Strategic Objective 9: To improve nutrition, food safety...

SEA/SPPDM-Meet.2/2.3 Page 309

Strategic Objective 9: To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development

REGIONAL PLANNING BRIEF 1. Major work of WHO for this SO in the region (RO and countries) during 2008-2009:

Nutrition • Ninth South-East Asia Research-cum-Action Network was organized in September 2008. The

forum allowed discussion on the nutritional impact of the food price increases in South-East Asia, importance of behavioral change communication and constraints to effective Iodine Deficiency Disorders (IDD) control programmes.

• The SEA-RCA Newsletter is published on a quarterly basis and disseminates relevant food and nutrition issues to all member states and partner groups.

• Technical assistance provided to selected member states (Timor-Leste, Nepal, Sri Lanka) to establish integrated food security, food safety and nutrition strategies in response to food price increases and climate changes affecting food production, availability and consumption.

• Technical and financial support provided to the national nutrition survey in Bhutan. • In collaboration with the International Centre for Diarrheal Diseases Research (ICDDRB) of

Bangladesh, a manual incorporating latest knowledge and practices for the management of children with severe malnutrition is being developed.

• Training workshop on managing children with severe malnutrition following WHO guidelines was conducted in Nepal as part of AGFUND support. The project also enabled mapping of health facilities able to manage children with severe malnutrition in Nepal.

• Research studies on the efficacy, effectiveness and safety of Ready-To-Eat-Food (RUTF) initiated in India (National Institute of Nutrition) and Bangladesh (ICDDRB).

• A manual on current quality control and assurance issues in salt iodization programme was developed in collaboration with the International Council for the Control of Iodine Deficiency Disorders (ICCIDD).

• Technical training in the monitoring and Quality Assurance /Quality Control aspects of national IDD programme has been arranged for Bangladesh, Myanmar and DPR Korea.

• Assessment of Thailand and SRL national IDD programme was conducted. • Integrated counseling for infant and young child feeding has been conducted in Sri Lanka,

Nepal and Indonesia. • A regional workshop on strengthening national capacity to address nutrition issues in

HIV/AIDS in collaboration with NHD-Geneva. • Regional training workshop on nutrition surveillance and the use and interpretation of WHO

growth references from birth to adolescence. Technical and financial support provided to Nepal to develop the national Food Based Directory Guidelines (FBDG).

• Training on developing national FBDGs in Maldives and Sri Lanka. • Communication materials on nutrition following the life-course approach and dietary

approaches to chronic diseases have been prepared.


Food safety • Legislation and regulation: draft national standard for monitoring of food safety, guideline,

key indicators and monitoring tools developed and a multisector working group for food safety was established to coordinate the food safety programme in Timor-Leste. Monitoring system for heavy metals and organic compounds in locally consumed and exported fish established in Maldives. Supported the preparation of a National Action Plan and policy of food safety in Indonesia and Sri Lanka. In Indonesia national food safety program was supported to adapt global guidelines, standards and training materials.

• Consumer empowerment: A national directory on food safety and quality control is revised and updated by the National Agency for Drug and Food Control. And a revised and updated protocol on food safety networking is finalized in Indonesia. Also a model for mass communication through radio airing on food safety awareness was developed and trialed. Aware of the importance of preventing the spread of avian influenza H5N1 in live animal markets, Indonesia developed a National Healthy Food Market Programme (NHFMP). A key element of the NHFMP envisages training public health managers. A ten module Training of Trainers regional course was developed and finalized. The modules are currently being field tested locally and a pilot project on healthy food markets has been initiated.

• Capacity development: Training on manual on how to prepare safer food based on the 5 key messages was provided to the hotels and restaurants in all 9 districts in Timor-Leste. Nationals trained in the area of food safety, foodborne diseases, and food inspection system in Maldives .A national guideline on building competency and skill of field safety workers and inspectors for food safety and quality control is developed in Indonesia and used in national and divisional level seminars on food safety in Indonesia.

• Risk assessment: Monitoring and assessment of chemical and microbiological risks related to food strengthened in Maldives. Two of the Total global Diet studies pilots conducted in India.

2. Scope of work and major results planned for 2010-2011: Nutrition • Continuing assistance provided to member states in formulating country collaborative

strategies and plans of action with well-identified roles and responsibilities of all stake-holders and partners in areas of nutrition, food safety and food security.

• Disseminating evidence-based approaches toward the control and prevention of micronutrient disorders to member states.

