SECOND ANNUAL INTERNATIONAL SYMPOSIUM OF THE AFRICAN SCIENCE ACADEMY DEVELOPMENT INITIATIVE: PRIORIT...
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SECOND ANNUAL INTERNATIONAL SYMPOSIUM OF THE AFRICAN SCIENCE ACADEMY DEVELOPMENT INITIATIVE: PRIORITIZING FOOD SECURITY POLICIES FOR HEALTH AND DEVELOPMENT IN AFRICA. YAOUNDE, NOVEMBER 15 – 16, 2006 WED. 15/11/200611.30 – 13.00

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I. PLAN OF PRESENTATION

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I plan of presentation

SECOND ANNUAL INTERNATIONAL SYMPOSIUM OF THE AFRICAN SCIENCE ACADEMY DEVELOPMENT INITIATIVE: PRIORITIZING FOOD SECURITY POLICIES FOR HEALTH AND DEVELOPMENT IN AFRICA.

YAOUNDE, NOVEMBER 15 – 16, 2006

WED. 15/11/200611.30 – 13.00

SESSION III: STRUCTURED, DOCUMENTED PROCESSES FOR PROVIDING EVIDENCED-BASED POLICY-ADVICE: CASE STUDIES.

CASE STUDY FROM CAMEROON: INFORMING POLICIES TO IODIZED SALT

BY Prof Daniel. N. LANTUM


I plan of presentation

  • I. PLAN OF PRESENTATION

  • SYMPOSIUM OBJECTIVE: TO FOSTER ACADEMY/POLICY-MAKER INTERACTION FOR EVIDENCE – BASED POLICY ENACTMENT.

  • WHAT WAS THE PUBLIC HEALTH PROBLEM REQUIRING POLICY?

  • A CASE OF ENDEMIC GOITER

  • GOITER PREVALENCE SURVEYS: EVIDENCE

  • POLICY STRATEGIC OPTIONS

  • POLICY INSTRUMENTS

  • PARTNERSHIPS – COALITIONS = ALLIANCES = BY POLICY

  • IMPLEMENTATION – MONITORING = POLICY AMENDMENT

  • OUTCOMES: IODIZED SALT; USI, MONITORING. PROCESS

  • PROGRAMME – USI IMPACT EVALUATION

  • SUSTAINABILITY

  • REVIEW OF SCIENTIST/POLICY MAKER INTERACTION CYCLE

  • LESSONS LEARNT


I plan of presentation

II. WHAT WAS THE PUBLIC HEALTH PROBLEM?IODINE DEFICIENCY MALNUTRITIONSEE TABLECOMMON INDICATOR: GOITRE

Goitre


Iii a case of endemic cretinism from oshie photo

III. A CASE OF ENDEMIC CRETINISM FROM OSHIE PHOTO

A Cretin 50 yrs old North West Province with Dr Kamga Fotso August 1993


Iv evidence collection goiter prevalence surveys

IV. EVIDENCE – COLLECTION – GOITER PREVALENCE SURVEYS

  • ISOLATED RESEARCHERS – 1950 –1990

  • BASE-LINE SURVEY: 1990-1991

  • COMMUNITY DIAGNOSIS

  • COMMUNICATION TO POLICY MAKERS

  • EVIDENCE – GOITER PREVALENCE

  • GERMAN REPORT OF 1904 – WUM – NW

  • R. MASSEYEFF (1955) – EAST CAMEROUN

  • PELE PELE 1969 – AKONOLINGA

  • F. STEPHANY ET AL 1970 – EAST CAMEROUN

  • LOWEINSTEIN 1972 - EAST CAMEROUN

  • PIERRE NGUESSI 1975 – EAST CAMEROUN

  • D. MFONFU ET AL 1987 – OCEAC – NATIONAL REVIEW

  • ANDI CHI TEMBON – 1988 – NORTH WEST PROVINCE

  • R. AQUARON ET AL 1971-1977 – IODINE IN SPRINGS

  • J. WONGHI NGUM – 1990 – N/W – BUI SCHOOLS


V community diagnosis table ii estimates of population at risk of idd in cameroon in 1991

V. COMMUNITY DIAGNOSISTABLE II: ESTIMATES OF POPULATION AT RISK OF IDD IN CAMEROON IN 1991

For 1991, with population annual growth of 2.92%, add 10%. Pop at risk « Multiplier » is 2.5

(Source = 1987 census, Cameroon National IDD Survey 1990 – 1991, By Lantum et al 1991


Vi communication to policy makers mph

VI. COMMUNICATION TO POLICY – MAKERS (MPH)

  • COMMUNICATION TO POLICY – MAKERS (MPH)

  • CONFERENCE

  • WORKSHOP – YAOUNDE 8-24 APRIL 1991

  • PAMPHLET: “IDD IN CAMEROON 1990-91”


