"programme_id","programme_title","programme_language","programme_type","other_program","iso3code","country_name","program_location","area","status","start_date","end_date","brief_description","references","related_policy","new_policy","partner_gov","partner_government_details","partner_un","partner_un_details","partner_ngo","partner_ngo_details","partner_donors","partner_donors_details","partner_intergov","partner_intgov_details","partner_national_ngo","partner_nat_ngo_details","partner_research","partner_research_details","partner_private","partner_private_details","partner_other","partner_other_details","cost","fsector_0","fpartner_0","fdetails_0","fsector_1","fpartner_1","fdetails_1","fsector_2","fpartner_2","fdetails_2","fsector_3","fpartner_3","fdetails_3","fsector_4","fpartner_4","fdetails_4","fsector_5","fpartner_5","fdetails_5","fsector_6","fpartner_6","fdetails_6","fsector_7","fpartner_7","fdetails_7","fsector_8","fpartner_8","fdetails_8","fsector_9","fpartner_9","fdetails_9","fsector_10","fpartner_10","fdetails_10","fsector_11","fpartner_11","fdetails_11","fsector_12","fpartner_12","fdetails_12","fsector_13","fpartner_13","fdetails_13","fsector_14","fpartner_14","fdetails_14","fsector_15","fpartner_15","fdetails_15","fsector_16","fpartner_16","fdetails_16","fsector_17","fpartner_17","fdetails_17","fsector_18","fpartner_18","fdetails_18","fsector_19","fpartner_19","fdetails_19","fsector_20","fpartner_20","fdetails_20","fsector_21","fpartner_21","fdetails_21","fsector_22","fpartner_22","fdetails_22","fsector_23","fpartner_23","fdetails_23","fsector_24","fpartner_24","fdetails_24","fsector_25","fpartner_25","fdetails_25","fsector_26","fpartner_26","fdetails_26","fsector_27","fpartner_27","fdetails_27","fsector_28","fpartner_28","fdetails_28","fsector_29","fpartner_29","fdetails_29","fsector_30","fpartner_30","fdetails_30","fsector_31","fpartner_31","fdetails_31","fsector_32","fpartner_32","fdetails_32","fsector_33","fpartner_33","fdetails_33","fsector_34","fpartner_34","fdetails_34","fsector_35","fpartner_35","fdetails_35","fsector_36","fpartner_36","fdetails_36","fsector_37","fpartner_37","fdetails_37","fsector_38","fpartner_38","fdetails_38","fsector_39","fpartner_39","fdetails_39","fsector_40","fpartner_40","fdetails_40","fsector_41","fpartner_41","fdetails_41","fsector_42","fpartner_42","fdetails_42","fsector_43","fpartner_43","fdetails_43","fsector_44","fpartner_44","fdetails_44","fsector_45","fpartner_45","fdetails_45","fsector_46","fpartner_46","fdetails_46","fsector_47","fpartner_47","fdetails_47","fsector_48","fpartner_48","fdetails_48","fsector_49","fpartner_49","fdetails_49","action_id","theme","topic","new_topic","micronutrient","micronutrient_compound","target_group","age_group","place","delivery","other_delivery","dose_frequency","impact_indicators","me_system","target_pop","coverage_percent","coverage_type","baseline","post_intervention","social_det","social_other","elena_link","problem_0","solution_0","problem_1","solution_1","problem_2","solution_2","problem_3","solution_3","problem_4","solution_4","problem_5","solution_5","problem_6","solution_6","problem_7","solution_7","problem_8","solution_8","problem_9","solution_9","other_problems","other_lessons","personal_story","language" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","
The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6073","Maternal, infant and young child nutrition","Breastfeeding promotion and/or counselling","","","","Women of reproductive age (WRA)","","Doha","Hospital/clinic|Media|Primary health care center","","Regular counselling during antenatal care clinic; establish a friendly baby hospital initiatives; develop a clear guidelines for breast feeding in Qatar in collaboration with WHO/EMRO","Number of health sectors applying breastfeeding programs. Percent of infants exclusively breastfed for the first 6 months of life. Percent of children with continued breastfeeding for up to 1 year.","Regular monitoring of the process through collecting data from the well baby clinic regarding feeding practices; develop a research regarding KAP about breast feeding in Qatar in collaboration with academic institution.","","","","","","","","","Staff skills/training","","","","","","","","","","","","","","","","","","","","Lacking awareness about importance of breast feeding","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6075","","Complementary feeding promotion and/or counselling","","","","Lactating women (LW)","","Doha","Hospital/clinic|Media|Primary health care center","","Regular