Pan-African Conference 21 - 24 July 2002 Inter-Continental Hotel ...

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Abstracts 10/22/02 11:26 AM Page 6 S6 IT: Instrument privilégié pour la planification stratégique et la coordination intersectorielle en matière de lutte contre la malnutrition D. Berardi (1), A.Ag Iknane (2), M. Diarra (3) (1) Dario Berardi, Director Data Analysis Support Center (DASC), Rome, Italy (2) Akory Ag Iknane, Public Health Specialist, researcher in nutrition for the National Research Institute in Public Health (INRSP), Mali (3) Modibo Diarra, Head of the Unit for the Follow-up of Food and Nutrition Situation (DSSAN), Mali Au Mali, comme dans la plus part des pays en voie de développement, les problèmes nutritionnels représentent un important défi: comment résoudre de façon durable les problèmes de malnutrition face à une situation permanente de pauvreté. En absence de solutions prouvées, un élément indispensable d’une stratégie efficace et durable de lutte contre la malnutrition est la coordination des intervenants et le partage de l’information entre tous les intervenants, aussi bien dans le domaine de la recherche que des statistiques et des interventions. Le Mali a relevé le défi de la coordination en séparant les fonctions de coordination intersectorielle et planification stratégique des fonctions d’intervention et d’appui aux structures déconcentrées. Une Division du Suivi de la Situation Alimentaire et Nutritionnelle (DSSAN) a été crée au sein de la Cellule de Planification et Statistique (CPS) du Ministère de la Santé pour s’occuper de la coordination intersectorielle et de la planification stratégique. Pour atteindre ces objectifs, la DSSAN a beaucoup investi dans la Technologie Informatique (IT) et ainsi a développé le Système d’Information pour le Suivi des Interventions Alimentaires et Nutritionnelles et des Statistiques (SISINAS), un Fond Documentaire sur l’alimentation, les pratiques alimentaires, la nutrition et un Journal trimestriel “Les Echos du SISINAS”. Le SISINAS et le Fond Documentaire utilisent un site web dynamique (utilisant une banque de données en ACCESS (® Microsoft) et les Cold Fusion Server Applications (® Macromedia) pour la mise à jour et la diffusion des informations sur les interventions et la documentation, tandis qu’une version en CD-ROM du SISINAS et le Journal sont les instruments de diffusion pour les zones non connectées à Internet. Le développement du SISINAS et du Fond Documentaire a débuté en mai 2002 et sa mise en route est prévu pour octobre 2002. Le choix de Internet vise aussi le renforcement de la coordination et de l’échange d’informations au niveau sous-régional. IT in nutrition communication / La TI en communication nutritionnelle Suzanne Elbon Centers for Disease Control and Prevention, CDC, USA Instructional Technology (IT) provides an innovative approach to communicate nutrition concepts in a way that is interactive and engaging, compact, and economically reproducible. Health and nutrition communication is a complex field requiring study and practice, like epidemiology and laboratory science. Due to a lack of capacity, many international micronutrient efforts either neglect communications, or rely extensively on expensive consultants. IT products can play a role in increasing awareness and participation of communication experts in nutrition programs. These tools also enhance the understanding of nutrition program managers about the need for communication to be an integral part of the overall program. The US Centers for Disease Control and Prevention (CDC) developed CDCynergy for Micronutrients, a CD-Rom based tool designed to respond to this need. CDCynergy expands nutrition communication planning capacity, allowing international counterparts to plan and manage programs competently on their own. The CDC has also developed other instructional tools, such as MAPit (Micronutrient Action Plan instructional tool) to be used as part of epidemiology training programs. MAPit includes a component that teaches epidemiologists and other health professionals about the crucial role of nutrition communication within a micronutrient program. July 2002, Vol. 15, No. 2 SAJCN (Supplement) ABSTRACTS The role of IT in dietary assessment / La TI dans l’évaluation diététique J.G. Erhardt Hohenheim University, Stuttgart, Germany In this lecture different procedures to assess the dietary intake will be presented. Since most of the procedures were developed in industrial countries a focus of the presentation will be the applicability of these dietary assessment methods for african countries. The methods can be differentiated in prospective and retrospective methods. The most important are protocol methods, 24 hour recalls, food frequencies and diet history methods. Each of these methods have advantages and disadvantages which will be addressed in detail during the presentation. To illustrate the methods a software will be used which was developed by the speaker. The software is public domain and can be downloaded at www.nutrisurvey.de. IDPAS: Networking global expertise to expand research and action on anaemia prevention and control/ IDPAS: Le Réseau Global d’expertise pour l’extension de la recherche, du contrôle et de la prévention de l’anémie Gary Gleason International Nutrition Foundation, USA Iron Deficiency Anaemia (IDA) is Africa’s most widespread micronutrient problem. IDA threatens the lives, health, cognitive, physical and social performance and overall quality of life of infants, children, youth, adult women and men across the continent. In recent years, technical consensus was achieved in several areas needed to accelerate introduction and effective and sustainable integration of the key interventions for prevent and control iron deficiency anaemia. In May 2002, the United Nations General Assemble ratified a document setting a target for all countries to reduce anaemia by 30% during the current decade at the Special Session on Children. Efforts to prevent iron deficiency are moving higher on the public health agenda of many African countries and more concretely into national