National Plan of Action for Nutrition 1995

REVIEW WORKSHOP, 16-18 DECEMBER 1996 INTERNATIONAL DATELINE HOTEL, NUKU'ALOFA, TO}VGA Tongan Plan of Action for Nutrition. Introduction. The Tong3 Plan of Action for Nutrition was first drawn up at the National Plan of Action for Nutrition Workshop at the Pacific Ro~1ale in January 1995. ?a'l:cioants included reoresentatives of both government and nongovernment organizations. The document was then st.brnitted to the Nation3I Food and 1\Jutrition Committee and to Government and was aooroved in Cabinet Decision No. 451 of 29 March 1995. ' ' The Tongan Plan of Action for Nutrition Review Workshop was held 16 -18 December, 1996. An up-date to the plan was mad3 and this was then submitted to (3overnment and approved in Cabinet Decision No. 138 of 5 February 1997. It is hoped that the plan will p1·ovide a useful guide to further nutrition work in Tonga. See Annex 1 for a list of the participants in the workshop. The P:an sets forth all activities necessary to help achieve and maintain nutritional well-being and to make safe nutritious food available in sufficient amounts to all. Activities are grouped in the nine themes agreed upon at the International Conference on Nutrition (ICN) Rome, December 1992. T1ese nine outputs include the following:. lncorporatin ~ nutritional objectives, considerations and components into development policies and programmes. 2. Improving h,Jusehold food security. 3. Protect;ng cJnsumers through improved food quality and safety. 4. Preventing and managing ·infectious diseases. :i. Promoting breastfeeding. 6. Caring for tr e socio-economically deprived and nutritionally vulnerable. 7. Pr<?venting and controlling specific micronutrient deficiencies. 8. Promoting appropriate diets and healthy lifestyles. 9. Assessing, analysing and monitoring nutrition situations . . l\cknowledgement is made to the World Health Organization which provided the funding for the workshop and for the production of the plan. ,, #1# #2 # 1.1 Food and Nutrition Policy and Activities in the Central Planning Department will have been str,gthened. I Activity , I 1. ,·. 1 Appoint nutrition planner to the existing 1 pCSition in the Central Planning Department. 1.-; .2 Revive the t~ational Food and Nutrition Cornmittee (NFNC) and review and confirm membership, preferably with members with planning and nutri·ion experience. Appropriate NGOs to be consid,3red for full members. I 1.1.3 Carryo~t active program of institutional development of NFNC, including examining the possibility of becoming a statutory body, Minutes of meetings to b,3 sent to the Development Coordination Committee (DCC) and Cabinet on a monthly basis. 1.1.3.1 The NFNC should help develop posters, charts and manuals for community training, and increasing nutrition awareness, as well as promoting vegetable and home gardening, cooking demonstrations etc. I Who CPD CPD plus all sectors CPD NFNC NFNC Outcomes • Vizo Halavatau. • Nutrition Adviser - Lois Englberger. • NFNC revived. • Membership needs to be reviewed. • Statutory body needs an act of Parliament. • Minutes are recorded and sent to DCC and Cabinet. • do provide. • is an on-going activity. • it will continue in the future. Timeline Jan 1996 Jan 1996 Nov 1994 Benefits/risks Nutr ion on the a1 enda of Go ernment. Ensu es nutrition rec1 ive a high riority. Risk: ecessary to be p2 rt of govt. for sw ainability. ( in-going c mmunity Education in ormation. 1.2 All new policies will have been submitted to the National Food and Nutrition Committee. ,Activity 1.2.1 Submit all ne'N policies to the NFNC. 1.2.1.1 Assess impacts of policies on nutritional status of any group in the community likely to be affected. 1.2.1.2 Raise awc.reness of all policy makers (especially if not represented on NFNC) to economic and social aspects of NCDs, iron deficiency anaemia, breast-feeding etc. 1.2.1.3 Disseminat3 approved policies for public information. 