agrifood Forum
W3:The Agriculture Nexus and the Way Forward
November 2, 2015
3. Preventing disease, promoting and protecting health
• Nutrition Issues in the Caribbean
• Why are we at this Stage?
• Nutrition Challenges in the Caribbean
• What has CARPHA been doing? /CARPHA Success Factors:
– Nutrition- specific
– Nutrition sensitive
• Conclusion
Overview of Presentation
4. Preventing disease, promoting and protecting health
Nutrition Issues
Nutritional Status:
• Undernutrition (Stunting and wasting; underweight)
• Overnutrition (Obesity) and the related NCDs
• Micronutrient Deficiencies
– Nutritional Anaemia (mainly Iron-deficiency
Anaemia)
– Vitamin A Deficiency
5. Preventing disease, promoting and protecting health
Micronutrient Deficiencies
• Even though Vitamin A deficiency is not a serious problem
in the region (<1% in many countries), iron deficiency
anaemia remains a major public health issue in children and
[pregnant women.
• In many countries iron deficiency anaemia is about 30% and
this has been the case as far back as 1997 and again
recorded in 2002.
• In 2007, CFNI/PAHO/WHO undertook an Adolescent Survey
in a few Caribbean countries (Antigua and Barbuda, St. Kitts
and Nevis, Montserrat) and the results are similar.
6. Preventing disease, promoting and protecting health
Survey of Adolescents in Antigua and Barbuda: Prevalence of
Anaemia by WHO Standards
WHO
cut-offs
7. Preventing disease, promoting and protecting health
• Vitamin E is not routinely checked but based on a
survey conducted in Jamaica in 1997, it was shown
that about 50.4% of children 1-4 years were
deficient and 17% of children 5-16 years.
• Moderate Iodine deficiency is uncommon but may
surface in Guyana, Suriname and Belize.
Micronutrient Deficiencies
8. Preventing disease, promoting and protecting health
Overweight and Obesity
(Adults)
Obesity is the major risk factor for
NCDs
13. Preventing disease, promoting and protecting health
Childhood Obesity
• Childhood obesity epidemic
• In 2010 prevalence of overweight children<5
years was estimated at 42 million: close to 35
million of those lived in developing countries.
• In the Caribbean obesity in <5 age group
(Pre-school children) doubled over the
past decade
14. Preventing disease, promoting and protecting health
2010
Source: CFNI, March 2012
Burgeoning
Obesity
0
5
10
15
20
25
30
%
Proportion of overweight children in the
region
at risk of overweight overweight
15. Preventing disease, promoting and protecting health
Source: School Health data, 2000
Obesity,
major risk
factor for
NCDs
Adolescent
population
obesity up
to 14%
Burgeoning Obesity
0
2
4
6
8
10
12
14
16
18
85th-95th P 95th P
Overweight among 10-14 yr old - St Vincent
male
female
16. Preventing disease, promoting and protecting health
Prevalence of Overweight/Obesity
Country Publication
Year
Obese/Overweight
Antigua
(4-20 years)
Walwyn, L. et al
2012
(4029 students)
Overweight -20.5% ; Obese - 6.3%
Bahamas
(Grade 10/Form 4)
Taylor, S. et al
2011
(719 students)
Overweight – 13.9%; Obesity –
14.0%
Rivers, K.L. et al 2013
(861 students)
Overweight – 15%; Obese -15.2%;
severely obese -7.9%
Barbados
(11-16 years)
2007
(400 students)
Overweight – 32.0%; Obesity – 19%
17. Preventing disease, promoting and protecting health
Country Publication
Year
Risk Factors
Trinidad and
Tobago
(5-17 years)
2012
(32 schools)
7 Type 2 Diabetes
1 Type 1 Diabetes
5 Pre-diabetics
2012
(2066 students)
Risk Factor Profile
At least 1 risk factor – 44.3%
At least 2 risk factors –
23.1%
At least 3 risk factors – 2.9%
Bahamas
(13-19 years)
2013
(861)
Impaired fasting glucose –
16.1%
Diabetes – 1.3%
Diabetes
19. Preventing disease, promoting and protecting health
Greater quantities of
energy dense foods
Increased use of fast
foods (proliferation of
fast food outlets).
Promotions/
Advertisements
Increased food
purchasing
opportunities
Increased frequency of
eating occasion
Why are we at this stage?
