Guyana - Panel 1 - Políticas públicas para enfrentar la malnutrición en América Latina y el Caribe

Public policies to address Malnutrition in Latin America and the CaribbeanExchange for national experience

Hon. Dr. Leslie RamsammyMinister of Agriculture, Guyana

Population of 751,223

Land mass of 214,970 sq. km

Life expectancy: 68 years (men), 72 years (women) (UN)

GDP per capita: US$3,600

Debt/GDP : 43%

Member of CARICOM

Member of RIO Group of Countries

Member of CELAC

Agriculture accounts for 23% of GDP

Agriculture accounts for 33% employment

Food Import Bill = $US150 per capita

Guyana is fully committed to the Regional Hunger-Free Initiative.

We enthusiastically embrace the goals of the Hunger-Free Initiative and Guyana’s own timeline is consistent with the Hunger-Free Initiative for Latin America and the Caribbean by 2025.

THIS IS A PILLAR OF THE DEVELOPMENT PROGRAM FOR GUYANA

Guyana’s Strategic Direction

• Consolidate Guyana’s Food Security status

• Achieve Nutrition Security

• Ensure reduction of food imports, such as corn, soya, potato, garlic, onion and spices

• Increase exports of rice and sugar, as both bulk and value-added agriculture commodities

• Increase export of non-traditional crop products

• Meet the local demand for milk and dairy products through local production

• Reach export level production for meats, such as beef and small ruminant meat

• Increase agro-processing for the local and export markets

• Transform agriculture to a F5 strategic direction, accomplishing its target for food and fiber (nutrition) security, but playing a significant role in fuel production, fashion and medicine and furniture and other commodities

• Achieve an annual growth of greater than 5%

Overall Goal of the Food and Nutrition Security Strategy

To improve the health and well-being of all persons living in Guyana through enhanced food and nutrition security. In the development and implementation of policies and programmes to achieve this overall goal, measures will be taken that will impact the entire population. However, specific focus will be given to the section of the population that lives in poverty and is therefore considered vulnerable to food and nutrition insecurity.

Facing up to the challenge – Globally

http://www.wfp.org/hunger/stats

1990

MAIN CAUSES OF DEATH IN THE CARIBBEAN

1980 (%) Nutrition Causes = 53% 2000’s (%) Nutrition Causes = >60%

Heart Disease 20 Heart Disease 16

Cancer 12 Cancer 15

Stroke 11 Stroke 10

Injuries 08 Diabetes 10

Hypertension 06 Injuries and Violence 07

ARI 05 HIV/AIDS 06

Diabetes 04 Hypertension 06

Facing up to the challenge – Globally

• 842 million people in the world do not have enough to eat. This number has fallen by 17 percent since 1990.

• The vast majority of hungry people (827 million) live in developing countries, where 14.3 percent of the population is undernourished.

• Asia has the largest number of hungry people (over 500 million) but Sub-Saharan Africa has the highest prevalence (24.8 percent of population).

• If women farmers had the same access to resources as men, the number of hungry in the world could be reduced by up to 150 million.

• Poor nutrition causes nearly half (45%) of deaths in children under five - 3.1 million children each year.• One out of six children -- roughly 100 million -- in developing countries is underweight.• One in four of the world's children are stunted. In developing countries the proportion can rise to one in

three.• 80 percent of the world's stunted children live in just 20 countries.• 66 million primary school-age children attend classes hungry across the developing world, with 23

million in Africa alone.• WFP calculates that US$3.2 billion is needed per year to reach all 66 million hungry school-age children.

http://www.wfp.org/hunger/stats

Facing up to the challenge – Globally

• In 2010, it is estimated that 171 million children (167 million in developing countries) were stunted.

• Globally, childhood stunting decreased from 39.7 (95% CI 38.1, 41.4) % in 1990 to 26?7 (95% CI 24?8, 28?7) % in 2010.

• This trend is expected to reach 21.8 (95% CI 19?8, 23?8) %, or 142 million, in 2020.

• While in Africa stunting has stagnated since 1990 at about 40% and little improvement is anticipated,

• Asia showed a dramatic decrease from 49% in 1990 to 28% in 2010, nearly halving the number of stunted children from 190 million to 100 million.