counselling in well baby clinic to women by a nutritionist; distribute educational materials in ante-natal care clinic & well baby clinic; establish working group education in primary health care & women clubs","Number of nutritionists available per primary health care center. Percent of mothers referred to nutrition counseling during pregnancy.percentage of children growing within the 50 percentile.","Regular monitoring of the process through collecting data from the well baby clinic regarding feeding practices; develop a research regarding KAP about breast feeding in Qatar in collaboration with academic institution.","","","","","","","","Complementary feeding>>>Complementary feeding>>http://www.who.int/elena/titles/complementary_feeding","Insufficient staff","Recruit more nutritionists in PHC","Staff skills/training","Training of the staff working in well baby clinic on how to counsel the women","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6076","Overweight and diet-related NCDs","Nutrition education and counselling","","","","All population groups","","Doha","Community-based|Hospital/clinic|Kindergarten/school|Media|Primary health care center","","Comprehensive media campaign about healthy nutrition by all media channels; regular screening of population in PHC and provide appropriate counselling for high risk group; awarness through school sitting about healthy nutriton appropriate counselling in hospitals and clinics for special cases by expert nutritionists or dietitions.","Formative research on public knowledge about the importance of healthy eating. Social marketing campaign conducted. Number of media channels involved in the campaign out of total available.","Through different types of research","","","","","","Vulnerable groups|Sex|Socio-economic status","","","Insufficient staff","","Staff skills/training","","","","","","","","","","","","","","","","","","","expert Health communication companies to lead the media awareness campaign","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6077","Overweight and diet-related NCDs","Nutrition education and counselling","","","","School age children (SAC)","from 3 to 18 years old","Doha","Kindergarten/school","","Introduce nutrition in school curriculum","Percentages of schools that introduce the curriculm.","Review the schools curriculum","","","N/A","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6078","Overweight and diet-related NCDs","Promotion of fruit and vegetable intake","","","","All population groups","","Doha","Commercial|Community-based|Media","","Provide more fruit & vegetables in the schools, universities & work places cafeteria; comprehensive media campaign through all channels; increase advertisments regarding healthy meals; start food labelling of menus in restaurants","","STEPwise survey conducted. National nutrition surveillance system established.","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6079","Overweight and diet-related NCDs","Promotion of reduced fat intake (total, saturated, trans)","","","","All population groups","","Doha","Community-based|Kindergarten/school|Media","","Percentages of schools that introduce the curriculm; comprehensive media campaign; food labelling introduce a policy regarding banning of trans fat.","Declare of the policy; number of media campaigns; introduce food labelling","Implement the policy; STEPwise survey; nutrition survey","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6080","Overweight and diet-related NCDs","Salt reduction","","","","All population groups","","Doha","Commercial|Media","","Policy to stop high salted products; comprehensive media campaign; food labelling
","Declare the policy; decrease the prevelance of high blood pressure
","Implement the policy; STEPwise survey; nutrition survey
",".",".","","","","Other","","eLENA titles related to sodium reduction>>>Reducing sodium intake to control blood pressure in children>>http://www.who.int/elena/titles/sodium_bp_children|Reducing sodium intake to reduce blood pressure and risk of cardiovascular diseases in adults>>http://www.who.int/elena/titles/sodium_cvd_adults","","","","","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6081","","Growth monitoring and promotion","","","","Infants and young children","","Doha","Hospital/clinic|Kindergarten/school|Primary health care center","","By implementing the new growth monitoring chart","Number of trainings on growth monitoring and basic nutrition conducted.","Percentages of health care sectors implement the new growth monitoring