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Micronutrient deficiencies are common across the developing world and have major effects on the health outcomes of its population. Although this is well understood, many countries find it difficult to bring about policy change in this regard. This paper uses micronutrient policies designed and implemented in Malawi as a case study to shed light on the barriers and gaps faced by developing countries for similar programs and policies. To understand the drivers of policy change, this paper uses the kaleidoscope model to trace the policy processes of three major micronutrients—iodine, vitamin A, and iron. Using a select set of policy process tools, as well as field interviews with key informants who were part of Malawi's micronutrient policy process, the authors test a set of hypotheses on 16 variables that drive policy change in the micronutrient policy sphere. Results indicate that much of the agenda setting for micronutrient policies and programs was triggered by external events that focused on the elimination of micronutrient deficiencies as part of the global development agenda. These events include the International Conference on Nutrition, the Millennium Development Goals, and, more recently, Scaling up Nutrition. The design of micronutrient policies and program interventions in Malawi was adopted by locally mandated ministries and institutions, in collaboration with development partners who provided both financial and technical support at the design stage. The adoption of micronutrient policies and intervention programs was driven primarily by external funding, particularly through supplementation programs related to vitamin A and iron. Adoption of fortification standards for vitamin A has been going on for more than a decade due to continuous resistance from the private sector, which faces additional costs and needs greater technical expertise. The biofortification method of micronutrient interventions for iron and vitamin A is externally driven and relatively new in Malawi. Although this method is widely accepted by policy makers, no concrete strategy has been developed for its design, adoption, and implementation. Further, supplementation and fortification programs continue to face implementation challenges due to poor physical infrastructure and monitoring systems. However, the national institutional architecture required for agenda setting, design, adoption, implementation, evaluation, and review to address micronutrient deficiencies is in place in Malawi. The system needs continued support from development partners for effective functioning at all levels. The use of various tools for the policy change part of the kaleidoscope model indicate that policy change is a dynamic process; over time, changes in the nature and composition of the members of policy and institutional architecture can result in different policy outcomes. The Malawi case study demonstrates two things. First, local leadership is crucial in keeping micronutrient deficiencies on the policy-making agenda, and second, it matters where coordinating power is placed in the policy hierarchy. This paper finds that, even with policy champions, adopted policies will face implementation challenges unless they are supported with adequate resources and are systematically followed through to final execution and delivery. ; Non-PR ; IFPRI1; F Strengthening institutions and governance; F.2 Political Economy of Development Policy and Investment Processes ; DSGD; DGO

The Nancy N. Boothe papers, 1980-2009 [bulk 1990-1997], are composed of articles, notes, reports and a wide variety of feminist publications. Much of the material documents the U.N. Fourth World Conference on Women, which Ms. Boothe attended as Executive Director of Atlanta's Feminist Women's Health Center. Artifacts, artwork and textiles relate to the conference and to other women's and health issues. ; Born in Battles Wharf, Alabama (1948), Nancy N. Boothe graduated from the University of South Alabama as a registered nurse (1971). She received a B.S. in nursing from the Medical College of Georgia (1976), and a master's degree in Counseling from Troy State University [Florida Region] (1981). Boothe served in the U.S. Nurse Corps in the U.S. and Korea (1970-1984), and worked as clinical director and consultant at a number of health facilities in Louisiana and Florida. She became Executive Director of the Atlanta Feminist Women's Health Center in 1994. In 1995, she attended the Fourth World Conference on Women in Beijing, China, where she taught the workshop, ""GYN Self-Help."" Boothe has served on the boards of All Women's Health Services in Portland and Eugene, Oregon; the Sexual Assault Center, Atlanta, Georgia; and the Jeanette Rankin Foundation, Athens, Georgia. She is also a member of the Feminist Majority Foundation's ""Women's Commission for Congressional Oversight"" and A.P.D. Citizen Review Panel.; Founded in California in 1971 by Carol Downer (1933-) and Lorraine Rothman (1932-2007), the Feminist Women's Health Center was established to empower women through self-knowledge, education and self-help groups. The Atlanta Feminist Women's Health Center was established in 1977. Its mission is to ""provide accessible, comprehensive gynecological healthcare to all who need it without judgment. As innovative healthcare leaders, [they] work collaboratively within [their] community and nationally to promote reproductive health, rights and justice. [They] advocate for wellness, uncensored health information and fair public policies by educating the larger community and empowering [their] clients to make their own decisions.""; The United Nations convened the Fourth World Conference on Women, September 4-15, 1995, in Beijing, China, with a Platform for Action that aimed at achieving greater equality and opportunity for women. Three previous World Conferences were held in Mexico City (International Women's Year, 1975), Copenhagen (1980) and Nairobi (1985). 189 governments and more than 5,000 representatives from 2,100 non-governmental organizations participated in the Beijing Conference. The principal themes were the advancement and empowerment of women in relation to women's human rights, women and poverty, women and decision-making, the girl-child, violence against women and other areas of concern. The resulting documents of the Conference are The Beijing Declaration and Platform for Action. The U.N. Fourth World Conference on Women manifested a global women's movement for change and has been called ""the Woodstock of the women's movement.""; The World Conference on Women was also accompanied by an informal meeting (August 30-September 8) of non-governmental organizations (NGOs). This NGO Forum on Women, Beijing '95, brought together thousands of women from around the world to exchange information and ideas, celebrate women's achievements and contributions and draw attention and develop solutions to discrimination facing women world-wide.