• It is anticipated that this trend will continue and that in 2020 Asia and Africa will have similar numbers of stunted children (68 million and 64 million, respectively). Rates are much lower (14% or 7 million in 2010) in Latin America.

http://www.who.int/nutgrowthdb/publications/stunting1990_2020/en/

Facing up to the challenge – Guyana

Multiple Burden – The Hunger Challenge – Over and under- nutrition in young children – Overweight and obesity as well as under nutrition among adults. – Micro-Nutrient Deficiency– Nutrition-Related causes linked to more than 60% deaths overall– Nutrition-related causes linked to increasing non-communicable

disorders such as cardiovascular disease, hypertension and diabetes.

THE STORY OPF GUYANA• STUNTING AT AGE 12 TO 59 MONTHS = 4%• SEEVRE WASTING FOR UNDER 5 YEARS OLD = <1%• ANEMIA IN CHILDREN UNDER 5 YEARS OLD = 24%, FROM >

70% IN 1990• AMENIA IN ADOLESCENTS = 20%, FROM >70%IN 1990• ANEMIA OF PREGNANT WOMEN = 41 FROM >78% IN 1990

Facing up to the challenge – Guyana -- Adolescents

Global School Based Health Survey 2010

Facing up to the challenge – Guyana -- Adults

• 11% of women were underweight (BMI <18.5) • with more than half of these below the age of 15 - 29 year.

• 48% OF WOMEN WERE Overweight and obese (BMI ≥25.0), highest in older women 30 – 49 years (DHS Report 2009)• 12% of men were underweight (BMI <18.5) with about 47% of

these being men 15-19 years old and 38% from 20-29 years old.

• 24% of men were overweight (BMI 25.0-29.9) while 9% were obese (BMI 30.0 or higher).

Demographic Health Survey 2009

Facing up to the challenge – Guyana

Micro nutrient Study 2013

Table 1 – Comparative analysis of National Average of Anaemia Prevalence

Table 2 Anaemia Prevalence by target populations and Geographic Locations 2012

Year < 5 years >5 – 16 years Pregnant Women1997 47.9 56.7 52.0

2012 24.0 20.8 41.3

Locations < 5 years >5 – 16 years Pregnant WomenUrban 21.8 22.1 40.9Coastal Rural 25.9 22.4 45.1Hinterland 26.6 15.3 34.1

Micronutrient Study 2013

Multi-Sector, Multi-Partnership Approach

• Guyana recognizes that the problem is not – Health – Agricultural– Economical

Solutions lies in a multi-sectoral, multi-partnership approach

Food and Nutrition Security Strategy

• Goals – Goal 1: To facilitate sustainable and stable employment-generating

opportunities that would increase availability of and accessibility to food, especially among vulnerable groups.

– Goal 2: To promote Information, Education and Communication / Dissemination systems for use and consumption of healthy foods for improved nutrition of all Guyanese and especially of vulnerable groups

– Goal 3: Promote increased institutional coordination and functioning for improved food and nutrition security.

POLICY COHESION AND INTEGRATION

BRINGING THE SECTORS AND PARTNERS TOGETHER• The National Food and Nutrition Security Council– Inter-sector collaboration– Greater national accountability– ANNUAL FOOD AND NUTRITION SECURITY REPORT CARD– Annual Sector Work Plans– FOOD AND NUTRITION SECURITY MONITORING AND EVALUATION– FAO, IICA, UNDP, UNICEF, UNFPA, UNADIS, UNESCO, PAHO

NATIONAL AND GLOBAL GOALS ALIGNED

GUYANA COGNIZANT OF REGIONAL AND GLOBAL RESPONSIBILTIES • MDG• HUNGER FREE INITIATIVE• CELAC DECLARATION – END POVERTY• POST 2015 SUSTAINABLE DEVELOPMENT AGENDA• CARICOM FOOD AND NUTRITION SECURITY GOALS• JAGDEO INITIATIVE• FAO AND WORLD FOOD PROGRAM GOALS

PURSUING ZERO HUNGER

SOME OVERARCHING STRATEGIES• INCREASE VEGETABLES AND FRUIT CONSUMPTION MORE THAN 60% OF ADULTS COMSUME LESS THAN 200G/DAY• REDUCE DIETARY TRANS FAT, SALT AND SUGAR REDUCE FOOD IMPORT AND ESTABLISH FOOD STANDARDS• ENCOURAGE CROP DIVERSITY AND LOCAL PRODUCTION• PROMOTE FAMILY FOOD PRODUCTION• FORMALIZE INTEGRATED SCHOOL FARMS • SCHOOL FEEDING PROGRAMS• INFANT AND PREGANT WOMEN SPRINKLES