• Continuing support to member states to establish nutrition surveillance systems and improved coordination with the national health information systems.

• Promoting food-based approaches toward the prevention and control of chronic diseases, micronutrient deficiencies and malnutrition in different age groups.

• Continuing support to member states in the development / improvement of the national food-based dietary guidelines.

• Enhancing national capacities for the management of severe malnutrition in children in hospital facilities and communities.

SEA/SPPDM-Meet.2/2.3 11

Food Safety • Legislation and regulation: Promotion of the use of appropriate standards, guidelines, and

protocols on food nutrition and food quality control. National strategies and policies for setting up the national programme for prevention and control of food borne diseases and food hazards developed and implemented in Maldives and Sri Lanka

• Consumer empowerment: strengthen inter-sectoral coordination at national and sub-national level, promote partnerships to raise awareness, and advocate for action to address food safety in Bangladesh, Indonesia and Timor Leste. Food safety promotion through the “Healthy Setting” approach in Indonesia.

• Capacity development: To support and strengthen the capacity of FDA in monitoring and assessment of chemical and microbiological risks related to food in the Region, especially in Myanmar and Maldives. Training in monitoring and surveillance of food stuffs; develop a systematic approach to food-borne disease surveillance and provide estimates of the burden of food-borne disease. Food industries adopting of HACCP, GMP, GHP and other appropriate tools for increasing quality compliance. Strengthen capacity to develop appropriate courses for food inspectors and food handlers. Strengthen managerial and technical capacity for quality implementation of the food safety program, in particular of management and staff at the municipal level, including laboratories. Strengthen capacity to meet requirements of Codex and support setting up national CODEX information center in Nepal and in Maldives.

• Risk assessment: Assess food safety risks and develop and implement appropriate strategies to reduce the risks, emphasizing intersectoral collaboration and integration into existing national surveillance systems. National INFOSAN systems established and operational. Study on climate change impacts on food quality deterioration and malnutrition especially among children. Support the accreditation process of laboratories in Nepal and Indonesia. Strengthen the capacity of the laboratories in Bhutan in general, with emphasis on heavy metals and other chemical food contaminants in Maldives. Expand the use of Total Diet Studies in India, Indonesia and Nepal. National laboratory supported to undertake testing of food products for zoonotic and non-zoonotic food borne diseases in the region, in particular in Timor-Leste.

3. Regional Expected Results (RERs) with indicators, baselines and targets (attached):


4. Budget information for the Strategic Objective for Country Offices (CO) and the

Regional Office (RO) (in USD thousands)

PB 2008-2009* PB 2010-2011 Country offices Regional Office

SO Component Planned Resources Planned Resources CO RO Multisectoral Coordination 1,126 397 1,053 806 Clinical management of malnutrition 1,282 506 779 186

Nutrition monitoring and surveillance 291 189 440 0

Improving nutrition throughout life 826 232 375 0

Surveillance for zoonotic and non-zoonotic foodborne diseases

1,339 435 729 439

Prevention and control of foodborne diseases 1,168 369 310 25

TOTAL 6,032 2,128 3,686 1,456 7,398 3,700 * Resources as of May 31, 2009


South-East Asia Regional Expected Results for Regional PB 2010-2011

Strategic Objective 9: To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development

Organization-wide Expected Result Regional Expected Results Indicator Baseline Target

1. Partnerships and alliances formed, leadership built and coordination and networking developed with all stakeholders at country, regional and global levels, in order to promote advocacy and communication, stimulate intersectoral actions, increase investment in nutrition, food-safety and food-security interventions, and develop and support a research agenda.

1. Technical partnerships and alliances established for promoting / strengthening food security and nutrition activities at the Regional level.

No. of technical partnerships and alliances established for promoting / strengthening food security and nutrition activities at the Regional level.

2 5

2. Norms, including references, requirements, research priorities, guidelines, training manuals and standards, produced and disseminated to Member States in order to increase their capacity to assess and respond to all forms of malnutrition, and zoonotic and non-zoonotic food borne diseases, and to promote healthy dietary practices.

1. Standard references, guidelines and training manuals produced by WHO disseminated to and introduced in Member States.

Number of member states utilizing WHO standard treatment protocols and statements on micronutrient deficiencies, infant and young child nutrition, and dietary approaches to chronic diseases.

5 7



Number of member states with national plans of action for improving infant and young child nutrition.

5

9

Number of member states with appropriate nutrition programmes for adolescents.

