Iodised salt, fortified flour: What are the next nutrition challenges?

Health officials and experts gathered at a regional forum in the Turkmen capital, Ashgabat, on 8 April to assess the achievements and challenges relating to mother and child nutrition in Central Asia.

Over 100 participants, including health officials from the five Central Asian countries - Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan - international health experts and representatives of donor agencies and the UN in Central Asia are attending the two-day event co-organised by the Turkmen government and the UN Children?™s Fund (UNICEF).

“This forum is really important for sharing experience among the Central Asian countries. Most of the countries are engaged in a whole range of interventions and policies to strengthen the care of children. Some of the countries have made significant progress in terms of, for example, interventions in micronutrients; they [the countries] are using iodised salt and fortified flour more,” Waheed Hassan, head of the UNICEF mission in Turkmenistan, told IRIN.

First held in 1997 in Almaty, Kazakhstan, the forum has served as a common platform for Central Asian governments to exchange knowledge and experiences in addressing the health issues of children and women.

The forum is also discussing health innovations and options that the governments could adopt to improve their health care systems and facilities, UNICEF said in a statement.

This year the annual event focuses on maternal and child nutrition and HIV/AIDS. Each country will review the progress made in improving the nutrition status of children and women and the strategies and initiatives that made this progress possible.

Key achievements

“Iodine deficiency disorder has been eliminated in Turkmenistan and Kazakhstan, and the other countries are close to achieving the goal,” Shahnaz Kianian-Firouzgar, deputy UNICEF regional director for Central and Eastern Europe and the Commonwealth of Independent States (CIS), said.

Turkmenistan achieved universal salt iodisation in 2004, the first CIS country and the fourth in the world to have done so in accordance with generally accepted international standards.

Photo: David Swanson/IRIN

In Kyrgyzstan, 98 percent of children under five have received Vitamin A

Kazakhstan has followed suit and 92 percent of the Kazakh population use adequately iodised salt. A national system for regular surveillance of adequate and sufficient food-grade iodised salt supplies to the highest at-risk group (pregnant women) has been established, according to UNICEF.

In Kyrgyzstan, 98 percent of children under five have received Vitamin A. Two out of three children in Kyrgyzstan receive high-dose Vitamin A capsules twice a year, protecting them from common childhood infections which can lead to death.

Almost three million women in Tajikistan - the overwhelming majority of the country’s female population - have received iron pills and Vitamin A. Over a million under fives have received Vitamin A through two rounds of supplement campaigns.

In Uzbekistan, the National Flour Fortification Programme (launched in 2003) has increased flour mills’ capacity to fortify about 1.9 million tonnes of flour annually. This will meet the needs of about 90 percent of the at-risk population, including children and women, UNICEF said.

Challenges

“Nutrition is not only important for child development, it has a serious impact on child survival and mortality. The region still faces serious nutrition problems, marked by chronic malnutrition [stunting], vitamin and mineral deficiencies and an increasing number of children who are overweight - the double burden of malnutrition,” Kianian-Firouzgar said.

There are disparities, which are masked by national averages. Children in rural areas, living in poorer families and whose mothers have lower education levels are more severely affected, she said. “The consequences are that children suffer irreversible damage to physical growth, brain development and health. The youngest children aged below two are among the hardest hit,” the UNICEF regional deputy director added, noting that the focus should be on that particular group.

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