Nutrition capacity development in the middle East and North Africa

The Middle East and North African Nutrition Capacity Development Initiative started in July 2004 as a component of a global initiative spearheaded by UNU and IUNS for development of human and institutional capacity in nutrition. The Middle East and North Africa Nutrition Association [MENANA] was established as an affiliated body to IUNS and took responsibility for identifying core areas for nutrition capacity building in the region. The members adopted a "new conceptual framework for planning nutrition capacity development activities within a comprehensive ten-year plan of action, using a new Conceptual Framework and Guideline for Nutrition Capacity Development Planning developed by Dr. Gohar for use by the MENANA members. A future vision for food security was agreed upon, supported by a prioritized plan of action. The member found that Regional research capacity needs strengthening to address the role of nutrition in prevention of diet related diseases and combating .malnutrition, including micronutrient deficiencies. Mapping research centers in the region was the first task decided to be undertaken by MENANA. Nutrition training to strengthen regional skills of nutritionists has been planned. Nutrition academic education and accreditation of dieticians was discussed, and a regional accreditation examination for dietitians established by MENANA. In the area of nutrition advocacy/education communication, a steering committee was established to organize workshops to enhance regional advocacy. Nutrition networking was planned to strengthen regional inter-country collaboration and cooperation for nutrition capacity building. The selected priorities were supported by the establishment of a regional Nutrition Capacity Building website to include a database of nutritionists in the region, their affiliations and field of interest. A matrix of selected, simple and sensitive nutrition status indicators was planned to be published in the website for the purpose of monitoring regional nutrition status. The website will also provide information services to nutrition professionals in the region and will be linked to important updated nutrition information

Consumer perceptions and constraints regarding iron deficiency anemia and flour fortification using focos group discussion technique

Bread is staple food and also sacral food item in the Egyptian diet. Any Change in its content or characteristics may be a very sensitive issue. Therefore consumer perceptions toward fortification of baladi bread with iron must be carefully taken into consideration. Consumer perceptions regarding anemia and fortification were investigated using focus group discussion technique. Eleven focus groups were conducted in Fayoum among different target groups [university students "males, females and mixed", physicians, nurses, teachers "males and females" NGO's leaders, illiterate housewives and consumer protection committee]. The discussion included, their perceptions towards nutritional disorders, priority of iron deficiency anemia and its impact on health, methods of prevention and flour fortification with iron alone versus iron plus vitamins and mineral. The main results of the discussion were as follows: Some consumers believed that anemia doesn't affect more than l0%of the population while others thought that around 70% of the population mainly the poor or rural residents are affected.-The impact of anemia on health varies according to the gender of consumer target groups female consumers stressed the importance of its impact an beauty while male consumers stressed the importance of its impact on power and reproduction. The majority of the target groups supported flour fortification with iron as a cheap and easily administered method for prevention of iron deficiency anemia. Nevertheless this support was given with some suspicion toward iron [perceived as a chemical product added to their sacred bread]. The main perceptions varied from suspect of harmful effects on health, suspected changes in loaf characteristics, or suspicions toward the efficacy of quality assurance techniques. Almost the consumers refuse to give a new name to the fortified bread but they did prefer the use of iron plus vitamins and minerals. The consumers appreciated that the government has taken their views and perceptions into consideration

Social marketing strategy for promotion of iodized salt in Egypt

Despite the fact that the iodized salt program has been implemented in Egypt since 1996, yet Egypt health Demographic survey [DHS/2001] revealed that household iodized consumption at the national level was only [56%]. One of the main reasons behind such a low figure is lack of consumer awareness. Accordingly the National Nutrition Institute NNI [in collaboration with MOHP /UNICEF Egypt] planned and implemented a marketing strategy to demonstrate its impact in creating consumer demand for use of iodized salt in two Egyptian governorates with the least household consumption levels [Gharbia and Fayoum]. A Qualitative study using focus group discussion technique was carried out followed by development of educational communication materials. Social marketing activities included; advocacy and orientation meetings- local committee formulation- training of community volunteers- two launching meetings for the campaign- promotional communication activities in [schools, health centers, agricultural extension units, religious sites and mass media channels]. Monitoring and evaluation of the social marketing campaign activities was made. A field survey of the iodized salt status at retail and household levels at the end of the campaign showed improvement by almost 1.6 times in Gharbia and 2.5 times in Fayoum. It was concluded that using a social marketing approach for promotion of the iodized salt program is an important and effective strategy, which should be expanded in other Egyptian governorates together with legislation and control of illegal salt availability at market level and increased provision of iodized salt availability for consumer purchase

Effect of nutrition and social factors on menarcheal age among Egyptian adolescent girls

The aim of this study was to determine the nutritional and social factors affecting age at menarche. In a cross sectional analytical study, 2021 adolescent girls aged [11-18 years] were surveyed in six different governorates. Age at menarche was estimated by the recall method and given by the study participants. A questionnaire was designed to collect information about education of girls, family size, number of rooms, parent's education and occupation. Anthropometric measures [weights and heights] were done. Food intake was determined by using 24 hours recall method. Adolescent girls were grouped into three levels according to social characteristics regarding the education and occupation of their parents. Crowdness index was calculated by dividing the family members over the number of rooms. Weights and heights were computed in accordance with age and compared with WHO [1995] percentiles of BMI/age. It was found that 67.2% of the sample had commenced menarche. The mean age for girls at menarche was 12.9 +/- 1.3 years. Among the non menstruating girls 13.1%were under weights. While among the menstruating 19.4%were over weights and 10% obese. The mean percentile of body mass index/age was significantly higher among the menstruating girls [p=0.00].Girls with high level of education commenced menses significantly earlier.[p=0.00] Family size,crowdness index, social levels showed no significant differences between pre and postmenarcheal girls. The total caloric intake and total protein intake were consumed by a higher percentage among girls who experienced menses though not significant. Intake of Micronutrients, retinol, iron and calcium were below the reference values by all girls suspecting under nutrition problems namely vit A deficiency, calcium deficiency problems and iron deficiency anemia. The mean age of menarche in Egypt is [12.9 +/- 1.3] years. Better nutrition on a balanced diet, girls education are important predictors for age at menarche