"policy_id","iso3code","countryname","province","policy_title","policy_type","policy_type_other","language","start_month","start_year","end_month","end_year","published_by","published_month","published_year","adopted","adopted_month","adopted_year","adopted_by","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","goals","strategies","me_indicators","me_indicator_types","legislation_details","topics","link_action","url","further_notes","references","attached_file" "7992","BRA","Brazil","","Estratégia Nacional para a Alimentação Complementar Saudável","Nutrition policy, strategy or plan focusing on specific nutrition areas","","","","2008","","","Coordenação-General da Política de Alimentao e Nutrição - Ministério da Saúde","","2008","","","2008","Health ministry","Nutrition council|Health","","World Health Organization (WHO)","","International Baby Food Action Network (IBFAN)","","","","","","","","","","","","","","
A Estratégia Nacional para Alimentação Complementar Saudável (ENPACS) visa fortalecer as ações de apoio e promoção à alimentação complementar no Sistema Único de Saúde – SUS. Ela propõe o incentivo a orientação alimentar para crianças menores de dois anos como atividade de rotina nos serviços de saúde, contribuindo assim para a formação de hábitos alimentares saudáveis desde a infância.
","A ENPACS é uma estratégia que visa à qualificação do profissional da Atenção Básica com o fortalecimento das ações de apoio e promoção da alimentação saudável no âmbito do SUS. A replicação e continuidade da ENPACS é garantida através do trabalho local dos tutores, que são profissionais selecionados pelos estados e/ou municípios e que participam de uma Oficina de formação de tutores. A oficina tem duração de três dias (24h – 3 turnos de 8 horas). Assim, ao retornar para seu âmbito de atuação, o tutor tem a missão de replicar o conteúdo da ENPACS, que pode ser feito de duas formas: com a realização de novas oficinas de formação de tutores (formando multiplicadores da estratégia) ou com a realização de oficinas de sensibilização sobre o tema nas Unidades Básicas de Saúde (UBS), chamadas “Rodas de Conversa”, conforme figura abaixo.
","O monitoramento da ENPACS está dividido em duas fases: Monitoramento da implementação da estratégia e monitoramento dos resultados alcançados nos indicadores de alimentação e nutrição em crianças menores de dois anos. Todos os atores envolvidos na implantação e implementação da ENPACS são responsáveis pelo seu monitoramento e avaliação. O objetivo desse material é subsidiar os tutores na utilização do monitoramento do processo de implementação da ENPACS.
","","","International Code of Marketing of Breast-milk Substitutes|Low birth weight|Stunting in children 0-5 yrs|Wasting in children 0-5 years|Underweight in children 0-5 years|Overweight in children 0-5 yrs|Overweight in adolescents|Growth monitoring and promotion|Breastfeeding promotion/counselling|Complementary feeding promotion/counselling|Nutrition counselling on healthy diets","","http://189.28.128.100/nutricao/docs/Enpacs/outros/passo_a_passo_enpacs.pdf","","WHO Global Nutrition Policy Review 2009-2010","https://extranet.who.int/nutrition/gina/sites/default/filesstore/BRA%202008%20Estrat%C3%A9gia%20Nacional%20para%20a%20Alimenta%C3%A7%C3%A3o%20Complementar%20Saud%C3%A1vel.pdf" "17770","AFG","Afghanistan","","National Infant and Young Child Feeding Policy and Strategy 2009-2013","Nutrition policy, strategy or plan focusing on specific nutrition areas","","English","","2009","","2013","Ministry of Public Health","9","2009","Adopted","","2009","Executive Board","Other|Education and research|Food and agriculture|Health|Trade|Women, children, families","Breastfeeding Promotion Network of India (BPNI), Interior (MoI) to promote IYCF and the application of the Code of Marketing of BMS, Religious Affairs, Rehabilitation and Rural Development (MRRD), Justice, Labor and Social Affairs","Food and Agriculture Organisation (FAO)|United Nations Children's Fund (UNICEF)|World Food Programme (WFP)|World Health Organization (WHO)","","Basics Support for Institutionalizing Child Survival (BASICS)|International Baby Food Action Network (IBFAN)|Nutrition International|World Alliance for Breastfeeding Action (WABA)","","US Agency for International Development (USAID)","","","","","","","","","","","","2.3. Goal and objective of the National IYCF Policy and Strategy
The IYCF Policy and Strategy is designed to contribute to the objectives of the Afghanistan National Health and Nutrition Sector Strategy 2008-2013 of reducing child and maternal mortality and malnutrition.
Its overall goal is the same as the overall goal of the Public Nutrition Policy and Strategy, namely: To reduce all forms of undernutrition, thereby improving the growth, development and health of Afghan infants and young children, through improved infant and young child feeding practices.
The objective of the Infant and Young Child Feeding Policy, and its associated Strategy is:
To increase the percentage of child caregivers adopting appropriate infant and young child feeding and caring practices (by 20%, by 2013).
Strategic components and approaches to achieve this objective are described in section 3 of the present document.
