A North-South-South Collaborative Action to Prevent Micronutrient Deficiencies in Women and Young Children in South-East Asia: The SMILING Project
Jacques Berger *
Institute of Research for Development, Montpellier, France.
Campos Ponce Maiza
University of Amsterdam, Amsterdam, The Netherlands.
Chhoun Chamnan
Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia.
Mary Chea
Ministry of Health, Phnom Penh, Cambodia.
Marjoleine Dijkhuizen
University of Copenhagen, Copenhagen, Denmark.
Coleen Doak
University of Amsterdam, Amsterdam, The Netherlands.
Umi Fahmida
Southeast Asian Ministers of Education Organization, Tropical Medicine and Public Health Indonesia, Jakarta, Indonesia.
Elaine Ferguson
London School of Hygiene & Tropical Medicine, London, UK.
Paul Hulshof
Wageningen University, Wageningen, The Netherlands.
Yves Kameli
Institute of Research for Development, Montpellier, France.
Khov Kuong
Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia.
Kongsap Akkhavong
Ministry of Health, Vientiane, People's Democratic Republic of Lao.
Sengchanh Kounavong
Ministry of Health, Vientiane, People's Democratic Republic of Lao.
Le Bach Mai
National Institute of Nutrition, Hanoi, Vietnam.
Siti Muslimatun
Southeast Asian Ministers of Education Organization, Tropical Medicine and Public Health Indonesia, Jakarta, Indonesia.
Nanna Roos
University of Copenhagen, Copenhagen, Denmark.
Prak Sophonneary
Ministry of Health, Phnom Penh, Cambodia.
Frank Wieringa
Institute of Research for Development, Montpellier, France.
Emorn Wasantwisut
Mahidol University, Bangkok, Thailand.
Pattanee Winichagoon
Mahidol University, Bangkok, Thailand.
*Author to whom correspondence should be addressed.
Abstract
Objectives: SMILING "Sustainable Micronutrient Interventions to Control Deficiencies and Improve Nutritional status and General Health in Asia" (FP7), is a transnational collaboration of research institutions and implementation agencies in five SEA countries: Cambodia, Indonesia, Laos PDR, Thailand and Vietnam, with European partners, to introduce state-of-the-art knowledge into policy to alleviate micronutrient malnutrition in SEA women of reproductive age (WRA) and young children. Objectives were to: build capacity on problem analysis; identify priority interventions and develop roadmaps for national policies.
Methods: SMILING has been built around a consortium that worked on Optifood software to identify nutrient gaps; nutritional problem analysis and potential interventions by reviewing current situation and program, and knowledge on effective interventions and multi-criteria mapping for stakeholder analysis to develop national guidelines.
Results: Iron, zinc, vitamin A and iodine deficiency remain common in SEA. Even though the five SEA countries differ in nutritional situation and stages of development, iron intake in young children in all countries was inadequate, as folate intake in WRA, even with theoretical best possible diets. Consequently, interventions including supplementation, food-based strategies and public health measures were appraised through multi-stakeholder analysis. Successful experiences and lessons in implementing nutrition programs in these countries were also critically reviewed. Policy roadmaps by country are being drafted accordingly.
Conclusions: SMILING conducted an analysis of nutrition situation in each SEA country. Gaps in intake of several micronutrients cannot be currently solved by dietary solution and e.g. food fortification needs to be considered. Roadmaps for each country policy-makers are being formulated.
Funding: European Commission-FP7, GA-2896-16.