sharing experiences on gender, food security and nutrition ktontisirin

8/22/2019 Sharing Experiences on Gender, Food Security and Nutrition KTontisirin

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Sharing experiences on gender,

food securit and nutritionin the region/sub-region in

intervention

Prof. Kraisid Tontisirin, M.D., PhD

Senior Advisor, Insti tute of Nutri tion,

Mahidol University, Thailand

Former Director, Nutrition and

Consumer Protection, FAO, Rome, Italy

ADB/FAOAsiaandPacificRegionalConsultation

24July2013

The views expressed in this paper are the views of the authors and do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or thegovernments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. The countries listed in thispaper do not imply any view on ADB's part as to sovereignty or independent status or necessarily conform to ADB's terminology.


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romo onPreventionTreatment

Food Nutrition HealthFood supplyFood service

Nutrition is a link between food and health,

regarding the fulfil lment of energy, protein and

micronutrient requirements from food throughout

-

being for allKraisid Tontisirin, Mahidol University


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Food and nutrition security*Food and nutrition security*

Food and nutrition security exists when

,

economics access to food, which is safe and

consume n su c en quan y an qua y o

meet theirdietary needs and food preferences,

and is supported by an environment of

adequate sanitation, health services and cares,

Kraisid Tontis irin, Mahidol Universityallowing for a healthy and active life.

*From FAO CFS 2012


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Food and nutrition challen esContinuingandpersistentundernutrition

Undernourished

(protein

and

energy

deficiency)

inmothers,childrenandadults:foodinsecurity

Micronutrientdeficiencies:ofiron,iodine,vit.A

andothers:poordietsandfrequentinfection

Overweight&obesity

,

,

highbloodpressure,cardiovasculardiseases

Foodsafety

and

quality

Kraisid Tontisirin, Mahidol University


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Undernourishment in 2010, by region (millions)Undernourishment in 2010, by region (millions)


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Re ublic of Korea

Thailand

Nauru

New Zealand

Japan

Austral ia

Non-pregnant women

Pregnant women

% prevalence

China

Palau

Cook Islands

Seychelles

Singapore

Timor Lestein women

Samoa

Tuvalu

American Samoa

Vietnam

Niue

Sri Lanka

Countries

Kiribati

Malaysia

Marshall Islands

Micronesia

Mongolia

DPR Korea

Myanmar

Bangladesh

Indonesia

Philippines

Pakistan

Brunei Darussalam

Lao PDR

Fiji

Maldives

Papua New Guinea

Solomon Islands

India

0 10 20 30 40 50 60 70 80

Nepal

Cambodia

French Polynesia

Vanuatu

(From WHO: SEARO & WPRO, 2007)


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Nepal (2001)

Maldives (2001)

Sri Lanka (2000)

Cambodia (2000)

Bangladesh (1998)

India (1999)

% prevalence

Bhutan (1999)

Myanmar (2000)

Philippines (2000)

Lao PDR (1998)

Micronesia (2000)

N.Mariana Islands (2000)o ow rweight (2.5 Kg)

Singapore (2004)

Thailand (2001)

Fiji (1996)

Malaysia (2004)

Papua New Guinea (2002)

Timor-Leste (2002)

Marshall Islands (1999)

in Asia Pacificcountries

New Zealand (2003)

Guam (2004)

Kiribati (2002)

Indonesia (2002)

Japan (2004)

Palau (1998)

Tuvalu (2000)

Australia (2003)

Viet Nam (2004)

Brunei Darussalam (2003)

DPR Korea (2002)

French Polynesia (2001)

ew a e on a

Samoa (2004)

American Samoa (2004)

Tonga (2002)

Vanuatu (2003)

Korean Republi c (2004)Mongolia (2004)

0 5 10 15 20 25 30

Niue (2005)

Tokelau (2003)

China (2002)

oo s an s

Prevalence (%)

WPRO, 2007)


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Bangladesh

Cambodia

Indonesia

% prevalence

Marshall Islands

Lao PDR

Timor Leste

Nepalamong Under

Philippines

DPR Korea

India

Bhutan

in Asia Pacific

Vanuatu

Maldives

Myanmar

Vietnam

Sri Lanka

Malaysia

Thailand

China

Samoa

Solomon Islands

Brunei Darussalam

From WHO: SEARO &

0 5 10 15 20 25 30 35 40 45 50

Tonga

Singapore

Fiji

WPRO, 2007)


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Nepal

Cambodia

India

Bangladesh

%Prevalence of

Marshall Islands

Lao PDR

Papua New Guinea

Timor Lesteamong Under five

children in Asia

Sri Lanka

Vietnam

Myanmar

Philippines

Pacific countries

Bhutan

DPR Korea

Maldives

Indonesia

Thailand

China

Malaysia

Vanuatu

Republic of Korea

New Caledonia

Singapore

Fiji

0 10 20 30 40 50 60

Palau

Solomon Islands

Samoa

(From WHO: SEARO & WPRO, 2007)


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The Millennium Development Goals

MDGsMDGs

achievedachieved

improvementimprovement

Kraisid Tontis irin , Mahidol University


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Trends in Preschool Child Malnutrition (weight for age)



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Elimination of undernutrition: a global deficit and priorities*