1.2.2 Submit for review projects related to food and nutrition, however peripherally. ,Who NFNC/AII Sectors/Relevant NGOs/Foreign Aid projects etc. NFNC • need to include "relevant" . • up to NFNC to decide on priorities and to advise govt. on Food and Nutrition matters. • draft "food in schools" policy • Dr. 'Ake radio, TV campaign "health awareness". • on-going MOH anaemia and breastfeeding promotion at MCH clinic. • NPAN. • National Nutrition Policy. • Weight and Height Charts, Food guides • Healthy Weight Loss Competition. • Hami Sauce Project. #3# 1996 1995 on-going 1995 1996 1995 '· ...... ·.' ·d•; ~-:;.,;., ,, lnfor tiation sharing. * Pr~vides a ba$eline. * N~eds asf essment. Raises the impo tance of nutrit on. lnfor~s the publitj, ! I nforn liation sharir g. I # 4 # 1 .3 All education and communication programmes related to food, nutrition and health to be implemented by ol:~:er iv1inistrie:;/Departments and NGOs will have been coordinated by NFNC. = ··-·-='-==================::;======================================== ! ··- . -·-------- A.ctivity -----~ .. - ·--l--·~h~--~ ? ~tc~~--~---··--·---Q-·-···---T i m e l in e + B e i~,:J.:;k~ ! i.~. l ~stablish integrated Nutrition Education :1,·:;~irarnmes for t1e Youth and parents through c\:i ·->~dia 3nd formats, including radio, village 2.::,j c;,)mmunity le\/el meetings and seminars. 1.3.1.1 Consider the integration or comple­ rn1-3ntarity of the on-going monthly integrated MCH plan of fami y planning, breast-feeding and immunisation in all food and nutrition activities. 1.3.1.2 Emphasise the importance of local and regional foods .~g. by teaching in schools, ,t\gricultural Sho'IV competitions and demon­ strations etc. 1.3.1.3 Promote knowledge of local foods through home ~ardening, demonstrations of cooking and fooc preparation, by the designing of 'user-friendly' :raining manuals on local food values for comm Jnity use, and possible values for community use, and possible commercial applications of local foods. NFNC/ iv10H/ • 3 multisectoral workshops. MOE/ MAF/ MOF MLCI/ " MOE teacher in-service training. NGOS/ TNCC • MOE student training. • NGOs nutrition component of womens' development program. • MOH MCH, immunisation clinics. • MAF radio programs. • womens' projects at village level. • no competition organised yet. • MOE practical projects for schoolchildren. • MAF womens' development training program in purchasing, cooking and nutrition. on-going on-going lncre3.ses nutrition knowledge. lncorJorates nutrit on into routine health screE 1ings. Improves food secunty. Improves food security. ==============================================:d:::======:::!=:========::!.I ,.·::,Who '] --., .. ,<, . '. ·')'.···· .< :··. ,,. ·. ... .. · tPimelin:e , ... \Ber{efits/risks' .Activity . Outcomes 1.3.2 Upgrade kncwledge of consumer skills - NFNC/ MAF/ • workshop on consumer education "South 1995 keeping the public especially reading food labels and buying skills, MOH/ MOE/ pacific Consumer". ir.formed. including at village level. FSP/ Village/ Communities 1.3.2.1 DistributB training manual on food • nutrition composition charts of Tongan on-going values. foods available. 1.3.2.2 Translate nto Tongan some food labels • needs clarification on who is responsible. Risk: misinforma- e.g. especially wa ·nings and for powdered milks tion given about etc. foods to public. 1.3.2.3 Encourage· and support the formation of • South Pacific Consumer working to form on-going Protection of the a consumer assoc,ation. an association. consumer. 