Togo Vitamin A

uganda

Iron

 Iodine Zambia
     
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EPIDEMIOLOGICAL DATA
   
Anemia
* 4 out of the 45 total districts were excluded due to insecurity
Most Recent Anemia Survey:   Household National Survey
Date: 2000-2001
Groups Surveyed Children 6-59 months, Women 15-49 years, and Men 15-54 years of age.
Sample Size: 15,590 (5,833 children, 7,408 women, and 2,349 men)
Sampling Method: Household national survey was conducted to obtain the prevalence of anemia in Uganda.  7,885 households were surveyed from which Women 15-49 years, Pregnant Women in the age group, Children 6-59 months, and Men 15-54 years were separated into different categories.  From each group, samples of hemoglobin were taken using the HemoCue method and the prevalence of anemia was ascertained.
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 6-59 months

5,833

 Severe (<7.0 g/dl)- 6.5

Moderate (7.0-9.9 g/dl)- 37.1

Mild (10.0-10.9 g/dl)- 20.5

Not Anemic (>11.0 g/dl)- 35.9

Women 15-49 years

6,548

 Severe (<7.0 g/dl)- 0.7

Moderate (7.0-9.9 g/dl)- 7.5

Mild (10.0-10.9 g/dl)- 22.1

Not Anemic (>11.0 g/dl)- 69.6

Pregnant Women

860

 Anemic (<10 g/dl)- 41.2
Men 15-54 years

2,349

 Severe (<7.0 g/dl)- 1.0

Moderate (7.0-9.9 g/dl)- 7.4

Mild (10.0-10.9 g/dl)- 9.9

Not Anemic (>11.0 g/dl)- 81.7

National Total

 15,590

 

 
 

POLICY AND LEGISLATION
Legislation on IDA
     There is legislation to address iron deficiency in Uganda, and it has been implemented since February 2002.
     This legislation discusses the 'National Anemia Policy' which addresses iron deficiency among other causes of anemia.  Legislation calls for routine iron and folic acid supplementation during pregnancy along with intermittent treatment for malaria, deworming, and nutritional education as part of the Antenatal Clinics package.  
     Legislation also focuses on iron/folic acid supplementation, deworming, life skills/reproductive health information, and nutritional education for adolescent girls.  School age children are targeted as well through regular deworming, nutritional education, and school sanitation.  The last group targeted are preschool children, who are targeted through detection and management of anemia along with regular deworming as part of interventions to promote optimal feeding practices.  
     There is a national policy on iron supplementation for pregnant women and for children.  
     The national policy for children targets children who suffer from malaria, worm infestations, and anemia through a combination of daily/weekly supplementation based on the need of the child.    
     There is no national policy regarding iron fortification programs nor is it under consideration.
 
Government Agency to Address IDD
     Government Agency: Ministry of Health- Nutrition Unit.  The function of this agency is coordination, funding, and monitoring.
     Contact Information: Mrs. Ursula Wangwe, Principal Nutritionist.
     
     

PROGRAM DATA
   
 Supplementation - (Women)  
Targeting

    

Pregnant women

    

More than one million pregnant women per year are targeted through the campaign
   n
Capsule Information

    

Iron tablets (60 mg of iron) and Folic Acid tablets (400 µg of folic acid)

    

Capsules were a part of the essential drug kit which contains 1,000 tablets and is distributed to all Health Units on a quarterly basis.
Implementation

    

Supplements are distributed through Antenatal Clinics.

    

The intended frequency of supplementation is daily supplementation for 6 months during pregnancy  If women did not began until late in the program, their supplementation was extended post-partum to complete a duration of 6 months supplementation.

    

The program began when Antenatal clinics were started.
   
Supplementation - (Children)
Targeting

    

Children under 5 years of age who were infected with anemia, malaria, or worm infestations.

    

Approximately 1.5 million children were targeted through this program.  

    

Only 40% of the more than 5 million children under 5 years have access to health facilities when ill. 
   n
Capsule Information

    

Iron tablets (60 mg)
   n
Implementation

    

Supplements were distributed through Integrated Management of Childhood Illness (IMCI)/ facility based centers.

    

The intended frequency of supplementation depended on the level of anemia in each child.  Supplementation was given daily during the first stage followed by weekly supplementation during the second stage.

    

More than 1,000 iron tablets were contained in essential drug kits that were catered to children and women resulting in less than sufficient number of capsules for the program.
 
Fortification

    

No food is currently fortified with iron although a proposal for maize fortification is in place.

    

This fortification of maize would be with a mixture of micronutrients.
Dietary Change
National Programs

    

There are large-scale/national promotions conducted by the Ministry of Health and the Ministry of Agriculture.  These ministries create and implement policies that provide diet diversification.
Community Based Programs

    

There may be some community-based programs, but these programs are not coordinated or widely known.
Other Programs

    

Other programs in Uganda include the Malaria program which promotes bednets, home management of fever, and the intermittent treatments of pregnant women to prevent the infection and spread of malaria.

    

Other programs also include the Worm Control program which promotes regular deworming as well as water and sanitation promotion.
     
     
 

MONITORING
 
Anemia
Current monitoring activities for iron deficiency anemia:
    

There is no current anemia monitoring in Uganda.
    

Surveys previously discussed and implemented are repeated by the UDHS every 5 years.
    

There are laboratory facilities available in health units and health center 2 or 3 for Hb estimates.
    

Field tests are not implemented, rather Hb testing is conducted at the facility level.
Anemia
Programs
    

Monitoring of the supplementation is not conducted.
     
     

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

Ministry of Health- Nutrition Unit:  lllllllllllllllllllll             Overall Policy development

 

External agencies

UNICEF

 

USAID/MOST