7

7

3. Monitoring and surveillance of needs and assessment and evaluation of responses in the area of nutrition and diet-related chronic diseases strengthened, and ability to identify best policy options improved, in stable and emergency situations.

1. Improved national capacities to monitor and assess changes in the nutrition profile of the population in member states.

Number of member states with national plans of action for nutrition interventions in emergencies

3

6

No. of member states with existing national food and nutrition policy / plan of action.

4 7 4. Capacity built and support provided to target Member States for the development, strengthening and implementation of nutrition plans, policies and programmes aimed at improving nutrition throughout the life-course, in stable and emergency situations.

1. Nutrition programme development and implementation enhanced in member states.

No. of countries using national food-based dietary guidelines.

3 6



5. Systems for surveillance, prevention and control of zoonotic and non-zoonotic food borne diseases strengthened; food-hazard monitoring and evaluation programmes established and integrated into existing national surveillance systems, and results disseminated to all key players.

1. Efforts of Member countries strengthened to develop strategies and policies and set up national programmes for prevention and control of food borne diseases and food hazards.

Number of countries that have a functioning system for surveillance early warning and monitoring of food hazards and risks

1 3

6. Capacity built and support provided to Member States, including their participation in international standard-setting in order to increase their ability to assess risk in the areas of zoonotic and non-zoonotic food borne diseases and food safety, and to develop and implement national food-control systems, with links to international emergency systems.

1. Member countries efforts strengthened for standard-setting and monitoring and technical documentation disseminated on assessment of microbiological and chemical risks related to food.

Number of countries that have attended training sessions on total diet studies (TDS)

3 5


Country Planning Brief: Bangladesh (SO 09)

1. Major work of WHO for this SO in country during 2008-2009: • Provided support to the adaptation of revised WHO anthropometric norms for the

calculation of malnutrition • Provided support to the integration of micronutrient supplementation (VitA) and

deworming ectivities into PHC (EPI) outreach activities • Provided support to the Integration of nutrition into National Village Health Worker

training manual • Supported the preparation of a National Action Plan of food safety • Developed a training manual on healthy food markets, and initiated a pilot project

on healthy food markets • Facilitated National and Divisional level seminars on food safety

2. Scope of work and major results planned for 2010-2011 (by SO component): • Provide Technical Assistance (TA) to the development and testing of TOT manuals

for the community and facility based treatment of Severe Acute Malnutrition (SAM) • Provide support towards further integration of micronutrient supplementation into

PHC activities especially at Upazila and below levels, including Community Clinic levels

• TA to strengthen inter-sectoral coordination at national and sub-national level, promote partnerships to raise awareness, and advocate for action to address food safety

• TA to strengthen monitoring and surveillance of food stuffs; develop a systematic approach to food-borne disease surveillance and provide estimates of the burden of food-borne disease

3. How the scope and results are related to the Country Cooperation Strategy:

Ad I. SD 1.4, 6.1, Ad II SD 1.1, 1.4 Ad III: SD 4.3 Ad IV: SD 2.3


4. Budget information for the Strategic Objective (USD thousands)

PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 162 127 0 Clinical management of malnutrition 0 69 0 90 480

Nutrition surveillance 0 0 0 Improving nutrition throughout life 0 0 0


136 35 0 70 230

Prevention and control of foodborne diseases 0 60 0

TOTAL 298 291 0 160 1,146 * Available as of 31 May 2009

5. Possible VC funding through new or continuing projects:

• Possible EU funds available through FAO for nutrition.

6. Staff requirements for 2010-2011 (short and long-term): • Temporary International Professional for Nutrition


Country Planning Brief: Bhutan (SO-09)

1. Major work of WHO for this SO in country during 2008-2009:

• The study on infant and young child feeding and care practices among the care givers has been included as part of Nutrition Survey conducted through UNICEF support.

• Capacity building in the area of infant feeding. • Kitchen garden concept promoted in the community.

