Theme1: Incorporating Nutritional Objectives, Considerations and Components into Development Policies and Programs.
- Strengthen the technical and managerial capacities at both the community and intermediate levels for identifying and solving nutritional problems.
- Incorporating nutrition considerations into the objectives of all sectors would ensure that efforts are nutritionally beneficial.
- People's participation in selecting and implementing projects, so that it becomes more responsive to their own needs.
- Given more emphasis on gender planning and women empowerment issues in order to decrease the gender gap especially among rural underdeveloped regions and thus alleviate poverty.
- Nutritional issues should be on the agenda of concerned ministries, where the focus of attention aims at improvement of the nutrition situation, especially among vulnerable groups.
Theme2: Improving Household Food Security
- Rural development: Integrated rural development is an effective approach to assault rural poverty and improve household food security (HFS).
- Increasing employment opportunities: Social development fund can play an important role in financing youth projects. Also, public works programs can reach the food insecure population by giving priority to the less developed regions. (Upper Egypt and border governorates).
- Giving credit to poor households provide liquid money for the development of small projects to raise their income (chicken, farm, diary production etc.) also for personal consumption. Poor women head of household should be given equal access to credit facilities exactly as men.
- Increasing household nutritional awareness which results in improving nutritional levels and intra-family food distribution, with emphasis on mothers and children.
Theme3: Protecting Consumers through Improved Food Quality and Safety
- Institutional restructuring:
Formulation of food safety council. The council can lead the coordinating task of different concerned agencies. Different specific working groups could be formulated by the council including technical persons from different concerned agencies, business people from the food industry and non governmental organizations (NGOs). The council can refer to the interministerial committee for decision makers.
- Reviewing and updating legislation:
Legal advisers of different concerned agencies should cooperate with technical key persons and work together for updating laws and regulations clarifying the responsibilities of each agency.
- Monitoring and information system:
Programs of routine collection of samples from the market could reflect the present status and help the council to take the quick suitable actions in due time.
- Quality assurance in food processing and quality control:
Industry should be aware of the different elements of quality assurance system and its application to prevent contamination of foods during production, processing and storage. Build a partnership between different kinds of laboratories in the area of standard and quality assurance of analytical and administrative topics.
- Good agricultural practices:
Continuous educational programs for farmers to protect the food crops from being contaminated with different types of contaminants and also to keep the quality and nutritive value of different food crops. Advanced post harvest techniques should be developed.
- Establishing a monitoring system for food born diseases.
- Promotion of consumer awareness:
An effective food control infrastructure must include effective educational programs. These programs should cover food quality, safety and nutrition in an integrated fashion. Such programs should be designed to assure that consumers have sufficient information on how to feed themselves adequately and safely and protect themselves against food related problems.
The programs should also be evaluated to determine how effective they have been in achieving their goals.
In Egypt, appropriate measures have already been taken in concerned ministries.
Ministry of Education (MOE)
Ministry of Information (MOI)
Ministry of Agriculture (MOA)
Ministry of Health (MOH)
All these programs are implemented without coordination. This could be one of the important tasks of the working groups.
- Design a program for upgrading the street food vendors sector.
- Encouraging the role of the consumer protection society.
- Supply of safe water.
- Participation of the country in Codex to food safety has to be strengthened.
Theme4: Preventing and Managing Infectious Disease.
- General Measures:
- Sanitary environment: potable water supply, proper sewage disposal, food control in addition to improvement of the infrastructure.
- Proper feeding and adequate nutrition including breast feeding for health promotion.
- Health education as regards mode of transmission, immunization and other measures for prevention.
- Specific Measures:
- Increase immunization coverage for the vaccine preventable disease.
- Early detection and prompt treatment of infectious diseases.
- Appropriate dietary management of the case during illness. Rehydration in diarrhea and Vit. A supplements to case of measle, ART, and acute diarrhea.
- Control measures of communicable disease should be conducted for cases, contacts, carriers and environment.
- Disease surveillance.
Theme5: Promoting Breast Feeding
- Upgrading the performance of health care facilities by training of human resources in the field of B. F. and provide them with training curriculum, training materials and equipments. Trained staff should be of an adequate number, under constant guidance, supervision and evaluation.
- Creation of popular awareness towards importance of B.F. by
- Formulation of local committee for B.F. in all governorates.
- Disseminating the national B.F. policy to all governorates.
- Formulating mass media messages on benefits and advantages of B.F.
- Establishing new branches of Egyptian Breast Feeding Friends Society in governorates.
- Community participation through mother support groups.
- Decreasing the market impact on distribution and consumption of milk substitutes.
- Increase the free paid maternity leave from 3 months to 6 months with full or partial salary at least 4 months by legislation.
- Completing the activities of baby friendly hospital initiative in PHC unit and other health care facilities.
- Issuing measures to control milk distribution through the Egyptian code of marketing breast milk substitutes.
- In the field of information:
- Preparation of a nation wide information programs in the field of B.F.
- Health education programs on B. F. in PHC units and other health care facilities.
- Advertising campaign to disseminate the national policy of B.F. promotion and protection.
Theme6: Caring for the Socio-economic Deprived and Nutritionally Vulnerable
- Infants and young children:
i. Adoption of breast feeding policy.
ii. Proper child feeding and weaning practices through an appropriate nutrition education programs at MCH centers. Agriculture Extension services, formal and non-formal education and mass media.
iii. Health care services to be provided to infants and young children to ensure proper growth and development. This includes growth monitoring, immunization, health education, provision of supplements, treatment of infections and parasites and nutrition rehabilitation for the undernourished.
i. Antenatal care, provision of supplements during pregnancy and lactation, health and nutrition education as well as family planning services.
ii. Social support of women to cope with stressful situations, through various safety nets, help them with income generating activities and with access to training and credit.
iii. Recognizing the rights and needs of women in education, employment, earning income, decisions making and protection from heavy work load.
