Thailand Nutrition Chronicles

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Rosa Quinn
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2 Thailand Nutrition Chronicles Low income country Rapid economic development & Globalization Underwt,>50% Stunting, 40+% Wasting, 8-10% Negligible Severe PEM Stunting 10-12% VAD Xerophthalmia, blindness Bitot s Spot Low stores, Pre& Sch 20% Low S. retinol, Lact, <0.5% Sch, 3% IDA (preg) IDA, >35%, high severe anemia Anemia 20-25%, (Mild-mod.) Anemia 20%, mild IDD ZDD I-salt, endemic area Resurvey, high TGR Low S. Zn-Sch 30-50% TGR< 5% high % & variable low UIE Low S.Zn Sch 30-50%

3 National Nutrition Policy & Planning Low income country Rapid economic development: nutrition transition Multisectoral FNP sustainability 4 th NESDP 5 th NESDP 6 th NESDP 7 th NESDP 8 th NESDP 9 th NESDP 10 th NESDP Communitybased model dev & op. res PHC PAP BMN Scale-up Fd fortification (PPP & research) Obesity & NCD in 10th NESDP

4 Community-based action to improve nutrition Promotive action (e.g., weighing, N.Ed) Problem Identification Village-base supplementary food Community-based action Analysis of causes Formulation action plan BMN P. Winichagoon, INMU Valyasevi, et al, FNB, 1995

(Manpower) Support - contribute - mobilize - control Village

5 The Village Infrastructure for PHC Programme Village committee (Organization) - VHV /VHC - Mother s Group - Other Volunteers (Manpower) Support - contribute - mobilize - control Village Development Fund (Finance) Appropriate Technology Programme Management A. Nondasuta, pers. com.

6 Food production/distribution Staple foods - rice, legumes - chicken, fish - vegetables, fruit trees Complementary food production Rice + legume + sesame mixes for infants & young children Backyard chicken Provision of shelter, feeding, vaccination Home, school & community gardening ground/soil preparation, crop rotation, organic fertilizer, pest control Fish ponds Supplementary food & nutrition education for pregnant & lactating women P Winichagoon, INMU

7 WHO Global NCD Report 2010/Lancet Series 2010

8 The predicted escalation of the burden from diabetes and IGT The future for Thailand? Diabetes Atlas, International Diabetes Federation, 2003.

9 Dietary Intake Survey in Thailand, Item Year Rice, cereals and tubers (g) Fish and shellfish (g) Meat and poultry (g) Eggs (g) Milk and products (g) Source: Department of Health, Ministry of Public Health, Thailand

10 Dietary Intake in Thailand Energy (kcal) Protein (g) As %energy % animal fds Fat (g) As %energy Carbohydrate (g) As %energy

The National Food Committee Component Chairman : Prime Minister (or designated

Ministry of Agriculture 7 Resource persons in : -Food Security (2) -Food Safety (1)

Defense Committee members 11 related ministries, 4 executive administrators Ministry of

Ministry of Industry Ministry of Public Health Ministry of Commerce Ministry of Interior

National Security Council The National Economic and Social Development board The

11 The National Food Committee Component Chairman : Prime Minister (or designated Deputy-Prime Minister) Secretary : FDA, Ministry of Public Health Co-secretary : ACFS, Ministry of Agriculture 7 Resource persons in : -Food Security (2) -Food Safety (1) -Food Quality (1) -Law (1) -Economic and Trade (1) -Food Innovation (1) Ministry of Defense Committee members 11 related ministries, 4 executive administrators Ministry of Finance Ministry of Foreign Affairs Ministry of Social development and human security Ministry of Industry Ministry of Public Health Ministry of Commerce Ministry of Interior Ministry of Science Ministry of Education Ministry of Agriculture and Commodity The National Security Council The National Economic and Social Development board The Consumer Protection board The national health committee Committee / Sub-Committee 11 Kraisid Tontisirin, Mahidol University