2. Scope of work and major results planned for 2010-2011.

To provide policy and technical support in: • promoting advocacy and inter-sectoral coordination for food safety • assessing all forms of mal-nutrition and zoonotic and non-zoonotic food-borne

diseases so as to promote healthy dietary practices • continued post elimination strategy for IDD and other micronutrients


Strategic Priority #04 • Foster the improvement of maternal health, child health and nutrition (MDGs 3, 4,

and 5) • Improvement of the nutritional status of the population (MDG#03)

4. Budget information for the Strategic Objective (in USD thousands)

PB 2008-2009 PB 2010-2011

SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 0 0 0 Clinical management of malnutrition 39 26 0 35 30



0 0 0 8 20


TOTAL 47 46 20 43 50 * Available as of 31 May 2009


None 6. Staff requirements for 2010-2011 (short and long-term):


None


Country Planning Brief: DPR Korea (SO-09) 1. Major work of WHO for this SO in country during 2008-2009:

Nutrition: • To provide Technical reference to help development of strategic plan for improved

nutritional status of the people including institutional development and capacity development

• To improve local capacity to conduct IDD survey for mapping of micronutrient deficiency

• To further support implementation of infant and young child feeding strategies • Introduction and scaling up of WHO New Growth Reference Standards

Food Safety • Strengthened national food safety program to adapt global guidelines, standards

and training materials.

2. Scope of work and major results planned for 2010-2011 (by SO component):

Nutrition • Assessment of micronutrient deficiency level in the country • Development of strategic plan for reduced severity of IDD • Pilot project in selected areas for remedial interventions • Mainstreaming of WHO growth reference standards • Promoting infant and young child feeding interventions including expansion of BFHI

hospitals

Food Safety • To strengthen managerial and technical capacity for quality implementation of the

food safety program including laboratories


Nutrition It is linked to strategic priority # 2 set in CCS 2009-2013: Addressing Women's and Children's Health

Food Safety Strategic Priority No. 5: Addressing Environmental determinants for health with focus to strengthen capacity for food safety



PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 0 0 0 0 0 Clinical management of malnutrition 24 15 24 14 25

Nutrition surveillance 65 22 65 30 25 Improving nutrition throughout life 0 0 0 20 50


40 68 40 36 25

Prevention and control of foodborne diseases 0 0 0 0 0



• Many UN agencies are involved in addressing malnutrition among children and women. Joint activities are planned with UN agencies but no VC funding is available so far.

• In food safety area also, there is no VC funding. • New funding would need to be explored with assistance from SEARO and HQ.

6. Staff requirements for 2010-2011 (short and long-term):

• National Professional Officer • Medical Officer (shared responsibility)


Country Planning Brief: India (SO 9)

1. Major work of WHO in country during 2008-2009

Nutrition • Enhancement of capacities of senior program managers and laboratory technicians of

Central/State Nutrition and IDD Cells with respect to the National Iodine Deficiency Disorders Control Program.

• Support for advocacy cum sensitization of policy level officers and the community in relation to iodine deficiency disorders and the national program.

• Development of a pool of master trainers trained on the new WHO growth standards and incorporation of the same within the pre-service nursing curriculum.

• Supported research on the determinants of under-nutrition in the community and its consequent management in the health facility.

Food Safety • Total Diet Study in two selected states. • Training & motivation of street food vendors in three selected areas. • Microbiological aspects of fresh fruits and vegetables around NCR. • Oral pre-cancer biomarkers using areca nut.

2. Scope of work and major results planned for 2010-2011

Nutrition • The capacities of the concerned health workforce need to be strengthened for

prevention and management of under nutrition in infants and children. The focus of prevention would be on the systematic promotion of appropriate infant and young child feeding practices in the community and health facility. The management aspect would pertain to the development of a framework fore establishing management of sever acute malnutrition in the community.

• The scope of work here would be on enhancing capacities for effective implementation of nutrition programs and plans during development and crisis situations with a focus on persons living with HIV/AIDS.

Food Safety • To strengthen the National food safety infrastructure by enhancing testing facilities,

information sharing and surveillance system • To strengthen and upgrade the National Food Safety regulations • To promote fair trade practices through harmonization of National Food Standards with

International Standards by the strengthening Infrastructure


3. How the scope and results are related to the Country Cooperation Strategy: • The WHO Country Cooperation Strategy 2006-2011 identifies improvement of maternal

and child health as one of the high priority areas. Nutrition therein is an input to and foundation for health and development. Better nutrition is therefore a prime entry pint for improving maternal and child health.

• The Country Cooperation Strategy does not directly look into food safety issues. But without having safe food programme health of the community may be at a great risk. Hence it has got its own priority for addressing community health improvement programme.


PB 2008-2009 PB 2010-2011

SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 64 110 0 50 200 Clinical management of malnutrition 101 0 0 120 0



113 390 0 70 400


TOTAL 486 1,220 0 350 1,480 * Available as of 31 May 2009

5. Possible VC funding through new or continuing projects Available through NIPI for new and continuing projects.

6. Staff requirements for 2010-2011 (short and long-term) National Professional Officer - Nutrition


Country planning brief: Indonesia (SO-9)


Food Safety

• Current review and development of a protocol on food safety networking is finalized.

