KENYA

Global Newborn Health Conference 14th to 18th April 2013 Johannesburg, South Africa
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PUTTING A FOCUS ON ANAEMIA CONTROL IN KENYA

Kenya Country Presentation James Njiru Program Manager, MIYCN

Overview of the presentation

Introduction Policy direction and positioning Legislations Government leadership, stewardship and coordination Strategies used Monitoring and evaluation Challenges and constraints Next steps
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Introduction
Iron-deficiency anaemia among pregnant and nonpregnant women is 55.1% and 46.4% respectively (Kenya Micronutrient Survey, 1999). The prevalence of anaemia for children below 4 years is 60% (Malaria Indicator Survey, 2010). Supply chain breakage in the last decade led to stock outs:
only 41% of health facilities had iron tablets while 74% had folic acid supplements (KSPA 2010)

Iron supplementation uptake by pregnant women for 90 days at only 2.5%(KDHS 2008/9)
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Policy direction and positioning

To achieve the Millennium Development Goal of reducing infant and maternal mortality anemia reduction and control is a priority strategic area in:
Food and Nutrition Policy Kenya Health Sector Strategic Plan III National Nutrition Action Plan Focused Ante Natal Care Maternal, Infant and Young Child Nutrition policy, strategy and guidelines

Legislation
Amended of the Food, Drug and Substance Act (Cap 254) through a legal notice No 62 ensuring mandatory fortification of cereals (maize and wheat), fats and oils.

Government stewardship and leadership

Coordination and leadership NICC Fully fledged multi-sectoral body - National Micronutrient Deficiency Control Council (NMDCC) Public - Private Partnership through Kenya National Food Fortification Alliance (KNFFA) High level advocacy and dialogue for increased budgetary allocation and return of IFA to Essential Drugs program Inclusion of Iron and Folic acid supplementation of pregnant women in High Impact Nutrition Intervention package
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Strategies Used Food Fortification for the entire population Iron and Folic acid supplementation;
Pregnant women adolescent girls

Home fortification of complementary foods using micronutrient powders for children aged 6-23 months Other public health measures malaria and Helminthes control through LLITNs and deworming respectively
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Strategies Used

Continued.

Stakeholder commitment and participation in Iron and Folic Acid supplementation plan
BCC & Advocacy capacity building systems strengthening

Private Sector Engagement Local production of IFA and MNPS through private sector support Distribution and social marketing to improve uptake. Government commitment to fund IFA through essential medical medicines and supplies
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Monitoring and Evaluation IFA is an essential component of Focused Ante Natal Care Screening and treatment of pregnant women with low Hb done routinely Individual record on anemia and supplementation in the Mother Child Booklet and reported in District Health Information System

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Challenges and Constraints Late starting of ANC by pregnant women Low levels of compliance and adherence (2.5%) on uptake of iron supplementation Inadequate resources for communication and advocacy Inadequate Knowledge and perception barriers

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Challenges and Constraints Continued.. Fear of HIV testing and stigma associated barrier to early start of ANC Inadequate counseling and information provided by Health Workers (Formative assessment 2012)
10% advised on dosage 12.1% advised on how to take IFA 13.5% IFA supplements prescribed

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Way Forward Encourage early ANC attendance Adoption of the combined IFA supplement Study success stories of other countries for community distribution for both IFA and MNPs Further strengthen partnerships and male participation Capacity building of health workers and community health workers
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Acknowledgement WHO UNICEF USAID-MCHIP Save the Children GAIN PATH Micronutrient Initiative(MI) WFP Universities Research Institutions Implementing Partners

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