Prevention of Micronutrient Deficiencies Tools for Policymakers and Public Health Workers (1998) / Chapter Skim
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From page 1... ...
The adverse sequelae of micronu~aient deficiencies are profound and include premature death, poor heals, blindness, growth stunting, mental retardation, leanling disabilities, and low work capacity. Worldwide attention first focused on the massive problem of micronu~ient malnutrition in the mid- to late 1980s.
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From page 2... ...
and multiple micronutrient deficiencies. To respond to USAID's request, the Board on International Health in consultation with the Food and Nutrition Board constituted an expert committee of eleven members with broad expertise related to micronutrient nutrition, diet, and health, especially as these relate to iron, vitamin A, and iodine, and to the conduct and evaluation of global micronutrient deficiency prevention programs.
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and international organizations with a programmatic interest in combating micronutrient deficiencies. Participants will discuss the implications of the report's findings and recommendations for fixture policy and action.
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Groups are in continuous movement along a continuum of nutritional risk, extending from a situation of severe micronutrient malnutrition, through a wide spectrum of presumed nutrient adequacy, to one of nutrient overload and toxicity at the upper end. The goal of micronutrient interventions should be to move at-risk groups within populations along a continuum from a state of public health risk or crisis, which occurs when deficiencies and their health consequences are widespread, to states of nutrient sufficiency and health.
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From page 5... ...
In addition, relatively few interventions have incorporated complementary public health control measures- for example, integrating dietary with supplementary measures or parasite control or the teaching of personal hygiene and sanitation practices in their approaches to the alleviation of micronutrient malnutrition. · Review of past programs reveals an almost total lack of attention in program design and implementation to the systematic collection of data on costs linked to program components and effectiveness of different interven tions.
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From page 6... ...
Because deficiency of a single micronutrient seldom occurs in isolation, often existing in the context of deprivation and multiple micronutrient deficiencies, plans for sustained intervention should consider interventions to target multiple deficiencies to the degree appropriate and feasible. Interventions should incorporate all four strategies supplementation, fortification, food-based approaches leading to dietary diversification, and complementary public health control measures again, to the degree appropriate and feasible.
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From page 7... ...
Furthermore, there is a proven, cost-effective IDD control intervention-universal ionization of salt-that should receive continued support, using oral iodine supplements to control the problem in limited, unyielding situations. Combining of nutritional interventions with other complementary public health measures is frequently necessary to eliminate deficiency of a specific micronutrient.
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From page 9... ...
Key elements of program information systems include: An ability to monitor sentinel aspects of performance at low cost and refine process and output in a way that provides timely and relevant feedback at each decisionmaking level ofthe program. A capability to monitor dietary intakes and micronutrient status over time, as needed, to detect changes in these key outcomes and to determine the level and stability of a population's risk so that interventions can be responsive to changes in need.
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From page 10... ...
As socioeconomic conditions gradually improve in many developing societies, it is likely that the private food industry will increasingly influence the nature and nutritional adequacy of the diets in these populations. Initiating constructive working relationships and instilling a sense of responsibility within the food industry are likely to yield stronger and more committed partnerships in preventing micronutrient deficiencies in the future.
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