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Addressing Nutrition Needs in the
Post-2015 Agenda
Eduarda Zandamela Mungói, Ph.D
Ministry of Industry and Trade
National Food Fortification Program
Johannesburg, South Africa
June 30, 2014
República de Moçambique ___________
Ministério da Saúde Ministério da Indústria e Comércio
OUTLINE
Overview of Nutrition Situation in
Mozambique
Food Fortification in Mozambique
Compliance Activities
Challenges
Next Steps
Conclusion
Nutrition Situation in Mozambique
About 36% of deaths in children under 5
years related to malmutrition;
14% of children have low birh weight;
37% of children receiving exclusive
breastfeeding until 6 months of age;
6% of children under 5 suffer from acute
malnutrition.
Only 36% of the children have access to an
adequate diet (MICS 2008)
.
DEFICIENCIES OF MICRONUTRIENTS
MOZAMBIQUE (MISAU, 2002, 2004)
Deficiencies of micronutrients like Vitamin
A, Iron and Iodine are very common and
have High prevalence in children under- five
years of age and women.
Iron aproximatelly 89% of children 6-24
months of age
Vitamin A about 69% of children 6-59
months of age
Iodine about 68% of children under 5 years
Nutrition Situation in Mozambique
55%
53%
45%
47%
44%
42%
36%
36%
27%
23%
23%
Chronic Malnutrition 43% (IDS, 2011)
Nampula
C Delgado
Zambézia
Niassa
Tete
Manica
Sofala
Inhambane
Gaza
Maputo P
Maputo C
Magnitude and impact of micronutrient
deficiencies in Mozambique
Source: Mozambique "Vitamin and Mineral Deficiency - UNICEF / MI 2003"
1,470 maternal deaths occur due to severe
anemia
14,000 child deaths are precipitated by
vitamin A deficiency
subclinical deficiency in children <6 years
estimated at 26%.
1,500 children are born with diseases
resulting from defects in the neural tube.
1 in 2 children suffer from chronic
malnutrition in Mozambique (MICS, 2008)
Geografic Distribution of Chronic Malnutrion & Food Insecurity & Agricultural Production
7
Food Insecurity Agricultural Production Chronic Malnutrition
Gaza
Manica
Tete
Niassa C. Delgado
Nampula
Zambézia
Inhambane
Maputo
Maputo cidade
Sofala
34
48
48
45 56
51
46
35
28
25
41
% Chronic Malnutrition
25 - 30 30 - 35 35 - 40 40 - 45 45 - 50 50 - 55 55 - 60
Maps show that areas of higher agricultural production has lower indices of food insecurity and higher chronic malnutrition
Actions to Reduce Chronic Malnutrition
8
Approval by the Council of Minister of the Multisectorial Plan for Reducing Chronic Malnutrition (PAMRDC).
OBJECTIVE OF THE
MULTISECTORIAL ACTION PLAN
9
0%
20%
40%
60%
IDS2003 MIC2008 IDS2011 Previsão
2015
Previsão
2020
48% 44% 43%
30%
20%
Chronic Malnutrition
Accelerate the reduction of chronic malnutrition in children under 5 years
from 44% in 2008 to 30% by 2015 and 20% in 2020.
Strategies against, control and prevention of the
Deficiencies of Micronutrients
Integrated Interventions
Supplementation
Public Health
Measures
Fortification
Dietary improvement
2000 2005 2010
Rel
ativ
e co
ntri
butio
n of
inte
rven
tions
to e
limin
ate
MN
D
INTEGRATED INTERVENTIONS
Suplementation
Public Health
Measures Fortification ̸
Biofortification
Dietary Improvement
•High Cost
•Short –medium
period
•Low Costs
•Long period -sustainables
Food Fortification:
Simple Process their success depends on the
correct selection of food to be used as a
vehicle for fortification and the type of
compound or micronutrient to be added.
Strategy more cost-effective and sustainable
prevention of multiple micronutrient
deficiencies
Being the food industry the focus of
activities for adding micro nutrients
Biofortification:
Biofortification: breeding crops to increase their
nutritional value.