- School children
i. School feeding programs should cover all primary school children specially those in rural areas.
ii. Health care should be provided as well to ensure proper growth and development, well being and productive life later on.
- Other groups:
i. Encourage all forms of community participation to eliminate hunger and malnutrition particularly in rural areas through proper organization of agricultural, social and income earning activities.
ii. Integration of health care services for elderly people into system of PHC to combat nutritional disorders among them.
iii. The disabled should be supported and helped to cope with disabilities and skills training.
iv. Identification and Social.
v. NGOs can play an important role in identifying and supporting the nutritional vulnerable groups and families.
Theme7: Preventing and Controlling Specific Micronutrient Deficiencies
- Supplementation of high risk groups for prevention & treatment
- Prevention & control of infectious diseases (viral, bacterial and parasitic).
- Fortification education considering the following:
- Promote consumption of iron, vitamin C and protein rich sources.
- Reduce consumption of tannins and phytic acid sources which decrease absorption of iron.
- Fortification of salt with iodine at the national level for both human and animal consumption.
- Prevention and treatment of target groups in areas of severe affection using iodized oil orally which gives 1-2 years protection.
- Nutrition education to promote use of iodizes salt, consumption of iodine rich food sources (fish- milk- egg and dairy products) and avoidance of goitrogenic foods (cabbage- onion).
III. Vitamin A
- National survey on children aged 6-72 months to determine magnitude of vitamin A deficiency problem in Egypt.
- Supplementation of vitamin A capsules to high risk children (6 Months-72Months) and to lactating women.
- Nutrition education in primary health care centers and mass media for dietary diversification to promote of vitamin A intake according to RDA, from available sources in the community.
Theme8: Promoting Appropriate diets and Healthy Life Styles.
- Early detection of hypertension by routine measuring of blood pressure in outpatient clinics, preparatory and secondary school, universities when they first join and annually. The same thing might be done among governmental and private sector employees particularly, at risk groups.
- Early detection of diabetes by routine urine analysis in schools, universities and among employees and in particular pregnants to avoid maternal complications and perinatal complications in infants of diabetic mothers.
- Initiate action for appropriate management to prevent long-term complications of diabetes such as vision- threatening retinopathy and end-stage renal failure.
- Preparation of dietary guidelines to advise people, based on:
- Reduction of cholesterol intake below the average 300 mg for adults.
- Reduction of saturated fat in diet by its replacement with mono and poly unsaturated fad.
- To have fat energy ration between 20-30%.
And emphasize the following:
- Reduction of salt used in cooking.
- Not to use canned food and eat only fresh meats, vegetables, and fruits.
- Encourage eating white meats only. If red meat is used, it should be lean meat.
- To increase consumption of complex carbohydrate derived from vegetables, fruit, whole grains and legumes which are high in fibre.
- Prohibiting smoking in all governmental premises, hospitals, clinics.
- Encourage exercise for children and young adults and continue for all age groups which can play an active role in prevention and control of over weight, high blood pressure, hyperlipidemia and non-insulin dependent diabetes.
- Promoting and protection of breast-feeding.
- Controlling obesity as it is considered a major risk factor for the occurrence of non-insulin dependent diabetes.
- Disseminate information through:
- T.V sports & drama.
- Local newspapers.
- Family health file for every family including all the health details of each member of the family.
- Food labeling with nutrition information.
Theme9: Assessing Analyzing and Monitoring Nutrition Situation
v Study the results of the previous nutrition surveillance project conducted by FAO and nutrition unit of the Ministry Of Agriculture to be modified for setting the national surveillance system.
v Target groups:
- Newly born.
- Infants and preschool children.
- School children.
- Mother particularly pregnant and lactating women.
- Young adults particularly military recruits.
v Choice of representative sample.
v Collection of regular information:
- Nutritional status information:
- Weight, length/height.
- Positive clinical deficiency signs.
- Hb concentration.
- Determinants of nutritional status:
- Food availability.
- Food consumption.
- Food prices.
- Economic information.
- Infrastructure (non targeted nutrition intervention e. g water supply and sanitation).
- Morbidity rates of infectious diseases.
- Rate of breast feeding.
- Availability and utilization of health care facilities including rate of immunization coverage.
v Choice of indicators:
- Percentage of newborn with birth wt. < 2.5 kg
- Percentage of under -5 children with wt/A < -2 S.D.
- Percentage of under -5 children with ht/A < -2 S.D.
- Percentage of adult males and females with BMI >25
- Percentage of targets with systolic blood pressure > 140
- Percentage of targets with diastolic blood pressure > 90
- Prevalence rates of nutrition deficiency diseases.
- Percentage of prechoolers and pregnants with Hb < 11 gm %
- Percentage of nonpregnant mothers with Hb < 12 gm %
- Percentage of young adults with Hb < 13 gm %
- Percentage of targets with glucosuria.
- Dietary indicators (minimum food basket)
v Establishment of sentinel surveillance units in representative governorates in the suitable place mainly PHC units and Agriculture Extension units both working together in the assessment of nutrition situation. This should be connected to a central surveillance unit via the district and governorate levels.
v Formulation of a steering committee to administer the surveillances system from the Ministry Of Health and Ministry Of Agriculture and nutrition experts from universities and research centers.
The steering committee will refer directly to the interministerial committee for proposals to decision makers. Feedback to the peripheral level is essential.