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A Summary of SCN Working Group Discussions, Oslo 1998

On the occasion of the SCN's 25th Session in Oslo, Norway (26 March - 2 April, 1998), eight working groups met to discuss scientific, policy and programmatic developments, and to develop priorities and recommendations for action. Presented here are summaries of the discussions and decisions taken during these meetings. Full reports of each of the working group meetings are available on request from the SCN Secretariat, c/o World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. Tel: 41 22 791 0456 Fax: 41 22 798 8891 Email: accscn@who.ch

Nutrition, Ethics and Human Rights

There is a growing interest in a human rights approach to food and nutrition among SCN members, attributed in part to the UN reform process to incorporate human rights approaches in all programme activities. This move away from a basic needs approach means that people can not only express their needs for, but also claim their rights to adequate food and nutrition.

The working group discussions were guided by a document prepared by WANAHR1 entitled 'The Promotion and Protection of the Human Right to Food and Nutrition by ACC/SCN Members', which identifies challenges and opportunities for the SCN in defining, adopting and monitoring a human rights approach to food and nutrition. Prominent among these is the need to develop an IEC (information-education-communication) strategy on the right to food and nutrition in close collaboration with the UN High Commissioner for Human Rights (UNHCHR).

¹World Alliance for Nutrition and Human Rights

One of the main recommendations of this working group was that the Symposium at the 26th Session of the ACC/SCN in 19992 have the theme "The Substance and Politics of a Human Rights Approach to Food and Nutrition Policies and Programming'. This recommendation was approved by the SCN.

²The 26th Session of the SCN will be held at the office of the UNHCHR in Geneva, Switzerland, April 1999.

Iodine Deficiency Disorders (IDD)

The remarkable success by countries and the international community in eliminating IDD has been greatly helped by commitment and prioritisation at all levels. However, in some countries, interest is declining and sustainability is emerging as a major concern. In response, the working group drew up 10 key requirements for sustainability of programmes and urges the ACC to maintain its commitment to the elimination of IDD.

The working group also discussed the need to improve coordination of databases, the relative merits of different kits to measure iodine in salt and urine, and the issue of IDD elimination as a human right.

Household Food Security

The working group heard a number of presentations on different agencies' approaches to household food security as an integrated part of a larger livelihood security approach. These included a presentation of CARE'S Household Livelihood Security approach to assessment, action and monitoring, and a presentation by FAO of the document "Household Food Security and Nutrition: Approaches and Experiences of FAO'.

The working group proposed that a workshop on promoting household food security in Africa be organised during 1998, and that agencies prepare brief summaries of highlights in the household food security area, focusing on one or two countries with successful programmes as examples. The working group is currently addressing the problems of targeting household food security interventions, and the operational methods required to target such interventions.

Breastfeeding and Complementary Feeding

Seven issues were discussed by the working group: maternity legislation, the care approach, complementary feeding, Code implementation, the Baby-Friendly Hospital Initiative, the economic value of breastfeeding, and HIV and infant feeding in the context of vertical transmission. For the latter, the urgent need for detailed practical guidance to manage the distribution of breast-milk substitutes for use by infants of HIV-positive mothers was stressed. This was subsequently addressed at a WHO-UNAIDS-UNICEF technical consultation on HIV and infant feeding (Geneva, 20-22 April 1998 - page 63).

The 1942 ILO Maternity Protection Convention No.103, which includes the right to maternity leave, cash benefits and medical benefits, is currently being revised and will be presented by the ILO in the year 2000 for consideration. The working group reaffirmed that UNICEF and WHO will work with ILO to ensure the protection of breastfeeding rights of working women. Further information is available through the new WASA webpage on breastfeeding rights of women at http://www.elogica.com. br/waba/working.htm

Chairs and Rapporteurs for SCN Working Groups, 1998

Working Group

Chair(s)

Rapporteur(s)

Nutrition, Ethics and Human Rights

Urban Jonsson (UNICEF)