planning strategies. This progress is causing a temporary but serious problem in many countries and for those international agencies and NGOs support efforts to prevent and control anaemia. Those with advocacy, organizational and operational responsibilities for the multiple intervention strategies needed to improve iron nutrition, often need detailed technical information, access to ongoing advice and pragmatic operational experiences. Further complicating overall efforts to prevent and control anaemia are the multiple, often poorly connected sectors and groups involved. These may include millers and bakers (cereal fortification), Government standards committees (regulatory and monitoring roles) and health staff and NGOs (iron supplements and improving diets through education). Successfully developing an overall strategy to successfully address anaemia requires a spectrum of technical information and experience that is most often beyond the expertise of any of the specialists and project personnel working in this field. Current information technologies, channels and access levels now available in most African countries and experience in areas such as “applied knowledge utilization” and “proactive networking” led to the development of the Iron Deficiency Project Advisory Service (IDPAS) and “Iron World” as a global network for technical information support and project level experience exchange. Beginning in 2000 with grant support from the Micronutrient Initiative, IDPAS Iron World focuses on iron nutrition and supports evidencebased advocacy to improve national policies related to amenia control, acceleration of pragmatic research and the strengthening and expansion of field projects aimed at reducing iron deficiency in children and women in developing countries. The major strategy employed by IDPAS is a multi-channel, proactive network that carries general and specifically requested technical information to national and project level users and promotes facilitates sharing of information among network users globally. IDPAS Iron World developed direct channels with users in 49 countries, 18 in Africa. Network channels for technical information and interaction on specific technical and operational issues includes the world wide web, a series of updated CD ROMs, e-mail, fax, telephone, post and courier. The network operates without any fees or advertising and provides users with a fully searchable database of over 1,100 references organized by topic, over 400 full text chapters and articles, contacts for both other users and experts working on iron nutrition and individualized rapid responses to both queries on technical and project operations. The first 12 months of IDPAS Iron World operations emphasized building and devising an accessible, manageable, and up-to-date technical information
Abstracts 10/22/02 11:26 AM Page 7 system comprehensively covering prevention and control of iron deficiency research and interventions. This period also focused on promoting participation and use of IDPAS services among international organizations, NGOs, bilateral agencies, universities and project personnel throughout the developing world. The second, current phase of the project aims at extending Iron World much more actively into field level project operations, in a number of selected countries. The objectives are to supply specific information and technical advice to more of those doing research, and supporting and implementing interventions related to iron nutrition. However, this phase of network development also aims toward developing more active “populating” Iron World more information on the experience of its users and more active sharing of experiences among them. To better balance information reports based on laboratory and field research, IDPAS is actively exploring mechanisms aimed at drawing out and sharing practical, field level operational experiences. Initial efforts demonstrate the challenges of proactive networking. Identifying the core group of those working on research and relevant projects in African countries, reaching them by means other than an actual visit, and finding effective and acceptable means for encouraging them to share experiences are difficult. The experiences of IDPAS in developing both a global technical information service and in trying to develop a proactive networking model should be useful for those working in several other technical fields of nutrition, particularly if barriers to communication among those working in related fields can be overcome and a genuine epistemic and virtual community can be developed. IT and food security / La TI dans l’évaluation de la sécurité alimentaire Dr. Helen Hambly Odame Research Officer ISNAR (International Service for National Agricultural Research), The Netherlands The world has the tools, wealth, food and know-how to fight poverty and hunger. This may be no surprise to those us who as individuals or organizations work in nutrition and agricultural research and development. Yet the extraordinary actions to prevent 800 million people in the world being undernourished in 2010 are sadly lacking. The largest proportion of people who suffer from this inaction lives in Africa. To what extent can IT be an opportunity to achieve food security through improved assessment and action? If less than one in one hundred Africans have any access at all to a single modern information technology (i.e. a radio, a telephone, a fax, the Internet, etc.) is IT the means for a digital divide or a digital bridge? The conceptual basis of this paper rests on the sharing of knowledge and participatory assessment, and not the control and release of information. To this end, the experiences of various international interventions related to IT and nutrition in Africa are discussed. The agencies include the CTA, the CGIAR, IICD, UNESCO, IDRC and others. Links with national partners in Africa and the role of critical stakeholders such as rural women and youth are emphasized. The paper concludes by suggesting that only if IT engages fully with social communication and learning will it impact universal food