Advocacy Advocacy in Micronutrient in Micronutrient

ProgramsPrograms

Dr. Azza GoharDr. Azza Gohar

Training UnitTraining Unit

National Nutrition National Nutrition InstituteInstitute

EgyptEgypt

Micronutrient DeficienciesMicronutrient Deficiencies

Among the Most Prevalent Among the Most Prevalent Health Problems Health Problems

Worldwide Worldwide

YetYetPrograms may have the leastPrograms may have the least Success achievedSuccess achieved Enthusiasm directed at Enthusiasm directed at

solutions solutions

Micronutrient deficiencies Micronutrient deficiencies Don’t always have easily Don’t always have easily

noticeable symptoms & warning noticeable symptoms & warning signssigns

May remain unrecognized May remain unrecognized despite their devastating despite their devastating impactimpact

May not be viewed as a priorityMay not be viewed as a priority

Why ?Why ?

Common Common Communication GoalsCommunication Goals

Most Health/Nutrition ProgramsMost Health/Nutrition ProgramsBuild Concern for ProblemBuild Concern for ProblemMotivate ActionMotivate ActionSustain the SolutionSustain the Solution

Who?Who?

Not Only End BeneficiariesNot Only End BeneficiariesBut AlsoBut Also

Government Decision/policy-makersGovernment Decision/policy-makers NGO PartnersNGO Partners Medical CommunityMedical Community Religious LeadersReligious Leaders IndustryIndustry Mass MediaMass Media Other Professional groupsOther Professional groups

We Need Them To Be….We Need Them To Be….

Aware there is a problemAware there is a problem Know how to solve itKnow how to solve it Convinced there is a benefit in Convinced there is a benefit in

doing sodoing so Convinced that it is feasibleConvinced that it is feasible

Communication StrategyCommunication Strategy

In order In order To SucceedTo Succeed & have & have

Sustained impactSustained impact

Needs more Needs more

Positive reinforcementPositive reinforcement

byby

AdvocacyAdvocacy

General Steps for AdvocacyGeneral Steps for Advocacy in Health Programs in Health Programs

Confirm that the Confirm that the problem existsproblem exists (prevalence)(prevalence)

Define the Define the Impact of the problemImpact of the problem (individual/national)(individual/national)

Show that the Chosen approach is a Show that the Chosen approach is a proven proven and tested solutionand tested solution for this problem for this problem (experiences)(experiences)

Describe the Describe the potential benefitspotential benefits and and cost-cost-effectivenesseffectiveness (Communicate the cost/benefit (Communicate the cost/benefit (problem/solution)(problem/solution)

Alleviate the Alleviate the fears and concernsfears and concerns of targets of targets (identified by research eg. FGD…..)(identified by research eg. FGD…..)

Remember……..When Remember……..When AdvocatingAdvocating

Focus on ways to present Focus on ways to present the problemthe problem

Most Simply and Most Simply and DramaticallyDramatically

TailoredTailored

According to Target GroupAccording to Target Group

Lack of Effective AdvocacyLack of Effective AdvocacyStrategies Strategies

Leads to Leads to

Lack ofLack of Priority & AwarenessPriority & Awareness

Lack of SupportLack of Support

Increased Fears and Increased Fears and SuspicionsSuspicions

Reflecting itself as program Reflecting itself as program problemsproblems

Thank YouThank You

Advocacy GuidelinesAdvocacy Guidelines

Dr. Azza GoharDr. Azza Gohar

Training UnitTraining Unit

National Nutrition National Nutrition InstituteInstitute

EgyptEgypt

Advocacy Presentation to Advocacy Presentation to Medical CommunityMedical Community

What to Tell What to Tell Medical CommunityMedical Community

According to the level/typeAccording to the level/type Magnitude of the problemMagnitude of the problem Impact on healthImpact on health Safety of fortified foods/Other Safety of fortified foods/Other

countries successescountries successes Impact of food fortification on healthImpact of food fortification on health No Impact on Clinical Conditions No Impact on Clinical Conditions

(Thalassemia)(Thalassemia) Role in Patient Information Role in Patient Information

Research, ……..Research,….. Research, ……..Research,….. Research………Research………

Define the Problem & its Define the Problem & its Magnitude Magnitude

Define & describe the problem & Define & describe the problem & its causesits causes

Confirm the problem exists in Confirm the problem exists in quantity (prevalence by age –quantity (prevalence by age –sex-geographical..)sex-geographical..)

Mention actual facts on Mention actual facts on biological , Dietary & biological , Dietary & consumption indicatorsconsumption indicators

Define & Clarify Impact of the Define & Clarify Impact of the Problem on healthProblem on health

Clinical Impacts: Mortality rates, Clinical Impacts: Mortality rates, Morbidity rates, maternal deaths, Morbidity rates, maternal deaths, still births , LBW, immunity, still births , LBW, immunity, childhood development, childhood development, disabilities/impairments disabilities/impairments

Social Impacts: IQ/intelligence, Social Impacts: IQ/intelligence, mental capacity, school mental capacity, school performance, work performanceperformance, work performance

Impact of Food Fortification Impact of Food Fortification on Health Problemon Health Problem

Give examples for Give examples for comparisonscomparisons

Other rich food sources (food Other rich food sources (food tables) in numberstables) in numbers

Other Countries that solved Other Countries that solved the problem by food the problem by food fortification (names & fortification (names & numbers)numbers)

Give Evidence of Safety of Give Evidence of Safety of Fortified FoodsFortified Foods

Safety of Level (type of Safety of Level (type of fortificant)fortificant)

Evidence thatEvidence that Individuals not at risk can consume Individuals not at risk can consume

the fortified food safelythe fortified food safely Fortification process has a very Fortification process has a very

good QC & QA systemgood QC & QA system Successful Examples of Successful Examples of

Industrialized & Similar Countries Industrialized & Similar Countries

DescribeDescribe Possible Side Possible Side EffectsEffects

Describe clearly any side effects Describe clearly any side effects from consumption of Fortified from consumption of Fortified food if any and how to handlefood if any and how to handle

Describe proper management Describe proper management and what to say to their patients and what to say to their patients in that casein that case

Describe clearly any changes Describe clearly any changes expected in color, taste, expected in color, taste, appearance, odor, texture of appearance, odor, texture of fortified food fortified food

Remember….Remember….

Involve them as part of the Involve them as part of the solutionsolution

Motivate them to shareMotivate them to share

Thank YouThank You

What to Tell What to Tell Decision -MakersDecision -Makers

Magnitude of the problem (According Magnitude of the problem (According to Sector)to Sector)

National Cost of neglecting itNational Cost of neglecting it Cost- effectiveness & efficacy of Cost- effectiveness & efficacy of

fortificationfortification Safety of fortificationSafety of fortification Experiences in other countriesExperiences in other countries

General population General population (Consumers)(Consumers)

Define the problem simplyDefine the problem simply Impact of problem on health, well Impact of problem on health, well

being, productivity, intelligence…..being, productivity, intelligence….. Safety of fortificantSafety of fortificant Expected changes in taste or colorExpected changes in taste or color Expected side effects Expected side effects Expected cost Expected cost

Food producers (Millers)Food producers (Millers)/ Food distributors (Bakers)/ Food distributors (Bakers)

Cost of new technologyCost of new technology Technical Feasibility & Know how Technical Feasibility & Know how Marketing Benefits & ProfitsMarketing Benefits & Profits Other countries successful Other countries successful

experiencesexperiences Types , level & Safety of fortificantTypes , level & Safety of fortificant Expected extra work load Expected extra work load Shelf life and storageShelf life and storage