Transcript Capacity Development in Nutrition in Central and Eastern

Capacity Development in Nutrition
in Central and Eastern Europe
Mirjana Pavlovic, Fre Pepping, Arne Oshaug and
the participants from CEE countries
Joint meeting of SCN Working Groups on
“Capacity Development” and
“Nutrition, Ethics and Human Rights”
15th March 2006
Geneva , Switzerland
Report from the inaugural meeting of the Network on Capacity
Development nutrition in CEE countries
Background
Regional networks already exist in Asia, Latin
America, the Middle East and Southern Africa.
Thus the network in Central and Eastern
Europe is the newest network facilitated by the
UNU Food and Nutrition Programme and by
SCN.
The inaugural meeting took place in Budapest
on the13-14 February 2006, at the FAO SEUR
Office.
Participating countries
The meeting was attended by participants from
10 countries:
Bosnia and Herzegovina, Bulgaria, Czech Republic,
FYR Macedonia, Hungary, The Netherlands,
Norway, Romania, Serbia and Montenegro and
Slovakia.
Participants
 Lajos Biro, HU
 Katarina Chudikova,
SK
 Zlatka Dimitrovska,
MK
 Veselka Duleva, BG
 Aida Filipovic, BIH
 Mirjana Pavlovic,
SCG
 Jana Parizkova, CZ
 Camelia Parvan, RO
Facilitators
Fre Pepping, NL
 Arne Oshaug, NO
FAO provided support staff and engaged somewhat in the discussion
Objectives
The objectives of the meeting were to:
 Formally initiate the Network on Capacity Development for
the CEE countries within the capacity development initiatives
of SCN, UNU and other European research and training
institution.
 Present and discuss the profile of challenges identified by
participants.
 Identify follow-up activities in order to facilitate the initiatives
of the Network in the field of capacity development in the
CEE region.
 Identify strategic elements to meet the capacity development
plans of institutions and individuals in the region.
 Prepare a presentation of needs and strategies to be presented
at the 33rd session of SCN in Geneva, March 2006.
Some results
The main characteristics of nutrition and life style in
CEE countries
Foods and meal pattern
 Irregular meal pattern
 Low intake of certain food groups - particularly fruits and
vegetable, milk products and fish
 High intake of total fat (in particular saturated), sugar, and
salt
 Low intake of vitamins: folate/folic acid, and minerals e.g.
calcium, iron, iodine (except in countries having
programmes on salt iodisation) (Relevant for some
countries)
 High level of alcohol intake in some countries
 Low breastfeeding rates.
The main characteristics of nutrition and
life style in CEE countries (cont.)
Nutritional and life style related public health
problems
 High prevalence of NCD – hypertension, atherosclerosis, CHD, CVI,
certain cancers, diabetes mellitus, etc.
 High level of overweight and obesity.
 Dyslipidaemia.
 Low level of Haemoglobin, although some data are lacking.
 Generally low level physical activity, in particular in urban areas.
 Increasing osteoporosis in both genders, in particular with increased age.
 Eating disorders in certain groups may increase, in particular in younger
girls.
 Consumption mega doses of minerals and vitamins; lack of information
about risk of mega doses.
 High level of smoking.
Overview of challenges in CEE countries
1.
National nutrition action
plans
2.
Food based dietary
guidelines
3. RDA
4. National food database
5.
6.
7.
Nutrition information center
Training of professionals on
academic level
Education and promotion
(for the public)
1.
2.
3.
4.
5.
6.
7.
Bulgaria 2005, Macedonia 2004, Bosnia
(draft waiting approving), Hungary 2004,
Slovak Republic 1999, Rumania (draft
waiting approving), Czech Republic
(approved), Serbia & Montenegro (none).
Bulgaria, Macedonia, Bosnia, Hungary,
Slovak Republic, Czech Republic.
Bulgaria, Macedonia, Hungary, Slovak
Republic, Rumania, Czech Republic.
Bulgaria, Hungary , Slovak Republic,
Rumania, Czech Republic, Serbia &
Montenegro.
Not formalized.
Modest in many countries, few countries
have special education of nutritionists.