1.3.3 Encourage the practice of responsible NFNC/ MOH/ • NGOs "healthy lifestyle". on-going Promoting healthy personal health decision-making skills to MOE/ All lifestyles. promote health e.g. choosing a prudent diet, Sectors/ • Healthy Weight Loss Program. on-going choosing not to smoke, to drink alcohol in NGOs/TNCC moderation or not 3.t all, to exercise etc. 1.3.3.1 Develop tr.3.ining programmes, radio and • weekly radio programs by NFNC and on-going Information other information to help the making of wise MOH. giving. health choices. : #5# #S# 2.1 Food production research will have been carried out. Activity Who Outcomes Timeline Benefits/risks 2. 1. 1 Carry out food production research through MAF • PRA now introduced . on-going Needs the ivlinistry of hgriculture and Forestry, Research new integrated approach now employed - assessment. • Division. Farming Systems Research. 2. 1.1. 1 Do re~;earch on resistant varieties of • sweet potato, irish potato and banana on-going crops and food:,. varieties released. • taro, yam variety evaluation now on- going. 2.1.1.2 Do research on crop protection • pesticide recommendations. on-going technologies. • insect pa,rasite released . 2.1.1.3 Carry out research on rapid and disease- • banana plantlets released . on-going free propagation of crops and other foods such • work on taro, kava and vanilla now on- as trees, vines etc. going. 2.1.1.4 Encourage the acceptance of nutritious • new research on subsistance farming on-going foods and crops e.g. legumes. and root crops. I I 2.1.1.5 Expand animal production aiming at self- • new focus on animal husbandry . on-going l sufficiency by encouraging the community to • women's development section, local fruit I raise poultry and pigs at home. trees. 2.1.2 Disseminate all research findings for NFNC/MAF/ • available but not in layman's language on-going Informs the public. information/dii,tribution by reporting findings to MCLI/USP (technical papers). NFNC for widEr distribution. etc. "" '.·• •• * --• .. I' '- • I '• • ,• a • J ~ • ! /:: :a Outr.;om,:::s •. lff\;rnne Bene·:lts/fr~ks * ""• ., ,,.- ,·• *" - * *, ,..,-. . .. ~ ,·.,~, ,.,, .. .,,....,,,*,,,.,, .,. ,. •,-,•.*• · ·*··•·•o , .. ,,..,. .., , . .,* .,,-, ........... ,,·......, • •·•·I*-. ,......, ,.., "~-'>'.T"..0.......,.,,., ,...,,, ~-.1/..,---~- ""' ...... L--.--..... ,1 *-J•-~ • ... ..,,,. *.*,,. ,..., . ,., ,"°".. .. .. -...., ., ·' Cor;·:pany f,;:rrned to estab!isr1 a dairy 'ndustry ba..;;c,d on a 1993 study. ~ Request made to FA.O for funding a pasteurisation piant. " lndep,:31-!dent local industry. Less reliance on impotied foods. " Risk continuity of . I supply? j ·- .-·--····· --··-·---·--·----=---======.!.========o================================-----~ '.?: ') Environmental Impact Assessments {EIA) will have been performed. r:,. i.\liow 1m~; , .:~opropriat,3, f:-,at, i submit a pro,Josa ' ' : :-:.ien,iiied problerr !t'- · .. --:c .. ,:--:· /\cti vity "··~-- l ., .. ;,,,,; .. EIA for every proposal, where :omes up before the NFNC and I on how to mitigate any IS. Who Outcomes J ! imeline ., >., , ....., .,. ,. ,. ,...,.~",. "' rs •-- CPD • none submitted in 1996 . NFNC • contained in existing 1985 government legislation. MLSNR #7 # BHnents/risks , *, #8# 2.3 Souncl crop production technologies will have been adopted. Activity Who Outcomes Timeline Benefits/risks -2.3.1 Promote ve,;ietables and home gardening, NFNC/MAF/ • MAF assistance in village and farm 1994 Increases food emphasising local fruits and vegetables and MOE/NGOs research. secu ·ity through organic gardeninq, eg. through families, schools, the ability to village/community officers, village farm • MOE primary, secondary and tertiary establish an inde- meetings, active Jamily food production level teaching in schools. on-going pendent food programmes, ensuring seedlings are available • NGOs work with MAF in promoting home supp y. etc. and community gardens. on-going 2.3.1. 1 Submit all plans to promote vegetable None received yet. and home garder ing to NFNC to review and to advise so as to a11oid duplication of efforts. 