chart","","","","","","","","","Staff skills/training","","","","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6082","Overweight and diet-related NCDs","Implementation of legislation on marketing of unhealthy foods and beverages to children","","","","School age children (SAC)","","Doha","Community-based","","Introduce a policy","Establish the policy; percentages of schools providing healthy snacks","Regular monitoring of the snacks provided to children in the schools","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "6074","National nutrition & physical activity action plan","English","National","","QAT","Qatar","Doha, Qatar|Al Wakrah, Qatar|Lusail, Ad Dawhah, Qatar","Urban","on-going","04-2011","04-2016","The national nutrition and physical activity action plan is comprehensive plan of action that contain eight area of actions:
ᅠ
","","","","Urban planning","","","","","","","","","","","","Research/academia","Qatar University & Rand","","","","","","Government","Health","","Government","Education and research","","Government","Sport","","Government","Urban planning","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","6083","Overweight and diet-related NCDs","Labelling of food products","","","","All population groups","","Doha","Commercial","","introduce food labelling on both products & resturants level","Food labelling introduced; percentages of products labelled; percentages of resturants implemented","Collect data regarding all restaurants through Ministry of municipality; checking the products in supermarkets","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English" "8907","Suplementacion con Hierro y Acido Folico a Embarazada y Puerperas","Spanish","National","","GTM","Guatemala","Guatemala","Urban|Rural|Peri-urban","on-going","","","Entrega de tabletas de hierro y acido folico a mujeres embarazadas y puerperas
","","","Plan Hambre Cero","Health","Direcciones de Areas de Salud y su red de servicios","","","","","","","","","","","","","","","","","El costo de la tableta de Hierro es de Q0.12El costo de la tableta de Acido Folico es de Q0.18Se entregan 52 tabletas al año por mujer de hierro y acido folico","Government","Finance","A travéz del presupuesto del Ministerio de Salud Publica y Asistencia Social","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8906","","Iron and folic acid supplementation","","Folic acid|Iron","Tableta de Sulfato Ferroso y tableta de acido folico","Pregnant women (PW)","Mujeres embarazadas y puerperas","Guatemala","Hospital/clinic|Primary health care center","","Se entregan 52 tabletas de hierro y 52 tabletas de acido folico por año mujer
13 tabletas de cada una de forma trimestral para que la mujer consuma una tableta a la semana.
","Numero de embarazadas y puerperas con entrega de hierro y acido folico * 100
Numero de embarazadas y puerperas
","A travéz del registro en el Sistema de Información Gerencial en Salud -SIGSA-
","90,491","90%","Period","Mujeres embarazadas y puerperas con entrega de hierro y acido folico","Mujeres embarazadas y puerperas suplementadas con hierro y acido folico","Vulnerable groups","","","Adherence","","","","","","","","","","","","","","","","","","","","","","","Spanish" "8909","Monitoreo del Crecimiento","Spanish","National","","GTM","Guatemala","Guatemala","Urban|Rural|Peri-urban","on-going","","","Programa de control de crecimiento de los niños menores de cinco años a los cuales se les realiza el monitoreo de peso y talla con su respectiva consejeria
","","","Plan Hambre Cero 2012-2016","Health","Toda la red de servicios del Ministerio de Salud Publica y Asistencia Social","","","","","","","","","","","","","","","","","El costo aproximado del control de crecimiento de un niño es de Q134.00 al año, incluyendo el equipo antropométrico, el material de registro y el tiempo invertido del personal de salud. ","Government","Finance","con el presupuesto regular del Ministerio de Salud Publica y Asistencia Social","UN","United Nations Children's Fund (UNICEF)","UNICEF-Guatemala","UN","World Health Organization (WHO)","OPS-Guatemala","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","8908","","Growth monitoring and promotion","","","","Infants and young children","Niños de 0 a 60 meses de edad","Guatemala","Hospital/clinic|Primary health care center","","Toma de peso y talla : De 1 a < 2 años cada mes, de 2 a <3 años cada 3 meses y de
3 <5 años cada 6 meses.
Esta actividad lo realiza el personal de salud de los servicios en su mayoría auxiliar de enfermería o enfermera profesional.