• A model developed and trialed for mass communication through radio airing on food safety awareness.

• A national directory on food safety and quality control is revised and updated by the National Agency for Drug and Food Control.

• A national guideline on building competency and skill of field safety workers and inspectors for food safety and quality control is developed.

Nutrition • WHO growth standards adopted and introduced • Comprehensive nutrition guidelines developed • Revitalization of mother baby friendly hospitals initiated • Integrated nutrition training course performed • Community management of severe malnutrition initiated


Food Safety

• Providing technical support to the national health and food authorities in promoting food inspection and certification, food quality surveillance, and food-borne disease control

• Introducing operational research and recommendations for necessary changes on national food legislation, regulation, policy and strategy

• Revitalize national adoption of HACCP (hazard analysis and critical control Points), GMP (Good Manufacturing Practice), GHP (Good Hygienic Practice) and other relevant operational tools to enhance food quality compliance specifically in small and medium food enterprises

• Support for partnership and collaboration to strengthen national INFOSAN (International Food Safety Authority Network) and promotion of information, education, communication and training on food safety, and healthy food habits

• Technical support to the food control laboratory on building analytical capability and capacity


• Developing activities to link climate change impacts on food safety and malnutrition targeting to the vulnerable groups

• Strengthening national capacity in developing innovations and promoting the use of appropriate standards and protocols on food nutrition and quality control

• Supporting implementation of nutrition interventions and their integration in all related programmes

• Contributing to the national preparedness and response to food-borne disease outbreaks and pandemic (current focus on AI); with promotion of preventive-health measures, especially in the context of the International Health Regulations (IHR-2005)

Major Results Planned for 2010-2011:

• National food inspection and food watch system supported • Food industries adopting of HACCP, GMP,GHP and other appropriate tools for

increasing quality compliance • National INFOSAN system established and operationalized • Activities piloted to study on climate change impacts on food quality deterioration

and malnutrition especially among children • Food safety promotion through “Healthy Setting” approach • Promotion of use of appropriate standards, guidelines, and protocols on food

nutrition and food quality control

Nutrition

• Support implementation of comprehensive materials for nutrition • Supporting implementation of nutrition interventions and their integration in all

related programmes • Revitalize baby friendly hospital initiative • Support community management of severe malnutrition • Develop approach to improvement of complementary feeding • Socialize IYCF to Puskesmas PONED • Develop Puskesmas PONED become Mother and Baby friendly Puskesmas

3. How the scope and results are related to the Country Cooperation Strategy Food Safety

The above-mentioned scope of the work and major results for 2010-2011 plan are also related to the different explanations and expressions in CCS document those related to food safety, healthy lifestyle and environmental health areas, as mentioned in the different context such as;


• Page 33: chapter 7 – Implementing the strategic agenda mentions that the health and

environment area would benefit from special assessments to determine local strategies and priorities in line with the available global best practices. It further mentions that “Periodic reviews also need to consider the extensive work of other development partners who may have a much larger impact and the role than WHO. It is essential to identify where WHO can make a key contribution in these areas and play a proactive role in integrating with other partners to maximize the health benefits”. Nutrition 3.5 support implementation of nutrition interventions – and their integration – in all related programmes.


PB 2008-2009 PB 2010-2011




0 0 0 50 338


TOTAL 195 834 0 130 1,317 * Available as of 31 May 2009

5. Possible VC funding through new or continuing projects: There is no clear indication of forthcoming donor funding in maternal, neonatal, child and adolescent health. Existing major supporters, such as GTZ and AusAid, are discontinuing their programmes. However, some contributors might be willing to co-fund activities in the country.