Mostly part of national action plans for
food and nutrition.
Is it adequate nutrition education and
training of professionals in CEE countries?
The gap in capacity in nutrition education is major challenge. Those
challenges included:
 inadequate/insufficient
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knowledge of nutrition among medical specialists.
international training in modern nutritional epidemiology.
international training in modern clinical nutrition.
training of nutrition in schools and universities.
knowledge of nutrition in the population.
education and curricula of nutrition in medical faculties e.g. incorporated in
hygiene. Nutrition is now considered to be a part of specialization in hygiene.
 knowledge of nutrition among health professionals working with the population.
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Nutrition is only a part of other trainings (mentioned earlier).
Lack of ‘pure’ nutrition education at academic level.
Lack of in-service training of nutrition.
Lack of methodological approaches and software for data collection,
assessment and analyses.
Political dimensions-Governmental level
(resistance or neglect of addressing nutrition issues)
 Engagement of ministries and public agencies in food, dietary
and nutrition related issues is lacking due to lack of funds
(official explanation).
 Lack of a national nutrition strategy, or action plan (e.g. based
on WHO Global Strategy on Diet and Physical Activity, or
Food and Nutrition Action Plan for Europe), except Hungary
and Bulgaria.
 Lack of contact and collaboration between responsible
ministries (e.g. Ministry of Health, Agriculture, Education, and
Research) and institutions working in the field of nutrition
(except for Bulgaria and Hungary).
 Lack of coordinated activities at national and regional level in
nutrition and nutritional status monitoring (except Bulgaria
and Macedonia).
Possible elements of a common strategy for the network and
possible actions for improvement of capacity development in
CEE countries
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Continue/start developing national food and nutrition policies and
action plans
Standardize education and training programs in nutrition for medical
professionals (undergraduate and postgraduate studies)
Need common training courses for relevant professionals within
health, food and nutrition in CEE countries
Need mass media in nutrition, health and lifestyle modification
Need promotion of food and nutrition at all levels (including
incorporate nutrition in the curricula of elementary and high schools)
Stimulate school canteens to improve nutrition quality of school
meals
Standardisation and collaboration on recommended dietary
allowances (RDA) in Europe
Possible elements of a common strategy for the network and
possible actions for improvement of capacity development in
CEE countries (cont.)
 Harmonize research, evaluation and monitoring of the
nutrition situation in the region
 Develop dietary guidelines for different population groups
 Collaborate with the food industry to produce healthier
products
 Conduct specific programs to prevent obesity, noncommunicable diseases and micronutrient deficiencies
 Get support from the UN, such as the UNU, FAO, UNICEF
and WHO to the network
 Establish relevant internet web pages/modules for exchange
and collaboration between countries in the CEE.
 One example is the Food and Nutrition Agro Web Network in CEE
Countries (http://agrowebcee.net)
Framework for analyzing actors and responsibilities
in nutrition in CEE
Levels
Governmental:
1
Primarily MoH, and MoA, MoT(E), MoST,
MoE, MoWSA, MoLD.
Policy makers/civil servants, Parliament,
local level authorities
Institutional:
2
Health and research institutions (including statistical),
clinics (medical doctors, public health specialists,
dietitians, nurses, food controllers), agriculture
extension, hygiene
Educational:
3
Universities, faculties, scientific academies, institutions/
departments, scientists, researchers, professors, primary
and secondary, school teachers, kindergarten personnel,
catering staff
Community:
4
Main responsibility
Actors
Farmers, cooperatives, industry/business
Mass media (public and private)
NGO’s, professional associations
Families, individuals
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Policy development (food security,
nutrition, health, training), decision
making, legislation for protecting and
supporting the human right to adequate food
National plans of actions
Funding
Monitoring and evaluation
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Implement policies
Providing expertise and advisory function
Evidence base (research) in nutr.
