Mai Mahmoud and Sikandra Kurdi - IFPRI Egypt
Egypt's recent national campaign "100 Million Health" is an evidence of the country's commitment towards eradicating the "silent epidemic" of Hepatitis C and raising awareness for controlling the spread of non-communicable diseases (NCD) such as high blood pressure, diabetes and obesity.
In order to support the 100 Million Health initiative with research-based evidence, the International Food Policy Research Institute (IFPRI) held a seminar in partnership with the National Nutrition Committee at the Academy for Scientific Research and Technology (ASRT) on February 26, 2019. The IFPRI Egypt seminar titled "100 million healthy lives: Scientific evidence on the double burden of malnutrition in Egypt" shared international and national experiences and research findings on the status of nutrition, the causes and consequences of malnutrition and possible actions for eradicating malnutrition in Egypt.
For the first time in a public seminar, the "100 Million Health" initiative was presented by Reham Ghaleb, director of the campaign and head of the cardiology department at the National Bank Hospital. In order to reach the target population of all adult Egyptians across the 27 governorates, a comprehensive social marketing campaign is taking place in parallel with the health campaign for screening NCDs in Egypt. The "100 Million Health" campaign is the result of thorough planning and coordination by all departments of the Ministry of Health and Population (MoHP) with the aim of raising health awareness among all segments of the population. Ghaleb also announced that MoHP will start screening of school children for anemia, stunting and obesity.
Sikandra Kurdi, associate research fellow at IFPRI, introduced the seminar and stressed the importance of evidence-based policies in tackling pressing issues such as the spread of NCDs. She also highlighted the role of IFPRI Egypt seminar series in providing a platform for dialogue and knowledge exchange among stakeholders. Ahmed Khorshid, head of the National Nutrition Committee, focused on the importance of a healthy population for the country's development and called for innovative channels to convey nutrition knowledge to all people. Sameh Sorour, supervisor of scientific and cultural relations at ASRT, also commented on the burden of malnutrition in Egypt and introduced the research efforts by ASRT in addressing health-related issues. Sorour announced that ASRT is in the process of preparing for the launch of a research call on malnutrition in Egypt.
Representative of the National Nutrition Institute (NNI), Wafaa Fahmy, presented the role of NNI in the presidential initiative of 100 Million Health. Through its specialized outpatient clinics, NNI is providing nutrition consultations and promoting nutritional well-being for all age groups. In addition, NNI is supporting the "100 Million Health" campaign with training of universal health hospitals personal to be involved in the screening of school children for anemia, stunting and obesity.
Hoda El-Enbaby, research associate at IFPRI, explained the issue of "double burden of malnutrition", which refers to the coexistence of undernutrition along with overweight and/or obesity at the household level or even the individual level (e.g. a stunted child who is also overweight or obese). She also presented three possible channels for improving nutrition, namely: the evidence and research channel, the policy and governance channel, and the capacity strengthening channel. Finally, El-Enbaby commented on research findings from IFPRI's impact evaluation for Takaful and Karama program of the Ministry of Social Solidarity which shows that cash transfers had a positive impact on the quality of diets for Takaful beneficiaries.
On a similar note, Sahar Zaghloul, deputy head of the National Nutrition Committee, emphasized the role of research and data in supporting decision makers for developing sound strategies and policies. A multidimensional framework for controlling obesity in Egypt was introduced by Zaghloul, who explained the health complications associated with obesity as well as the socio-economic factors contributing to the problem. She also called for raising the priority ranking of NCDs through comprehensive coordinated actions that reactivate inter-ministerial collaboration and involve all the stakeholders.
Ghada Radwan, professor of public health and community medicine at Cairo University Faculty of Medicine, echoed on Zaghloul's illustration of the causes and consequences of obesity. Radwan also presented best practices for strengthening national efforts to address the burden of NCDs, and the role of the NCDs unit at the MoHP in adapting the WHO action plan for the prevention and control of NCDs to the Egyptian context.
In her presentation, Nesma Mamdouh, statistician at the Central Agency for Public Mobilization and Statistics (CAPMAS), reported on the nutrition status among children in Egypt based on the household income, expenditure and consumption survey (HIECS) data collected by CAPMAS. In addition, she showed some results on the association between stunting on the one hand, and poverty, overcrowding and access to sanitation on the other hand.
The linkages between agriculture and nutrition were highlighted by Nomindelger Bayasgalanbat, FAO regional nutrition officer, who presented lessons learned from FAO project in Egypt. The project provided field training in agricultural practices and nutrition education to households in Upper Egypt; while at the same time it introduced better crop varieties with high nutritional value. One of the key lessons learnt through the implementation of the project is the importance of adapting strategies to increase local opportunities for gainful livelihoods.
The questions and answers session was moderated by Habiba Hassan-Wassef, an independent health and nutrition consultant and expert in the field, and involved wide-ranging contributions from the audience which reflected the multi-dimensionality of health and nutrition issues in Egypt. There was a clear consensus among the audience on the importance of raising awareness on the health consequences of food consumption practices and dietary habits.
The outcome of the seminar presentations and discussions is summarized in the following recommendations:
- Increase data sharing and communication among ministries and NGOs working in areas related to nutrition with attention to making data accessible to researchers so that there can be a greater consensus on the current levels and patterns of NCDs, obesity and under-nutrition in Egypt
- Publicize what is known already about the underlying causes of malnutrition in Egypt through the release of policy briefs
- Take advantage of the current political energy around non-communicable diseases through the 100 Million Health Presidential initiative to focus the attention of policy makers on the need for a comprehensive approach to nutrition planning given intersections between policies in areas as diverse as education, health care, food affordability, agricultural production, trade and urban planning.
- Encourage the scientific community in Egypt to use the opportunity of the call for proposals by the ASRT to generate rigorous evidence on the effectiveness of interventions to improve nutritional status
