Transcript NATIONAL INSTITUTE OF NUTRITION NATIONAL TARGET …

NATIONAL INSTITUTE OF NUTRITION
NATIONAL TARGET PROGRAM FOR IMPROVING NUTRITION
STATUS OF CHILDREN
Nutrition interventions to improve nutrition
and health status of women and children
under five years in areas impacted by
climate changes
Hoang Thi Duc Ngan, M.D., MPH.,
National Target Program for Improving Nutrition Status of Children
[email protected], Mobile: 0986 38 1982
Contents
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Introduction
Overall introduction
Climate change, water and nutrition
Climate change, agriculture and food and nutrition
security
Climate change, infectious diseases and nutrition
Specific nutritional impacts on women and children.
Response to climate change for human health
WHO strategies
Aim and objectives of the proposed project
Components of the project
Introduction: overall introduction
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Viet Nam consistently ranks amongst the
top ten most at risk countries to climate
change- a global “climate change hotspot”
Viet Nam loses 1-1.5% of GDP each year
due to natural disasters (WB).
The capacity to adapt to CC can influence
the effects of climate change on individuals,
communities, countries, and the wider
population. Furthermore, it differently
affects sectors and groups of people
Introduction: CC, water and
nutrition
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Water supply and foodborne diseases and other water related
diseases increase with rising of extreme climatic events.
Saltwater from rising sea level, storms, increasing water
temperatures may threat safe water resources.
Conditions of climate have strong effects on waterborne
diseases [1]. Weather influences the transfer and distribution of
the risk factors. While climate changes rapidly and
unpredictably health series and investments in protective
measures in Vietnam is still in limitation to appropriate respond
to the increased case load[2].
CCs are risk factors for human health as the increased
frequency, duration and intensity of waterborne diseases. This
is a reason for increased prevalence of malnutrition, particularly
for vulnerable subject such as women and children
[1] Rose J. B., Epstein P. R., Lipp E. K., Sherman B. H., Bernard S. M., & Patz J. A. (2001). Climate variability and change in the United States:
potential impacts on water- and foodborne diseases caused by microbiologic agents. Environ Health Perspectives, 109(Suppl 2), 211-221.
Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1240668/
[2] Bộ Tài Nguyên Môi Trường. (2009). Kịch bản biến đổi khí hậu, nước biển dâng. Hà Nội: Retrieved from
http://upd.edu.vn/attachments/article/39/KichBanBienDoiKhiHauVietNam.pdf.
Introduction: CC, agriculture and food
and nutrition security
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The changes in temperature, rainfall and other weather
events are predicted to become more severe, and
impact on agricultural production and capability which
presents challenges to food and nutrition security in at
risk regions.
Agricultural land is decreased because of rising sea level,
tropical hurricanes and human activities.
In terms of aquaculture, frequency of tropical storms,
inundation and level of rising temperature may be above
the bio-threshold of major varieties at local areas
CCs affect food security, particularly in developing
countries such as Vietnam. If the extreme weather
events occurs in these areas people are more vulnerable
for food and nutrition insecurity, resulting in hunger and
malnutrition.
Introduction: Climate change, infectious
diseases and nutrition
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Weather and climate might affect the prevalence of diseases
include malnutrition, diarrhea and other disease related to
water and basic sanitation, and malaria. Globally, it is
estimated that 88% of the existing global burden of disease
due to climate change occurs in children under 5 [4].
Under rising sea level and consequences of extreme weather
events, populations have to move to new areas, which may
modify mental disorders and other infections in communities.
CC can extend season for infection and alter their geographic
characteristics.
It is not an exception in Vietnam for the effects of CC on
infectious diseases and nutrition status. Certain groups of
people will be at particular risk for the adverse health effects
from climate change. The effects of CCs therefore, should be
assessed and responded to by different approaches for
particular sub-groups of population.
[4]
www.who.org/climate
Introduction: Specific nutritional
impacts on women and children
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CCs may lead to under-nutrition and
hungers.
Vietnam records more than 120,000 new
cases of SAM children under 5 per year.
The number of SAM children may quickly
increase as a result of increased frequency
and intensity of extreme weather events as
well as their consequences for economic
development.
Particularly, the children who are currently
malnourish or severe malnutrition may be
at risk from dying in the extreme events.
Response to CC for human health: WHO
strategies
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Advocacy: Improve awareness of communities of
climate change to understand risk factors for human
life.
Cooperation: Cooperate with development partners
to ensure that health is a priority in the global
response to climate change.
Technology and scientific evidence: Review
scientific evidence in the relationship between health
and climate change and plans for researching globally.