2.4. Purpose of the Infant and Young Child Feeding Policy and Strategy
The purpose of the present Policy and Strategy is to describe the Government of Afghanistan’s position on IYCF, in accordance with the Global Strategy on IYCF. All key stakeholders directly or indirectly involved in IYCF, notably health sector professionals, NGOs, UN agencies, military, and private sector, are responsible, and will be held accountable, for respecting the present Policy.
This document also clarifies the strategies that need to be adopted and interventions to be implemented to achieve the policy objectives. It will serve to support advocacy and resource mobilization, as well as coordination between the main implementing partners (MoPH Departments, BPHS partners, NGOs, UN, private sector, communities). Finally, it provides guidance on how to monitor the protection and promotion of optimal IYCF in Afghanistan.
","Strategy for Promoting Optimal Infant and Young Child Feeding
The IYCF Policy and Strategy is designed to contribute to the objectives of the Afghan National Health and Nutrition Sector Strategy and the overall goal of the Public Nutrition Policy and Strategy by focusing on the following objective:
To increase the percentage of child caregivers adopting appropriate infant and young child feeding and caring practices (by 20% by 2013).
This objective will be achieved through the following three strategy components:
1. Application of IYCF Policy and Strategy supported by advocacy, technical guidance and law enforcement
National IYCF Policy and Strategy
1. Disseminate the National IYCF Policy and Strategy amongst all key stakeholders (MoPH, MAIL, MoJ, MoMI, MoEd, MoRA, MoWA, NGO’s, private sector).
2. Regular updating of IYCF action plan and preparation of a resource mobilization plan to support the implementation of the IYCF Policy & Strategy
3. Review MoPH related sub-policies, strategies and guidelines and make sure IYCF has been reflected in these documents
The Code of Marketing of Breast-milk Substitutes
4. Establish a National Committee for the Enforcement of the Code
5. Establish enforcement mechanisms for the Code of Marketing of BMS
6. Disseminate information on the Code (including translations) and related legislation to all key stakeholders (Provincial Departments of Health, PRTs, private sector, all health facilities, MOWA, NGOs, etc.) through posters, leaflets, and workshops
7. Training of Code monitors (IBFAN)
Maternity protection
8. Establish enforcement mechanisms and develop guidelines for the implementation of the Maternity Protection Act
9. Inform working women of their rights under the Maternity Protection Act (e.g. through leaflets and radio; can be part of IYCF Public Awareness Campaign)
IYCF Guidelines
10. Review existing international guidelines and national training packages and develop a comprehensive and coherent set of harmonized guidelines covering IYCF policy and priorities and strategic interventions, namely: IYCF promotion in different health facilities (including BFHI guidelines); IYCF promotion at community level; Infant and Young Child Feeding in Emergencies; Implementation of the Code, etc.
11. Disseminate guidelines to the relevant stakeholders, and conduct trainings on their implementation (c.f. also training activities under outputs 2 and 3)
Infant and Young Child Feeding in Emergencies
12. As part of the Afghan IYCF guidelines, develop a section on IYCF in Emergencies based on the internationally endorsed Operational Guidance for IFE
13. Disseminate the IFE Guidelines to all relevant stakeholders (including the Disaster Management Committee, the PRT, NGOs and Provincial Development Councils) and ensure they are implemented in emergency situations.
2. Caregivers know optimal IYCF practices and are supported in providing optimal care and mobilizing the resources required for IYCF, through IEC/BCC and community support interventions.
Public awareness Raising
Establishment of community support groups and interventions
Integration of IYCF in non-health community-level interventions
3. IYCF promotion and counselling is effectively implemented as part of the BPHS and EPHS in all health facilities.
Capacity-building of various categories of personnel involved in implementation will be an integrated component of each strategic priority/output. Advocacy and resource mobilization will be essential to enable the implementation of the activities required to achieve these outputs. An advocacy and resource mobilization plan will therefore be developed. The activities to be implemented to achieve these outputs/strategic priorities are described below.
Expansion of Baby-Friendly Hospital Initiative to more hospitals and selected health facilities providing MCH services
1. Review lesson learned from the current BFHI
2. Train pool of BF assessors/advocates at the central and regional level.
3. Develop tools, conduct assessment/re-assessment to certifying health facilities as Baby-friendly
4. Train health facility staff on measures required to comply with BFHI criteria and implement these measures
5. Supervise and monitor facilities and provide certificates for facilities complying with BFHI criteria
Integrationif IYCF counselling in all health gacilities
6. Develop guidelines and establish IYCF corners in health facilities, including breastfeeding counselling and participatory cooking sessions (N.B. can be part of child health corner)
7. Ensure IYCF counselling is part of health education activities, including breastfeeding demonstration and participatory cooking sessions
8. Ensure breastfeeding counselling and re-lactation assistance are part of the management of acute malnutrition (in TFU and CMAM)
9. Identify at least one referral centre in each province for referral of complicated and difficult lactation and IYCF cases.