","Niños y niñas menores de cinco años en control de crecimiento *100
Numero de niños y niñas menores de cinco años
","A travéz del Sistema de Información Gerencial en Salud -SIGSA- formato cuaderno del niño y la niña 5a
","1,581,280 correspondiente al 60% de la poblacion menor de cinco años","70%","Period","Niños y niñas en control de crecimiento","Niños y niñas con estado nutricional Normal","Vulnerable groups","","","Insufficient staff","","","","","","","","","","","","","","","","","","","","","","","Spanish" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Twice a year, at designated times, the three programs distribute capsules to children aged six months to five years. Each program follows a campaign model based upon intensified social mobilization and service delivery over two to seven days. The twice-yearly events have created a cadre of field-tested personnel in the three countries, who are skilled at working with the local communities and at promoting their support and active participation. All three programs have been associated with National Immunization Days (NIDs), a WHO global program to eradicate polio. Since NIDs were held annually, however, they provided an opportunity for only one dose of vitamin A each year. Because children with vitamin A deficiency should receive a supplement at least twice a year (every four to six months), another mechanism was needed for the second dose. Relying exclusively upon facility-based distribution to deliver the second dose was not a viable option for several reasons, but in particular because healthfacility attendance for older children was not high enough to ensure adequate coverage in the one-to-five-year age group.
In Zambia, the first non-NIDs vitamin A supplementation program was launched in August 1999, and later renamed Child Health Week (CHW) to make the focus on the child more explicit. It was also felt that, instead of limiting activities to a vertical vitamin A supplementation program, the opportunity should be seized to deliver an integrated service that included not only vitamin A capsules but also other health services such as de-worming, health education, immunization, family planning, prenatal care, and growth monitoring. Districts were encouraged to provide an integrated package of services commensurate with their local capacity and need — as long as vitamin A supplementation remained the core activity during that week. In Zambia, the first NIDs campaign took place in 1997, and was a nationwide undertaking. The program was scaled down to about half the districts in recent years. Since 1999, the focus has shifted to priority districts, where communities have been at a constant risk of cross-border polio infections due to civil-war-related migrations from neighboring countries. This narrower focus is referred to in Zambia as sub-NIDS.
The first round of vitamin A supplementation in Ghana was integrated into NIDs in 1996. By 1999, a detailed plan was developed to implement a nationwide stand-alone supplementation program for the second round. In 2000, the Ministry of Health (MOH) carried out the first vitamin A standalone capsule distribution in the country’s ten regions. Since that date, the program has become a two- to three-day stand-alone event used to deliver a second dose of vitamin A to all children 6 to 59 months of age. Volunteers from the Ghana Education Service, along with personnel from other decentralized departments, assist with the supervision and capsule-distribution effort. Community-based volunteers are in direct contact with caregivers and children and also work very closely with health workers, assemblymen, chiefs, opinion leaders, gong-gong beaters, and other community leaders to mobilize beneficiaries, administer vitamin A, and maintain distribution records.
In contrast to Zambia and Ghana, Nepal followed a phased approach to program implementation. Integration of vitamin A into NIDs in Nepal was initiated in 1997,
four years after a supplementation program was established in 8 of the country’s 75 districts. The second distribution campaign has since been phased in at a rate of eight to ten districts per year. By 2001, the program covered all but three politically unstable districts. Under the program, high-dose vitamin A capsules are distributed to all children aged 6 to 59 months during a twoday event.
","
Ghana
A monitoring team consisting of national, regional, and district supervisors carries out organized and random spot checks. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. Capsule-distribution teams use all means of transportation available within the region and district, whether these be 4x4 vehicles, 2x4 pickups, motorcycles, or bicycles. MOH, district assemblies, decentralized departments, and local and international NGOs provide fuel and contribute to vehicle maintenance. At the end of each day, tally sheets are counted and summary sheets completed. Data are compiled by sub-district and district health management teams. After all figures are checked for accuracy, district coverage is calculated. District coverage data are sent to the regional nutrition officers and senior medical officers of public health, who compile regional coverage figures before sending them to the Nutrition Unit in Accra. Using regional figures, the Nutrition Unit estimates national coverage.
