Title: Capacity Development in Nutrition in Central and Eastern Europe Mirjana Pavlovic, Fre Pepping, Arne Oshaug and the participants from CEE countries Joint meeting of SCN Working Groups on
1Capacity Development in Nutrition in Central and
Eastern EuropeMirjana Pavlovic, Fre Pepping,
Arne Oshaug andthe participants from CEE
countries Joint meeting of SCN Working Groups
onCapacity Development and Nutrition, Ethics
and Human Rights 15th March 2006Geneva ,
Switzerland
- Report from the inaugural meeting of the Network
on Capacity Development nutrition in CEE
countries
2Background
- Regional networks already exist in Asia, Latin
America, the Middle East and Southern Africa. - Thus the network in Central and Eastern Europe is
the newest network facilitated by the UNU Food
and Nutrition Programme and by SCN. - The inaugural meeting took place in Budapest on
the13-14 February 2006, at the FAO SEUR Office.
3Participating countries
- The meeting was attended by participants from 10
countries - Bosnia and Herzegovina, Bulgaria, Czech Republic,
FYR Macedonia, Hungary, The Netherlands, Norway,
Romania, Serbia and Montenegro and Slovakia.
4Participants
- Lajos Biro, HU
- Katarina Chudikova, SK
- Zlatka Dimitrovska, MK
- Veselka Duleva, BG
- Aida Filipovic, BIH
- Mirjana Pavlovic, SCG
- Jana Parizkova, CZ
- Camelia Parvan, RO
- Facilitators
- Fre Pepping, NL
- Arne Oshaug, NO
FAO provided support staff and engaged somewhat
in the discussion
5Objectives
- The objectives of the meeting were to
- Formally initiate the Network on Capacity
Development for the CEE countries within the
capacity development initiatives of SCN, UNU and
other European research and training institution. - Present and discuss the profile of challenges
identified by participants. - Identify follow-up activities in order to
facilitate the initiatives of the Network in the
field of capacity development in the CEE region. - Identify strategic elements to meet the capacity
development plans of institutions and individuals
in the region. - Prepare a presentation of needs and strategies to
be presented at the 33rd session of SCN in
Geneva, March 2006.
6Some results
7The main characteristics of nutrition and life
style in CEE countries
- Foods and meal pattern
- Irregular meal pattern
- Low intake of certain food groups - particularly
fruits and vegetable, milk products and fish - High intake of total fat (in particular
saturated), sugar, and salt - Low intake of vitamins folate/folic acid, and
minerals e.g. calcium, iron, iodine (except in
countries having programmes on salt iodisation)
(Relevant for some countries) - High level of alcohol intake in some countries
- Low breastfeeding rates.
8The main characteristics of nutrition and life
style in CEE countries (cont.)
- Nutritional and life style related public health
problems - High prevalence of NCD hypertension,
atherosclerosis, CHD, CVI, certain cancers,
diabetes mellitus, etc. - High level of overweight and obesity.
- Dyslipidaemia.
- Low level of Haemoglobin, although some data are
lacking. - Generally low level physical activity, in
particular in urban areas. - Increasing osteoporosis in both genders, in
particular with increased age. - Eating disorders in certain groups may increase,
in particular in younger girls. - Consumption mega doses of minerals and vitamins
lack of information about risk of mega doses. - High level of smoking.
9Overview of challenges in CEE countries
- National nutrition action plans
- Food based dietary guidelines
- RDA
- National food database
- Nutrition information center
- Training of professionals on academic level
- Education and promotion (for the public)
- Bulgaria 2005, Macedonia 2004, Bosnia (draft
waiting approving), Hungary 2004, Slovak Republic
1999, Rumania (draft waiting approving), Czech
Republic (approved), Serbia Montenegro (none). - Bulgaria, Macedonia, Bosnia, Hungary, Slovak
Republic, Czech Republic. - Bulgaria, Macedonia, Hungary, Slovak Republic,
Rumania, Czech Republic. - Bulgaria, Hungary , Slovak Republic, Rumania,
Czech Republic, Serbia Montenegro. - Not formalized.
- Modest in many countries, few countries have
special education of nutritionists. - Mostly part of national action plans for food and
nutrition.
