development of food-based dietary guidelines in ghana: a
TRANSCRIPT
Development of Food-Based Dietary Guidelines in Ghana: A Learning Journey
Prof. Richmond Aryeetey, University of Ghana
outline• Food and nutrition situation in Ghana
• Policy and program landscape
• Food Based Dietary guidelines progress
• Lessons learned
Low Birth weight
29.9
22.4
28
22.7
18.8 18
0
10
20
30
40
2003 DHS 2006 MICS 2008 DHS 2011 MICS 2014 DHS 2017 MICS
% o
f ch
ildre
n <
5y
stunting wasting underweight
76.1 77.9
57
65.7
5.8 7.42.6 2.2
0
20
40
60
80
2003 DHS 2008 DHS 2011 MICS 2014 DHS
% o
f ch
ildre
n <
5y
child anemia (any) child anemia (severe)
Child Anemia
58.7
42.445.1
0
20
40
60
80
2008 DHS 2014 DHS 2017 MNS
Perc
ent
of
Wo
men
15
-49
yr
0
5
10
15
2008 2011 2014
Perc
ent
of
live
bir
ths
Child Growth faltering Maternal Anemia
Overweight -adults
2530
40
8.1 9.3
15.3
2003 2008 2014
Perc
ent
of
wo
men
, 15
-49
y overweight obese
GSS et al, 2015
18
21
8
10.3
7
Aryeetey et al., 2017
DHS2014
GSBSHS2012
DHS 2008
GSBHS 2007
Percent
Overweight -adolescents
19.624.5
16.921.5 21.7
1015 16.7
58
67
158.6
41
18
10
0
20
40
60
80
SAGES2007/08
SAGES2014/15
Blankson &Hall, 2012
Aganiba etal, 2015(NR)
Agbozo etal., 2018
per
cen
t
Nutritional Status -Elderly Overweight
Obese
Centraladiposity
Underweight
Breastfeeding trends
46.1
35.2
52.3
45.9
55.653.4 54.4
62.8
45.7
52.3
0
20
40
60
80
2003 DHS 2006 MICS 2008 DHS 2011 MICS 2014 DHS
% o
f ch
ildre
n
early initiation (1 hr) EBF (0-5) prelacteal feeding bottle with nipple
0
20
40
60
80
2008 DHS 2011 MICS 2014 DHS 2017 MICS
% o
f ch
ildre
n
diverse diet meal frequency mimimal acceptable diet
Complementary feeding trends
GSS et al, 2015; 2018
Dietary situation
Dietary situation• Increasing food availability
• Household food insecurity remains a challenge
• 42% of household annual expenditure is on food
• Ghana is already undergoing a nutrition transition, especially in urban areas; resulting in unhealthy dietary patterns
• High exposure: energy-dense foods
• Low exposure : Fruits and vegetables
• Important food environment challenges drive these behaviours
GSS et al, 2009, 2012; GSS et al, 2017; Ecker and Fang, 2015
Key dietary issues• Urban areas: Access to healthy foods, but also unhealthy foods• Promotion: High exposure to food unhealthy advertising, street
foods; limited communication on healthy eating• School food environment exposes children to cheap highly
processed foods• Informal markets: safety, adulteration, & environmental
sanitation• Affordability: Healthy food is expensive• Culture: Friends and family influence diet choice
Interventions in Policy environment
Government response across Fd
system
Elements of Nutrition-sensitive
agriculture
Challenges with system for value
addition
Distribution system lacks
optimal storage for perishables
Access to healthy options limited by price
volatility and seasonal effects
Consumption behaviors
influenced by inappropriate marketing and misinformation
Gaps in existing policies and interventions
Development of Ghana FBDGs
Multisectoral team(Commitment and
Leadership)
Set objectives &
characterize the
target group
Prepare Technical
Recommendations
-Evidence review/situation analysis
-Prioritize the issues to address
-Diet modeling
Pilot testingValidation
Correction,
Adjustment &
Finalization
Dissemination &
Implementation
Monitoring &
EvaluationPrepare Messages
& Graphic
Development of Ghana FBDGs
• Multi-stakeholder technical task team (MTTT) in place (N=21)
• Completed review of local evidence to guide decisions of MTTT
• Validated the reviews
• Prioritization of key issues ongoing
Actions yet to be completed
Scope of FBDG Mini launch
Linear programming
Development of technical
messages/food guide
Testing and validation of
messages/food guide
Finalization and launch of FBDG
Lessons learned
Thank you for your attention