Addressing Nutrition Needs in the

Post-2015 Agenda

Eduarda Zandamela Mungói, Ph.D

Ministry of Industry and Trade

National Food Fortification Program

Johannesburg, South Africa

June 30, 2014

República de Moçambique ___________

Ministério da Saúde Ministério da Indústria e Comércio

OUTLINE

Overview of Nutrition Situation in

Mozambique

Food Fortification in Mozambique

Compliance Activities

Challenges

Next Steps

Conclusion

Nutrition Situation in Mozambique

About 36% of deaths in children under 5

years related to malmutrition;

14% of children have low birh weight;

37% of children receiving exclusive

breastfeeding until 6 months of age;

6% of children under 5 suffer from acute

malnutrition.

Only 36% of the children have access to an

adequate diet (MICS 2008)

.

DEFICIENCIES OF MICRONUTRIENTS

MOZAMBIQUE (MISAU, 2002, 2004)

Deficiencies of micronutrients like Vitamin

A, Iron and Iodine are very common and

have High prevalence in children under- five

years of age and women.

Iron aproximatelly 89% of children 6-24

months of age

Vitamin A about 69% of children 6-59

months of age

Iodine about 68% of children under 5 years

Nutrition Situation in Mozambique

55%

53%

45%

47%

44%

42%

36%

36%

27%

23%

23%

Chronic Malnutrition 43% (IDS, 2011)

Nampula

C Delgado

Zambézia

Niassa

Tete

Manica

Sofala

Inhambane

Gaza

Maputo P

Maputo C

Magnitude and impact of micronutrient

deficiencies in Mozambique

Source: Mozambique "Vitamin and Mineral Deficiency - UNICEF / MI 2003"

1,470 maternal deaths occur due to severe

anemia

14,000 child deaths are precipitated by

vitamin A deficiency

subclinical deficiency in children <6 years

estimated at 26%.

1,500 children are born with diseases

resulting from defects in the neural tube.

1 in 2 children suffer from chronic

malnutrition in Mozambique (MICS, 2008)

Geografic Distribution of Chronic Malnutrion & Food Insecurity & Agricultural Production

7

Food Insecurity Agricultural Production Chronic Malnutrition

Gaza

Manica

Tete

Niassa C. Delgado

Nampula

Zambézia

Inhambane

Maputo

Maputo cidade

Sofala

34

48

48

45 56

51

46

35

28

25

41

% Chronic Malnutrition

25 - 30 30 - 35 35 - 40 40 - 45 45 - 50 50 - 55 55 - 60

Maps show that areas of higher agricultural production has lower indices of food insecurity and higher chronic malnutrition

Actions to Reduce Chronic Malnutrition

8

Approval by the Council of Minister of the Multisectorial Plan for Reducing Chronic Malnutrition (PAMRDC).

OBJECTIVE OF THE

MULTISECTORIAL ACTION PLAN

9

0%

20%

40%

60%

IDS2003 MIC2008 IDS2011 Previsão

2015

Previsão

2020

48% 44% 43%

30%

20%

Chronic Malnutrition

Accelerate the reduction of chronic malnutrition in children under 5 years

from 44% in 2008 to 30% by 2015 and 20% in 2020.

Strategies against, control and prevention of the

Deficiencies of Micronutrients

Integrated Interventions

Supplementation

Public Health

Measures

Fortification

Dietary improvement

2000 2005 2010

Rel

ativ

e co

ntri

butio

n of

inte

rven

tions

to e

limin

ate

MN

D

INTEGRATED INTERVENTIONS

Suplementation

Public Health

Measures Fortification ̸

Biofortification

Dietary Improvement

•High Cost

•Short –medium

period

•Low Costs

•Long period -sustainables

Food Fortification:

Simple Process their success depends on the

correct selection of food to be used as a

vehicle for fortification and the type of

compound or micronutrient to be added.

Strategy more cost-effective and sustainable

prevention of multiple micronutrient

deficiencies

Being the food industry the focus of

activities for adding micro nutrients

Biofortification:

Biofortification: breeding crops to increase their

nutritional value.