Food Safety Short-term National Professional Officer – Food Safety National Professional Officer - Nutrition


Country Planning Brief: Maldives (SO9) 1. Major work of WHO for this SO in country during 2008-2009:

Food safety:

• Food inspected system of Maldives Food and Drug Authority to be upgraded by end of 2009

• Nationals trained in the area of food safety, foodborne diseases, and food inspection system

• Monitoring system for heavy metals and organic compounds in locally consumed and exported fish to be established by end of 2009

Nutrition:

• Orientation meeting held for private sector and government on regulations of marketing breast milk substitutes

• Orientation meeting held for health care providers on breast milk substitute regulation and the new growth charts

2. Scope of work and major results planned for 2010-2011 Food safety:

• Assess food safety risks and develop and implement appropriate strategies to reduce the risks, emphasizing intersectoral collaboration

• Review and revise food safety standards, regulations and legislation • Strengthen the capacity of the National Health Laboratory to monitor quality

and safety of food products, and to detect heavy metals and food contaminants • Strengthen capacity to develop appropriate courses for food inspectors and

food handlers • Strengthen capacity to meet requirements of Codex • Strengthen capacity of food inspection system

Nutrition:

• Implementation of National Nutrition Strategic plan • Strengthen capacity to implement National Nutrition Strategic Plan

3. How the scope and results are related to the Country Cooperation Strategy: Priority areas: 1 – Strengthening health systems 6 – Food Safety


Other priority area: Nutrition in collaboration with UNICEF


PB 2008-2009 PB 2010-2011 SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 10 47 0 Clinical management of malnutrition 27 130 0



2 8 7




None 6. Staff requirements for 2010-2011 (short and long-term): None


Country Planning Brief: Myanmar (SO 9) 1. Major work of WHO in country during 2008-2009:

• WHO guidelines, standards and training materials for new WHO growth standard, nutrition in HIV/AIDS and nutrition in emergency adapted and utilized

• Technical capacity of various categories of health staff strengthened, nutritional surveillance system strengthened and community based nutrition intervention sustained and expanded

• Monitoring and assessment of chemical and microbiological risks related to food strengthened

2. Scope of work and major results planned for 2010-2011 • Norms produced and disseminated to increase capacity to assess and respond to

malnutrition, and zoonotic and non-zoonotic foodborne diseases, and to promote healthy dietary practices (OWER2): To assist the National Nutrition Centre in utilizing WHO Guidelines in Nutrition in HIV/AIDS, Nutrition in Emergencies and new WHO Growth Standard.

• Capacity building for development, strengthening and implementation of nutrition plans, policies and programmes (OWER4): To support capacity building and, strengthening, expanding and sustaining nutrition surveillance system and community based nutritional interventions and growth monitoring to reduce malnutrition among children

• Surveillance, prevention and control of zoonotic and non-zoonotic foodborne diseases; food-hazard (OWER5) : To support and strengthen the capacity of FDA in monitoring and assessment of chemical and microbiological risks related to food


• The CCS Myanmar has mentioned that malnutrition continues to be a concern in

Myanmar with four nutrient deficiency states identified with major nutrition problems. • There is a need to build capacity, strengthen and expand nutrition surveillance system

and community based nutritional interventions and growth monitoring to reduce malnutrition among children



PB 2008-2009 PB 2010-2011




40 30 0 38 20




• Not foreseen


• Staff requirements covered under other SOs


Country Planning Brief: Nepal (SO-09)


During the last two years major efforts have been conducted by the Nutrition section under the Department of Health Services / MOHP with a focus on improving the nutritional status of under-five children. WHO has particularly supported the Nutrition section in the:

• Strengthening of proper Infant and Young Child Feeding, including in emergency situations, through developing trainings and training health care providers

• Improving the emergency preparedness and actions related to nutrition through the Emergency Health and Nutrition Working Group as well as the newly established working group for nutrition in emergencies

• Capacity building of health care providers in hospitals and Nutrition Rehabilitation Homes in the management of severe malnutrition

• Promoting and strengthening the national growth monitoring programme, through adaptation of training materials and conducting trainings

• Developing of National guidelines for growth monitoring (which are to be finalized during 2009)

• Development of Food Based Dietary Guidelines for Nepal – for promoting healthy dietary habits among the general public

In the last two years, DFTQC has focusing on its capacity to develop a good SPS infrastructure and a system that is adequate to monitor and address food based risks. While several actions have been undertaken by Government and its partners, WHO has in particular supported:

• Capacity building of management and staff at the municipal level to gradually augment the capacity in food safety management and control in the existing and newly emerging municipalities

• Regional training have enabled DFTQC to draft a protocol for Total Diet Studies (TDS) and a pilot in one district will be undertaken in 2009

• Review of the Draft Food Act, and the inclusion of a National Food Safety Council as an instrument to develop a National Food Safety Strategy and ensure farm-to-fork controls (with FAO)

• During 2008 and 2009 further expansion has been achieved of DFTQC involvement in CODEX activities. A national CODEX information center is also operational at the DFTQC


• Opportunities have been provided for international linkages through participation in regional food-related Conferences and through training (with SIDA).

