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National public health experts call for action to improve the nutrition status of women and children

Skopje, 30 April 2012: After three days of sharing information, discussion, and deliberation at a UNICEF and Ministry of Health supported National Workshop on Anemia and Nutrition, medical professionals and public health experts agreed on the need for additional investments in programs to improve the current nutrition status of women of reproductive age and children under five.

The workshop brought together some 150 experts and practitioners in public health, pediatrics, hematology, gynecology, and hygiene and nutrition.  After reviewing the evidence and discussing global best practices from the World Health Organization (WHO), UNICEF and the US Centers for Disease Control (CDC), the group agreed on key actions needed to strengthen nutrition.

“The numbers tell us that, on a national scale, under -nutrition is not a wide-spread problem but it does    continue  to affect pockets of women and children” said Mr. Sheldon Yett, UNICEF Representative. “Evidence has repeatedly shown that the health care costs of treating the impact of under-nutrition, and the resulting losses to national economies, are much higher than the investment needed to prevent under-nutrition in the first years of life.”

The latest available statistics from the Institute of Public Health (2011) show that one in five children aged 6 to 59 months is anemic due to inadequate feeding practices.  The same data highlight that one in ten children in the country is stunted - a measure of low height for age – likely due to inadequate nutrition over long periods of time (including poor infant and young child feeding practices).  Furthermore, Roma children are 2.5 times more likely to be stunted compared to their peers.  Both anemia and stunting are indicators of underlying nutritional deficits which constrain physical and cognitive development of children, with the effects lingering through adulthood.

“The findings from our survey show significant disparities in nutrition indicators based on income, ethnicity and place of residence and is strongly associated with the level of poverty,” said Mr. Vladimir Kendrovski, Head of the Nutrition Department in the Institute of Public Health and continued: “For example, the prevalence of anemia was significantly higher than the national average for children in the North East region, which is one of the poorest regions in the country, as well as in rural areas, households with poor income and children from different ethnic communities.”

In addition, anemia in pregnant women can lead to poor birth outcomes, including neural tube defects and premature births, threating the health and survival of both mother and child.  With anemia rates in pregnant women reported at 28.5%, it is estimated that ten per cent of perinatal deaths annually are attributed to maternal anemia.  These conditions call for investing in a large scale national nutrition program targeting women of childbearing age, pregnant women and children under age of five.

“While planning for national nutrition programmes, special consideration should be given to addressing cultural differences in feeding practices and ensuring that financial barriers the limit access to quality food are removed,” continued Mr. Kendrovski.

At the workshop public health experts and practitioners agreed on the need for additional investment in programmes to ensure: 

  •  Multiple micronutrient supplements are made available to all pregnant and lactating women to improve birth outcomes and protect health and growth of infants;
  •  Mothers and caregivers are informed and educated on improved breastfeeding and child feeding practices to lower mortality, morbidity and improve growth and development of children;
  • Multiple micronutrient supplements (for children 6-24 months) are made available to improve the nutritional value of complementary foods for optimal physical and intellectual development;
  • Staple food is enriched with at least iron and folic acid to reduce anemia and iron deficiency among adult women, as well as the general population and to prevent congenital birth defects;
  • Systems are in place for reporting and analysis of nutrition and medical data to better understand the current and future nutrition status of women and children.

“We believe that these world renowned programmes to improve the nutritional status of pregnant women and children under five should be considered and applied in the context of the country and that investment in these programs will yield returns in wider socioeconomic development,” said Dr. Aleksandar Sajkovski, President of the Association of Pediatricians.

According to recent health and economic analysis supported by UNICEF to measure the negative impact of the current nutrition indicators, the conservative estimates tell us that by introducing the micronutrient supplements; providing greater support for exclusive breastfeeding and introducing flour fortification, could avert a third of the countries’ infant deaths and save 10 million EUR in economic loses, on yearly basis.

The National Scientific and Educational Nutrition Workshop was organized by the Institute for Public Health, Association of Pediatricians, Association of Hematologists, Association of Perinatal Medicine, Association of Hygiene and Nutrition Specialists, under the auspices of the Ministry of Health and the United National Children’s Fund (UNICEF).  It brought together some 150 local medical and public health practitioners and five international experts from Centers for Disease Control and Prevention (CDC Atlanta), the World Health Organization (WHO) and UNICEF global experts in nutrition and public health.

For further information, please contact:
Suzie Pappas Capovska, UNICEF Skopje (02) 3231-150 (ext :127),  072  236 725 or or Irina Ivanovska (02) 3231-150 (ext :107),  072  236 722 or




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