Interview - Dr. Sandra Pinel, Vice-minister of Health Networks of Honduras
Honduras has finished the national micronutrients standard with emphasis on pregnant women and children under age five
“With the micronutrients standards, we are going to contribute in a 15 percent reduction of the prevalence of anemia in the poorest population”, says Dr. Sandra Pinel. The Salud Mesoamérica 2015 (SM2015) Initiative helped the Secretary of Health (SESAL) during this national strategy with emphasis on pregnant women and children under age five. Dr. Pinel tells us more about it.
What is the greatest challenge posed by the standard still in force?
The standard the country had was fragmented, out of date and it did not provide answers to health managers to guide users in the change of behavior and best nutritional practices.
Why is this change so important?
Municipalities benefitted by the SM2015 Initiative have the highest rates of anemia and chronic malnutrition prevalence in children under age five in the country. This situation has led the Secretary of Health –in the fulfillment of its governing function–to consider the development of this strategy to fortify food at home with powdered micronutrient (MNP) based on regulatory principles that regulate the use of micronutrients. The purpose is preventive and curative, and for the whole national territory beyond SM2015 areas, thus contributing to the reduction of child anemia.
“It is a challenge for the country to strengthen research to obtain national evidence”
What have been the main challenges SESAL has had to face to achieve this change?
The reduction of child malnutrition is the main risk factor for disease and death since it mainly affects poor rural and urban populations and indigenous groups. Chronic malnutrition (small size for age) in children under age five from poor homes is 42.1 percent if we compare it to the national average, which is 22.6 percent [anemia may be related to chronic malnutrition]. To elaborate the micronutrients standard, we had to use international scientific evidence, since there is a limited availability in the country of information or scientific evidence related to the status of the effects of micronutrients deficiency, therefore it is a challenge for the country to strengthen research to obtain national evidence.
How has the SM2015 Initiative supported this process?
The elaboration of the national micronutrients standard closes a gap in the national standards on the micronutrients topic. Its design was conducted by technicians from the national nutritional food safety program and from the SESAL Comprehensive Child Care Program, with the support from the UNAH Pediatrics and Gynecological-Obstetrics Association, IHSS and PAHO-WHO. The SM2015 Initiative has supported through national and international specialists providing technical assistance and financing for the design and implementation of the standard.
What impact is expected on child health for the children of Honduras?
With the introduction of the strategy to fortify food at home with MNP, the strengthening of community participation and primary health care –as well as the promotion of behavioral changes– will contribute in a 15 percent reduction of the prevalence of anemia in the population of children under age five in the country’s poorest municipalities. This target population is the beneficiary of the SM2015 Initiative.
Powdered micronutrients were obtained by means of an international public bid at a cost of US$ 65,216.71
- They arrived in the country in July 2013.
- Child population (6-23 months) is being supplemented since October 2013
- 1,700,000 envelopes are distributed.
- Honduras has had to design and distribute clinical guidelines for fortifying food with MNP at home.
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