security. IT in nutritional status assessment / La TI dans l’évaluation nutritionnelle Leif Hambræus, MD PhD Professor emeritus, Unit for Preventive Nutrition, Dept of Bioscience, Karolinska Institutet at Novum, Sweden Too low as well as too high intakes of energy and nutrients may to some extent be compensated by changes in body stores, reflected by changes in body composition. However, sooner of later it leads to disturbances in the metabolic regulation resulting into malnutrition disease. Deficiency of energy or one or more nutrients, malnutrition minus, leads to more or less well-defined deficiency diseases and increased susceptibility to infections. A surplus of energy or nutrient intake also leads to long-term deleterious effects, often referred to as malnutrition plus, i.e. obesity, cardiovascular disease. Nutritional epidemiology depends on valid assessment of nutritional status of individuals and populations. For any preventive health care measures, it is essential to find methods to identify individuals and populations at risk at an early stage. as well as exposure of individuals to various risk factors. In the flow sheet of various methods and diagnostic tools used to assess ABSTRACTS nutritional status, the assessment of dietary intakes by various record and recall methods may offer possibilities to identify risk groups at an early stage. Changes in body composition as result of reduced stores of nutrients and changed plasma levels may be used as biomarkers of potential malnutrition before any clinical symptoms and signs have developed. Clinical data are, however, relatively late results of malnutrition. The final outcome of the health effect of malnutrition is revealed by morbidity and mortality data in health statistics. All above mentioned methods for assessment of nutritional status benefit from the use of computer technology. Valid data on dietary intake are depending on (1) accurate food databases available on the net or CD; and (2) data processing procedures of results obtained from food questionnaires as well as dietary records and recalls, to express the results in relation to recommended daily allowances (RDA). Local or regional valid data on RDA should preferably be used as references. Computer-assisted self-interviewing programs may prove to be an economic approach to assess dietary intake not only of nutrients but also of potential food-borne exposures in a population. In order to evaluate the accuracy of dietary intake it is also essential to analyse body composition and physical activities for indirect estimation of energy balance. Specific computer assessment programs have also been developed for assessment of nutritional status.. These are based on a number of measurement techniques including nutrient intake, body composition data and exercise. Many of the programmes take advantage of interactive health communications technologies in order to screen multiple behaviours and initiate interventions, for making nutrition and exercise plans for athletes as well as patients. This also makes it possible to combine assessment of nutritional status with nutrition education and information. It is understood that health statistics comprising morbidity and mortality data in relation to dietary intakes are almost completely depending on accurate data processing procedures. Information technology and use of computer analysis as well as interactive communication technologies have the potential to eliminate and greatly reduce many of the barriers to analyse nutrition assessment data and support nutrition education of the public. Communicating nutrition research: obstacles and opportunities through IT / Communication de la recherche nutritionnelle: obstacles et opportunités par la TI Nik Harvey International Food Policy Research Institute (IFPRI), USA As nutrition researchers rise to face the challenges surrounding food policy issues, information technology (IT) is greatly enhancing their work. IT is revolutionizing the field by allowing for greater accuracy in data collection, quicker information sharing and new methods of teaching and learning. IT is also being introduced as a tool to effectively communicate nutrition research and strengthen the linkage between nutrition science and public policy formulation. The goal of IT is not simply wiring houses and classrooms; it is bringing information to people whom are deprived of it. The challenge for nutrition communications is to expand the use of IT in regions where technology is limited, unreliable or too costly. Considering the principles of techno-realism, it is important to note that IT is not the ultimate solution to nutrition communications, and should not be the focal point of any communications strategy for developing countries. IT should be viewed as a means of assisting knowledge transfer, and augmenting communications. Since usage of IT varies by location, it is also important to consider IT within the capacity that it is available. Communicating Nutrition to Policymakers While improving nutrition appears to be a moral imperative, nutrition as a means for economic and social development is an illusive concept for many policymakers. To communicate nutrition requires information that “sells” the issue, convincing policymakers and their advisors of its importance. Since policymakers receive information from a variety of sources, the extent to which policymakers use IT for nutrition information is debatable. However, policy advisors are looking to IT for information, as well as traditional mediums. Communicating Urban Nutrition Urban growth in developing countries affects nutrition, and many of these countrys’ urban food security policies need to be reevaluated. Unfortunately, communicating nutrition information is difficult because many urban policymakers focus more on squalid environments, security and infrastructure. As cities grow, urban food security is often crowded out of the public policy agenda. S7
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Pan-African Conference 21 - 24 July 2002 Inter-Continental Hotel ...

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