Zambia
Monitoring teams consisting of national, provincial, and district staff carry out systematic or random observations, depending on what they are monitoring. Where necessary, vitamin A capsule administrators are assisted in performing their tasks. At the end of each day, tally sheets are counted, summary sheets completed, and data compiled. District figures are then checked for accuracy, after which district coverage is calculated and the results forwarded to NFNC.
","Ghana: 3.5 million children ","Ghana: Exceeded target in May 2001; Zambia: 28 percent in 1999, 88 in Febraury 2002","","serum retinol levels of &lt;20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","serum retinol levels of <20 ug/dl,night-blindness prevalence,vitamin A supplementation coverage for children,subclinical vitamin A deficiency,","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","Insufficient staff","In Zambia and Ghana, it has been somewhat more difficult to generate a consistent cadre of volunteers for the vitamin A distribution. In each country, districts mobilize health post and sub-health post staff, identify extended outreach sites (including clinics, schools, and community centers),and then recruit community members to assist them with their activities. In Ghana, this has been relatively successful since there have been adequate clinic staff and a manageable number of outreach sites. In spite of this, many districts have continued to do some house-to-house visits to ensure high coverage. In Zambia, it has been more difficult to recruit community volunteers, and the clinic staff have been stretched to cover outreach sites.","","","","","","","","","","","","","","","","","","","","","Robin Houston (2003). Why They Work: An analysis of three successful public health interventions - Vitamin A supplementation programs in Ghana, Nepal, and Zambia
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Five data collection methods were used:
During the fieldwork, the enumerators worked in pairs. The enumerators were not allowed to use the instruments in the facilities where they worked. Each pair spent a full day at a health facility. Field supervisors supported the enumerators during the data collection and checked the questionnaires for consistency and completeness. This was to ensure that the data collected was accurate as possible.
","""""Many pregnant mothers do not come to ANC because they had several normal pregnancies and think all will continue to go on well always.”
- Health worker, Apac
“ The health worker at the health centre is very rude, she has no time for us; so we fear even asking questions or discussing any issue about our health. So I go all the way to Naguru health clinic and only here if I have no money for transport.”
- A pregnant woman, Kojja, Mukono
“ I think these tablets for blood should be given only to pregnant women who have no blood. It may cause a high blood level and lead to high blood pressure.”
- TBAs, Kyampisi
“ Women with increased blood should not take these tablets (iron and folic acids) because their heartbeats will increase and they will sweat very much.”
- TBAs, Seeta Nazigo
“ Some mothers say it smells and they throw away the tablets soon after the clinic.”
- Pregnant mothers, Kojja
“ Some mothers do not like taking tablets when they are pregnant.”
- Pregnant mothers, Seeta Nazigo
Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Ethiopia
MOST is providing technical and implementation support to the Ministry of Health in the development of a national micronutrient program. The program is a cooperative effort between the MOH, USAID/Ethiopia, MOST, and UNICEF. Program components include strengthening of the newly formed nutrition division at the MOH and the micronutrient committee; development of a locally designed vitamin A supplementation strategy and its pilot test; support for initial trials of vitamin A sugar fortification in one of the country's four sugar factories; and support for information, education, and communication activities.
South Africa
MOST is working with counterparts at the University of the Western Cape (UWC) to support and strengthen a new vitamin A supplementation program being started by the Department of Health in Eastern Cape province. MOST is also supporting a pilot initiative by UWC that aims to incorporate micronutrient interventions into the Eastern Cape Integrated Nutrition Program.
.
","","","","","","","Vulnerable groups","","Vitamin A supplementation in neonates>>>Vitamin A supplementation in neonates>>http://www.who.int/elena/titles/vitamina_neonatal","","","","","","","","","","","","","","","","","","","","","","","","English" "11483","The MOST Project","English","Multi-national","","ETH|GHA|ZAF|UGA|ZMB","Ethiopia|Ghana|South Africa|Uganda|Zambia","Ethiopia|Ghana|South Africa|Uganda|Zambia","Urban|Rural|Peri-urban","completed","01-1997","01-2001","Background
Micronutrient deficiency adversely affects the health and economic and social development of individuals, communities, and nations. Given their high prevalence in developing regions, deficiencies in vitamin A, iron, and iodine have great public health significance.
