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Programs
Micronutrient Intervention (MI)
Programs
ORT (Oral Rehydration Therapy)
Program Definition
A program is a set of organized
activities designed to accomplish a
clearly-defined goal.
 Programs

target a specific population,
 are conducted by governmental or
non-governmental organizations, and
 have evaluation components or
measures.

Major MI Program Types
Supplementation
 Fortification
 Dietary diversity

Agricultural
 Education


Food assistance
Examples—Vitamin A
Supplementation—capsules
(Pakistan)
 Fortification—margarine, cooking oil,
milk (US, Philippines, Pakistan)
 Dietary diversity

Agricultural—sweet potatoes (Africa)
 Education—growing food (Nepal)


Food assistance—WIC (US)
Examples—Iron



Supplementation—liquid drops (Ethiopia),
oral supplements (India)
Fortification—enrichment of flour (Nigeria,
Mexico, US)
Dietary diversity (many countries)



Agricultural
Education—iron needs for women, iron pots
Food assistance—WIC (US)
Examples—Iodine
Supplementation—oil capsules
(Philippines), “sprinkles” (Pakistan)
 Fortification—salt, soy sauce

Relative Costs and Benefits
Supplements
Supplements inexpensive and
effective
 Require

Clinical support
 Distribution network
 Assessment

Relative Costs and Benefits
Fortification


Appropriate fortification programs reach a
large target audience with nutrients that are
likely low in the general food supply.
Infrastructure requirements





Equipment
Expertise
Monitoring
Distribution
Assessment
Relative Costs and Benefits
Dietary Diversity

Agricultural
Subsistence crops v cash crops
 Improved agricultural methods
 Farmer education

Food processing and storage
 Education
 Assessment

Relative Costs and Benefits
Food Assistance
Emergency
 Long-term
 Dependency v development

Water and ORT
Water uses
 Waterborne diseases
 Water sanitation and disinfection
 Oral Rehydration Therapy (ORT)

Death from Infectious
Disease
TB
Respiratory
Infections
Childhood Diseases
HIV
Water-Related
Diseases
Maternal, Perinatal,
and Nutrition
Water Diseases



Pathogens—bacteria, parasites, viruses
 Guinea Worm
 Ascariasis
 Campylobacteriosis
 Cholera
 Hepatitis
 Leptospirosis
 Onchocerciasis
 Typhoid
 Schistosomiasis
 DIARRHEA and ANEMIA
Mosquitoes—malaria, dengue hemorrhagic fever
Heavy metals—runoff from mining or manufacturing
Water Sanitation and
Disinfection

Temperature
Boiling
 NEW TREATMENT—solar heating


Chemical treatment—largely
chlorination
Diarrheal Disease


In developing countries children typically
exhibit diarrhea 2-6 times per year.
Children die from diarrheal diseases



Approximately 2.2 million children/y under 5
1/20 die from diarrheal disease before age 5
Other issues


Impairment of nutritional status
Susceptibility to other acute infections
Oral Rehydration Therapy
(ORT)


Hospital v home
ORT—defined by WHO in 1993


Increased volume of fluids, either oral
rehydration salts (ORS) or other
recommended home fluids, along with
continued feeding
ORS—packet of salt and sugar to increase
water absorption (does not destroy diseasecausing microorganisms)
ORT Saves Lives
UNICEF and WHO predict that ORT
could save the lives of 90% of the
children under 5 who die from
diarrheal diseases.
 Estimates of ORT use in households
in developing countries

75% use some ORT
 33% use ORT following the 1993
definition

Programs as Models
Programs work toward achieving
measurable goals.
 Programs include organized activities
and evaluations.
 Programs target specific populations.
 Data needed for developing program
models.

Program Examples
Diouf (Video 2, Clip 1)
 Bertini (Video 2, Clips 3, 4)
