Dorit Nitzan Kaluski

Food security and nutrition – the Ethiopian case for action

OBJECTIVE To assess the 1999-2000 food security situation and the food relief programmes in Ethiopia, and evaluate the need for a national food and nutrition policy. DESIGN A systematic search of data sources from the Ethiopian Disaster Prevention and Preparedness Commission (DPPC), the Ethiopian Central Statistical Authority, the World Food Programme (WFP) and United Nations Childrens Fund (UNICEF), the bibliographic database Medline and direct contacts with associations, institutions and people concerned with food security in Ethiopia. SETTING Consultations to WFP Ethiopia. RESULTS Food availability was severely restricted due to recurrent disasters such as drought, flood, war and a lack of diversity of food items. Food accessibility was limited due to a weak subsistence-agriculture-based economy, depletion of assets, absence of income diversity and a lack of alternative coping mechanisms. Food intake adequacy was rarely achieved due to food shortages, improper diet and poor sanitary conditions. There was a lack of early warning data to monitor food security indicators. Food aid programmes did not meet the requirements for food quantities and composition, and faced major obstacles in logistics and targeting of the vulnerable population. CONCLUSIONS Improvements in food security and the eradication of famine will require investment in sustainable projects. There is an immediate need for better planning and targeting of food aid and a national food security monitoring system. A national food and nutrition policy is recommended, focusing both on relief efforts and on underlying factors contributing to the famine.

BMI May Overestimate the Prevalence of Obesity Among Women of Lower Socioeconomic Status

Objective: Our objective was to examine gender differences in height and weight associated with socioeconomic status (SES) and the consequent effect on body mass index in a multiethnic society.

A Global Nutritional Index

Background A standardized global nutritional index (GNI) would provide a single statistic for each country according to its overall level of nutrition, which could then guide national policies. Objectives and methods We have developed a GNI modeled on the human development index (HDI), based on three indicators of nutritional status: deficits, excess, and food security. Calculations were made within four groups of countries (GNI) (32 developed countries, 26 countries in transition, 64 low-mortality developing countries, and 70 high-mortality developing countries) as well as between them—the Global Nutrition Index World wide (GNIg). Results Complete data were available for 192 countries. The ranking of the highest and lowest countries in the four groups (with their GNIg values) is as follows: developed countries—Japan 1 (0.989), United States 99 (0.806); countries in transition—Estonia 10 (0.943), Tajikistan 173 (0.629); low-mortality developing countries—Republic of Korea 12 (0.939), Nauru 185 (0.565); high-mortality developing countries— Algeria 47 (0.876), Sierra Leone 192 (0.420). A “double burden,” in which nutrient deficits and excesses coexist in the same country, was seen in Mauritania (rank 139), South Africa (rank 146), Samoa (rank 157), Lesotho (rank 160), and Fiji (rank 169). The correlation between GNIg and HDI was intermediate (0.74, 55% of variance explained), demonstrating that good nutrition and development are not necessarily synonymous. Countries may be developed yet have a low GNIg (e. g., Australia, Canada, and the United States) and vice versa (e. g., Indonesia and China). Conclusions Since nutrition is fundamental to a nations health and productivity, the GNI and GNIg should be used alongside the HDI to obtain an optimal index of a countrys overall well-being.

Public Health in South-Eastern Europe – Exploring Synergies

In the past decade countries in the South-eastern Europe Health Network (SEEHN) have been making big strides to reform their health systems. The SEEHN has been providing a platform to share experiences and opening doors to resources, partnerships, technical capacity and political commitment. The ability of health systems to prevent, react, mitigate and recover from emergencies and crises is a visible indicator for the functionality of the health systems. In some of the health systems in the SEEHN there are still gaps that do not allow for a smooth and a seamless ability to respond to such demanding needs. Sometimes, parts of the populations are not accessible to the health services, and in many the public health services do not have sufficient finances and capacity to carry their tasks. Potential synergies between public health services and other arms of the health systems and beyond should be strengthened in SEEHN Member States. The WHO agenda for public health, health system strengthening and Health in All Policies continue to bring together the know-how, the ideology, partnerships, resource generation and the platform for subsequent policy development and implementation.