Training of health staff on IYCF
10. Integrate IYCF into the curricula of all medical and paramedic education institutions including community midwifery school and postgraduate programs (esp. residency training programs in paediatrics, obstetrics and gynaecology).
11. Develop training packages and job aids on IYCF for different health staff categories, including: doctors, nurses, midwives, community midwives, and CHWs
12. Integrate IYCF training modules as part of in-service trainings, in particular for MCH staff, CHWs & midwives (e.g. as part of C-IMCI training)
13. Distribute printed material and job aids to all facilities, including for CHWs and community midwives as part of C-IMCI
15. Train and establish pool of trainers at the national level and in “each region” on MBFI and IYCF, in particular by training Provincial Nutrition Officers on IYCF
16. Train at least 2 MCH staff of each health facility.
17. Train out-reach staff to enable them to integrate IYCF in out-reach services.
","Indicator (Baseline, Target)
Overall Goal: The prevalence of chronic and global acute undernutrition among children 0-59 months and the prevalence of MDDs are reduced by 10% of current levels
Objective: To increase the percentage of child caregivers that have adopted appropriate infant and young child feeding and caring practices.
(see new WHO indicators for IYCF in annex 5)
Component 1: Application of IYCF Policy and Strategy supported by advocacy, technical guidance and law enforcement
Component 2: Caregivers know optimal IYCF practices and are supported in providing optimal care and mobilizing the resources required to apply adequate IYCF through IEC/BCC and community support interventions
Component 3: IYCF promotion and counselling is effectively implemented as part of the BPHS and EPHS in all health facilities
","Outcome indicators|Process indicators","","Breastfeeding|Baby-friendly Hospital Initiative (BFHI)|Breastfeeding - Early initiation by 1 hour|Breastfeeding - Continued|Breastfeeding - Exclusive 6 months|Counselling on infant feeding in the context HIV|International Code of Marketing of Breast-milk Substitutes|Maternity protection|Stunting in children 0-5 yrs|Wasting in children 0-5 years|Anaemia|Complementary feeding|Minimum acceptable diet|Growth monitoring and promotion|Breastfeeding promotion/counselling|Promotion of exclusive breastfeeding for 6 months|Counselling on feeding and care of LBW infants|Complementary feeding promotion/counselling|Nutrition in the school curriculum|Promotion of fruit and vegetable intake|Media campaigns on healthy diets and nutrition|Nutrition counselling on healthy diets|Vitamin A|Iodine|Iron|Zinc|Micronutrient supplementation|Food fortification|Wheat flours|Food grade salt|Management of severe acute malnutrition|Home, school or community gardens|Improved hygiene / handwashing","","","","","https://extranet.who.int/nutrition/gina/sites/default/filesstore/AFG%202009%20National%20Infant%20and%20Young%20Child%20Feeding%20Policy%20and%20Strategy.pdf" "14782","UGA","Uganda","","Nutrition in the Context of HIV and Tuberculosis Infection. Strategic Plan 2009-2014","Nutrition policy, strategy or plan focusing on specific nutrition areas","","","","2009","","2014","Ministry of Health","","2009","Adopted","","2009","MoH","Health","Ministry of Health Health: Ministry of Health","World Food Programme (WFP)","World Food Programme (WFP)","Global Alliance for Improved Nutrition (GAIN)|International Baby Food Action Network (IBFAN)","International NGOs: Global Alliance for Improved Nutrition (GAIN), International Baby Food Action Network (IBFAN),","US Agency for International Development (USAID)","Bilateral and donor agencies and lenders: US Agency for International Development (USAID)","","","","","Research/academia","","","","","","
Goal
The overall goal of the Strategic Plan is to provide a framework for technically sound, integrated and coordinated food and nutrition interventions in the context of HIV and TB programs.
