Transcript Developing a societal plan to prevent childhood obesity

Experiences with community based
nutrition programs in Thailand
Prof. Kraisid Tontisirin
Institute of Nutrition, Mahidol University & Former
Director of Nutrition and Consumer Protection, FAO.
Presentation at the 4th National Seminar on Food Security and Nutrition
Under the theme: “Child and Maternal Nutrition”
Phnom Penh, Cambodia, 21-22 May 2012
Service Driven Programmes
Vertical, many become
welfare oriented
Little intra/inter sectoral
coordination
Little people /community
participation
Individual
Family
Community
Dependency creation
Not sustainable
Inadequate coverage
Kraisid Tontisirin, Mahidol University
Elimination of undernutrition: a global deficit and priorities*
*ACC/SCN 1999
Kraisid Tontisirin, Mahidol University
• Agriculture/
• Food supply/
• Service
Food
Nutrition
Health
• Promotion
• Protection
• Treatment
Nutrition is a link between food and health,
regarding the fulfillment of nutrient and non-nutrient
requirements from food in human life cycle.
Ultimate Goals
Food and Nutrition Security for All
Leading to Good Health and Well-being
Kraisid Tontisirin, Mahidol University
Main Causes of Child Malnutrition
• Maternal poor nutrition and health lead to
LBW of newborn, low milk quality and quality
• Declining of BF practices
• In adequate and in appropriate CF
• Poor sanitation in IYC feeding and cares
• Recurrent of illness i.e. diarrhea and
respiratory tract infection
• Undesirable eating habits
Kraisid Tontisirin, Mahidol University
Community-Based Approaches
• Is an integrated program implemented
at local level (district level and below)
• National commitment with sound nutrition
improvement strategies and goals
• Community actions: basic services, mass
mobilization, mutual efforts/actions to reach
all people and to prevent malnutrition
Kraisid Tontisirin, Mahidol University
Components of a successful community based program
Minimum Basic Services
(Health, Education, Agr. Extension)
Menus (Activities)
•ANC
•GMP
•Food production
•Nutrition education
•Food sanitation &
safety
•Other activities
Supportive System
•Training
•Funding
•Problem Solving
•Supervision
Facilitators
Interface
(service providers and
community leaders)
•Plan/goals
•Implementation
•Monitoring/evaluation
Community Leaders
Family
Individual
Mobilizers
(1:10 households)
Basic Minimum Needs Goals/Indicators
Kraisid Tontisirin, Mahidol University
Menu Activity on ANC
(to prevent maternal morbidity and mortality, and LBW)
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•
•
•
•
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4 ANC visits for all pregnant mothers
High risk check up and treatment
monitoring wt. gain
Nutrition and health education
Food supplementation if needed
MTV, iron and folate supplementation
Two tetanus toxoids
Referral system and safe delivery service
Kraisid Tontisirin, Mahidol University
Menu on Growth Monitoring and
Promotion (GMP)
• Monthly or quarterly monitoring wt.& ht.
• Child growth education and cares
• Breastfeeding and CF
• Immunization
• Village based food production (+CF for IYC
and supplementary food for mothers)
• Health and nutrition education
• Cooking and feeding demonstration
• Treatment of malnourished child
• Referral of severe illness and malnutrition
Kraisid Tontisirin, Mahidol University
Community Food Production
• Home and school gardens growing
vegetables, fruits, fishes and chicken for
learning, consumption and income
• Supplementary food for pregnant mothers
• Complementary food for IYC
• food preservation and simple food
processing techniques
• Cooperative and micro credit
Kraisid Tontisirin, Mahidol University
Maternal and child health and nutrition
Thailand, 1980- 2006
1980
1990
2006
35
75
95
50-75
18.8
10
LBW %
16
10
<10
PEM (Wt/Age of U 5)%
51
20
<10
ANC coverage %
Anemia in preg. %
Kraisid Tontisirin, Mahidol University
Conclusion 1
• Interface of basic social services with strong people
participation at community level is crucial for prevention
and control of malnutrition.
• Village Health Volunteers (1 VHV per 10 HH) have been
proven to be effective. Current number of VHV are over
800,000.
• Nutrition indicators are most useful for goal setting and
follow up actions i.e. birth weight, under weight of
under 5, stunting, and weight for height
• Research and capacity development are essential to back
up the program
Kraisid Tontisirin, Mahidol University
...Thank you for your
attention...
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