12 Thailand Food Strategy Guided plan Risk based analysis Principles Participation/ Partnership Evidence based plan Integration Sustainability REVIEW Related Food Strategies of: ASEAN Australia Japan Canada England EU Etc. SWOT Analysis Food Management Strategic Framework Vision Objectives Outcomes Theme 1 Food security Theme 2 Food quality and safety Theme 3 Food education Theme 4 Management System REVIEW Related Food Strategies of Thai Gov. Agencies: NESDB Min. of Public Health Min. of Agriculture and Commodity Min. of Industry Min. of Commerce Etc. Continued Research and Knowledge Based Inputs Food Chain Approach / Global Reach / Local Links to the community and household 12 Kraisid Tontisirin, Mahidol University

13 Principle : Ensuring a sustainable food security and effective management of food production resources by active stakeholders participation Production Supply & Access Land & Water Mgt/Reforming Balancing Food, Feed & Fuel Food Production Zoning Innovation & Technology Capacity Development & Career Enhancing Food Access at Household & Communities Logistics Improvement Establish Crisis Management Systems R & D Along the Food Chain Active Stakeholders Participation 13 Kraisid Tontisirin, Mahidol University

Theme 2 : Food Quality and Safety Principle : Ensuring high quality and safe food to

Production Food Standards Quality Safety Nutrition Food Industry Strengthening Community

Production Practices Establishment of harmonized standards Strengthening of food quality

14 Theme 2 : Food Quality and Safety Principle : Ensuring high quality and safe food to protect consumer health and to facilitate domestic/international trade Community Food Production Food Standards Quality Safety Nutrition Food Industry Strengthening Community Food Processing (food loss reduction / value added) Strengthening - Value Added - Enhance Production Practices Establishment of harmonized standards Strengthening of food quality and safety assurance systems Trading & marketing promotion 14 Kraisid Tontisirin, Mahidol University

Theme 3 : Food Education Principle : R&D and knowledge utilization through engaging stakeholders in sustainable and effective use of food production resources along the food chain and also

15 Theme 3 : Food Education Principle : R&D and knowledge utilization through engaging stakeholders in sustainable and effective use of food production resources along the food chain and also strengthening desirable consumption behavior for well-being R&D Output Research and Knowledge Development Best Practice Knowledge Integration Knowledge Dissemination Knowledge Utilization & Practice Basic Knowledge Utilization 15 Kraisid Tontisirin, Mahidol University

Strengthening Database & Management System Legal

16 Theme 4 : System Management Principle : Effective food management systems along the food chain to deal with current and emerging issues in food Organization Reorganization & Strengthening Database & Management System Legal system Revise and Reform 16 Kraisid Tontisirin, Mahidol University

17 New theory for land uses in agriculture* Land is divided in 4 areas Vegetables/Fruits House & gardens with animal foods Rice field (and paddy field fishery) *From H.M. the King s Sufficiency Economy aiming for household food security ท มา : Water reservoir and aquaculture 17

18 Kraisid Tontisirin, Mahidol University Community Food Production Home and school gardens growing vegetables, fruits, fishes and chicken for learning, consumption and income Supplementary food for pregnant mothers Complementary food for IYC food preservation and food processing at village to be OTOP products Cooperative and micro credit

19 Goals for Community nutrition program Promote normal weight and height in life cycle age Goals Infants - avg. weight kg (LBW 5 %) Children under 5 - Underweight 5 % - Stunted 5 % - Overweight and obese 5 % Children Stunted 10% in 5 yr and 5 % (after 5 yr) - Overweight and obese 10% in 5 yr and 5 % (after 5 yr) Teenage and adults - Overweight and obese 10% in 5 yr and 5 % (after 5 yr) Elderly - BMI Kraisid Tontisirin, Mahidol University

20 Implementation of the Strategic Framework of Food Management (SFFM) 1. Integrated the SFFM in the 11 th National Economic & Social Development Plan Each sector implementing the SFFM & reports back to the National Food Committee 3. Three thematic committees for promotion the implementation on: Food Security, Food Quality & Safety, and Linking Food to Nutrition& Health Kraisid Tontisirin, Mahidol University

Chairman of the Food Strategic Planning Committee

Thailand s Food Research Policy Prof. Kraisid id Tontisirin i i Chairman of Policy Board, the TRF Chairman of the Food Strategic Planning Committee of the National Food Committee Presentation at the 2nd