21. Preventing disease, promoting and protecting health
1500
1700
1900
2100
2300
2500
2700
2900
19961-63 1971-73 1981-83 1991-93 2001-2003
Calories/caput/day Energy Availability in the Caribbean
1961-2003
Average
Energy
supply
RDA
Source: CFNI
Increased national availability of energy, fats, proteins and
sugar
22. Preventing disease, promoting and protecting health
Energy availability in selected CARPHA
member states for 2011
0
500
1000
1500
2000
2500
3000
3500
ENERGY(Kcal/cap/dy)
COUNTRY
ENERGY
23. Preventing disease, promoting and protecting health
Protein availability in selected CARPHA
member states for 2011
0
10
20
30
40
50
60
70
80
90
100
PROTEIN(g/cap/dy)
COUNTRY
Population food Goals
PROTEIN
24. Preventing disease, promoting and protecting health
77.9 78.4
79.6 80.1
80.8 81
84 83.7
81.2
82.7
50
55
60
65
70
75
80
85
90
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
GmsFatperCaputperday
Trends in Fat Availability in 10 Selected Caribbean Countries, 2000-2009
(grams/caput per day)
Source: FAO Statistics 2009: www.fao.org
Population Food Goals
25. Preventing disease, promoting and protecting health
30
40
50
60
70
80
90
100
110
120
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
gmssugar/caput/day
Trends in Sugar Availability in 10 Selected Caribbean
Countries, 2000-2009 (Grams Sugar/Caput/Day)
Sugar
Source: FAO Statistics 2009: www.fao.org
Population Food
Goal
26. Preventing disease, promoting and protecting health
TrendsinFruitandVegetableConsumptionintheCaribbean
1961-2003
0
50
100
150
200
250
300
350
400
1961-63 1971-73 1981-83 1991-93 2001-2003
calories/caput/day
Local Imported Goal
Source: FAO
28. Preventing disease, promoting and protecting health
0
10
20
30
40
50
60
70
80
ANT BAR BEL BVI CAY DOM GRE MONT GUY SKN St.
Lucia
SVG TRT
Physical Activity levels and Consumption of
Carbonated Beverages (12-15 year olds)
Physical Activity for 60 mins Sedentary Carbonated beverages
Physical inactivity
GSHS – Global School-based Student Health Survey
29. Preventing disease, promoting and protecting health
0
20
40
60
80
100
120
140
160
180
200
ANU BAH BEL DOM MONT SKN SVG TRT
Breastfeeding Rates
Initiation 1-2 months 3 months 4 months 5 months 6months
Source: Country Food & Nutrition Policies ; IYCN Policies
Falling breastfeeding Rates (Average Exclusive BF rate is 39%
with some countries as low as 5%)
31. Preventing disease, promoting and protecting health
Challenges
• Double burden of undernutrition and overnutrition
• Shift away from individual solutions to population-based
solutions
• Habits; Beliefs; Traditions; Culture – difficult to change bad
lifestyle behaviours
• Information Sources –some spurious and from unqualified
persons
• Lack of resources (Human, Financial)
32. Preventing disease, promoting and protecting health
Challenges
Nationally and Regionally - A lack of human resources
• A survey conducted in 2014 assessed the qualifications and
training of Nutrition and Dietetics Professionals in the
Caribbean, as well as their distribution and employment status
within the region.
• The numbers of nutrition and dietetic professionals are small
and insufficient. When compared to other health professionals
the results were as follows:
• Dietitians and Nutritionists - 14.25 per 10,000 population
• Physicians - 79.2 per 10,000 population
• Nurses and Midwives 199.7 per 10,000 population
33. Preventing disease, promoting and protecting health
Challenges
In schools
• Lack of implementation and evaluation of structured life skills
programmes such as Health and Family Life Education (HFLE)
In the community
• Getting the community involved in the design and
implementation of projects for the prevention of obesity
particularly in high-risk low-income groups.
• Sustainability - if do not have a community leader and
adequately sensitized individuals.
• The ability to have a presence in the community. Actions
wane if there is a perception that they are forgotten.
• Security.
34. Preventing disease, promoting and protecting health
Challenges
Public/Government
• Cost to make the public aware, and convinced of, the
need to develop and maintain healthy lifestyle habits.
• Provision of support and incentives.
• Insufficient support from Governments to put
measures in place to reduce food and nutrition
insecurity (policies; legislation; guidelines etc)
35. Preventing disease, promoting and protecting health
Challenges -NCD Related Legislation
• Legislation in English-speaking Caribbean countries and territories
applicable to the prevention and control of NCDs are few.
• Only the Bahamas, Jamaica, Montserrat and St. Lucia have enacted
legislation specifically referring to obesity, diabetes and cardiovascular
diseases.
– National Insurance (Chronic Diseases Prescription Drug Fund) Act,
2009 of the Bahamas;
– National Health Fund Act 2003 of Jamaica;
– Public Health Act (Chapter 14:01) of Montserrat;
– Public Hospitals (Management) Act (Chapter 11:03) of St. Lucia.