This book, inclusive of 19 chapters, provides discussions on the benefits and limitations of food-based approaches for the prevention and control of micronutrient malnutrition. Different chapters focus on specific relevant topics, including current developments in food-based approaches and their program applications, relevance of agricultural interventions to nutrition, impact of multi-sectoral programmes with food-based approaches components in alleviating undernutrition and micronutrient malnutrition, animal-source foods as a food-based approach to address nutrient deficiencies, aquaculture's role in improving food and nutrition security, benefits of vegetables and fruits in preventing and combating micronutrient malnutrition, benefits of food-based approaches for overcoming single specific micronutrient deficiencies, and food fortification. This book will be of great use to professionals interested in public health, human nutrition, micronutrient deficiency interventions, food and nutrition security policy interventions, and agricultural research.

Intro -- Contents -- Preface -- Prevention and Mitigation of High-Dose Radiation-Induced Injury -- Zinc as Essential Micronutrient: Physiological Role and Factors Affecting Its Bioavailability -- Biotin (Vitamin H or B7) -- Double Fortification of Salt with Iron and Iodine as an Effective Tool in Simultaneously Alleviating Two Micronutrient Deficiencies -- Biofortified Wheat to Alleviate Micronutrient Malnutrition Globally -- Effects of Iodine and Selenium on the Thyroid Function -- Micronutrient Interrelationships: Synergism and Antagonism -- Lentils (Lens Culinaris L): A Superior Whole Food Solution to Micronutrient Malnutrition -- Use of Antioxidant Micronutrients as an Adjunctive Therapeutic Strategy against Hearing and Balance Disorders -- Index.

Several catastrophes could block the sun, including asteroid/comet impact, super volcanic eruption, and nuclear war with the burning of cities (nuclear winter). Previous work has analyzed alternate food supplies (e.g., mushrooms growing on dead trees, bacteria growing on natural gas). This was shown to be technically capable of feeding everyone with macronutrients (protein, carbohydrates, and lipids) and minerals, although economics and politics remain uncertain. The present work analyzes vitamin availability in such alternative food scenarios. The vitamin content of various alternate foods is compared to the US recommended daily allowance (RDA) as well as the average requirement defined by the European Food Safety Authority (EFSA) and insufficiencies of single food sources are discussed. Single alternate food sources are always deficient in some vitamins, and the problems associated with this are discussed. To prevent disease in an alternative food scenario a wide range of foods must be consumed, or the dietmust be supplemented. Backup plans discussed include chemical synthesis of vitamins, plants grown with artificial light and growing bacteria rich in certain vitamins. Finally, insights from this analysis are provided for combating existing micronutritional deficiencies using alternative foods today. ; Peer reviewed

Several catastrophes could block the sun, including asteroid/comet impact, super volcanic eruption, and nuclear war with the burning of cities (nuclear winter). Previous work has analyzed alternate food supplies (e.g., mushrooms growing on dead trees, bacteria growing on natural gas). This was shown to be technically capable of feeding everyone with macronutrients (protein, carbohydrates, and lipids) and minerals, although economics and politics remain uncertain. The present work analyzes vitamin availability in such alternative food scenarios. The vitamin content of various alternate foods is compared to the US recommended daily allowance (RDA) as well as the average requirement defined by the European Food Safety Authority (EFSA) and insufficiencies of single food sources are discussed. Single alternate food sources are always deficient in some vitamins, and the problems associated with this are discussed. To prevent disease in an alternative food scenario a wide range of foods must be consumed, or the diet must be supplemented. Backup plans discussed include chemical synthesis of vitamins, plants grown with artificial light and growing bacteria rich in certain vitamins. Finally, insights from this analysis are provided for combating existing micronutritional deficiencies using alternative foods today.

