Guinea Bissau Vitamin A

Kenya

Iron

 Iodine Lesotho
     
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CURRENT SITUATION
     

The prevalence of moderate anemia is 54% in Kenya, while almost 70% of pregnant women in Kenya are anemic.  There are currently no national policies on iron deficiency, supplementation, or food fortification, but policies are under discussion.  Pregnant women attending antenatal clinics are routinely given supplements of iron, and some industries have begun voluntarily fortifying foods.
     
     

EPIDEMIOLOGICAL DATA
   
Anemia
Most Recent Anemia Survey  
Date: May - October 1999
Groups Surveyed: Children 2-72 months and their mothers (pregnant and non-pregnant), adult males 28-36 years old.  The sample comprised of 3229 children aged between 2 and 72 months while the mothers were 3163 in number. Among the mothers a distinction was made between pregnant and non-pregnant subjects. There were 1183 adult males aged between 28 and 36 years of age. The mother-child pairs were from randomly selected households from the cluster sampling. 
Sample Size:

3229 children (3163 were sampled), 3163 mothers, 1183 adult males (overall sample size = 7575)
Sampling Method: The national survey used two stage cluster sampling with first stage for clusters and second for households.  Subjects were randomly selected from the sampled households.  There were 12 districts and 8 sub-regions. Three to four clusters were selected from each sub-region.
Estimated Anemia Prevalence:  Indicators are HBC and Serum Ferritin.

Group

Sample Size

Indicator

Prevalence in Sample (%)

Est. Population Affected*

Infants <6 months

 

 

19.1   g/dL

 

>/  36 months

 

  

10.3 g/dL

 

Mothers mean age  28.31+/7.67

2876 (12.6% were pregnant)

  

mild 28%

moderate  21.2%

 

Pregnant women

968

Serum Ferritin <40µg/L

69.3%

 

Adult Males

1183 (mean age 36.63 +/- 10.948

 

26.2  -5.1 %

 570,368 - 111,025

          Sub regions

Lake Basin

 

 

66.7-71

 

Western Highlands

 

 

16.5-49.3

 

Coastal and arid lowlands

 

 

66.3-96.9

 

Central and mid west highlands

 

 

7.5-14.1

 

Overall Total

7575

 

mild  19.2%

moderate  54.2%

 

* Estimate based on US Census Bureau data for Kenya, 1999, males aged 25 - 34 yrs of age.  (www.census.gov)

 

POLICY AND LEGISLATION
Legislation on IDA
   
    

Kenya does not currently have legislation to address iron deficiency, supplementation, or food fortification with iron (although supplementation for pregnant women is routine).  A national policy is under consideration.  The policy being discussed includes interventions such as supplementation for children and food fortification.  Discussion on guidelines is in progress and is to be followed by policy discussion.
 
Government Agency to Address IDD
    

The government agency that deals with IDA is the National Committee on Micronutrient Deficiencies, under the Ministry of Health.  The agency’s functions include both coordination and monitoring.
    

Contact information: Mrs. Pam Malebe, Child Health Division, Ministry of Health, P.O. Box 43319, Nairobi
     
     

PROGRAM DATA
   
 Supplementation
Program Description - Women

    

There is routine supplementation with Fe/folic acid through MCH clinics.
     All pregnant women attending clinic are targeted, but the number of women targeted is not available.
     Supplements provided are Iron/Folate 60 mgs/day.
     Supplements are distributed through MCH clinics/Antenatal clinic.
     Intended frequency of supplementation doses is daily, from 2nd trimester.
There are currently no supplementation programs for children.
Fortification
     Fortification of maize and some fats and oils with iron has been implemented by some industries on an individual basis, but there is currently no national policy or monitoring.
     No systematic approach is in place, but there is currently a trial project in initial phase on double and triple fortification of salt with iron, iodine, and vitamin A.
 
Other Programs
     Distribution of insecticide treated nets has a dual role in anemia and malaria control
     Current government/UNICEF work-plans include community-based programs to promote improved iron status through dietary change.
     Deworming is done as part of a school health project.
     
     
 

MONITORING
 
Anemia
Current monitoring activities for iron deficiency anemia:
     Routine collection of Hb concentration data at MCH and antenatal clinics.
     Surveys are being repeated only in small communities based on specific projects.
     There are well-equipped National Labs (for Hb estimates) under the Ministry of Health, Referral Hospitals and also under Kenya Medical research Institute and all district hospitals.
     Field tests (e.g. HemoCue) are used, but mainly for specific research projects.
     There is currently no facility or community-based monitoring of anemia.
   
Programs
    

There is no monitoring of supplementation or fortification programs, but there are plans to improve monitoring.

     
     

PROGRAM RESOURCES
 
Donor and Implementing Agencies

 

Implementing Agency

 

Description of Activities

Expenditure and source of funds in

Current year

Supplementation

Fortification

National/State governments

There is no funding specifically targeted to IDA. Minimal activities are normally supported through other care/nutrition projects.