2.3.2 Encourage nclusion of legumes in gardens MAF • Womens' development section working Increase the and diets by working at grassroots level through with the Japan Government. variety of foods the Women's De\·elopment Section of MAF. 1996 consumed. • Competition organised for Agriculture staff. 2.3.3 Strengthen women's section of MAF, MAF • New building with a kitchen in MAF for Decmase the especially traininq on skills for nutritious food teaching purposes. dependence on preparation, pres,3rvation and processing, home on-going imported foods. gardening, distribution of healthy cookbooks etc. • Writing and distribution of cookery books and recipes. 2.3.4 Increase and improve education and NFNC/MAF/ • MOE teacher training program. Increase training of all Tongans on nutrition and foods MOE/NGOs knowledge about through all methcds including training of trainers, • Student training courses. on-going food and nutrition. vocational coursE s on nutrition etc. i 2.3.5 Encourage District Agriculture Committees MAF • Organisation of monthly meetings for Allow:; the sharing '1 and District Women's Agricultural Committees to women at the village level. of infc,rmation. meet monthly and to set new planting targets on on-going I I a village basis. II - : 2.4 Appropriate land use policies will have been developed- and-adopted. Activity Who Outcomes Timeline Benefits/risks - 2.4. ·1 Revisw and reinforce on-going activities NFNC/ I deferred. with input from Ministry of Lands and Survey. MLSNR I ! 2.5 Food production for export and local consumption will have been increased. ~ Activity Who Outcomes Timeline Benefits/risks o ;t·e, a~aiy;~-;;~1d-disseminate . NFNC/MAF/ • MAF output of information on agriculture. ln1orming local I agricultural/horticultural/fishing information MOF/Media pr,)ducers about through v 3.rious media but especially at a local 0 MOF output of information on fishing. on-going what help is qrass roo :s level on a weekly basis by working available. with farm13rs and fishermen directly, including • NFNC and MAF weekly radio programs. reporting on the radio of local and export sales. 2.5.2 Increase adoption rates of improved MAF/MOE • MAF produce leaflets and information on-going Reduce technolo~1y eg. organic farming, fruit trees etc. kits. de:pendence on including development of organic farming artificial agricultural manuals 3-nd charts and leaflets. • There is a need to establish a baseline. cr,emicals. 2.5.3 lnc1ease volume of vegetable and fruit MAF/MLCI • There is a need to establish a baseline. TBA R3duce marketec locally by expa11ding information on dependence on planting and producing procedures eg. of citrus • i 996 was a very good year for the imported fruits and trees. production of local fruits and vegetables. vegetables. 2.5.3.1 Identify potential markets for local fruit • Tonga-Fiji trade established. 1996 S:rengthen local and vegEitables. a1~d national • Japan, Korea, Taiwan trade mission. economies. #9# ;~y r··roduction of JL·;h 2.nd other marlne products will have been increased- r----- ============:::;:::=======;::=======================;===---- ,, .. ,,.... . .... l f------~, ... .,, . ", ,~ctivij ~·~yJ:.9 ., .. -~ 2:Jt~~?17:~.:;: . ., ,. ~·---- ;1 ;'.6.1 i:~i-1c,)w,=-:q(:o :::ommercial pwciuction rn' MOt-/MLCI ~ i'·/, · .;al training pro;irams in Tuna I\ oualily t1st1 anrl rrarine products tor both han---l!inq and storage alld food processing: ; dor,H?sr1c co11::::i!Jrpt1on and export thrnugr1 I, .. I'! trallling and co1 isJltancies and research into , new fisl1ing l(';Chniques. I 2.6-2 Crea1 i=: 3nd environment conducive to the rlsvelopment of private sector involvement in fishe:-ies, illcludin;i protection to local fisi1errnen by imp eme11tation of the hsheries Coris 1crv:-1tio!l Ma11agem,3nt Act MOF/MFN/ MLCI ~ MO!