Strengthen health care systems: Support nations
to evaluate weaknesses of their health care systems
in order to improve capacity to overcome the
weaknesses in the climate change context
Aim and objectives of the proposed
project
Ca Mau, An Giang, Can Tho, Quang Tri and Hue are projected to implement.
Aim: Improve health and nutrition status of women and children through
improved food and nutrition security; increased quality of health care, water
and sanitation. Determine the opportunities of the program to be conducted in
other similar provinces.
Objectives:
1. Provide evidence of impacts of CC on water and sanitation, food security and
nutrition status of women and children in the project areas.
2. Improve nutrition security of households under the effects of CCs in the
studied areas.
3. The IMAM programs cover at least 80% severe malnutrition children and
reduce the prevalence of global acute malnutrition of children in cohort under
5% at the follow up survey in the intervened areas
4. Improve capacity for preparedness of bodies/agencies involved in the
program
5. Determine the effectiveness of the program in improving nutrition security of
households, ensuring the water sanitation and food safety and hygiene,
improving health and nutrition status of populations as well as cost benefits for
integrating climate risk analysis in nutrition security approaches. Identify the
mechanism to integrate activities proposed by the program in other similar
areas
Components of the project
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Component 1: Research and evaluation of the
inputs
Component 2: Interventions conducted by NIN,
Department of Hygiene and Environment –
MOH, Ministry of Natural Resources and
Environment, National Institute of Agriculture
Research and Development, NGOs and
international partners.
Component 3: Monitor, supervision, and
midterm and endterm evalutations
Component 1: Research and
evaluate for inputs
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Indicators for nutrition security of
households
Indicators for water sanitation and food
safety and hygiene
Indicators for health and nutrition status of
children and women at the studied areas
Indicators for the health care system,
acceptability of communities and branches
for the activities which are implemented in
the component 2 of the program.
Component 2: Intervention
Interventions for nutrition secutrity of
households
 Interventions that promote agricultural
production at home-garden
 Education and communication for methods
to respond to climate changes in order to
ensure the nutrition security of households.
 Training communities for ways to ensure
food supply resources for households
Component 2: Intervention
Interventions for ware sanitation and food safety and
hygiene
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Ensure the availability of products which help to clean
water such as chlorine, iodine etc and containers for water
storing up through social marketing approaches.
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Guide, train and educate and communicate communities
for:
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Methods to clean water such as chemicals and boiling.
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Methods to store, utilize effectively and ensure the
amount of water for basic demand for everyday life.
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Methods for food selection, preparation and cook safely
and hygienically.
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Methods to primary cure and treat for food poison
Component 2: Intervention
Interventions for improving nutrition and health status
 Establish out-patient care units which manage and continued treat for SAM children at
communities.
 Establish the in-patient units in hospitals for SAM children.
 Establishing the mobile treatment units in emergencies. The mobile treatment units
include the out-patient units and medical doctors. In the extreme weather events
these units will examine, consult, cure, treat and relieve for communities based on
regulations.
 Train health workers and health village collaborators for:
 Malnutrition prevention in children and nutrition care for pregnant women.
 Skills for education and communication in communities.
 Knowledge and skills for effective working under the extreme weather events in order
to ensure food security of households and secure the conditions for health and
nutrition care.
 Skills in group working, information and support seeking etc.
 Education and communication (ECs) will be implemented through various methods
based on cultural, educational of populations and availability of resources in local
areas to improve awareness of communities for climate change.
 Manufacture therapeutic products for treatment and recovering SAM children and
supplementary products for moderately malnourished children and women at the
studied areas.
Component 2: Intervention
Policy development and advocacy
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Mechanism and policies will be developed in order to effectively
combine different sectors in securing nutrition status of children and
women in communities under the conditions of CCs.
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A summary for necessary policies will be issued for advocacy
purposes. It is expected that several policy papers will be produced
to present i) recommendations for national policy to ensure climate
risks are integrated in nutrition provision and ii) document the
experience of climate informed nutrition interventions in Viet Nam to
share at national, sub-national and international forums.
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The indicators for assessing and providing for policy markers includes
those that can describe the integration of the activities into the
Vietnamese health care system, the lessons and possible and
feasible recommendations to engage different sectors in the society
to implement the project in areas affected by climate changes.
Component 3: Evaluation
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Baseline and follow-up evaluations will be conducted to
assess the effectiveness of the interventions.
Additionally, the program will be evaluated for cost
benefits of nutritional investment in order to respond to
climate changes. Acceptability of communities and
capacity of the health care system in implementing the
program will also be assessed.
This component also provides the effectiveness of
nutrition and health improvement of the interventions
which is evidence based for policy making process and
establishing mechanism to integrate different sections
in the society for nutritional responses for CCs in
Vietnam.
THANK YOU