Develop basic rich crops (staple) in order to achieve

micronutrient is the provitamin A, and the

concentrations of iron and zinc, from deficiency of

these micronutrients and with a view to improving

the nutritional status of the population.

Easy reach rural populations in situations of

malnutrition

- Intervention low cost

- No recurring costs beyond the cost of maintenance

of varieties

Mozambique Interventions for

prevention of micronutrient

deficiencies

Prevention of macrounient deficiencies

Salt Iodization

Industrial Food

Fortification

Bio fortification

The home Food Fortification (nutritional

supplements)

Food and nutrition Education

Promotion of breastfeeding

Nutritional Supplementation

(Health Week)

FOOD FORTIFICATION IN

MOZAMBIQUE:

The National Committee for Food

Fortification in Mozambique (CONFAM)

was created in April 2010 and Official

launched in March 2012, and is fully

operational.

The terms of reference and the Fortification

Program are approved by the Ministers

The Committee was Official approved by the

Ministerial Diplom

Ministry of Industry and Commerce

Production & Industry

Legislation &Quality Control

/ Assurance

Advocacy, Social Marketing &

Communication

Performance Monitoring &

Evaluation

Ministry of Health

Ministry of Industry

and Trade

MoAgriculture

Customs, WFP,

UNIDO, WV,

Industry

Association,

Confederation of

Economic

Associations

Costums, Economic Activities Institute,

INNOQ, MoH (LNHAA), MoA, WFP, USAID, UNICEF, HKI

SETSAN, MoH, MoIndustry and

Commerce, USAID, UNICEF, HKI, PSI, WV, Consumers Defence

Association

One focal point from each one of

the 3 working group

National Committee for Food

Fortification (CONFAM)

FOOD FORTIFICATION IN

MOZAMBIQUE:

Mozambique is benefit by the GAIN funding for

a four year fortification Program (2011-2015),

two new donors, Danida and Irish Aid

The Program was draft and adopted by

CONFAM

The project was approved in February/2011

HKI is the Executy Agency

Vehicles (wheat flour, edible oils) and

micronutrients have been identified for 1st phase

– Oil (vit A); wheat (NaFeEDTA, Zn, B12,

Folic Acid)

Successes :

CONFAM membership is growing and now counts

regular participation by line Ministries, private

sector, agencies, development partners and

producers.

Food Fortification is part of Multisectorial Action

Plan for the Reduction of Chronic Undernutrition

in Mozambique 2011 – 2014(20) Approved by

Ministers Council

Additional donors have shown interest in

contributing to the program

Successes :

The commitment to fortification among key

stakeholders, including millers and oil producers,

is still growing strongly

Development of the Mozambican standards for

fortification ( Wheat Flour, Wheat maize and

edible oils) in line with the WHO recommendations

and harmonized in the region. The standards was

published in March 2013.

Challenges:

Irregular participation of some key stakeholders

(Consumers Defense Association)

Sensitivity of the flour and bread sector in light

of public protests against increase in prices in

September 2010

Ensuring sustainability of a food fortification

program (stakeholder’s commitment and funding)

Changes of staff in Government body

Inclusion in the market of new companies that were

not budgeted in the project.

Industry will not start fortifying until its mandatory

by law

NEXT STEPS :

Official approval of food fortification

strategy and related legislation

Preparation of baseline study on VAD

and IDA

Industry assesssments

Establishment of miller association

Continue participation of Mozambique

in ECSA and other events more

strongly

NEXT STEPS :

Workshop to disseminate FF Strategy and

Gain Project and other opportunities

Development of standards, regulations

and QC

Mobilization & Social Marketing

Development of fortification law

Development of revolving fund

mechanism for premix

Preparation to start sugar, maize and

cassava flour fortification

LESSON LEARN :

From the project proposal and the

implementation new industries appear in the

pictures. (awareness, incentives)

Question that industry always ask is how

much is going to cost (awareness, incentives)

They will only start fortifying when it

becomes mandatory by law.

For the premix the industry prefer to buy it

from the thrird party that consolidates all

requirements

THANK YOU!!!