--:: regular training workshops. • Fish Conservation Management Act implemented. • Protection of local fishermen by prohibitillg foreign fishing vessels to fist-, Tongan waters. ~ 1976-79 protection of Torigan marine parks. 1996 on-going 1996 1996? Creaiic>n ot ernp!O)'IT1(:?;ll 8T:c.i improvemc,nt c,; t:1e Tongan economy. P.. neec s asse::;['. · men1 n,-quired ! ;F:r,: to d(-'!terminc! v,.!11:"l focaf fbherme,1 want. -·~-------· -------------------->---------- ·-------·---------~------------- .-~. -------!--------·---··· 2.6.3 t:::1r;,:;1 i;;1<:Je :tl: ·rnafr;e fishing habitats to i ;:::,r2.;r-:;~'. c11cr exploi',;-}::ior-, of trnc::it:cna! tishing ·, 91·01 i:' !s 8\,: deve!opment or 2,quocuiturc; and I di2sernini'ltion of relevant infcrm2'.io11 in 1 1 Tongan as well we English. 1! MOF/r\~LSNF, • rv10F: introductior1 o'f new s~1c::::ies of fisr1 into Tongan waters. • Looking for overseas donors. • USAID project for the setting up of fish aggregating devicc~s. Proter:tio:: of core, reefs through consumer r.- l',,.!;Ct: C1::;:T1r: .. :1st.r:~L~:jn cnnki1·;g anc .. rec!p>;::. c1£:.,.sses. 1995 Risk. No, 0 ci t·:> deL·r,··.i;:,:; wr1c:t H ~ pre;+ fL~1t: :::1,.:cks a;·:~ .. c~;1·1su~11p:\;=--, a:-·rc­ t--c~~ltn. I I i, 1: ,, 'ii. .. ,., --:; -:::-.::-~,·=-~~~="'." :.::..::::..::: - --:.::==.·.=:-=:";:. -::... -, ::."=:-;-:~:::.: : - • • ·--,--···-···--·----·-, ,. ...;; : ,-•• -· .-:...=..=-=.. .".' ·---· ·-•---·-·-.,.,-.. -•. ." - ===:.::...--=--:---"--;:::'":-.=;;·.·=:-,,;- :.•·-·==··.- .:'. '" :::.:.=,::-.=-=====--==- "} 2.7 Employment opportunities will have increased. Activity -------=----- Who Outcomes Timeline Benefits/risks 2. 7. 1 Offer techn ea/ and vocational education MOE/ MLCI/ • MOE Training courses in health, nutrition on-going Strengthen for girls and boy~ eg. by job participation, work TNCC/ PM's and catering. workforce and experience. Office knowledge in food • MLCI training courses for job seekers. and nutrition. on-going • TNCC training for school leavers. on-going 4 Pi\~s Office selection of people to undertake training with the SPC. on-going 2.7.2 Establish n 3W food industries. MLCI • 70-80 new industry applications this year, 1996 Dive~rsify the I one third of which involve food. Tongan economy. i l # 11 # # 12 ti- OUTPU'T 3: 3.1 'l~h t' ' r p ' !' l f l. I ' :;.- d s f ' • '!l h • ' d e na 1ona1 mNcHeness OT uo 1c neai"i:n ann ,oo,, ... ·a e-r.y 1t::rues vvi1 ave been raise . i---·-·· --·-·-··· -·-·- -- . . -- ,. . . . - ·. ---- -- . ·- ·- ··------- 1 /\Ci:!Vity r·~.?.1. -i" Dt~'Jc!or1. i.mplE~me:rnt and-~intai11 a -- . ) National Food Stand2rds Code. i I' ,I li II Ii I 3. i.2 Exami,·c fGasitJility of conducting a survey which examine':.; the level of pesticides and contaminant:-: i:, the TonDan d11::L prnbably by expct11S;1on of ~/jt, ; Laborato~y. 1-' -------- i 3. 1.~:; Develoo ;~ n1ec!1anism t0 coordinate the I rr.:,.---,. :' ,·' ·ood' O'•'"(J" a'· 1 -t,.- VJh·1ch pric.;c- - r1·sk r·o I p-~1~~;;~. ~:~alt!1., ' L, u -'-L c , i II ------------------- !,:,. , 2. f./ :-JC:'-'::;lcir. imp!2msnt 8.11d r11Eintain 2 I: "! - , ; , , . , · I ,· .. , • i-.i , .-. t. i, 1,-0,, "1,·1 .,AJGf? 0, r ,c.C: IC8. I' I' MLCi/f'/!OH MI CI/MAF Ml CI/MOH ML.Cl l~cc-:.::::. .. --···-·-···-· ·-------·--·--------- ---·-=--===== • Proposals to have consultant develop a FSC from DCC. ~ Mlci attempt to form a working group to develop 8 FSC for Tonga. .. MAF and CSIRO (,'-.ust) soil contamination study. ~ Strengthen MAF laboratory. • Fieport tor MLSNR on contamints in seafood. ~ Through a FSC when developed. 1996 1996 mi11irnu;T1 s:.,c,r1cfard of food safciy. of fooci contarni- nation. ·1 I i I I ------------·------------ I pubiic prnteciion. ,. Tl~ioc.;g-,h-a-FSC ~hen--d-e~-e-lc-,c-,e-c-,.