","Objective 1. To strengthen advocacy and mobilise resources for nutrition in HIV and TB interventions at all levels
Strategic interventions:
1.1 Convene annual donor conferences for resource mobilisation
1.2 Convene bi-annual advocacy meetings for the nutrition, HIV and TB stakeholders
1.3 Develop, produce, launch and disseminate a communication strategy on nutrition in HIV and TB
1.4 Identify and support activists on nutrition in HIV and TB
Objective 2.To increase coverage of food supplementation for persons infected with HIV and TB
Strategic interventions:
2.1 Support production and appropriate use of RUTF based on the locally available foods for TB and HIV infected persons
2.2 Promote appropriate use of the locally available foods at the household level
2.3 Integrate food supplementation and nutrition education into home based care, TB-DOTS and ART programmes
Objective 3. To establish and/or strengthen the institutional capacity to support quality nutrition in HIV and TB interventions
Strategic interventions:
3.1 Review, update and/or develop guidelines on the essential components of nutrition in HIV and TB
3.2 Produce and disseminate the guidelines through a comprehensive plan
3.3 Recruit additional human resource at national level; fill the existing gaps at national, regional and district levels
3.4 Source for appropriate technical assistance on nutrition in HIV and TB
3.5 Procure equipment and supplies for nutrition interventions and programmes
3.6 Develop standards and the regulatory framework for food products at the Ministry of Health
3.7 Finalise the development, production and integration of nutrition in HIV and TB into pre- and in-service training curricula
3.8 Support in-service training and other capacity building activities for formal and traditional service providers
3.9 Facilitate participation of nutritionists at regional training workshops and conferences
Objective 4. To promote coordination and strengthen linkages among partners involved in food and nutrition interventions in context of HIV and TB
Strategic interventions:
4.1 Integrate nutrition, HIV and TB into the existing coordination structures at national, regional and district levels
4.2 Develop, produce and disseminate policy and implementation guidelines on nutrition in HIV and TB
Objective 5. To strengthen the nutrition management information system and use of strategic information for decision making and planning for nutrition in HIV and TB
Strategic interventions:
5.1 Establish a data base and monitoring/ surveillance system that include nutrition in HIV and TB indicators
5.2 Train service providers at all levels on the nutrition information management system
5.3 Document best practices and periodically share experiences and technical updates on nutrition in HIV and TB e.g. Annual & Quarterly Bulletins
5.4 Develop a research agenda for nutrition in HIV and TB
Objective 6. To promote and support meaningful community involvement in nutrition within the context of HIV and TB
Strategic interventions:
6.1 Develop and produce a community information package on nutrition in HIV and TB
6.2 Train the VHT and other existing networks on nutrition in HIV and TB
6.3 Train PLHIV and caretakers on nutrition in HIV and TB
6.4 Support community-based nutrition education including the use of demonstration gardens and agricultural plots
Objective 7. To promote regular monitoring and evaluation of nutrition in HIV and TB Activities
Strategic interventions:
7.1 Monitor for the appropriate use of guidelines and standards
7.2 Conduct technical support supervision/ mentoring visits and regional meetings
7.3 Conduct mid-term review and evaluation of programme interventions
","The main input indicators identified for monitoring the nutrition programme in context of HIV and TB infections have been spelt in relation to the strategic interventions in the report’s Gantt chart.
2.2.1 Goal:
To operationalize the nutrition component of the Child Survival Strategy (CSS) in order to accelerate the reduction of under-five mortality, and thus contribute to the National Development Plan (NDP), the Health Sector Strategic Plan (HSSP) III, and the MDGs.
2.2.2 Overall Objective
To strengthen the implementation of a defined package of proven nutritional interventions that are cost effective and to achieve and sustain high coverage.
2.2.3 Specific Objectives
1. To implement cost effective nutrition interventions through community, population/scheduled, and clinical services.
2. To scale up proven nutrition interventions through community, population /scheduled and clinical services.
3. To sustain high coverage of proven interventions through community, population/scheduled and clinical services.
","Thematic Objective 1: Mainstreaming maternal nutrition interventions designed to ensure
adequate pregnancy outcomes and healthy infancy
Interventions
1. Providing iron and folic acid tablets to adolescents in and out of school, and to pregnant and
lactating mothers
2. Encouragement and support of antenatal care services through health education
3. Promotion of adequate intake of nutrient dense foods by the mother during pregnancy and
lactation, and of more daytime rest during pregnancy
4. Post-partum supplementation with vitamin A, iron and folate
5. Consideration of maize meal fortification with folic acid to help assure maintenance of
adequate serum folate prior to conception
6. Ongoing monitoring of service delivery, evaluation of impacts, and surveillance sites to
assess trends.
Thematic Objective 2: Mainstreaming infant and young child nutrition interventions to ensure
growth and development
Interventions
1. Counselling during ante-natal and post-natal care to promote and support exclusive
breastfeeding.
2. Continued and intensified growth monitoring and promotion with intensive counselling to
address needed behavioural change, and referral as necessary for facility-based attention.
3. Promotion and support for exclusive breastfeeding for six months, timely introduction of
adequate complementary feeding, and continued breastfeeding to at least 24 months
4. Semi-annual Vitamin A supplementation to infants and children 6 to 59 months
5. Semi-annual deworming of children aged 1 to 14 years
6. Ongoing monitoring of service delivery, evaluation of impacts, and surveillance sites to
assess trends.
Thematic Objective 3: Mainstreaming nutrition to ensure control and prevention of micronutrient
deficiencies
Interventions
1. Establishment of a comprehensive policy framework for micronutrient deficiency control
2. Support for implementation of a consolidated policy on micronutrient deficiency control
3. Advocacy for the control and prevention of micronutrient deficiencies
4. Control of iodine deficiency disorders
5. Vitamin A supplementation for children and post partum women
6. Iron supplementation for anaemic children and non pregnant women
7. Iron and folic acid supplementation for adolescent girls and for pregnant and lactating
women
8. Deworming of young children, school children and pregnant women
9. Food fortification, particularly of complementary foods with vitamin A, iron and other
micronutrients
10. Control of zinc deficiency through food fortification and supplementation as part of diarrhea
management
11. Ongoing monitoring of service delivery, evaluation of impacts, and surveillance sites to
assess trends.
