Iron Deficiency Anemia - Cambodia

Vitamin A

Cambodia

Iron

Iodine

China




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	EPIDEMIOLOGICAL DATA


Anemia
Most Recent Anemia Survey: Cambodia Demographic and Health Survey(CDHS) 2000

	Date:	February - July 2000
	Groups Surveyed:	Children from 5-59 months and women from 15-59 years old of age, including assessment of pregnant women.
	Sample Size:	1,461 of children aged 6-59 months and 3,634 of women aged 15-59 years old.
	Estimated Anemia Prevalence:

Region/group*	Sample size	Population in region/group (if known)	Indicator (e.g. Hb<120g/L, <110g/L, etc.)	Prevalence in sample %
#1 Children (National)	1,461	6 - 59 months	<110g/L	63
#2 Pregnant women (National)	refer CDHS 2000		< 120g/L	66
#3 Non pregnant women (National)	refer CDHS 2000	15-49 years	<120g/L	58




	POLICY AND LEGISLATION

Legislation on IDA


	Cambodia has legislation on IDA involving supplements for pregnant women. The Safe Motherhood Programme was enacted in 1997. It involves distribution of iron/folate(60) tablets on the first AN visit and iron/folate(30) tablets later after two months to pregnant women during ANC at the health center.
	There is a plan to conduct a study on iron supplements for children under 5 years of age in 2003 and iron supplementation of school children under consideration.
	There was a fortification feasibility assessment conducted in November 2001. There is a proposal on Iron/Vit. A fortification of fish sauce and wheat flour under consideration for 2003.


Government Agency to Address IDD
	The government agency that deals with IDA is the National Nutrition Programme.
	Contact information: Dr. Ouk Poly, National Nutrition Programme Manager, National MCH Center/Ministry of Health, No. 151-153, Kampuchea Krom, Phnom Penh, Cambodia. Tel. (855) 12 919 565. Fax: (855) 23 426 034



	PROGRAM DATA


Supplementation
Program Description - Pregnant and child bearing age women
	A national program to provide iron supplements to pregnant women. It was established since 1985.
	Pilot project for child-bearing age women of weekly supplementation conducted in seven factories in Phnom Penh and 2 districts in Kampng Speu province. It started in September 2001 and is to be completed by July 2002.


Targeting
	National: All pregnant women, estimated at around 450,000 per year
	Pilot study: Covers 20,000 child-bearing age women (not pregnant).


Capsule Information
	National: Iron content of 60 mgs and folate 400mg for pregnant women
	Pilot: content of 60mgs and folate 3.5mg for childbearing age women


Implementation
	National: Daily iron supplements starting from first trimester through ante-natal clinics at the health center.
	Pilot: Weekly supplements through outreach services and community based project (Seth Koma Programme) two districts in Kampong Speu for childbearing age women. Also through factory health clinics in seven factories in Phnom Penh.

Fortification

No current fortification programs.

Other Programs

Education Campaigns

	There are large-scale or national programs, including mass media campaigns, to promote improved iron status through dietary change. There is specific education on anemia during ANC and messages on ANC card. There is also the Safe Motherhood education during ANC.
	National Reproductive Health Programme, MOH.
	The UNICEF Seth Koma Program covers approximately 1,100 villages in 6 provinces and community-based programs of other NGO's.


De-worming Programs
	School children de-worming programme conducted by School Health Department, Ministry of Education, assisted by UNICEF and WFP.


Malarial Programs
	Malaria Control programmes by National Malaria Center, MOH.



	MONITORING

Anemia
Current monitoring activities for iron deficiency anemia:
	IDA assessment conducted during National Demographic and Health Survey2000. The CDHS is carried out every 5 years. Hemoglobin level is used as indicators.

Programs
	Coverage of supplementation programs is monitored via the Central Medical Store, Essential Drug Programme and Provincial Health Department/ Operational District pharmacist.



	PROGRAM RESOURCES

Donor and Implementing Agencies

Implementing Agency	Description of Activities	Expenditure and source of funds in current year
Implementing Agency	Description of Activities	Supplementation	Fortification	Other (specify)
National/State governments	Ministry of Health Ministry of Industry, Mines and Energy	$35,000 for supplies plus staff time	Staff time
External agencies*	UNICEF WHO	Donation of iron/folate tablets and mebendazole tablets $110,000 for 2001

Total Iron Program Funding History and Forecast for Country

Year	Iron Activity				Total $(000)
	Supplementation $(000)	Fortification $(000)	Other (specify)
	Supplementation $(000)	Fortification $(000)	Activity	$(000)
2001
2002	100 (Weekly iron/folate supplements study & situation analysis for weekly iron/folate supplements for child bearing age areas) 150 · National awareness and IEC activities and training health staff and teachers in 6 provinces to promote IDA programme covering women, young children and school children. · Short-term consultant to assist for revision of National Policy.				250
2003	220 Assessment study for school children 200 · Procurement of iron/folate for children. · Awareness and IEC activities and training of health staff and teachers to promote IDA programme covering women, young children and school children	100 Technical assistance, assessment studies, Supplies and equipment			520
2004	150 · Programme management · Training on IDA of Village Development Committees and volunteers, parents and child care providers · Procurement of iron/folate supplements	200 Technical assistance, capacity building monitoring.			350
2005	250 · Re-assessment of IDA situation · Training on IDA of Village Development Committees and volunteers, parents and child care providers · Procurement of iron/folate supplements	200 Technical assistance, evaluation and reporting			450