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Programs. Micronutrient Intervention (MI) Programs ORT (Oral Rehydration Therapy). Program Definition. A program is a set of organized activities designed to accomplish a clearly-defined goal. Programs target a specific population,
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Programs Micronutrient Intervention (MI) Programs ORT (Oral Rehydration Therapy)
Program Definition • A program is a set of organized activities designed to accomplish a clearly-defined goal. • Programs • target a specific population, • are conducted by governmental or non-governmental organizations, and • have evaluation components or measures.
Major MI Program Types • Supplementation • Fortification • Dietary diversity • Agricultural • Education • Food assistance
Examples—Vitamin A • Supplementation—capsules (Pakistan) • Fortification—margarine, cooking oil, milk (US, Philippines, Pakistan) • Dietary diversity • Agricultural—sweet potatoes (Africa) • Education—growing food (Nepal) • Food assistance—WIC (US)
Examples—Iron • Supplementation—liquid drops (Ethiopia), oral supplements (India) • Fortification—enrichment of flour (Nigeria, Mexico, US) • Dietary diversity (many countries) • Agricultural • Education—iron needs for women, iron pots • Food assistance—WIC (US)
Examples—Iodine • Supplementation—oil capsules (Philippines), “sprinkles” (Pakistan) • Fortification—salt, soy sauce
Relative Costs and BenefitsSupplements • Supplements inexpensive and effective • Require • Clinical support • Distribution network • Assessment
Relative Costs and BenefitsFortification • Appropriate fortification programs reach a large target audience with nutrients that are likely low in the general food supply. • Infrastructure requirements • Equipment • Expertise • Monitoring • Distribution • Assessment
Relative Costs and BenefitsDietary Diversity • Agricultural • Subsistence crops v cash crops • Improved agricultural methods • Farmer education • Food processing and storage • Education • Assessment
Relative Costs and BenefitsFood Assistance • Emergency • Long-term • Dependency v development
Water and ORT • Water uses • Waterborne diseases • Water sanitation and disinfection • Oral Rehydration Therapy (ORT)
Water Diseases • Pathogens—bacteria, parasites, viruses • Guinea Worm • Ascariasis • Campylobacteriosis • Cholera • Hepatitis • Leptospirosis • Onchocerciasis • Typhoid • Schistosomiasis • DIARRHEA and ANEMIA • Mosquitoes—malaria, dengue hemorrhagic fever • Heavy metals—runoff from mining or manufacturing
Water Sanitation and Disinfection • Temperature • Boiling • NEW TREATMENT—solar heating • Chemical treatment—largely chlorination
Diarrheal Disease • In developing countries children typically exhibit diarrhea 2-6 times per year. • Children die from diarrheal diseases • Approximately 2.2 million children/y under 5 • 1/20 die from diarrheal disease before age 5 • Other issues • Impairment of nutritional status • Susceptibility to other acute infections
Oral Rehydration Therapy (ORT) • Hospital v home • ORT—defined by WHO in 1993 • Increased volume of fluids, either oral rehydration salts (ORS) or other recommended home fluids, along with continued feeding • ORS—packet of salt and sugar to increase water absorption (does not destroy disease-causing microorganisms)
ORT Saves Lives • UNICEF and WHO predict that ORT could save the lives of 90% of the children under 5 who die from diarrheal diseases. • Estimates of ORT use in households in developing countries • 75% use some ORT • 33% use ORT following the 1993 definition
Programs as Models • Programs work toward achieving measurable goals. • Programs include organized activities and evaluations. • Programs target specific populations. • Data needed for developing program models.
Program Examples • Diouf (Video 2, Clip 1) • Bertini (Video 2, Clips 3, 4)