Guatemala Vitamin A

guyana

Iron

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EPIDEMIOLOGICAL DATA
   
Anemia
Most Recent Anemia Survey:   Household National Survey
Date: 1997
Groups Surveyed: Children 0-4 years and 5-14 years of age; Pregnant Women
Sample Size: 1022
Sampling Method: Survey consisted of 448 households from 6 strata identified in the country.  A strata was determined by grouping regions/areas of the country that had similar ethnic and economic backgrounds.  From this sample, children attending government health centers throughout the country, school children attending government primary and secondary schools, as well as pregnant women attending antenatal clinic were selected from throughout the country. 
Estimated Anemia Prevalence: 

Group

Sample size

Population in  region/group (if known)

Indicator

(e.g. Hb<120g/L, <110g/L, etc.)

Prevalence in sample %
Children 0-4 years

140

 Hb<110 g/L 47.9
Children 5-14 years

323

 Hb<120 g/L (<6 years) 

Hb<110 g/L (>6 years)      

56.7
Pregnant Women

269

 Hb<110 g/L 52.0
Adults 15-30 years

438

 Hb<120 g/L 42.2
Adults 31-50 years

301

 Hb<120 g/L 40.9
Adults 51 years and over 88

Hb<120 g/L

40.9

National Total

 1022

 

 
 

POLICY AND LEGISLATION
Legislation on IDA
     Legislation to address iron deficiency in Guyana has been implemented since 1996, and it has not been significantly revised.
     Legislation covers fortification of locally milled wheat flour with iron, programs to develop community-based anemia education programs, and methods to strengthen capacity of health personnel to conduct anemia education programs.. 
     There is a national policy on iron supplementation for pregnant women but not for children.  
     There is a national policy regarding iron fortification programs.
 
Government Agency to Address IDD
     Government Agency: Ministry of Health.  The function of this agency is coordination, funding, and monitoring.
     
     

PROGRAM DATA
   
 Supplementation - (Women)  
Targeting

    

Pregnant women
   n
Capsule Information

    

Ferrous sulphate (200mg)/ folic acid (0.25 mg) or Ferrous sulphate (200mg) and folic acid (5.0 mg)

    

Inferon injections for those individuals with low Hb levels (<80 g/L)
Implementation

    

Pregnant women are given a month supply of supplements on their first visit to health centers/antenatal clinics.  

    

Supplements are also available on the regular market.

    

The intended frequency of supplementation is daily starting from the first trimester (some women start in the second trimester depending on their visit to the health centers)

    

The national program started in 1970's.
   
Supplementation - (Children)

    

No programs currently being conducted.
 
Fortification

    

Wheat flour is the only food currently fortified with iron.  

    

Approximately 100% of the locally produced wheat flour is fortified, and this process is monitored.

    

The wheat flour is fortified with 147.0 grams of iron per 1000 grams of flour.  Fortification uses 0.50ozs.of pre-mix.

    

Pre-mix (type N-enrichment) consists of 14.0g thiamine mononitrate, 8.0g riboflavin, 97.0g Niacin, 5.0g folic acid, and 147.0g of iron. 
Dietary Change
National Programs

    

There are many national campaigns in Guyana conducted through clinics, schools/communities, and by health professionals through health centers.

    

First campaign deals with the promotion of iron foods using locally available food items.  This is done through demonstrations and food tasting sessions emphasizing the use of locally available food to iron-rich dishes. 

    

The second campaign consists of training health personnel in the prevention and control of iron deficiency anemia.  
Mass-Media Campaigns

    

Campaigns use leaflets, newspapers, and radio to promote various dietary programs.

    

Media campaigns focus on daily use of iron-rich foods as well as the use of vitamin C with iron-rich food to enhance iron absorption.

    

Media campaigns also presents information concerning foods that can inhibit iron absorption if taken at the same time with iron-rich foods.
Community Based Programs

    

There are 2 community based programs currently implemented in Guyana conducted through clinics, schools/communities, and by health professionals through health centers.
  Safe Motherhood/Anemia Education Program

    

This campaign targets teenagers in two rural communities, and implementation requires teenagers meeting once a week for lecture/discussions and practical food sessions.

    

Objectives for this campaign are: 1) expose teenagers to information regarding iron deficiency/anemia and how to prevent this condition and 2) provide opportunities for teenagers to select and consume iron-rich foods.
  Health Community Project

    

The second campaign targets the entire community with various programs conducted throughout the country.
        School Feeding Program

      

Designed to target school-age children attending nursery and primary schools in specific communities in the country.  

    

Twice a week, children are given a mid-morning snack which consists of black eye bun, peas ball, and a fruit drink.

    

Program was implemented due to the low Hb levels found in children.
        Anemia/Environmental Project

    

Group of volunteers hold discussions with various community members regarding various health-related issues.

    

Two main issues these group discuss are the consequences of poor sanitary facilities and iron deficiency anemia prevention and control.
        School Health Program

    

Health personnel from local hospitals conduct school health clinics.

    

Duties of the clinics include de-worming, checking Hb levels, and recording weight/height.

    

Clinics are also responsible for immunization against measles, mumps, rubella, tetanus, and toxoid.
Other Programs

    

Other programs in Guyana include 'The Malaria Control Program'.

    

Program consist of early diagnosis and treatment of infected persons.

    

Program also deals with the prevention of exposure through use of bed-nets or treated bed-nets.
     
     
 

MONITORING
 
Anemia
Current monitoring activities for iron deficiency anemia:
    

Hb analysis was conducted with pregnant women, but there are no plans to repeat this survey.
    

There is facility or community-based monitoring of anemia through the screening of pregnant women at health centers.
    

There are laboratory facilities at local and regional hospitals to conduct Hb estimates. 
     
     

PROGRAM RESOURCES
Donor and Implementing Agencies

 

Implementing Agency

 

Description of Activities

Expenditure and source of funds in

current year

Suppl.

Fortif.

Other (specify)

National/State governments

-Iron supplementation policy for pregnant women

-Anaemia education geared towards the public

-Monitoring of Hb levels of pregnant women

 

External agencies

IDB

-Sponsored training programs for health workers

-Funded production of anaemia leaflets

-Purchased HemoCue kits

 

CFNI

-Developed anaemia education manual for health workers