10 Is it adequate nutrition education and training
of professionals in CEE countries?
- The gap in capacity in nutrition education is
major challenge. Those challenges included - inadequate/insufficient
- knowledge of nutrition among medical specialists.
- international training in modern nutritional
epidemiology. - international training in modern clinical
nutrition. - training of nutrition in schools and
universities. - knowledge of nutrition in the population.
- education and curricula of nutrition in medical
faculties e.g. incorporated in hygiene. Nutrition
is now considered to be a part of specialization
in hygiene. - knowledge of nutrition among health professionals
working with the population. - Nutrition is only a part of other trainings
(mentioned earlier). - Lack of pure nutrition education at academic
level. - Lack of in-service training of nutrition.
- Lack of methodological approaches and software
for data collection, assessment and analyses.
11 Political dimensions-Governmental level
(resistance or neglect of addressing nutrition
issues)
- Engagement of ministries and public agencies in
food, dietary and nutrition related issues is
lacking due to lack of funds (official
explanation). - Lack of a national nutrition strategy, or action
plan (e.g. based on WHO Global Strategy on Diet
and Physical Activity, or Food and Nutrition
Action Plan for Europe), except Hungary and
Bulgaria. - Lack of contact and collaboration between
responsible ministries (e.g. Ministry of Health,
Agriculture, Education, and Research) and
institutions working in the field of nutrition
(except for Bulgaria and Hungary). - Lack of coordinated activities at national and
regional level in nutrition and nutritional
status monitoring (except Bulgaria and
Macedonia).
12Possible elements of a common strategy for the
network and possible actions for improvement of
capacity development in CEE countries
- Continue/start developing national food and
nutrition policies and action plans - Standardize education and training programs in
nutrition for medical professionals
(undergraduate and postgraduate studies) - Need common training courses for relevant
professionals within health, food and nutrition
in CEE countries - Need mass media in nutrition, health and
lifestyle modification - Need promotion of food and nutrition at all
levels (including incorporate nutrition in the
curricula of elementary and high schools) - Stimulate school canteens to improve nutrition
quality of school meals - Standardisation and collaboration on recommended
dietary allowances (RDA) in Europe
13Possible elements of a common strategy for the
network and possible actions for improvement of
capacity development in CEE countries (cont.)
- Harmonize research, evaluation and monitoring of
the nutrition situation in the region - Develop dietary guidelines for different
population groups - Collaborate with the food industry to produce
healthier products - Conduct specific programs to prevent obesity,
non-communicable diseases and micronutrient
deficiencies - Get support from the UN, such as the UNU, FAO,
UNICEF and WHO to the network - Establish relevant internet web pages/modules for
exchange and collaboration between countries in
the CEE. - One example is the Food and Nutrition Agro Web
Network in CEE Countries (http//agrowebcee.net)
14Framework for analyzing actors and
responsibilities in nutrition in CEE
Main responsibility
Levels
Actors
Governmental Primarily MoH, and MoA, MoT(E),
MoST, MoE, MoWSA, MoLD.Policy makers/civil
servants, Parliament, local level authorities
- Policy development (food security,
- nutrition, health, training), decision
- making, legislation for protecting and
- supporting the human right to adequate food
- National plans of actions
- Funding
- Monitoring and evaluation
1
Institutional Health and research institutions
(including statistical), clinics (medical
doctors, public health specialists, dietitians,
nurses, food controllers), agriculture
extension, hygiene
- Implement policies
- Providing expertise and advisory function
- Evidence base (research) in nutr.
