TNAG-2110-FCO40-3009-Hong-Kong-participation-in-international-organisations-1990 — Page 212

1

9

4.1.2 Programmes for Overcoming Micronutrient Deficiences

24. Governments themselves have over the years, through large scale programmes in their countries, addressed the problem of micronutrient deficiencies. National vitamin A programmes have been initiated since the early 1970s in Bangladesh, India and Indonesia. Their emphasis until recently however, was on short-term measures, i.e. the distribution of high dose vitamin A capsules. In India where the programme was implemented successfully, a significant reduction in the prevalence of vitamin A deficiency has been observed. In Bangladesh, based on previous results, a fall in the prevalence of night blindness is expected to occur as the coverage of supplementation is further increased and in Indonesia, surveys have revealed decreases in prevalences of deficiency states attributable to this effort.

25. National programmes to combat iodine deficiency disorders have been undertaken most prominently in India where a national goitre control programme has been ongoing for more than 30 years. Emphasis is primarily on salt fortification but in endemic areas oil-based injections of iodine are given which protect

National person for approximately 5 years. a activities for iodine deficiency disorders are also underway in Bangladesh, Bhutan, Indonesia, Myanmar, Nepal, the Philippines, Sri Lanka and Thailand. As in India, priority is given to salt fortification although injection of iodized oil is continuing.

have

26. National iron deficiency anaemia control programmes

also started in most of the countries of the region. They are part of governments' programmes to combat micronutrient deficiencies and elements of their national programmes for primary health care and Health For All By 2000 policies. Major interventions are the distribution of iron and folic acid pills to the vulnerable groups, primarily adolescent girls and women. Through nutrition education, the public's attention is focussed on the need for adequate intake of iron from animal foods and their products.

27. Analysis of the cost-effectiveness of three strategies to reduce vitamin A deficiency (supplementation, fortification and dietary modification), has been made in Indonesia. The results of this study indicate that when cost is a constraint, dietary modification, usually through education, is at low levels of expenditure the most effective in reducing blindness and death. With increased budget allocation for controlling this deficiency, capsule distribution provides the greater health benefits and at even higher levels of expenditure, fortification is the preferred alternative. Consequently, the selection of which strategy of such to adopt by different countries and within different areas countries

dependant

the upon

amount of

money available particulars of each given situation. FAO can assist governments to organize information on the pros and cons of different policy options and thus enhance decision making.

4.2

is

International Agencies

and

the

28. In order to address the three major micronutrient deficiencies (iron, iodine and vitamin A) the international community has established three high-level technical consultative groups and councils. They provide the international technical fora to discuss with national experts from the Region matters on research, programme implementation and evaluation and