2. Scope of work and major results planned for 2010-2011 (by SO

component):

• Advocate and support government to institutionalize functional coordination mechanisms and build partnerships to improve capacity in the area of food safety, food security and nutrition.

• Strengthening the national growth monitoring programme through capacity building of health care providers in growth assessment and nutrition counseling

• Improving the management of severe malnutrition at health facilities through capacity building and monitoring

• Analysis of national nutrition survey data and assessment of maternal nutrition and complementary feeding practices

• Revision of the National Nutrition Plan of Action and monitoring of its implementation

• Developing Food based dietary guidelines for specifically vulnerable districts / population groups and assessment of comprehensibility of messages

• Capacity building of management and staff at the municipal level to gradually augment the capacity in food safety management and control in the existing and newly emerging municipalities. Result: cover 60% of the existing municipalities.

• Phase 2 of the Total Diet Studies (TDS). Result: expand methodology to 5 other socio-cultural areas/districts and encourage other support agencies to adopt further areas to complete the TDS mapping in the country

• Support the accreditation process of the DFTQC laboratory and engender link up with Public Health Laboratory at Department of Health Services

• Monitor development of the National Food Safety Strategy, and provide technical support to the Food Safety Council.

• A national CODEX information center is also operational at the DFTQC • Opportunities provided for international linkages through participation in

regional food-related Conferences and through training.

3. How the scope and results are related to the Country Cooperation Strategy: Building effective partnerships for resource mobilization and improved coverage to address nutritional deficiencies as mentioned under Section 6.4 Child, adolescent and reproductive health Section 6.5 Healthier Environment lists a range of strategic approaches and urges to review the food act (2003) and support changes in health, hygiene and sanitation behavior.


In addition several horizontal linkages are foreseen within the GoN-WHO collaborative programme mainly in control of communicable diseases, and health and hygiene education relating to promote appreciation of food safety among consumers.


PB 2008-2009 PB 2010-2011

SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 75 0 0 Clinical management of malnutrition 52 165 0



36 275 0




• No funding agencies have been identified for the development of laboratory

(undertaken by JICA/UNIDO) and for strengthening the food surveillance capacity of DFTQC field staff and municipal inspectors.


• For OWER 5 and 6, no additional staff is required. This will be undertaken through SO8

• For OWER 2, 3 and 4 National Professional Officer / Medical Officer and support staff (can be shared with SO4 OWER 5)


Country Planning Brief: Sri Lanka (SO 9)


• The Nutrition sector concentration in this work plan has been in policy and strategy development, assistance with capacity strengthening for updating and formulating technical guidelines and the adaptation of a global nutrition behaviour change package and the training associated with this.

• Strengthening the civil society response through the facilitation of the National

Nutrition Alliance has been another major area of work. NGO members of the Alliance have been capacity built with several rounds of training as well as assistance provided with the development of a 5 year action plan and its implementation.

• Infant and Young Child Feeding Training of relevant staff of the Ministry and

Provinces has been completed. This has resulted in the training multiplying to the lower levels of field workers.

• In the area of food safety emphasis has been on developing a policy based on a 5

year assessment, formulating a plan of action for systems development, developing and printing of manuals and guidelines, training relevant personnel on surveillance and control of food disease outbreaks, improving infrastructure and systems and conducting awareness and advocacy programmes among the public.


• Emphasis during this biennium will be on strengthening intersectoral and civil society collaboration for nutrition from central level to grassroots, setting up a comprehensive hospital nutrition system from promotion to palliative care, improvement of the nutrition of adolescents, adult and the elderly, capacity strengthening in the area of landscape analysis for targeting nutrition programs and the preparation of a nutrition communications strategy for a holistic community nutrition approach.

• Priority in Food Safety is to set up the infrastructure for a well linked surveillance and control system and the requisite human resource development.


• Nutrition and Food safety is a cross cutting theme in all 6 areas of the CCS. If this

work plan is implemented effectively many of the causes of both communicable and non communicable diseases and optimum growth of children will be addressed in a cost effective manner.



PB 2008-2009 PB 2010-2011




21 60 0



5. Possible VC funding through new or continuing projects: • USAID is interested in funding community nutrition interventions.


• National Professional Officer - Nutrition • Short-term staff may be recruited as and when required.


