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Article Excerpt
Abstract
This article describes the process for development of the first national nutrition policy in the Sudan; an effort which was made possible by the willingness of the Sudan Federal Ministry of Health and the Support from the UNICEF--Sudan. The process for the development of this policy document is in fact a useful learning tool that should be documented and made available for researchers, for the purpose of updating and for monitoring and evaluation. The goal of this nutrition policy was to define a framework through which available technical, human, and financial resources may be mobilized in order to ensure the health and nutrition status of all Sudanese citizens is significantly improved through nutrition and other related interventions.
Introduction
Improving the health and nutrition status of the people of Sudan is one of the priorities for the Federal Government of Sudan (FMOH, 2005), and is vital to its development. While Sudan has enormous potential in terms of natural and human resources (FAO, 2005), it is not on track to meet the Millennium Goals by 2015 (UNICEF, 2006). Health, education, social services, and vital infrastructures for transport and utilities have all stagnated in recent years (Abdel Ati, 2002). Decades of civil conflict have contributed to high rates of morbidity and mortality, for the most part due to preventable communicable diseases and suboptimal health seeking behaviour, which has been exacerbated by the limited coverage and quality of health services and education infrastructures.
Recurrent episodes of natural and manmade disasters have crippled the economy and livelihoods of both urban and rural populations, contributing to rising levels of poverty and resulting in well over half of the population living below the poverty line.
A low but significant and rising prevalence of HIV+ and AIDS adds to the threats to health, productivity and wealth, and must be approached preventively, now, as well as through treatment (SHHS, 2007; FAO, 2005). Nutrition indicators from recent studies (SHHS, 2007) show a worrying nutrition profile in the country. Almost one third (31%) of children under the age of five in Sudan are moderately underweight, while 9.3% are severely underweight. Almost half (48%) of children under five suffer from moderate or severe chronic malnutrition, while 18.1% of children under five suffer from moderate or severe acute malnutrition.
Overall, nutrition status is found to be positively associated with increasing levels of maternal education and increasing household financial resources (SHHS, 2007), suggesting that efforts to reduce poverty and improve human resources is necessary to see improvement in nutrition for the population.
While not common, 3.6% of children under five are overweight (SHHS, 2007). In the context of increased access to non traditional, and processed foods, as well as limited physical exercise, children are put at risk of developing lifestyle diseases such as type 2 diabetes at a young age. Infant and young child feeding practices are not optimal (SHHS, 2007). Less than half of the children in Sudan are exclusively breastfed to four months (42 per cent), and only one in three infants (33.5 per cent) are exclusively breastfed to six months. Complementary foods are often introduced early, and continued breastfeeding until two years not common.
This effort of developing a national nutrition policy did not stem out of nothings, for instance, the Sudan's First National Food and Nutrition Seminar (Yousif et. al, 1973) recommended that a "malnutrition problem of such magnitude needs a coordinated and well-planned approach and requires the active cooperation of a large number of agencies". The seminar's findings are still relevant: the same course of action is still the key to improving the situation. On the other hand, the Sudan's National Plan of Action on Nutrition (Sudan government, 1995), written at the request of the 1993 FAO-WHO International Conference on Nutrition, and adopted by the Government of Sudan on 21st May 1995, reiterated the need for coordinated action in the area of nutrition.
The process for the development of the policy document
The consultants held series of meetings with the director of the National Nutrition Directorate (NND) and his staff and reviewed their activities and what has been documented in this matter. They then held several meetings with the relevant ministries including Federal Ministries of Health, Agriculture, Social Affairs, Humanitarian Affairs, General Education, and Higher Education as well as the Khartoum State Ministry of Health, the Population Council and the Sudan Central Bureau of Statistics. All academic and research institutions in Khartoum (the Capital) were visited and the issues of nutrition activities...
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