Maintain and develop staffs’ capacity
Adapt strategies to local needs
Monitoring and evaluation
Provide feedback to ministries
International collaboration/networking
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Implement policies on education
Provide and support staff development
Base education/training on local needs
Evaluate education/training
Provide feedback to ministries
Engage in international collaboration
Publishing education material
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Production of safe healthy foods, responsible
marketing
Promotion of healthy nutrition
Positive role models in healthy eating
patterns and life style
Making informed choices
Promotion of consumers’ rights
Availability of desirable food at acceptable prices
Compliances to legislation
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Framework for capacity development
in nutrition in CEE
Levels
1
2
Needs
• Political commitment
• Food and nutrition policies
• Develop nutritional action plan
• Reinforcing scientific evidence for increased awareness
• Strengthen capacity building
• Support for capacity development
• Adequate human resources (including knowledge)
• Most recent equipment, methodology and relevant standards
• Adequate facilities and organizational structure
• Transforming national policies to needs of various groups
• Updated/approximation of legislation on food and nutrition
Strategies/activities
•Lobby for political support for needs of
nutrition policy and national action plan
•Lobby for funding of national capacity development
•Monitor for government accountability
•Information/education of politicians/parliamentarians
•Requesting increased communication between line
ministries
•Terms of reference/job description - updates
•Promote staff development by academic education and
training in nutr./health (incl. in-service)
•Monitoring dietary intake/nutritional health status
•Exchange of experience (national/international)
•Communication and dissemination of scientific results
on nutritional health
•Establishing and using food database (software)
3
•Adequate institutional capacity (human resources)
•Research equipment, apply recognized methodologies and standards
•Adequate facilities and organizational structures
•Take account of relevant national policies
•Updated/approximation of legislation on food and nutrition
•Establish academic institution for nutrition training
•Develop curricula at each level of education
•Accreditation and certification of higher training activities
•Conformity of catering serviced to nutrition demands
•Harmonization/approximation of EU requirements of
the educational system according to the Bologna Process
•Preparing nutrition training and education material
•Establish training courses for professionals with
international collaboration
•Promote/update a web-based food and nutrition network
•Disseminate research results to users
•Research to support FNAP
•Develop food database
4
•Scientific based information for food selection
•Food based dietary guidelines
•Sustainable and adequate food supply
•Information for informed individual choice for diets (use of labeling)
•Application of legislation for food labeling
•Nutrition promotion and education
•Collaborate with industry/business on responsible marketing
•Specific programmes targeting certain population groups
•Contribute articles on nutrition to media
Planning guidelines for capacity development in
nutrition in CEE
Challenges/
Problem areas
Levels
Food security
(WFS 1996)
Nutrition
1. Governmental
2. Institutional
• Engage in monitoring/
Prioritized
Strategies/activities
Lobby/advocacy for
food and nutrition
action plans
evaluation activities
• Promote staff development
• Argue for funding food
database
• Apply intern. accepted
methodologies
• Develop project proposals
for EU
3. Educational
4. Community
• Develop project proposals for EU
• Engage in food database develop.
• Initiate the support the FNAP
• Disseminate res. results to users
• Raise awareness of EUFIC on the
needs for training materials in
CEE languages
•Update a web-based food and
nutrition network
• Nutrition
promotion
(including media)
• Popularize scientific
findings adapted to
local challenges
and food habits
For all: Fund raising/networking/communication material
Duration
Short term
Medium/long term
Continuous
Some plans
 3rd meeting of core countries (plus 2-3 universities), November 2006
 Presentation of two specific themes, one suggested: ‘the human right to food’
 preparation of 1 or 2 proposals for funding of the Network activities. Goal to finalise Socrates
application to be submitted March 2007
 Involvement in new EC-programmes, such as
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EuroFIR
Harmony, depends on go/no-go
NuGO
European Federation of the Associations of Dieticians (EFAD)
 Increase participation in existing post graduate courses, for example
food databases (VELAG), epidemiology (Florence), the right to adequate
food (Norway)
 4th meeting of the core countries and universities would be considered
for the second half of 2007 depending on go/no-go for Socrates
programme(s) for 2006/2007. VLAG can offer:
 Regulation of food intake (10 – 13 April 2006)
 Management of food safety issues (18 – 22 September 2006)
 Nutrition and lifestyle epidemiology (June 2007)