• Physical Planning Act, 2003 of Antigua
• Consumer Protection Act, 2002 of Barbados
• Education Act, 1887 of Dominica
• Health Authority Act 2003 of Anguilla, 2003
36. Preventing disease, promoting and protecting health
CARPHA’S Response to the Nutrition Issues
Key Success Factors:
Nutrition-specific interventions
Nutrition-sensitive interventions
37. Preventing disease, promoting and protecting health
Required response
• Sustained multi-sectoral, multi-level
action required.
• Must include strong policy and
legislative measures to address
primary prevention:
Obesogenic environments:
– food production,
– trade
– local prices,
– Advertising and marketing
– Compulsory standards for food
labelling
– Compulsory standards and
guidelines for physical
environment in schools
38. Preventing disease, promoting and protecting health
• Plan of Action for Promoting
Healthy Weights in the
Caribbean: Prevention and
Control of Childhood Obesity
represents a Collaborative
Plan of Action
Goal
• To halt and reverse the rise
in child and adolescent
obesity in the Caribbean by
2025.
39. Preventing disease, promoting and protecting health
Main Pillars
• CARPHA’s Response is based on the
Sacks et al 2009 framework which
include:
– Sociological or “upstream”
approach
– The behavioural or “midstream”
approach
– Health service or “downstream”
approach.
• We added a 4th pillar “ Capability
and capacity development to
support the response.
40. Preventing disease, promoting and protecting health
Plan of Action
Priority Areas (Mix of Nutrition
Specific and Nutrition Sensitive
Approaches)
Prevention
• Regulation, Policy and Advocacy
• Education and Behaviour Change
Interventions
Management and Control
• Treatment and Support
• Addressing Stigmatization
Surveillance , M and E, and Research
• Surveillance and data analysis
• Monitoring, evaluation and research
Strengthening Systems to support action
• Strengthening systems in education,
health and other critical sectors
• Strengthening capacity for multi-sectoral
and multi-level government action
41. Preventing disease, promoting and protecting health
• Regulation, Policy and Advocacy
Objectives:
• To make the environments where Caribbean children live
and learn more supportive of physical activity and healthy
eating.
• To create incentives to discourage unhealthy consumption
patterns and to encourage healthier dietary choices.
• Education and Behaviour Change Interventions
Objectives:
• To empower communities to embrace active living and
healthful eating.
• To provide parents and children with accurate information
about food, nutrition and exercise to enable informed
decisions
42. Preventing disease, promoting and protecting health
Treatment and Support
Objective:
• To provide children and families who are affected by
overweight/obesity with the necessary care and support.
Outcome
1. Evidence-based weight management services more available, accessible
and acceptable to children.
Addressing Stigmatization
Objective:
• To safeguard children who may be affected by overweight/obesity
from bias and stigmatization associated with their condition.
Outcome
1. National policies and programmes more responsive to the ethical issues
concerning childhood obesity and childhood weight management.
43. Preventing disease, promoting and protecting health
Strengthening systems within Government
Objective:
• To improve the capability of systems within Government to mount
effective responses.
Outcome
1. Systems in education, health and trade sectors better equipped to
conduct activities in the Plan of Action.
Strengthening multi-sectoral action
Objective:
• To foster multi-sectoral cooperation in responding to the epidemic.
Outcome
1. National multi-sectoral country teams have the technical capacity to
develop and implement multi-sectoral Action Plans for population-
based childhood obesity prevention.
44. Preventing disease, promoting and protecting health
Surveillance to support action
Objective:
• To provide core data for tracking the movement and determinants of the
epidemic.
Outcome
1. Quality comparable data on nutrition status and the food environment
available for policy and programming.
Monitoring, evaluation and research
Objective:
• To provide information for measuring and assessing results of the Plan
of Action.
Outcome
1. Childhood obesity programmes informed by comparable data on the cost
and consequences of the epidemic and the impact of prevention measures.
46. Preventing disease, promoting and protecting health
Regulation, Policy and Advocacy
Objectives:
• To make the environments where Caribbean children live
and learn more supportive of physical activity and healthy
eating.
• To create incentives to discourage unhealthy consumption
patterns and to encourage healthier dietary choices.
Outcomes
1. Member States enact strong regulatory frameworks for
reducing obesogenic environments.
2. Evidence-based policies to support production, access and
consumption of safe, affordable, nutritious, high quality food
commodities implemented in Member States.
3. Infant and child feeding policies, programmes and
interventions strengthened
47. Preventing disease, promoting and protecting health
Outcome 1:
Member States enact strong regulatory frameworks
for reducing obesogenic environments.