Vitamin A deficiency weakens the immune system and, hence, increases the severity of infections. It is also the most common cause of blindness among children in developing countries. Iron deficiency anemia impairs immunity and reduces physical and mental capacities of populations. Iodine deficiency is the leading cause of mental and physical retardation in infants and children worldwide. As with vitamin A and iron, iodine deficiency increases the risk of death in newborns.
Programs that promote improved micronutrient status can alleviate the disability, morbidity, and mortality—particularly among young children and women—that are the consequences of micronutrient deficiency.
The MOST Mission
The MOST mission is to 1) maintain and enhance USAID's global leadership position in addressing micronutrient malnutrition, particularly vitamin A deficiency; 2) implement and evaluate state-of-the-art interventions to alleviate micronutrient deficiencies; and 3) provide technical guidance and coordination to other USAID projects with micronutrient-related components.
The MOST Strategy
The MOST strategy is built upon a framework of global and country-level results:
The global agenda focuses on 1) promoting a revised global agenda in collaboration with other organizations worldwide committed to reducing micronutrient malnutrition; 2) translating scientific knowledge into policy and program action; and 3) maximizing lessons learned through USAID’s extensive field program experience.
Country-level results address deficiencies in vitamin A, iron, and iodine: 1) vitamin A coverage of at least 80 percent of deficient children under 6 years of age; 2) moderate to severe anemia decreased by 30 percent in pregnant women and children 6–24 months of age; and 3) percentage of the population with symptoms of iodine deficiency reduced by 30 percent.
Country Activities
For micronutrient delivery at the country level, MOST’s role is to provide technical support to countries to guide the use of not only USAID funds, but also the full range of financial and human resources needed to eliminate micronutrient deficiencies from the list of public health problems.
In the design of country activities, MOST seeks the appropriate balance between supplementation, food fortification, and other food-based approaches to deliver micronutrients to at-risk populations in an effective, yet affordable way. Country activities are based upon analyses of a variety of relevant information:
—Prevalence and severity of micronutrient deficiencies
—Awareness of effects of micronutrient deficiencies
—Nutrition policies and programs
—Providers’ motivation, knowledge, and practices
—Food consumption data
—Production, distribution, and marketing of staple foods
—Estimates of the costs of alternative interventions
Key Areas of Activity
—Application of behavior change techniques to create demand for micronutrient programs and services
—Enhancement of the effectiveness and sustainability of supplementation programs
—Sound planning, implementation, and quality control of fortification programs
—Inclusion of other food-based approaches in programs
—Application of appropriate economic analysis to guide the evolution of country programs
—Use of monitoring and evaluation to improve program operations
—Development of public and private sector alliances to enhance the effectiveness of interventions
Target Groups
MOST focuses on the improvement of the micronutrient status of children under 6 years of age and women of childbearing age. Several intervention options available to address micronutrient deficiency, such as food fortification, will benefit not only those target groups, but also school-age children and adult males.
The MOST Team
The MOST team consists of five organizations led by the International Science and Technology Institute, Inc. (ISTI) as the primary contractor. ISTI's partners are the Academy for Educational Development, Helen Keller International, the International Food Policy Research Institute, and Johns Hopkins University.
In addition, five resource institutions have joined MOST for in-country implementation and technical tasks: CARE, International Executive Service Corps, Population Services International, Program for Appropriate Technology in Health, and Save the Children.
","Government agencies encouraged the initial development of fortification: NFNC promoted initial research, sponsored meetings, and coordinated activities related to fortification; MOH researched the legal framework; the National Institute for Scientific and Industrial Research (NISIR) provided technical guidance; the Food and Drug Control Laboratory (FDCL) conducted monitoring and evaluation; and the Zambian Revenue Authority (ZRA) examined the tax structure. Industry acceptance allowed planning to begin, but donor support was critical to the development of the program: the U.S. Agency for International Development (USAID) was the lead financer of the project and provided technical assistance, UNICEF provided spare parts, and the Japanese International Cooperation Agency (JICA) provided spectrophotometers for Zambia Sugar and the FDCL.