Wenche Barth Eide & Uwe Kracht (WANAHR)

Iodine Deficiency Disorders

Graeme Clugston (WHO)

Francois Delange (ICCIDD)

Household Food Security

Bill Clay (FAO)

Lawrence Haddad (IFPRI)

Breastfeeding and Complementary Feeding

Lida Lhotska (UNICEF)

Felicity Savage (WHO)

Nutrition of School Age Children

Judith McGuire (World Bank)

Andrew Hall (PCD)

Nutrition of Refugees and Displaced People Iron Deficiency Control

Rita Bhatia (UNHCR)&Anne Callanan (WFP) Nevin Scrimshaw (UNU)

Judith Appleton (OXFAM-GB) Gary Gleason (INF),Rainer Gross (GTZ), Fernando Viteri (UNU) & Ray Yip (UNICEF)

Vitamin A Deficiency

Joanne Csete (UNICEF)

Martin Bloem (HKI)

Nutrition of Schoool-age Children

Recent data suggest that nutritional problems in school age children may be greater and more widespread than previously thought. There are a number of activities aimed at improving the nutritional status of school-aged children, including school feeding programmes, school health and nutrition programmes (micronutrient provision, deworm-ing, nutrition eduction and first aid), HIV prevention programmes, and water and sanitation projects.

The working group made three main recommendations. Firstly, more data on the nutritional status of schoolchil-dren are needed; secondly, the reference values on growth and anaemia need to be reviewed; and thirdly, there is a need to identify examples of good practices and success stories.

Nutrition of Refugees and Displaced People

The Oxfam report 'Acceptability and Use of Cereal-Based Foods in Refugee Camps' was presented. It was agreed that as a follow-up, plans to hold a meeting to discuss levels of micronutrient fortification in blended foods will be explored.

Panel discussions on 'How Food Aid Works' reflected perspectives and constraints for providing food aid by ICRC, WFP, USAID and CIDA. The working group agreed to continue discussions on appropriate indicators for assessment of needs and impacts, and to better understand the processes of emergency food aid provision.

Iron Deficiency Control

Iron deficiency and iron deficiency anaemia has consequences for cognition, resistance to infection, physical performance, metabolic impairments, morbidity and mortality. The working group recommended that governments, agencies and NGOs use an integrated strategy to reduce iron deficiency in combination with other micronu-tient deficiencies (e.g., vitamin A deficiency), based on a life cycle approach and focusing mainly on preventive measures. An integrated strategy should include a combination of dietary approaches, fortification of appropriate foods and supplementation of the most vulnerable groups. It was stressed that the focus of supplementation during pregnancy should be expanded to include young children (because of its impact on cognitive development) and non-pregnant women (so that women enter pregnancy with sufficient iron stores).

It was also recommended that iron deficiency prevention programmes be linked with related health programmes such as breastfeeding promotion, prevention of other nutritional deficiencies, reproductive health and measures to control infectious diseases - especially malaria and intestinal helminth infections.

Vitamin a Deficiency

The number of young children with sub-clinical vitamin A deficiency has been estimated by WHO/UNICEF and reported in the WHO/UNICEF MDIS report (1995). However, the working group expressed caution in citing the figure because of methodological difficulties, and recommended that WHO and UNICEF use a new method to update the prevalence and numbers.

The discussions of the working group covered a number of issues, including a presentation of the Bangladesh national vitamin A deficiency survey (in which access to home gardens was shown to play a role in addition to supplementation in reducing vitamin A deficiency), a presentation of the Nepal study on supplementation during pregnancy and maternal mortality (see SCN News No. 15 p27) and a discussion of the near-crisis in Guatemala whereby the government considered revoking a law to fortify sugar with vitamin A.

A new initiative (the Global Vitamin A Initiative, supported by UNICEF, USAID, Ml and CIDA) to accelerate progress towards the elimination of vitamin A deficiency as a public health problem was also presented to the working group.