2015 Output:
Legislative Brief outlining comprehensive strategy
and technical support to CARPHA Member States
(CMS to adapt Brief)
Work in progress: Yes
CARPHA/IDLO MOU- Draft Work plan
48. Preventing disease, promoting and protecting health
CARPHA/IDLO Memorandum of Understanding
Goal:
– Strengthen legal environments for responding to obesity, diabetes and for promoting
healthy diets and physical activity in the Caribbean
Objectives:
• Build regional technical capacity in law and NCDs
• Conduct and publish research to support law and policy reform
• Support regional networking on relevant legal issues
• Expert Advisory Group
– UWI Caribbean Law Institute Centre (CLIC)
– PAHO, Legal Counsel
– CARICOM
– Chair, PHNAC
– Ministry of Health, Trinidad and Tobago, Legal Adviser
– Healthy Caribbean Coalition
– IDLO & CARPHA
49. Preventing disease, promoting and protecting health
Outcome 2:
Evidence-based policies to support production, access and consumption
of safe, affordable, nutritious, high quality food commodities
implemented in Member States.
2015 Outputs:
• Food and nutrition policies and guidelines -in progress
• Guidelines for Feeding Children in Schools - in progress
• National School Nutrition Policies - in progress
• Guidelines for Fiscal incentives– in progress
• Food-based Dietary Guidelines – in progress
• Trade Policies
• Joint COTED/COHSOD meeting -in development
• Technical Brief - developed
50. Preventing disease, promoting and protecting health
Technical Brief
Comprehensive dictates that a portfolio of actions are required:
– Food labelling
– Nutrition standards and guidelines for schools and other institutions
– Food marketing
– Nutritional quality of food supply (levels of harmful ingredients)
– Trade and fiscal policy measures
– Food chain incentives
• Recommendations:
– Joint COTED-COHSOD declaration setting out a commitment to adopt a
comprehensive approach across all six areas
– Establish a cross-sectoral working group at the regional level including
CARICOM, CARPHA, trade, agriculture, education, civil society, CROSQ,
– Set time-bound targets for implementation
51. Preventing disease, promoting and protecting health
Outcome 3:
Infant and child feeding policies, programmes and interventions strengthened.
2015 Outputs:
– Cadre of health personnel trained to implement the Baby Friendly
Hospital Initiative (BFHI) - in progress
– Technical support to CMS to update/develop National Infant and Young
Child Feeding Policies - in progress
– National Childhood Obesity Policies - in progress
– Technical support to monitor growth and development of children - in
progress
– IYCF dietary guidelines - in progress
Work in progress: Yes
Ongoing work of CARPHA’s Public Health Nutrition Unit
52. Preventing disease, promoting and protecting health
• Education and Behaviour Change Interventions
Objectives:
• To empower communities to embrace active living and healthful eating.
• To provide parents and children with accurate information about food,
nutrition and exercise to enable informed decisions
Outcomes
1. Strengthened community capacity to provide opportunities for healthful
eating and physical activity in their environments (home, schools, places
of worship etc.)
2. National obesity prevention initiatives scaled up in accordance with the
Caribbean Charter for Health Promotion.
3. Social Marketing Campaigns for obesity prevention strengthened to
integrate traditional and new forms of media.
4. Education officials better equipped to strengthen the school curriculum
to promote emphasis on nutrition and physical activity.
53. Preventing disease, promoting and protecting health
Outcome 1:
Community capacity to provide opportunities for healthful eating
and physical activity in their environments strengthened
2015 Outputs:
– Multi-country whole of community behaviour change
intervention project
– Technical support to CMS to implement
Work in progress: Yes
• Submitted a few Grant Proposals
• School intervention in 1 CMS (4 components)
54. Preventing disease, promoting and protecting health
Outcome 2:
Obesity Prevention initiatives scaled up in accordance with
the Caribbean Charter for Health Promotion
2015 Output:
Technical support to CMS to design/re-design health promotion
strategies and messages
Any work in progress:
Launch of Regional Health Communication Network,
January 2015 – main purpose to develop, implement and
monitor and evaluate communication responses to identified
priority public health issues.
56. Preventing disease, promoting and protecting health
Outcome 1
• High Quality comparable data on nutrition status
and the food environment available
2015 Outputs:
– Surveillance system (Country reports on
nutritional and anthropometric status)
– Validated data collection instruments for conduct
of Food Consumption Survey
Work in progress: Yes
57. Preventing disease, promoting and protecting health
Conclusion
• We do have many challenges to food and nutrition
security but, with committed governments, and using
a combination of nutrition specific (BFHI, Early
Childhood Development, Growth Monitoring) and
nutrition sensitive approaches (research, public
policies and actions among other things), we can
overcome those challenges.
• Need to work with multi-sectoral partners/continued
support by and co-operation of all sectors