Vii policy strategic options

VII. POLICY STRATEGIC OPTIONS

  • IODIZED CAPSULES

  • IODIZED BREAD

  • IODIZED WATER

  • IODIZED SALT

  • * DECISION IODIZED SALT STRATEGY

  • (WHO/UNICEF/ICCIDD MARCH 1986

  • WHA 43.2 MAY 1990


Viii policy enactment process

VIII. POLICY ENACTMENT PROCESS

  • MPH/MINCOM – INDUSTRY – TO IODIZE

  • IODIZED SALT – READY IN THE MARKET

  • MIN ORDER NO 0133/A/MSP/SG/DSFM/SDSF/SN OF 09 MAY 1991

  • LAUNCHING – PRESS CONFERENCE 21ST JUNE 1991 = COMMUNICATION – USI

  • MONITORING PROCESS COVERAGE: 1992/93

  • BY FACULTY OF MEDICINE/IMPM

  • BY MIN P. HEALTH


Ix creation of advisory consultative partnership coalition alliance

IX. CREATION OF ADVISORY/CONSULTATIVE PARTNERSHIP = COALITION = ALLIANCE

  • DECISION NO 255/D/MSP/SG/DSFM/SDSF/SN OF 14/2/1995

  • INTER- SECTORAL – LIST

  • MPH, MINCOM, MINDIC, MINAS, MINAGRIC

  • WHO, UNICEF, WFP, ICCIDD

  • 3 Sub – Committees CREATED

  • IDD

  • VIT A

  • FER - ANAEMIA

  • INDUSTRY

    • FAC/MED - RESEARCH


  • X implimentation of idd usi policy madification

    X. IMPLIMENTATION OF IDD/USI, POLICY MADIFICATION

    • LABELING

    • FIELD FINDINGS: K1 USED

    • DECISION: K103: MANDATORY

  • NO 096/A/MSP/SG/DSFM/SDSF/SN/BCDA DU 16 MAI 1995 MODIFYING

  • No 0133/A/MSP/SG/DSFM/SDSF/SN of 9 May 1991

  • MONITORING – USI COVERAGE

  • - CONSERVATION - MAGAZINAGE

  • - QUALITY ASSURANCE

  • - PRODUCTION

  • - NORMS – ICCIDD/UNICEF/WHO

  • - IMPORTATION

  • - NORMS – CODEX ALIMENTARIUS

  • - COMMUNICATION FOR “DEMAND CREATION”


  • Xi results of programme

    XI. RESULTS OF PROGRAMME

    • IODIZED SALT PRODUCTION – INCREASE

    • PROGRESS: USI COVERAGE 0% - 90%

    • GOOD QUALITY IODIZED SALT IN MARKET

    • CHANGE: GOITRE PREVALENCE DECREASE

    • USE OF SENTINEL SITES

    • NATIONAL SURVEY 2002

    • CHANGE: URINARY IODINE EXCRETION LEVELS – PROGRESSIVE RISE

    • PRESENCE: CASES OF ENDEMIC CRETINISM – NO NEW ONES

    • POPULATION AWARENESS INCREASE

    • RADIO, PRESS, TV, LITERATURE, SCHOOL CURRICULA

    • INCREASE DEMAND FOR IODISED SALT


    Xii programme monitiring production at factory

    XII. PROGRAMME MONITIRING: PRODUCTION AT FACTORY


    Xiii testing for iodine in salt in schools

    XIII. TESTING FOR IODINE IN SALT IN SCHOOLS


    Xivprogramme impact verification 2003

    XIVPROGRAMME IMPACT VERIFICATION (2003)

    • PRODUCERS – COMMITMENTS – ALL 4

    • USI COVERAGE – SUSTAINED

    • IODIZED SALT PRODUCTION/IMPORTATION

    • PREVALENCE – TGR = 5-8%

    • URINARY IODINE EXCRETION MEDIAN 159ug/L

    • NO NEW CRETINS


    Xv sustainability

    XV. SUSTAINABILITY

    1. POLICY – LEGISLATION IN PLACE

    2. ENFORCEMENT OF POLICY

    3. QUALITY ASSURANCE INSPECTIONS

    4. QUALITY CONTROL PRACTICES

    5. IODINE LABORATORY IN IMPM / MINRESI

    6. PRODUCERS ASSOCIATION IN PROCESS OF FORMATION

    7. MPH – NUTRITION SERVICE – IDD DATA BANK

    8. RETRAINED PERSONNEL - NEEDED

    9. IDD IN SCHOOL CURRICULA

    10. VIGILANT CIVIL SECTOR – NUTRITIONISTS, COMMUNITIES

    11. YEARLY REPORTING = EPIDEMIOLOGIC SURVEILLANCE SYSTEM


    Xvi resume revolving social process of chronic endemic disease control

    XVI. RESUME: REVOLVING SOCIAL PROCESS OF CHRONIC ENDEMIC DISEASE CONTROL

    Scientists

    1

    Research Academies

    Scientists

    Managers

    2

    Communication

    SC/PM

    Resolution

    Sustain

    6

    Evaluation

    Feedback

    3

    Policy

    4

    Resource

    Development

    Management

    5

    Implementation

    Monitoring

    Managers

    -Training

    • Equipment

    • Material

    • Infrastructure


    Strengths and weaknesses

    STRENGTHS AND WEAKNESSES

    STRENGTHS

    • CONCERNED ACADEMIES

    • SCIENTIST IN POLICY POSITION

    • ACADEMY LINKS WITH SCIENTISTS/ PARTNERSHIP

    • CHAMPIONS OF A CAUSE

    • LINKS WITH INDUSTRY

    • DATA-BASE SERVICE IN FACULTY OF MEDICINE

    • COMMUNICATION SYSTEM

    • PARTNERSHIPS

    • WEAKNESSES

    • NON COORDINATION OF SCIENTISTS BY SOME MINISTRIES

    • LIMITED COMMUNICATION

    • VERTICAL/PARALLEL RELATIONSHIPS

    • WEAK ACADEMIES


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