- Maintain and develop staffs capacity
- Adapt strategies to local needs
- Monitoring and evaluation
- Provide feedback to ministries
- International collaboration/networking
2
Educational Universities, faculties, scientific
academies, institutions/ departments, scientists,
researchers, professors, primary and secondary,
school teachers, kindergarten personnel, catering
staff
- Implement policies on education
- Provide and support staff development
- Base education/training on local needs
- Evaluate education/training
- Provide feedback to ministries
- Engage in international collaboration
- Publishing education material
3
Community Farmers, cooperatives,
industry/business Mass media (public and
private) NGOs, professional associations
Families, individuals
- Production of safe healthy foods, responsible
- marketing
- Promotion of healthy nutrition
- Positive role models in healthy eating
- patterns and life style
- Making informed choices
- Promotion of consumers rights
- Availability of desirable food at acceptable
prices - Compliances to legislation
4
15Framework for capacity development in nutrition
in CEE
Levels
Needs
Strategies/activities
- Political commitment
- Food and nutrition policies
- Develop nutritional action plan
- Reinforcing scientific evidence for increased
awareness - Strengthen capacity building
- Support for capacity development
- Lobby for political support for needs of
- nutrition policy and national action plan
- Lobby for funding of national capacity
development - Monitor for government accountability
- Information/education of politicians/parliamentari
ans - Requesting increased communication between line
- ministries
1
- Adequate human resources (including knowledge)
- Most recent equipment, methodology and relevant
standards - Adequate facilities and organizational structure
- Transforming national policies to needs of
various groups - Updated/approximation of legislation on food and
nutrition
- Terms of reference/job description - updates
- Promote staff development by academic education
and training in nutr./health (incl. in-service) - Monitoring dietary intake/nutritional health
status - Exchange of experience (national/international)
- Communication and dissemination of scientific
results on nutritional health - Establishing and using food database (software)
2
- Adequate institutional capacity (human resources)
- Research equipment, apply recognized
methodologies and standards - Adequate facilities and organizational structures
- Take account of relevant national policies
- Updated/approximation of legislation on food and
nutrition - Establish academic institution for nutrition
training - Develop curricula at each level of education
- Accreditation and certification of higher
training activities - Conformity of catering serviced to nutrition
demands
- Harmonization/approximation of EU requirements of
- the educational system according to the Bologna
Process - Preparing nutrition training and education
material - Establish training courses for professionals with
- international collaboration
- Promote/update a web-based food and nutrition
network - Disseminate research results to users
- Research to support FNAP
- Develop food database
3
- Scientific based information for food selection
- Food based dietary guidelines
- Sustainable and adequate food supply
- Information for informed individual choice for
diets (use of labeling) - Application of legislation for food labeling
- Nutrition promotion and education
- Collaborate with industry/business on responsible
marketing - Specific programmes targeting certain population
groups - Contribute articles on nutrition to media
4
16Planning guidelines for capacity development in
nutrition in CEE
Challenges/ Problem areas
Food security (WFS 1996)
Nutrition
3. Educational
2. Institutional
1. Governmental
4. Community
Levels
Lobby/advocacy for food and nutrition action
plans
- Engage in monitoring/
- evaluation activities
- Promote staff development
- Argue for funding food database
- Apply intern. accepted
- methodologies
- Develop project proposals
- for EU
- Develop project proposals for EU
- Engage in food database develop.
- Initiate the support the FNAP
- Disseminate res. results to users
- Raise awareness of EUFIC on the
- needs for training materials in
- CEE languages
- Update a web-based food and
- nutrition network
- Nutrition promotion
- (including media)
- Popularize scientific
- findings adapted to
- local challenges
- and food habits
Prioritized Strategies/activities
For all Fund raising/networking/communication
material
Continuous
Medium/long term
Short term
Duration
17Some plans
- 3rd meeting of core countries (plus 2-3
universities), November 2006 - Presentation of two specific themes, one
suggested the human right to food - preparation of 1 or 2 proposals for funding of
the Network activities. Goal to finalise Socrates
application to be submitted March 2007 - Involvement in new EC-programmes, such as
- EuroFIR
- Harmony, depends on go/no-go
- NuGO
- European Federation of the Associations of
Dieticians (EFAD) - Increase participation in existing post graduate
courses, for example food databases (VELAG),
epidemiology (Florence), the right to adequate
food (Norway) - 4th meeting of the core countries and
universities would be considered for the second
half of 2007 depending on go/no-go for Socrates
programme(s) for 2006/2007. VLAG can offer - Regulation of food intake (10 13 April 2006)
- Management of food safety issues (18 22
September 2006) - Nutrition and lifestyle epidemiology (June 2007)
18Thank you for the attention!