Producing for our people

• Production of ADEQUATE AMOUNT AND VARIETY OF food • Meeting cereal and grain needs of our people• Improving cassava production as direct food source• Surpassing vegetables and fruit: Supply/Demand = >1• Fish Protein = 58kg per capita annually• Meat Protein 60 kg per capita annually

The Agriculture Sector

Providing Remedies and Solutions

Production of Rice

2014 Total 2013 Total

Area Harvested (ha) 180,723

164,983

Yields (bags/ha) 165

158

Paddy Production (mt)

944,760

823,930

Rice Production (mt) 614,095

535,555

EXPORTS (MT) 475.000

394,988

Value of Exports 270,000.000

239,826,3

90

For HY 2014• Rice and Paddy production is 15. 4 %

higher in 2014 than 2013• Exports is 23.4 % higher in 2014 than

in 2013

Production of Other Crops

Selected Crops 2011 20122013

Coconut (dry) - 000 nuts 18,800 17,068 23,216

Pumpkin MT 5,546 4,834 9,623

Hot Pepper MT 3,675 3,461 7,969

Pineapple MT 2,47 3,035 6,113

Watermelon MT 5,380 2,329 2,191

Papaw MT 5,990 4,712 4,980

2013 Exports for non-traditional fresh and processed commodities 12,700MT (~G$ 1,416,307,967)

COMMODITY

EXPORT VOLUME EXPORT VALUE MT $G

2012 2013 2013

Coconut (dry) 8,630 10,213 612,801,840Copra 971 755 133,170,213

Heart of Palm 320 386 211,813,852

Crude(coconut oil) 334 289 79,502,572Mango 182 163 40,988,094Pumpkin 189 146 26,135,174Watermelon 84 116 19,510,190

Coconut (Water) 132 94 21,206,100Eddo 61 89 30,433,402Pineapple 52 71 26,580,688Copra Meal 0 61 19,939,770Sauces 35 54 36,899,750

Pepper (wiri wiri) 41 42 32,588,938Lime 21 29 14,697,882

Breadnut (Katahar) 12 22 13,731,761

Other Exports 116 169 96,307,741TOTAL 11,186 12,700 1,416,307,967

Production of Livestock

Products 2011 2012 2013 Growth (2013-2012)

Poultry Meat (MT) 25,573 30, 412 29,280 -3.7

Beef (MT) 2,153 1,635 2,262 38.3

Pork (MT) 203 199 572 187.4

Mutton (MT) 167 129 125 -3.1

Egg (‘000) 23,508 21,234 17,965 -15.4

Milk (‘000 Litres) 34,176 39,271 46,484 18.4

Harvesting of Fisheries

2009

2010

2011

2012

2013

0 100,000 200,000 300,000 400,000 500,000 600,000

Aquaculture

KG

2007 2008 2009 2010 2011 2012 20130

10,000

20,000

30,000

40,000

50,000

60,000

Marine Fisheries

Total Shrimp Total Fish

MT

2013 Exports for Fish, Prawns and Fish products 21,403 MT (~G$ 14,888,541,000)

Shrimp include: prawns, seabob, whitebelly

Fish include: finfish (industrial and artisanal) and red snapper

Aquaculture include: Tilapia, Mullet, Querriman, Bashaw, Black Shrimp, Tambaqui and Hassar

26

• Global average for imported food - $US70 per capita. • LAC average - $US170. • Guyana’s Food Import Bill - $US200 per capita• imported food bill $US200M or $G40B annually.

Addressing dependency on food imports

REDUCING COST OF PRODUCTION FOR MEAT

PRODUCING CHEAPER STOCKFEED• PRODUCING OUR OWN CORN AND SOYABEANS • REDUCING COST OF IMPORTATION AND REDUCING STOCKFEED

COST BY MINIMUM 20%• GENERATING EMPLOYMENT FOR VULNERABLE POPULATIONS• FIST COMMERCIAL CROPS IN 2014

Addressing dependency on food imports

HIGH FOOD IMPORT BILL IS A FOOD SECURITY RISK•MILK = $US 32M•WHEAT = $US32M•POTATO =$US8M•CARROTS, GARLIC, ONION = $US10M•CORN = $US25M•SOYA = $US20M•CANNED FOOD = $US40M•CHICK PEAS AND PALM OIL = $US5M

Import Substitution (Export Promotion)

• Initiate cultivation of imported commodities including carrots, beet, chickpea and onions, POTATO,

• Develop production of culinary herbs such as cilantro, celery, and parsley.