While legislation was still being developed, Zambia Sugar went ahead with the launch of fortified Whitespoon Sugar on May 15, 1998. Zambia Sugar began its fortification program at 15 mg/kg, but cost considerations led the company to reduce the level to 10 mg/kg within three months. In May 1997, one year before fortification began, a consultant estimated the cost of fortifying 100,000 metric tons of sugar at 16 mg/kg to be around $1 million U.S., while fortifying at 20 mg/kg would cost almost $1.25 million.24 Reducing the level from 16 to 10 mg/kg could thus have reduced costs by approximately $375,000 a year.
","Modified Relative Dose Response Test (MRDR) in children
","The first outside tests of fortificant levels in sugar were controversial. Four months after the launch of fortified sugar, a team consisting of representatives from the MOH, the NFNC, and NISIR visited the Zambia Sugar mill. The team tested samples from the mill at the FDCL; these tests showed far lower levels of vitamin A than those shown in tests by Zambia Sugar. The government’s tests indicated a range of 0–13.6 mg/kg, while Zambia Sugar’s tests indicated a range of 9–21 mg/kg for the same samples. Zambia Sugar believes that the samples suffered sedimentation in the transport to the government laboratory and that this explains the different results.
MOST, the USAID micronutrient program, sponsored the creation of training manuals for health inspectors and Food and Drug enforcement officers, as well as a national training workshop from September 24 to October 7, 2000. The workshop focused on inspection procedures and methods, provided laboratory training where appropriate, and included a trip to the Zambia Sugar plant. Since the implementation of that program, Zambia Sugar has expressed satisfaction with law enforcement efforts. UNICEF subsequently funded workshops at the district level, using reproductions of the training manuals that had been produced with MOST funding.
","nationwide","..","","","","Vulnerable groups","","","Financial resources","","Communication","","Financial resources","","Adherence","","","","","","","","","","","","","","","","","English" "11445","Iodin deficiency disorders control programme","English","National","","GHA","Ghana","Accra, Greater Accra, Ghana|Kumasi, Ashanti, Ghana|Takoradi, Western, Ghana|Sunyani, Brong Ahafo, Ghana|Cape Coast, Central, Ghana|Wa, Ghana|Tamale, Ghana|Bolgatanga, Ghana|Koforidua, Eastern, Ghana|Ho, Volta, Ghana","Urban|Rural|Peri-urban","on-going","01-1996","","The programme focuses on the promotion of iodised salt consumption to elimate IDDs which are highly prevalent in Ghana. This done through sensitization of the public, training of salt producers and law enforcement agencies.
","Total goitre rates, household iodised salt consumption, market coverage of iodised salt, urinary and salt iodine concentrations
","Vulnerable groups","","Iodization of salt>>>Iodization of salt>>http://www.who.int/elena/titles/salt_iodization","Financial resources","Awareness creation of policy makers on the need to make funds available for IDD programms","Stakeholder","Ineffective collaboration is also dealt with by creating awareness of the importance of the programme to get them to include IDD in their work plan","Supplies","Removal of tax exemption on the import of potassium iodate to reduce the cost salt iodisation in the factories and cottage salt producers","","","","","","","","","","","","","","","","The programme focusses on the promotion of iodised salt consumption to eliminate IDDs which are prevalent in Ghana. This is done through enforcement of the Public Health Amendment law 2012 Act 851, which states that salts for human and animal cosumption must be iodised. The programme also trains salt producers on effective ways of iodising salt.
","Total goitre rates, urinary and salt iodine concentrations,Household iodated salt consumption coverageMarket coverage of iodated salt
","Vulnerable groups","","Iodization of salt>>>Iodization of salt>>http://www.who.int/elena/titles/salt_iodization","Financial resources","Creating awareness of the importance of the program in policy makers to make funds available for the programme","Stakeholder","Lyasing with international organizations to inculcate IDD in their programms","Supplies","Imposing tax exemption on the importation of potassium iodate to reduce the cost of salt iodisation","","","","","","","","","","","","","","","","Establishment of salt banks at salt producing areas to mop up salts produce by small scale salt producers
","","English"