Thematic Objective 4: Mainstreaming the treatment of acute malnutrition into the health delivery
system with nutrition interventions to control for co- morbidities
Interventions
1. Identification, referral and management of cases of acute malnutrition
2. Nutrition management and support of sick children following IMCI protocols.
Thematic Objective 5: Mainstreaming nutrition into the treatment and management of HIV/AIDS
Interventions:
1. Providing nutritional services and supplements in the context of HIV/AIDS
2. Support for Infant and Young Child Feeding (IYCF) in the context of HIV
3. Prevention of mother to child transmission of HIV.
Thematic Objective 6: Mainstreaming nutrition interventions into emergency planning,
preparedness and response
Interventions
1. Providing nutrition services in emergencies
2. Support for Infant and Young Child Feeding in emergencies.
Thematic Objective 7: Cross cutting issues
Interventions
1. Operational research
2. Human capacity strengthening
3. Linking services across ministries
4. Family Care Practices.
Thematic Objective 8: Development of a comprehensive communication strategy to support all
nutrition interventions
Interventions
1. Development of an effective and comprehensive communication strategy designed to
encourage optimal IYCN for use at all levels
2. Production of appropriate information, education and communication materials at all levels
3. Development of advocacy packages for policy makers, program managers and communities.
","M&E indicators are available.
","","","Baby-friendly Hospital Initiative (BFHI)|International Code of Marketing of Breast-milk Substitutes|Maternity protection|Low birth weight|Stunting in children 0-5 yrs|Underweight in children 0-5 years|Underweight in women|Anaemia|Anaemia in adolescent girls|Anaemia in pregnant women|Anaemia in women 15-49 yrs|Iodine deficiency disorders|Vitamin A deficiency|Dietary practice|Fruit and vegetable intake|Maternal, infant and young child nutrition|Counselling on healthy diets and nutrition during pregnancy|Growth monitoring and promotion|Breastfeeding promotion/counselling|Breastfeeding in difficult circumstances|Infant feeding in emergencies|Capacity building for the Code|Complementary feeding promotion/counselling|Promotion of healthy diet and prevention of obesity and diet-related NCDs|Nutrition counselling on healthy diets|Vitamin and mineral nutrition|Vitamin A|Micronutrient supplementation|Micronutrient powder for home fortification|Nutrition education|Food vehicles (i.e. types of fortified foods)|Complementary foods|Biofortifcation|Acute malnutrition|Food distribution/supplementation for prevention of acute malnutrition|Management of moderate acute malnutrition|Management of severe acute malnutrition|Nutrition and infectious disease|HIV/AIDS and nutrition|Nutrition sensitive actions|Health related","","http://www.health.go.ug/nutrition/docs/infant/Operational_Framework.pdf","","WHO 2nd Global Nutrition Policy Reviewhttp://scalingupnutrition.org/sun-countries/uganda","https://extranet.who.int/nutrition/gina/sites/default/filesstore/UGA%202009%20The%20Operational%20Framework%20for%20Nutrition%20in%20the%20National%20Child%20Survival%20Strategy.pdf" "17841","AFG","Afghanistan","","Strategy for the Prevention and Control of Vitamin and Mineral Deficiencies in Afghanistan","Nutrition policy, strategy or plan focusing on specific nutrition areas","","","","2010","","","Ministry of Public Health","","2010","","","","","Food and agriculture|Health|Other|Trade","Ministry of Public Health Ministries of Health, Agriculture, Trade; Public Nutrition Department","Food and Agriculture Organisation (FAO)|United Nations Children's Fund (UNICEF)|World Food Programme (WFP)|World Health Organization (WHO)","","Nutrition International","","The World Bank|US Agency for International Development (USAID)","International Donor Agencies,","","","National NGOs","","","Academic Institutions","","food industry: producers, importers and retailers","Other","Afgan National Standards Agency, Provincial Nutrition Officer, Salt Millers Association, Flour Millers Association","2.1.3. Goal
Contribute to the reduction of infant, child and maternal mortality and morbidity caused by malnutrition.
2.1.4. Objectives
By the end of 2013 in Afghanistan:
1. Reach and sustain >90% coverage of high dose Vitamin A capsule distribution among children 6 – 59 months.
2. Enable >50% of households to regularly access Vitamin A and D fortified cooking oil and ghee (clarified butter).
3. Enable >90% of households to regularly access and consume iodized salt.
4. Increase the coverage of iron and folic acid (IFA) supplementation for pregnant and lactating women and iron supplementation of children less than 24 months of age through Basic Package of Health Services to 50%.
5. Fortify all industrially produced flour produced or imported into the country with vitamins and minerals according to international recommendations.
6. Enable 30% of households to utilize commercially or home-fortified complementary foods to feed their children.
7. Increase use of zinc supplementation as a component of diarrhoea treatment among more than 80% of affected preschool children.
8. Build national human capacity in nutrition science and food science and industry to adequately prevent and control vitamin and mineral deficiency in Afghanistan.