Country Planning Brief: Thailand (SO 9)


2. Scope of work and major results planned for 2010-2011 (by SO component): Nutrition • Functional multi-sectoral network national level for promoting nutritional advocacy and

research • Improved mechanisms for intersectoral coordination. • Improved surveillance mechanisms for obesity control among school children and for

iodine deficiency prevention and control programme.

Food safety • Developed guidelines and functional network for implementing national programme for

control of food borne diseases and hazards • Improved capacity of local authorities in implementing food safety standard and

measures

3. How the scope and results are related to the Country Cooperation Strategy: • The scope and results stated in 2. respond to the CCS 2008-2011 (Thailand): ‘(6) To

promote environmental health and surveillance of environmental hazards.’ 4. Budget information for the Strategic Objective (in USD thousands)

PB 2008-2009 PB 2010-2011




0 50 19



5. Possible VC funding through new or continuing projects: 6. Staff requirements for 2010-2011 (short and long-term):


Country Planning Brief: Timor-Leste (SO 9)


Nutrition • WHO supported the Ministry of Health in training of health staff (District Public

Health Officer (DPHO) for Nutrition and DPHO- Maternal and Child Health on improving nutrition services in 2008

• Training of Trainers on promoting and improving infant and young child feeding, breastfeeding, complementary feeding and infant feeding and HIV/AIDS.

• Food based dietary guideline was initiated. This is an ongoing activity involved situation analysis and operational research on eating habits of population in different seasons. Recommendations of the study will be used to develop the national food dietary guidelines for Timor-Leste and is expected to be finalized in 2010-2011.

• Landscape analysis on nutrition programme will be finalized towards end 2009 to map the existing nutrition programme as well as to identity the gaps for priority essential nutrition services to overcome the high maternal and child malnutrition in TLS.

Food Safety

• A food safety specialist was recruited by WHO to develop draft of the national standard on monitoring of food safety. In addition, guideline for food safety monitoring and the monitoring tools as well as key indicators were also developed to be used by health staff in different level of health services. A SWOT analysis on food safety programme in Timor-Leste was also developed during one day workshop organized by MoH with WHO support. Multisector participants agreed to established a working group for food safety to coordinate the food safety programme in TLS.

• Training on manual on how to prepare safer food based on 5 key messages was provided to the hotels and restaurants in 9 districts by end of 2008. It is hoped that all remaining districts as well as in the newly established food establishment s in major city such as Dili will be trained using the same manual by end of 2009.

• National laboratory is supported to undertake testing of food products for zoonotic and non-zoonotic food borne diseases.



Nutrition • National strategy for Nutrition programme revised and implemented • Food based dietary guidelines finalized and implemented • Iodine programme established and implemented in collaboration with UNICEF • Provide technical assistance in the adaptation of WHO guidelines and protocols for

management of children with moderate malnutrition and those recovering from severe malnutrition.

Food Safety • Food Safety working group is established to coordinate and monitor the food safety

from farm to table involving relevant government ministries and agencies. • Monitoring of food handlers and serving (public places) are sthrengthened. • National strategies and policies for setting up the national programme for

prevention and control of food borne diseases and food hazards developed and implemented.

• Support the MoH in establishing a unit for Food Safety programme within the Department of Environmental Health.

3. How the scope and results are related to the Country Cooperation Strategy

• In the TLS CCS, Nutrition is included as “Other Focus” in the Strategic Priority 3 (Maternal and Child Health). Meanwhile, Food Safety is not explicitly stated in the CCS 2009-2013).


PB 2008-2009 PB 2010-2011

SO Component AC VC planned VC actual* AC VC Multisectoral Coordination 0 0 0 0 0 Clinical management of malnutrition 37 145 0 0 0



0 0 0 0 50





Nutrition: • There are some actors funded the Nutrition programme in TLS: USAID, AusAID, the

World Bank and UNICEF. During the implementation the funds were channeled through directly to the Ministry of Health or sub-contracted to the international and national NGOs. In the current biennium, Funding through WHO TLS was not available, except funding received from the SEARO. In 2010-2011, possibly, funds can be explored from UNICEF (USD 100,000) as part of the resource mobilization from the UNICEF to the Government of Spain. This will be utilized for management of severe malnutrition at the hospitals.

Food Safety: • Currently, no donor is interested in this area; funds may be explored from WHO

SEARO/WHO-HQ.

6. Staff requirements for 2010-2011 (short and long-term): • Core staff: Nil. • Non core staff: One national staff for 24 person months will be recruited for SO9

(Nutrition/Food Safety).

Strategic Objective 9: To improve nutrition, food safety...

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