*ACC/SCN 1999 Kraisid Tontisirin, Mahidol University


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THAILANDS DEVELOPMENT PLANS

1961

1st NEDP : Economic Infrastructure

19662nd NEDP

Sectoral Plans

1976

3rd NEDP

1981

5th NESDP

: oc a an+Food and Nut. Plan, PHC

: + Poverty Alleviation Plan (PAP)

1986

6th NESDP

n ca ors

1996

7th NESDP

Kraisid Tontis irin, Mahidol University


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Poverty Alleviation Plan (PAP) from 1982 on ward

malnutrition was considered as symptom of poverty with or anization chan es for mana ement

of rural development

wit new 5 asic princip es

PAP

Fd/Nut.Prog.PHC BMN indicators



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Forging the Link Between

Government and Community



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Community-Based Approaches Isaninte rated ro ram im lemented

atlocal

level

(district

level

and

below)

National commitment withsoundnutrition

improvementstrategies

and

goals

Community actions : basicservices,mass

mobilization,mutual

efforts/actions

to

reach

allpeopleandtopreventmalnutrition



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ComponentsofaSuccessfulCommunityBasedProgramComponentsofaSuccessfulCommunityBasedProgram

(Health, Education, Agr. Extension)

Support ive System

Menus (Activities)Facilitators

TrainingFundingProblem Solving

Interface

(Service providers and

GMP: BF, CF & caresGMP: BF, CF & caresFood productionFood production

Nutrit ion educationNutrit ion education

Food sanitation &Food sanitation &safetysafety

School lunch (SLP)School lunch (SLP)

Plan/goalsImplementationMonitoring/evaluation

Community Leaders

Family

Individual

programmesprogrammesOther activi tiesOther activi ties

(1:10 households)

Basic

Minimum

Needs

Goals/IndicatorsKraisid Tontisirin, Mahidol University


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MainCausesofChildMalnutrition

PoormaternalnutritionandhealthleadingtoLBWof

newborn,

low

milk

quality

and

quantity

In

adequate

and

in

appropriate

compl.feeding PoorsanitationinIYCfeedingandcares

. .

infection

Undesirableeatinghabits



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MenuActivityonANCsopreven

ma erna

mor y

an

mor a y,

an

Highrisk

check

up

and

treatment

on or ngw .ga n

Nutritionand

health

education

Foodsupplementation

MTV iron and folate su lementation

Twotetanustoxoids

e erra sys eman sa e e veryserv ce



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Kanom Toob tub

Gra ya sart(Thai sweet rice with peanut and sesame)

IngredientsIngredientsIngredientsIngredients

- Peanuts

Sesame

our

Peanuts

Sugar Sugar



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IngredientsIngredients

RiceRiceflakeflake Dried shrimpDried shrimp

Dried peanutDried peanut

Dried bean curdDried bean curd

Shredded Rice Grain()Kraisid Tontisirin, Mahidol University


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MenuonGrowthMonitoringand

Monthlyorquarterlymonitoringwt.&ht.andtakeremedyactions

Child

growth

education

and

cares BreastfeedingandComplementaryfeeding

Immunization

Village

based

food

production

(+CF

for

IYC

and

supplementary

food

ormo ers

Healthandnutritioneducation

Treatmentofmalnourishedchild



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CommunityFoodProduction

Homeandschoolgardens growing

vegetables,fruits,

fishes

and

chicken

for

learning,consumptionandincome

Supplementaryfoodforpregnantmothers

ComplementaryfoodforIYC

techniques

Cooperativeandmicrocredit



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Table 1 Suggested complementary feeding

complementary feeding guide-lines)

From Tontisir in, Ped Nutr in Practice, 2008Kraisid Tontisirin, Mahidol University


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Maternalandchildhealthandnutrition

a a n ,

ANC coverage % 35 75 95

Anemia in preg. % 50-75 18.8 10

PEM (Wt/Age of U 5)% 51 20


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Prevalencesofstunting,wasting,overweight,

%

Stunting Wasting Overweight Obesity

Aekplakorn W, et al. NHES4, 2008-2009.


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Trendofnutritionalstatusofchildren

%

Stunting Underweight Overweight&Obesity

NHES2;

Holistic

Development

of

Thai

Children;

NFNS

5;

NHES

4


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Ensuringgenderequality

Femaleequalityisafundamentalandessentialfor food

and

nutrition

security.

fromagriculture,food,nutritionandhealthat

householdand

community

level

Femaleneedsequalopportunityinnutrition,education,developmentandjobopportunity

Female,as

awell

equipped

mother

with

knowledge

and

skillswillleadtonutritionwellbeingtoallfamily

members



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peopleparticipation

at

community

level

is

crucialforhi hcovera eandeffectiveactions

Nutritionindicatorsaremostuseful

for

oalsettin

and

follow

u

actions

i.e.birthweight,underweightof

under5 stuntin wei htforhei htandBod

MassIndex

(BMI)



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Rolesoffemaleinachievingfoodandnutritionsecurityhavebeenrecognizedasover5060%

ofserviceprovidersaswellasvillagevolunteersarefemaleworkingwithcommunity

leaders

to

reach

the

unreached.

Thailandasacountrywithsuccessstoryisproudtosharelessonslearnttoother

countrieshow

to

alleviate

malnutrition

and

promotegenderequality.



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Thank You

For Your Attention

sharing experiences on gender, food security and nutrition ktontisirin

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