• Expanding the cultivation of rambutan and soursop.• Develop management strategies for the control of pests and

diseases especially BSD, Red Palm Mite and diamond back moth.

Addressing dependency on food imports

The case of milk

• Milk Production = 46,483,931 L • 20% of Local consumption• Milk Imports = $US34,812,894• Projection reduce milk imports by 15% by 2020

Value Chain

• Expand Guyana’s Agro-processing industry• Reduce post-harvest losses• Replace importation of processed products• Generate employment and income for rural and hinterland

communities• Replace use of sugary carbonated drinks with fruit and

vegetable juices

Value Chain: Food Safety

• Building of a veterinary laboratory• Establishing training programs in agro-processing• Creating an incubator hub for agro-processing• Promoting standards for food safety• Helping fledgling agro-processors with labeling and packaging• Development of Food Safety legislation

Integrated School Farms

• Demonstration farms created for community based organizations

• Integrated farm programme (Healthy Practices Project, St. Ignatius Secondary School, Lethem, Reg. 9: Improving Food Security and Healthy Diets While Adapting to Climate Change)– Ministry of Agriculture– Ministry of Education– Ministry of Health– PAHO– FAO– UNICEF

Grow More Food Campaign (2009)

• The Grow More Campaign was implemented to ensure that Guyanese had adequate food available for themselves and excess to export to Caribbean countries as well as other outside territories.

• This campaign encouraged and facilitated all households to have a kitchen garden in their backyards.

• The MOA through the New GMC distributes seeds on a daily basis to civil society encourage them to farm so that each household within Guyana can achieve food security through self sufficiency.

• Existing facilities upgraded to double or triple current production levels.

• Knowledge, technical capacity and entrepreneurial ability of farmers enhanced.

• Farmers enabled to adopt new and innovative technologies and to engage in safe practices.

Other FNS Programmes

• Utilization of crates and container by farmers boxes for the transport of fruit and vegetables.

• Improved and appropriate handling of fruits and vegetables for trade in the local and export markets for fewer post-harvest losses.

• Relevant training provided to agro processors. Improved quality of processed products.

Other FNS Programmes

Pesticide and Toxic Chemicals Control Board

• PTCCB is mainly mandated for the Management of all Pesticides & Toxic Chemicals and as such is responsible for all Import, Export, Vending, Use & Disposal of same.

• Guyana signatory to the following Conventions on Chemicals Management:

– Rotterdam Convention

– Stockholm Convention

– Strategic Approach to International Chemicals Management

– Coordinating Group of Pesticides Control Board of the Caribbean

• Awareness Programmes • Pesticide Storage Cabinet Project• Construction of Pesticides Storage Facility• Training of farmers on the safe use of toxic chemicals

Hydrometeorological Services

• Improve and develop a Monthly Farmers Weather Bulletin

• Expand network of Automatic Agromet Weather Stations - 2 automatic agromet by end of 2014

• Install automatic rain gauges in areas which are flood prone

• Expand its network of manual rain gauges by 20 by the end of 2014.

Drainage and Irrigation

• Improved drainage and irrigation infrastructure in key production areas.

National Programmes and policies focused on utilization

Ministry of HealthMinistry of EducationMinistry of Human Services and Social SecurityMinistry of Culture Youth and Sports

Maternal and Child Health Programme

• Safe Motherhood Initiative• National Breast Feeding Programme • National Immunization Programme – Maintained national coverage immunization for all routine antigens,

with no region under 85% coverage• Deworming of children was scaled up to a national programme

that includes everyone in households

Early Childhood Development Programme

– Lead by the Ministry of Human Services and Social Security – Child Protection Unit

– Inter sector Early Childhood Development Policy developed and to be endorsed

– Early Childhood Development Practitioners course at University of Guyana

– Licensing of day care facilities to ensure that Caribbean Regional Standards are met

Basic Nutrition Programme

1. Distribution of micronutrient supplement (Sprinkles) to all children 6-24 months of age and to pregnant women attending MCH clinics.

2. Use of WHO growth cards to monitor the nutritional status of children using WHO indicators for wasting and stunting.

3. Iron and folic acid tablets provided routinely for all pregnant women. 4. Screening for anaemia twice during pregnancy and at postnatal clinics.5. Health education and nutrition counselling for mothers.6. De-worming treatment for pregnant mothers in the second trimester.7. Use of inferon and or blood transfusions to correct severe anaemia in

certain hospital settings.