The overall aim of the “National Nutrition Policy and Strategy” of the MoPH is to “prevent, control and treat major micronutrient deficiency disorders and their outbreaks throughout the country with a major focus on iodine, iron, zinc, folic acid, Vitamin A and Vitamin C”. Some population-based interventions as well as a number of targeted local projects have been implemented to address vitamin and mineral deficiencies with support from international donor agencies such as UNICEF, WFP, FAO, USAID, and The Micronutrient Initiative. These programs should be strengthened or expanded while additional evidence-based interventions could be implemented to help improve the micronutrient status of the Afghan population, especially among women and young children.
Based on experiences from successful vitamin and mineral deficiency intervention programs in other countries, evidence from published literature, and the current public nutrition situation and capacity in Afghanistan, recommendations are proposed based on three broad themes:
1) Strengthen micronutrient deficiency prevention (and treatment) through the BPHS;
2) Expand and strengthen public-private-civic sector partnerships; and
3) Develop public and private sector human capacity and expertise.
","Strategies:
2.2. Three Pillars of the Proposed Strategy
2.2.1. Strengthen Preventive and Therapeutic Micronutrient Deficiency Interventions through the BPHS
To improve the coverage and effectiveness of micronutrient supplement and in-home fortificants distribution through the public health facilities and the BPHS, innovative and appropriate strategies are needed to encourage and enable large proportions of women and children to access health facilities for preventive and therapeutic services. In the past few years, the MoPH and its partners have been working to increase population access to primary health care and to improve the quality of preventive and therapeutic health services in the country. Such efforts have helped to decrease infant mortality rate from 165 to 129 and under-five mortality rate from 257 to 190 (per 1000 live births).
2.2.2. Public-Private Sector Partnerships: Recognizing the Role, Responsibility and Potential Capacity of the Food Industry and Local Markets in Afghanistan
It should be understood that the food industry – producers, importers, wholesalers and retailers have an essential role in enabling the majority of the population of Afghanistan to access vitamin and mineral rich foods and supplements. The role of government is to implement appropriate policies, and promulgate and enforce needed laws, regulations and standards to allow for the production, importation and sale of nutrient-rich foods, especially quality fortified products and vitamin and mineral supplements.
2.2.3. Strengthen National Nutrition Capacity
To help enable the national and local public nutrition and health personnel to advocate for, plan, design, implement, monitor, and evaluate effective population based vitamin and mineral deficiency prevention and control programs, it is essential that they have the needed technical and programmatic skills and expertise. Although participation in short-term training programs has helped to increase the knowledge of the limited number of Public Nutrition Department (PND) staff within MoPH at the Central level, most staff at the local levels does not have the minimum needed skills in public nutrition. Further, as mentioned above, there has been substantial turnover of PND staff since the Department was established in 2002. Currently, Afghanistan has no academically trained nutritionists with public health or clinical expertise, and the nutrition curriculum offered to medical and nursing students is reported to be relatively weak.
It is therefore recommended that a cadre of post-graduate Afghan nationals be encouraged and supported to attend graduate level training abroad in human and public nutrition science, policy and epidemiology, as well as food science. The existing nutrition curriculum offered to medical and nursing students should be 36 evaluated and appropriately modified to help meet the training needs of future Afghan physicians and nurses who make up the back-bone of the national health care system. To build a solid foundation for the future, bachelor and graduate level academic degree programs in nutrition and food science as well as public nutrition should be offered through public and private academic institutions within Afghanistan.
","
Indicators:
# of available doses of Vitamin A supplement
Estimated # of children to be supplemented
# of children who received Vitamin A supplement
# of children surveyed in target area
# of children with low serum retinol
# of children tested in target area
# of available doses of prenatal Fe/FA supplement
Estimated # of pregnant women to be covered
# of pregnant women who received supplement
# of target pregnant women surveyed
# of pregnant women with anemia_______
# of pregnant women tested for hemoglobin levels
Quantity of quality iodized salt produced and/or imported
Quantity of salt needed by target population
# of households using quality iodized salt
# of target households surveyed
# of women or school-age children with low urinary iodine
# of target women or school-age children tested
Quantity of quality fortified flour produced and/or imported
Quantity of flour needed by target population
# of households using quality fortified flour
# of target households surveyed
# of women of with iron deficiency
# of target women tested
# of birth with neural tube defects
# of live births among target population
Quantity of quality fortified oil/ghee produced and/or imported
Quantity of oil/ghee needed by target population
# of households using quality fortified oil/ghee
# of target households surveyed
# of women of with vitamin A deficiency
# of target women tested
","","","Anaemia|Anaemia in pregnant women|Anaemia in women 15-49 yrs|Iodine deficiency disorders|Vitamin A deficiency|Vitamin and mineral nutrition|Vitamin A|Vitamin B12|Micronutrient supplementation|Micronutrient powder for home fortification|Nutrition education|Food vehicles (i.e. types of fortified foods)|Wheat flours|Complementary foods|Nutrition and infectious disease|Nutrition sensitive actions|Food security and agriculture|Health related|Conditional cash transfer programmes","","","","WHO 2nd Global Nutrition Policy Review 2016-2017","https://extranet.who.int/nutrition/gina/sites/default/filesstore/AFG%202010%20Strategy%20for%20the%20Prevention%20and%20Control%20of%20Vitamin%20and%20Mineral%20Deficiencies.pdf" "25920","NGA","Nigeria","","National Policy on Infant and Young Child Feeding in Nigeria","Nutrition policy, strategy or plan focusing on specific nutrition areas","","English","","2010","","","Federal Ministry of Health, Department of Family Health","11","2010","","","","","Health|Food and agriculture|Women, children, families|Information","Federal Ministry of Health, Department of Family Health; Federal ministry of Women Affairs;Federal Ministry of Information and Communication;National Agency on Food and Drug Administration and Control (NPHCDA);National Primary Health Care Development Agency (NPHCDA);","United Nations Children's Fund (UNICEF)|World Health Organization (WHO)","","Nutrition International","","","","","","National NGOs","Nutrition Society of Nigeria","Research/academia","","","","","","
Goal and Objectives
Infant and young child feeding is an integral part of the overall objective of ensuring the socio-economic well-being of all Nigerians. It is in this context that the problem of malnutrition exists and within which the goal and objectives of this Policy are derived.