Several catastrophes could block the sun, including asteroid/comet impact, super volcanic eruption, and nuclear war with the burning of cities (nuclear winter). Previous work has analyzed alternate food supplies (e.g., mushrooms growing on dead trees, bacteria growing on natural gas). This was shown to be technically capable of feeding everyone with macronutrients (protein, carbohydrates, and lipids) and minerals, although economics and politics remain uncertain. The present work analyzes vitamin availability in such alternative food scenarios. The vitamin content of various alternate foods is compared to the US recommended daily allowance (RDA) as well as the average requirement defined by the European Food Safety Authority (EFSA) and insufficiencies of single food sources are discussed. Single alternate food sources are always deficient in some vitamins, and the problems associated with this are discussed. To prevent disease in an alternative food scenario a wide range of foods must be consumed, or the diet must be supplemented. Backup plans discussed include chemical synthesis of vitamins, plants grown with artificial light and growing bacteria rich in certain vitamins. Finally, insights from this analysis are provided for combating existing micronutritional deficiencies using alternative foods today.

Risk assessments of micronutrients are carried out in the customary deficiency‐excess model. It is regarded as straightforward and unambiguous. Nevertheless, it is a problematic amalgamation of two different and to a certain extent contrasting perspectives on risk and science that we will criticize in this contribution. Our critique is framed in a conceptual scheme of opposing perspectives highlighted by the rival characteristics of RDAs and SULs and the role of science therein. The one part of our scheme holds the typically modern approach that centers on risks that can be scientifically assessed more or less confidently. Subsequent policies are aimed at preventing major health problems that affect the majority of the population from early on in life. The RDAs are the ideal type‐case here. The other part of our scheme holds a much more postmodern approach in which health risks are explicitly recognized as "uncertain." Dealing with those risks has little to do with major health problems from early on in life. Here, we encounter the scientific quandary of disentangling complex factors and impacts that may relate to some extra quality of life later on in life. SULs are exemplarily thereof. We will show that RDAs originally spawned from the scientific aim of securing objective knowledge "to lay down the requirements of an adequate" diet. SULs, conversely, are the upshot of generating acceptable outcomes driven by ever‐increasing safety requirements. This shift from securing objective knowledge to generating acceptable outcomes will be addressed in relation to precautionary culture.

La política actual del nuevo gobierno trae nuevas perspectivas de mejora en el aspecto nutricional. Sin embargo, desde mediados del año 2005, ya el Estado Peruano a través del sus diversas organizaciones viene implementando un programa de fortificación de la harina de trigo con micronutrientes. La ley28314 aprobó una modificación a la fortificación obligatoria de la harina de trigo con hierro, incrementando el contenido del hierro por kilo de harina de trigo de 30 mg/ kg a 55 mg/kg de sulfato o fumarato ferroso, además de la inclusión de 1 a 2 mg/kg de ácido fólico, entre otros micronutrientes. Este artículo revisa aspectos relacionados con los micronutrientes involucrados, hierro y ácido fólico, así como la información sobre sus deficiencias, como la anemia y los defectos del tubo neural, fundamentalmente. Finalmente, se da recomendaciones en mérito a la información presentada, con la intención de que las autoridades de salud y educación puedan tomar acciones orientadas a promover el consumo de alimentos fortificados con harina de trigo. ; Current government policies bring about new perspectives for improvements in the nutritional aspect. However, since mid 2005, the Peruvian government has implemented a wheat flour fortification program with micronutrients. Act # 28314 approved a modification to the mandatory fortification of wheat flour with iron, increasing the amount of iron from 30 mg/kg of wheat flour to 55 mg of ferrous sulphate, in addition to 1-2 mg/kg folic acid, among other micronutrients. This article reviews aspects related to iron and folic acid, as well as information on iron and folic acid defficiencies, such as anemia and neural tube defects. Finally, recommendations are provided based on the information presented to promote the use of food fortified with wheat flour.

Internationally recognized research findings on the potential health benefits of preventing micronutrient deficiencies-especially reduced child mortality from vitamin A deficiency and prevention of in utero developmental damage and mental retardation from iodine deficiency-have contributed to raising the awareness of deficiencies and the commitment of many governments to their reduction or near-elimination. The procedures undertaken to decide on large-scale programs followed conventional patterns in the 12 countries included in this study (11 Asian countries plus South Africa). Thus, a sequence of national surveys, institutional arrangements through intersectoral technical committees, legislation, incorporation of programs into national plans, and resource mobilization, including external assistance, was similar for all three micronutrients. Vitamin A supplementation twice yearly to children, then to women postpartum, has reached the national level. Iodized salt is universally adopted at the national level in most countries, with a need for continuing efforts to reach underserved populations and to implement legislation and quality control. Iron programs, usually aiming at daily supplementation during pregnancy, have been pursued, but with less intensity. However, it is clear that these procedures have succeeded in creating a rapid expansion of large-scale deficiency-control programs, which while evolving are generally being maintained. © 2004, The United Nations University.