Develop basic rich crops (staple) in order to achieve
micronutrient is the provitamin A, and the
concentrations of iron and zinc, from deficiency of
these micronutrients and with a view to improving
the nutritional status of the population.
Easy reach rural populations in situations of
malnutrition
- Intervention low cost
- No recurring costs beyond the cost of maintenance
of varieties
Mozambique Interventions for
prevention of micronutrient
deficiencies
Prevention of macrounient deficiencies
Salt Iodization
Industrial Food
Fortification
Bio fortification
The home Food Fortification (nutritional
supplements)
Food and nutrition Education
Promotion of breastfeeding
Nutritional Supplementation
(Health Week)
FOOD FORTIFICATION IN
MOZAMBIQUE:
The National Committee for Food
Fortification in Mozambique (CONFAM)
was created in April 2010 and Official
launched in March 2012, and is fully
operational.
The terms of reference and the Fortification
Program are approved by the Ministers
The Committee was Official approved by the
Ministerial Diplom
Ministry of Industry and Commerce
Production & Industry
Legislation &Quality Control
/ Assurance
Advocacy, Social Marketing &
Communication
Performance Monitoring &
Evaluation
Ministry of Health
Ministry of Industry
and Trade
MoAgriculture
Customs, WFP,
UNIDO, WV,
Industry
Association,
Confederation of
Economic
Associations
Costums, Economic Activities Institute,
INNOQ, MoH (LNHAA), MoA, WFP, USAID, UNICEF, HKI
SETSAN, MoH, MoIndustry and
Commerce, USAID, UNICEF, HKI, PSI, WV, Consumers Defence
Association
One focal point from each one of
the 3 working group
National Committee for Food
Fortification (CONFAM)
FOOD FORTIFICATION IN
MOZAMBIQUE:
Mozambique is benefit by the GAIN funding for
a four year fortification Program (2011-2015),
two new donors, Danida and Irish Aid
The Program was draft and adopted by
CONFAM
The project was approved in February/2011
HKI is the Executy Agency
Vehicles (wheat flour, edible oils) and
micronutrients have been identified for 1st phase
– Oil (vit A); wheat (NaFeEDTA, Zn, B12,
Folic Acid)
Successes :
CONFAM membership is growing and now counts
regular participation by line Ministries, private
sector, agencies, development partners and
producers.
Food Fortification is part of Multisectorial Action
Plan for the Reduction of Chronic Undernutrition
in Mozambique 2011 – 2014(20) Approved by
Ministers Council
Additional donors have shown interest in
contributing to the program
Successes :
The commitment to fortification among key
stakeholders, including millers and oil producers,
is still growing strongly
Development of the Mozambican standards for
fortification ( Wheat Flour, Wheat maize and
edible oils) in line with the WHO recommendations
and harmonized in the region. The standards was
published in March 2013.
Challenges:
Irregular participation of some key stakeholders
(Consumers Defense Association)
Sensitivity of the flour and bread sector in light
of public protests against increase in prices in
September 2010
Ensuring sustainability of a food fortification
program (stakeholder’s commitment and funding)
Changes of staff in Government body
Inclusion in the market of new companies that were
not budgeted in the project.
Industry will not start fortifying until its mandatory
by law
NEXT STEPS :
Official approval of food fortification
strategy and related legislation
Preparation of baseline study on VAD
and IDA
Industry assesssments
Establishment of miller association
Continue participation of Mozambique
in ECSA and other events more
strongly
NEXT STEPS :
Workshop to disseminate FF Strategy and
Gain Project and other opportunities
Development of standards, regulations
and QC
Mobilization & Social Marketing
Development of fortification law
Development of revolving fund
mechanism for premix
Preparation to start sugar, maize and
cassava flour fortification
LESSON LEARN :
From the project proposal and the
implementation new industries appear in the
pictures. (awareness, incentives)
Question that industry always ask is how
much is going to cost (awareness, incentives)
They will only start fortifying when it
becomes mandatory by law.
For the premix the industry prefer to buy it
from the thrird party that consolidates all
requirements
THANK YOU!!!
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