Goal
The overall goal of the National Policy on Infant and Young Child Feeding in Nigeria is to ensure the optimal growth, protection and development of the Nigerian child from birth to the first five years of life.
Specific Objectives:
i. To protect, promote and support exclusive breastfeeding in the first six months of life
ii. To create and sustain a positive image for breastfeeding throughout the society
iii. To empower all women (including women who work outside their homes) to adopt and practice optimal infant feeding.
iv. To promote the timely introduction of appropriate and adequate complementary foods while continuing breastfeeding up to 24 months and beyond.
v. To ensure the provision of specific feeding recommendations for all infants and young children irrespective of their circumstances of birth and health status.
vi. To promote the provision of appropriate information for nutrition counseling and support for households in the prevention of malnutrition in children.
vii. To develop and strengthen activities that will protect, promote and support adequate infant and young child feeding practices.
viii. To raise awareness on issues affecting infant and young child feeding in Nigeria
ix. To support and enhance the provision of an enabling environment without any form of discrimination for working mothers, fathers and other care-givers including those in part-time and domestic occupation to practice optimal infant and young child feeding.
x. To promote the prevention of mother-to-child transmission of HIV and ensure HIV-free survival through appropriate and safe measures that ensure optimal infant and young child feeding.
xi. To ensure that health workers and other care providers have adequate skills and information to support optimal infant and young child feeding, including in emergency situations.
xii. To support and enhance the national capacity to address issues of infant and young child feeding in different situations and circumstances.
","","","","","Breastfeeding|Baby-friendly Hospital Initiative (BFHI)|Breastfeeding - Early initiation by 1 hour|Breastfeeding - Continued|Breastfeeding - Exclusive 6 months|Counselling on infant feeding in the context HIV|International Code of Marketing of Breast-milk Substitutes|Complementary feeding|Counselling on healthy diets and nutrition during pregnancy|Growth monitoring and promotion|Breastfeeding promotion/counselling|Promotion of exclusive breastfeeding for 6 months|Health professional training on breastfeeding|Counselling on feeding and care of LBW infants|Infant feeding in emergencies|Complementary feeding promotion/counselling|Vitamin A|Iron|HIV/AIDS and nutrition","","http://www.health.gov.ng/index.php/resources/policy-documents/family-health","","","https://extranet.who.int/nutrition/gina/sites/default/filesstore/NGA%202010%20National%20Policy%20on%20Infant%20and%20Young%20Child%20Feeding%20in%20Nigeria.pdf" "24707","BFA","Burkina Faso","","Plan de Renforcement de la Lutte Contre les Carences en Micronutriments","Nutrition policy, strategy or plan focusing on specific nutrition areas","","French","","2015","","2020","Ministere de la Sante","","2015","","","","","Nutrition council|Health|Food and agriculture|Education and research|Social welfare|Finance, budget and planning|Industry","","United Nations Children's Fund (UNICEF)|World Health Organization (WHO)","","Helen Keller International (HKI)|Nutrition International|Terre des Hommes","","","","","","","","","","","","","","
Objectif général
financements pour une mise en oeuvre efficiente de la lutte contre les carences en Contribuer à la réduction des carences en micronutriments au Burkina Faso d’ici 2020.