-----+-------1 Sets c: rnir:i,r;: :~:, -- \ stc1.nd,:-,r=1 of fr:, d I ------==~L=--.c-~,-~~~=~~~=J ,:~a,:~ :/~~;~--, ...... j t. , Activity Who Outcomes Timeline Benefits/risks 4·1>\Ult.li,,,n. .. ~,~ ii 3. ·1 .5 Publish a· Food Composition Table" which NFNC/MLCI/ • Using SPC food composition tables (800 i996 Provide an :I ,ists nutrie11ts available in the Tongan Food 1\/IOH foods). information tool for i I supply and thus allows scientific, dietetic and public use. i I nutritional advicn to be given. • Have limited Tongan food composition i tables. i 980's I Will translate into Tongan language . 1997 I • 3.1.6 Develop programme of consumer NFNC/MOE/ • no program established. Keep the public I education MOHiNGOs informed. e i 996 workshop to plan an association. I i # 13 # /-\ssurance Dt=?ve!op,ment wnl havtc:, been work1:;:d out. i'C.~c···· =•~•c•· .. J'. ·''vi'" . Who · 1 . Outcomes Ti~1en,;,, I Bec;~·i;t,;hi••i·=C. ···~ ii----·-··-···---·------ -,L,Li ' :.y -·----··-------., ~,1'·,C',,f t,,AAA C -. Pr·op. r J C'. a-,1-',)'-Ll-':-r~,1-·1·t-''.",-.o-·'-to-c·-: .. ,-b-,1-r1e-. t-, f-,r--,,,----+----,l-(1-q5 .. l-nc.1'c -.':-.',t".·r10J,~r·1',·.-~; .. ,·c",, ·D-1,, 1 2.::.·. ·/ [~2minc h:a::if.1d'tty of e:,Liblish111\:J a Food 1v ,.,, 1 ~ u --:: ~ . ., ::; -'-- ,. , . I: I f-=::::sec.1rd1 8,. Dev::loprr1enl Centre probably in approval small unit envisaged. ' for I :)ngz:i Hrf.::;r.: coope,at1on with MM.:: or through a working eco11omic fF:asibili'1y \ group of MAF, iVOH, f1,,1tl=-, M! CI. ne8dS to be I l , -+------------------+-------.-e" "a ri'ned. 11 1 3.2.2 Provide technical services (information) MLC', ., 6 people sent overseas for short term on-going Keep~ and tedrnologie~ needed by the food industry seciO! tc, n1eet the quality requirements ot the ·,·nc1,ket ~:.g by s1 ;>pon tor training/attachments i:c,!n D,i'Ja.te c:1t,arr1ise and external bodies. training. stantJard o11Dc.0 ,:: 1 t: quality. i' i 1---· ----- --,--.-------·-·--------f----------+-----·----------------+------------i'------·--··---·--·-·-·- 1 3,2.3 Trc:1.in c!itfcr,3r:t !F:vels of personnel from the MLCI/MAr~ • training courses offered to individuals, on-going 1· Sust;,in a his1h j goverr;;·1·:en'.. foo(i industries and village standard 01 food commur1ities on 1he requirements for food quality I quali y. control. fc,od proc:essing and good manufacturing i \\ practic8s [:: , '} ~, r-. .,-~-:;·~~~--~-~,,-1 ~· r·.,;-··;:--~,.~~-~·-.·~,~-c.:i ,-I, v.,'..'o ,.,I , .. ·l .. f-' c-~.,,r·,.,,J,lc,.r-- luO" :J,,JL.C-~,n;i ;·.- : ;~OUil·· Ii',·, t,;e;:,u:, 1,c·.:;iss fro;,, v2.rious cg1icuiW1c'' a,1c1 fish I ~ I i i Request made 10 l\ustralian food research cent::;, to deVc'JIOD a food processing mc,JulG. I I ------··--·-,·-·-··-.. ·-·--·-····- ·-·- ., ~96 , ',rimruves Tc, :(}3.:-, I , . , .. , 1, ecunt:rrnc r,: .·;,:,,,-\r,a·,. ; I ,: 'I Ii ;~ ~~ ,: ~ ~ ~-~ i: I I I I I , ,. i .... - ... · --··. ! !: -.-·· .... --·-. :==- ---::.::::::"·· ... --==-· ::::==::.::..-::-..:.::::...:.:...--::::. :-... ~·-····::=.7.:....=.."- ·.:.::.::.:=-·::.:, ~--- -::.:=· =-:..:::...·:::::-: .":::':'· ... :::::.:. ::::--==~:.-==.:::."::::' ... : ... ... .::=: .. , -- ' I .··.=..:::. · ·-= ·:..·::c:.::-.::.- ~..L ·,.·. '"·:-.::::c .. c. .::= -.----.-.;::.-:.. ' -=--=· === I 3.3 The m~cessary infrastructure and equipment for Food Quality and Safety will be in place. I Activity Who ., .. ~outcomes .. :Timeline ··· .. :Ser efitsfrisks .· 3.3.1 Prov[sion of centrally based equipment NFNC/ MLCI/ • NFNC has attempted to compile a library on-going Enabl s access to such as computers, dietary software, and MAF of food tables, books and dietary advice. nutriti, ~n informa- equipment. tion. # 15 # OUTPUT 4: # 16 # INFECTIOUS DISEASES PREVENTED AND MANAGED. 