MID TERM REVIEW MEETING OF ECOWAS NUTRITION FOCAL POINTS BOBO DIOULASSO, AUGUST 21-23 2007

1. MID TERM REVIEW MEETING OF ECOWAS NUTRITION FOCAL POINTS BOBO DIOULASSO, AUGUST 21-23 2007 COUNTRY EXPERIENCE WITH IMPLEMENTATION OF CAP VERDE RECOMMENDATIONS GHANA

2. Rec. 1- To create awareness and strengthen institutional capacity and inter sectoral collaboration and leadership at national, and community levels for accelerating action to address the double burden of malnutrition. • Program responsible for non communicable diseases already established in Disease Control Unit, Public Health Division • Awareness creation & planning workshops (2) held for national and regional level persons to create awareness and initiate plan organized by the program • Issue regularly raised in addresses of immediate past Director Gen-GHS • Reduce oil content in foods especially stews • Exercise regularly • Instituted morning jogging at GHS residential conferences/meetings

3. Rec. 1- To create awareness and strengthen institutional capacity and inter sectoral collaboration and leadership at national, and community levels for accelerating action to address the double burden of malnutrition. • Feature articles/columns in many newspapers especially weekend papers • Healthy lifestyle discussions & exercises on TV morning shows • Keep Fit clubs formed in many communities especially urban areas (jogging mostly in the morning on weekends) • Group of doctors obtained permission from Education authorities for awareness creation (& quiz competition) in second cycle institutions • Nutrition Unit contributed to development of manual for the program

4. Rec. 2- To include data on obesity, diabetes and other diet related non communicable diseases in demographic and health surveys. • Data on obesity in 2003 demographic and health survey • One staff nominated to participate in planning process and training data collectors in DHS • Non communicable disease program plan to do national survey

5. Rec. 3- To give priority to interventions which target the window of opportunity from pre-conception to around 24 months of age, the critical period when the foundation for life long health is determined. • Implemented community based growth promotion with on 2-23 months age group in 40 pilot communities in 4 districts • Initiative being expanded into 65 districts (Nutrition and Malaria Control for Child Survival Project) • Reproductive and Child Health Unit organized series of meetings on neonatal & new born care

6. Rec 4.-To develop and implement institutional cross-cutting policies and actions which address the double burden of malnutrition (1). • Formulated new nutrition strategic document-Imagine Ghana Free of Malnutrition for period 2007-2011. • Formulation by multi sectoral group. • To serve as rallying point for ministries, departments and agencies to solve problem of malnutrition • Preliminary national dissemination in 2006 • Has one strategic objective which addresses obesity (reduce obesity by 1/3 in all physiologic groups)

7. Rec 4.-To develop and implement institutional cross-cutting policies and actions which address the double burden of malnutrition (2). • New MOH Policy for next Prog. Of Work (2007-2011) focus on Prevention & health Promotion • Stresses on promoting nutrition and healthy lifestyle • Introduced Regenerative Health and Nutrition (RHN) Project • Multi-sectoral committee led by Nutrition Unit adapted a manual for training on RHN • Persons responsible appointed in MOH & Nutrition Unit • Facilitator in regional trainings

8. Rec. 5- To urge communities and schools, including pre-schools, to be nutrition and physical activity-friendly, in order to promote health and well being throughout life.

9. Rec.6- To promote the production, processing, preservation and consumption of local foods, for safe and balanced diets at all season and promote food fortification and micronutrient supplementation when and where needed. • Initiatives to fortify: • wheat flour & maize meal with Vit. A B1, B2, iron, zinc • Vegetable oil with vit. A • Sponsored by GAIN (wheat flour, veg oil) • WFP (maize meal)

10. Wheat flour/vegetable oil fortification • National program • GAIN sponsorship with supply of fortificant to industry for first 3 months • Formed National Food Fortification Alliance (NFFA) – multi sectoral committee of public private partnership (govt agencies, industry, civil society) • NFFA planning & coordinating function • Fortification of flour/vegetable oil started July,2007 • Formative research on going for dev of communication strategy • Yet to get amendment of food law passed by parliament

11. Maize meal fortification • WFP sponsored, as exit strategy • Pilot in 2 communities in WFP program areas • Support women’s groups with corn milling machines, micronutrient feeders/mixing machine & fortificant • Developing radio program to create awareness

12. Rec. 7- To adapt and integrate into maternal and child health services the new WHO Child Growth Charts. • Established a multi sectoral New Growth Chart Implementation Committee- (Ghana Health Service, Korle Bu Teaching Hospital, Dept. of Nutrition & Food Science-Univ of Ghana, WHO, UNICEF -2006 • Disseminated WHO new growth standards at annual retreats of Public Health Division & Reproductive and Child Health Unit and adopted recommendation for separate curves for sexes • Re-print of child health record book bearing growth chart suspended until new chart is developed • Sub committee developed new growth chart (W/A. z-scores, 0.2kg divisions)

13. Key Challenges / Opportunities Challenges • Securing appropriate forum to share recommendations • Few staff at national level • Overload due to multiplying programs / activities Opportunities • Favourable Health Policy • Immediate past Director Gen-GHS, current Minister for Health-nutrition advocates