Objectifs spécifiques
Supplémentation médicamenteuse
La fortification à domicile
L’iodation universelle du sel
Education nutritionnelle
Renforcement du suivi et de l’évaluation des interventions
","Table Pages 44-45
","Outcome indicators","","Anaemia|Anaemia in pregnant women|Anaemia in women 15-49 yrs|Iodine deficiency disorders|Vitamin A deficiency|Nutrition in the school curriculum|Media campaigns on healthy diets and nutrition|Vitamin A|Micronutrient powder for home fortification|Food fortification|Nutrition education|Wheat flours|Maize flours|Complementary foods","","","","","https://extranet.who.int/nutrition/gina/sites/default/filesstore/BFA%202015%20Plan%20contre%20les%20carences%20en%20micronutriments.pdf" "24693","BEN","Benin","","Plan de Renforcement de L'Allaitement Maternel au Benin 2016-2020","Nutrition policy, strategy or plan focusing on specific nutrition areas","","French","","2016","","2020","Direction de la Sante de la Mere et de L’Enfant","8","2016","","","","","Cabinet/Presidency|Nutrition council|Health|Food and agriculture|Education and research|Social welfare|Trade|Information","","United Nations Children's Fund (UNICEF)|United Nations Population Fund (UNFPA)|World Health Organization (WHO)","","Catholic Relief Services|International Baby Food Action Network (IBFAN)|Other|Plan International|Terre des Hommes","URC, MCDI, PSI, , BORNEFONden, AFRICARE, COREGROUP","Other, please specify under further details|Swedish International Development Cooperation Agency (SIDA)|The World Bank|US Agency for International Development (USAID)","Coopération Technique Belge, Coopération Française, Coopération des pays Bas","","","","","","","","","","","
2.1. But
Contribuer à la réduction de la mortalité infantile à travers l’allaitement maternel.
2.2. Objectif général
Améliorer l’état nutritionnel des enfants de 0 à 24 mois, à travers la pratique adéquate de l’allaitement maternel d’ici fin 2020
2.3. Objectifs spécifiques
D’ici 2020 :
•Porter de 46,6 à 80% le taux de mise au sein dès la première heure de vie ;
•Porter de 41,4 à 60%, le taux d’allaitement maternel exclusif jusqu’à six mois ;
•Accroître de 45,5 à 70%, le taux d’allaitement maternel continu jusqu’à 24 mois en plus de la diversification alimentaire.
2.4. Objectifs intermédiaires
2.4.1. Chez les mères
D’ici 2020 :
1. Amener 90% des mères à avoir une bonne connaissance des avantages et des méthodes d’expression et de conservation du lait maternel,
2. Augmenter à 75% la proportion des mères qui adoptent un bon positionnement du nouveau-né au sein et une bonne prise de sein,
3. Porter à 75%, la proportion des mères qui pratiquent adéquatement la technique d’expression du lait maternel,
4. Augmenter à 60%, la proportion des mères qui jouissent de leurs droits relatifs à l’allaitement maternel au Bénin.
5. Amener 80% du personnel de maternité, de pédiatrie et de vaccination à faire la mise au sein précoce
6. Amener 80% des mères à appliquer la Méthode Kangourou chez les enfants de faible poids de naissance (hypotrophe et prématuré) ;
7. Rendre disponible dans toutes les formations socio-sanitaires, les fiches techniques et les affiches sur l’allaitement maternel ;
2.4.2. Chez les membres de la communauté
8. Augmenter à 80%, la proportion des mères qui continuent l’allaitement maternel jusqu’à 24 mois en plus de la diversification alimentaire adéquate,
9. Amener 50% des membres de la communauté à avoir une bonne connaissance des avantages et des méthodes d’expression et de conservation du lait maternel,
10. Mettre en place au moins un groupe de soutien à l’allaitement dans chaque village ou quartier de ville.
2.4.3. Chez le personnel socio-sanitaire
11. Amener75% du personnel socio-sanitaire à avoir une bonne connaissance sur les avantages, les méthodes d’expression et de conservation du lait maternel ainsi que la durée de conservation,
12. Augmenter à 75%, la proportion du personnel socio-sanitaire qui donne des conseils adéquats sur l’AM lors des séances d’éducation individuelle et collective
13. Amener 80% du personnel de maternité, de pédiatrie et de vaccination à faire la mise au sein précoce
2.4.4. Au plan administratif, politique et législatif
14. Renforcer les connaissances des différents acteurs (employeurs, agents socio-sanitaires, mères) sur les textes et les lois en faveur de l’AM.
15. Inciter à la révision et l’application des textes et lois en faveur de l’AM
","
I- STRATEGIES
Pour atteindre ces objectifs, les orientations stratégiques suivantes sont proposées :
process indicators: see pages 19-27
outcome indicators: see pages 30-34
","Outcome indicators|Process indicators","","Baby-friendly Hospital Initiative (BFHI)|International Code of Marketing of Breast-milk Substitutes|Maternity protection|Breastfeeding promotion/counselling|Promotion of exclusive breastfeeding for 6 months|Counselling on feeding and care of LBW infants|Monitoring of the Code|Capacity building for the Code|Regulation on marketing of complementary foods","","","","","https://extranet.who.int/nutrition/gina/sites/default/filesstore/BEN%202016%20Plan%20de%20Renforcement%20Alllaitement%20maternel.pdf"