National School Feeding Programme

Lead by the Ministry of Education supplies of Biscuits and fruit drinks

Targets : All Nursery (years 1 &2 ) and Primary Level Schools Hinterland School Feeding Programme ( i.e.(3) out of the ten (10)

regions of Guyana

Guyana’s Hinterland School Feeding Programme

• Collaboration between Ministry of Education, Ministry of Health and Ministry of Agriculture

• Project began in 2006– Aim – to strengthen capacity in areas of :

community based participation in schools improving school attendance school performance nutritional status in Primary level school aged

children in the hinterland regions

Progress Report Total number of participating schools -92# of children benefiting – approximately 16,000 out of a total of 19,000

Guyana’s Hinterland School Feeding Programme

2007- 2009 evaluation report “Nutritional findings revealed that children who were once considered malnourished and as a resulted had “stunted growth conditions”, after being enrolled in the SFP , grew more by 0.8 centimeters when compared to those students who were not a part of this initiative”Additional achievements included • Enhanced nutritional levels of pupils’ diet.• Closer school and community collaboration.• Enhanced agricultural activity within communities.• Improved capacity in project management at the community level.• Enhanced capacity at the community level in food handling and preparation.• Income generation at the community level.• Closer collaboration with the private sector and community administration, (village councils and private companies)• Productive efforts at the school level with some schools engaging in food production and preservation.• Collaboration between and among government ministries, (health, education, local government and agriculture, european

union micro projects programme).• Improved pupil performance and responsiveness in the classroom.• Improved school attendance.• Increased school enrollment.

National Programmes – all levels of school system – Students

School Health Promotion – via Health Promoting Schools (PAHO/WHO) and Child Friendly Schools Initiatives (UNICEF)

• Food Safety,

• Hygiene and Environmental Sanitation,

• Healthy Meal Preparation - training for Teachers, canteen workers, school dormitory Administrators, etc

• Workplace and School Health Wellness Programmes that seek to promote healthy behavioural practices and an awareness about NCDs

• Hand washing with soap awareness initiatives utilizing edutainment strategies

• Nutrition , diet and physical activity promotion programmes (e.g. curriculum implementation,debates, quiz ,and cooking competitions,etc.)

Food Safety and Nutrition Promotion

Training and Promotion Programmes

• Regions targeted - 2,5,6,7,10 & Georgetown

• # of Parents, teachers, canteen and dorm staff trained – 382

• # of Workshops held – 8

• # of Primary Schools - 96

• Reporting period (2010- 2012)

Adolescent Health and Wellness Programme

• Secondary School Health Clubs– Collaboration between the Ministry of Education and the Ministry of Health (adolescent Health Unit and Maternal and

Child Health Unit)

Promotion of adoption of healthy lifestyle choices– Sexual and reproductive health– Healthy eating and regular physical activities

• National peer education programme

– A cadre of adolescents trained and empowered to deliver information to their peers on various topics• Sexual and reproductive health• Teenage pregnancy• Diet• Physical exercise• Breast feeding practices

Complimentary Programmes

• Youth Friendly Programmes– Youth Friendly Health Centres – hosted by the Ministry of Health

• Staff members trained to provide targeted information for adolescents including teenage pregnancy prevention and healthy eating habits.

• Peer educators attached to the health centers trained to interact and provide information to peers within the attached communities in an informative manner

– Youth Friendly Community Centres – hosted by the Ministry of Culture Youth and Sports. • Adolescents within the communities are provided information on various health

topics and activities are guided by a community youth worker.

National Nutrition Programme managed by the Food Policy Division Unit

Along with the Health Promotion Unit, Chronic Diseases Unit, Maternal and Child Health Department

Love Life, Stay Healthy, Live Long Campaign • Obesity Reduction • Healthy Eating• Regular physical activity

Nutrition Components of the Love Life, Stay Healthy Live Long Campaign

• Who am I without my BMI • Count Your Calories• What’s in your shopping bag • Healthy Meal Planning • Million Mile Challenge for Health• Weight No More • Regular fitness walks

Programmes for the Elderly

• Social protection programmes• Senior citizen clinics at primary health care level

Programmes for Vulnerable Population

• PLWHA– Regular screening for amaemia for HIV positive pregnant women on

ART. – Nutrition Guidelines for Persons Living with HIV/AIDS – Food Bank Programme

THANK YOU