1. Experiences with community based nutrition programs in Thailand
Prof. Kraisid Tontisirin
Institute of Nutrition, Mahidol University & Former Director of Nutrition and Consumer Protection, FAO.
Presentation at the 4th National Seminar on Food Security and Nutrition Under the theme: “Child and Maternal Nutrition”
Phnom Penh, Cambodia, May 2012 1

2. Service Driven Programmes
Vertical, many become
welfare oriented
Little intra/inter sectoral
coordination
Little people /community
participation
Dependency creation
Not sustainable
Inadequate coverage
Individual
Family
Community
Kraisid Tontisirin, Mahidol University

3. Elimination of undernutrition: a global deficit and priorities*
*ACC/SCN 1999
Kraisid Tontisirin, Mahidol University

4. Agriculture/
Food supply/
Service
Promotion
Protection
Treatment
Food
Nutrition
Health
Nutrition is a link between food and health,
regarding the fulfillment of nutrient and non-nutrient
requirements from food in human life cycle.
Ultimate Goals
Food and Nutrition Security for All Leading to Good Health and Well-being
Kraisid Tontisirin, Mahidol University 4

5. Main Causes of Child Malnutrition
Maternal poor nutrition and health lead to LBW of newborn, low milk quality and quality
Declining of BF practices
In adequate and in appropriate CF
Poor sanitation in IYC feeding and cares
Recurrent of illness i.e. diarrhea and respiratory tract infection
Undesirable eating habits
Kraisid Tontisirin, Mahidol University

6. Community-Based Approaches
Is an integrated program implemented
at local level (district level and below)
National commitment with sound nutrition
improvement strategies and goals
Community actions: basic services, mass
mobilization, mutual efforts/actions to reach
all people and to prevent malnutrition
Kraisid Tontisirin, Mahidol University

7. Components of a successful community based program
Minimum Basic Services
(Health, Education, Agr. Extension)
Supportive System
Training
Funding
Problem Solving
Supervision
Facilitators
Menus (Activities)
ANC
GMP
Food production
Nutrition education
Food sanitation & safety
Other activities
Interface
(service providers and
community leaders)
Plan/goals
Implementation
Monitoring/evaluation
Mobilizers
(1:10 households)
Community Leaders
Family
Individual
Basic Minimum Needs Goals/Indicators
Kraisid Tontisirin, Mahidol University

8. Menu Activity on ANC (to prevent maternal morbidity and mortality, and LBW)
4 ANC visits for all pregnant mothers
High risk check up and treatment
monitoring wt. gain
Nutrition and health education
Food supplementation if needed
MTV, iron and folate supplementation
Two tetanus toxoids
Referral system and safe delivery service
Kraisid Tontisirin, Mahidol University

9. Menu on Growth Monitoring and Promotion (GMP)
Monthly or quarterly monitoring wt.& ht.
Child growth education and cares
Breastfeeding and CF
Immunization
Village based food production (+CF for IYC and supplementary food for mothers)
Health and nutrition education
Cooking and feeding demonstration
Treatment of malnourished child
Referral of severe illness and malnutrition
Kraisid Tontisirin, Mahidol University

10. Community Food Production
Home and school gardens growing vegetables, fruits, fishes and chicken for learning, consumption and income
Supplementary food for pregnant mothers
Complementary food for IYC
food preservation and simple food processing techniques
Cooperative and micro credit
Kraisid Tontisirin, Mahidol University

11. Maternal and child health and nutrition Thailand, 1980- 2006
1990
2006
ANC coverage % 35 75 95
Anemia in preg. %
50-75
18.8 10
LBW % 16
<10
PEM (Wt/Age of U 5)% 51 20
Kraisid Tontisirin, Mahidol University

12. Kraisid Tontisirin, Mahidol University
Conclusion 1
Interface of basic social services with strong people participation at community level is crucial for prevention and control of malnutrition.
Village Health Volunteers (1 VHV per 10 HH) have been proven to be effective. Current number of VHV are over 800,000.
Nutrition indicators are most useful for goal setting and follow up actions i.e. birth weight, under weight of
under 5, stunting, and weight for height
Research and capacity development are essential to back up the program
Kraisid Tontisirin, Mahidol University 12

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