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KENYA

Global Newborn Health Conference 14 th to 18 th April 2013 Johannesburg, South Africa

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PUTTING A FOCUS ON ANAEMIA CONTROL IN KENYA Kenya Country Presentation James Njiru Program Manager, MIYCN

PUTTING A FOCUS ON ANAEMIA

CONTROL IN KENYA

Kenya Country Presentation

James Njiru Program Manager, MIYCN

Overview of the presentation

Overview of the presentation • Introduction • Policy direction and positioning • Legislations • Government leadership,

Introduction Policy direction and positioning Legislations Government leadership, stewardship and coordination Strategies used Monitoring and evaluation Challenges and constraints Next steps

Introduction

Introduction • Iron-deficiency anaemia among pregnant and non- pregnant women is 55.1% and 46.4% respectively (Kenya

Iron-deficiency anaemia among pregnant and non-

pregnant women is 55.1% and 46.4% respectively

(Kenya Micronutrient Survey, 1999).

The prevalence of anaemia for children below 4 years is 60% (Malaria Indicator Survey, 2010).

Supply chain breakage in the last decade led to stock outs:

only 41% of health facilities had iron tablets while 74% had folic acid supplements (KSPA 2010)

Iron supplementation uptake by pregnant women for 90 days at only 2.5%(KDHS 2008/9)

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Policy direction and positioning

Policy direction and positioning To achieve the Millennium Development Goal of reducing infant and maternal mortality

To achieve the Millennium Development Goal of

reducing infant and maternal mortality anemia reduction and control is a priority strategic area

in:

Food and Nutrition Policy Kenya Health Sector Strategic Plan III National Nutrition Action Plan Focused Ante Natal Care

Maternal, Infant and Young Child Nutrition policy, strategy and guidelines

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Legislation

Legislation • Amended of the Food, Drug and Substance Act (Cap 254) through a legal notice

Amended of the Food, Drug and Substance Act (Cap 254) through a legal notice No 62 ensuring

mandatory fortification of cereals (maize and wheat), fats and oils.

Government stewardship and leadership

Government stewardship and leadership • Coordination and leadership – NICC • Fully fledged multi-sectoral body -

Coordination and leadership NICC

Fully fledged multi-sectoral body - National Micronutrient Deficiency Control Council (NMDCC)

Public - Private Partnership through Kenya National Food

Fortification Alliance (KNFFA) High level advocacy and dialogue for increased budgetary

allocation and return of IFA to Essential Drugs program

Inclusion of Iron and Folic acid supplementation of pregnant women in High Impact Nutrition Intervention package

Strategies Used

Strategies Used • Food Fortification for the entire population • Iron and Folic acid supplementation; –

Food Fortification for the entire population Iron and Folic acid supplementation;

Pregnant women adolescent girls

Home fortification of complementary foods using micronutrient powders for children aged 6-23

months

Other public health measures malaria and Helminthes control through LLITNs and deworming

respectively

Strategies Used

Continued….

Strategies Used Continued…. • Stakeholder commitment and participation in Iron and Folic Acid supplementation plan –

Stakeholder commitment and participation in Iron and Folic Acid supplementation plan

BCC & Advocacy capacity building systems strengthening

Private Sector Engagement

Local production of IFA and MNPS through private sector support

Distribution and social marketing to improve uptake.

Government commitment to fund IFA through essential medical medicines and supplies

Monitoring and Evaluation

Monitoring and Evaluation • IFA is an essential component of Focused Ante Natal Care • Screening

IFA is an essential component of Focused Ante Natal Care

Screening and treatment of pregnant women with low Hb done routinely

Individual record on anemia and supplementation in the Mother Child Booklet and reported in District Health Information System

Challenges and Constraints

Challenges and Constraints • Late starting of ANC by pregnant women • Low levels of compliance

Late starting of ANC by pregnant women

Low levels of compliance and adherence (2.5%) on uptake of iron supplementation

Inadequate resources for communication and advocacy

Inadequate Knowledge and perception barriers

Challenges and Constraints Continued… ..

Challenges and Constraints Continued… .. • Fear of HIV testing and stigma associated barrier to early

Fear of HIV testing and stigma associated barrier to early start of ANC

Inadequate counseling and information provided by Health Workers (Formative assessment 2012)

10% advised on dosage 12.1% advised on how to take IFA 13.5% IFA supplements prescribed

Way Forward

Way Forward • Encourage early ANC attendance • Adoption of the combined IFA supplement • Study

Encourage early ANC attendance Adoption of the combined IFA supplement

Study success stories of other countries for community distribution for both IFA and MNPs

Further strengthen partnerships and male participation

Capacity building of health workers and community health workers

Acknowledgement

WHO UNICEF USAID-MCHIP Save the Children GAIN PATH

Acknowledgement • WHO • UNICEF • USAID-MCHIP • Save the Children • GAIN • PATH •

Micronutrient Initiative(MI) WFP Universities Research Institutions Implementing Partners