4.1 Awareness of inter-relationship of nutrition, environment and disease will have been increased by public education and by health promotion of personal hygiene. I Activity Who Outcomes Timeline Benefits/risks I 4.1.1 Develop ,rnd disseminate health MOH/MOE/ • Need to establish closer links between on-going Increases public education/promotion materials, in particular on TNCC/NGOs/ MOH and MOE. knowledge about food handling, 3nd the interaction between sick community hygiene. and healthy pe )pie. groups/MLCI/ MOF/MAF I 4.1. 1.1 Promots health through vocational ~ MOH radio program. on-going Gives opportunities courses, workshops (e.g. on occupational health for exmployees to and safety) and through all available media • MOH occupational health course 1997 protect their health. (pamphlets, posters, radio and TV programmes overseas. I ! etc.). 8 nothing done on safety. 1996 a draft legislation on occupational health. 4.1.2 Raise awareness of close linkages MOH/MOE/ a MOH workshops. on-going Increases public between infectious diseases, nutrition and the TNCC/NGOs/ knowledge about environment through use of the mixed media. community • MOE workshops. on-going health disease and groups/ nutriton. MLSNR (EIA) • Need to have joint workshops to share intformation. 4.2 High immunization coverage and follow up of the 1 - 5 years age group will have been maintained. : Activity Who Outcomes Timeline Benefits/risks 4.2. 1 Continue to provide immunization to all MOH/MOE/ • MOH immunization coverage 93% of 1996 Public: protection Tongan children so that the target diseases of MAF/NGOs/ infants under 1 year. from infections the Expanded Piogramme of Immunization (EPI) TNCC disea:;e. cease to be public health problems. (see • investigation need to make about intermediate goc Is for 1995: World Summit for funding for vaccines. Children and goals for year 2000). 4.2.2 Ensure avctilability of vaccines and cold MOH/MFN ~ Japan have funded the cold chair on-going Susta 1ability of chain equipment, particularly in light of cessation equipment 1997-2000. protecion from of external fundi11g for vaccines in 1996. infectiJns disease 4.2.3 Ensure efficary of vaccines by proper MOH • regular tests made at Vaiola hospital. on-going Ensur3s adequate refrigeration and monitoring. protection. 4.2.4 Update knowledge of all health and related MOH 0 training arranged for 1997 WHO funded. on-going Keep :-1ealth staff staff. fully informed. 4.2.5 Raise awai eness and strengthen MOH/Media/ • needs support from other sectors. Sustains the community participation in the Expanded NGOs/ TNCC immuriization Programme on Immunization (EPI) and thus • NFNC need to collect the immunization program. develop cons um ,;r demand of parents for all statistics for children. children to be immunized. #17 # # 18 # 4.3 Case diaBnosis, case management and contact tracing would have been strengthened. ,Activity Who ' . o:utcornes ¾ . ,;:rimeline ! YiBenefits/fisks 4.3.1 Provide trainin~ on diarrhoel diseases MOH • MOH provide training. Control of diarrhoel prevention and control, management of disease reduces respiratory diseases and other infectious • ARI highest marbidity in children - needs on-going risk at fu·iher diseases (possibly u:;ing refined WHO/UNICEF further investigation. infection:s. Integrated child management modules), to both µublic health community staff and hospital staff. 4.3.2 Provide public information and training, MOH/Media/ • PMs Office - there is a need to other on-going lncrease:s particularly to mothrns, on home management NGOs/TNCC/ sectors to be involved in the Women's knowledge about through training. workshops and the mixed MOE Unit training program. protection from media. infections diseases. 4.4 Supportive measures from Environmental Health Section will have been strengthened. Activity Who Outcomes Timeline Benefits/risks 4.4. 1 Raise the c.wareness of Government NFNC/MOH/ • MOH major objective on the rationship on-going Gives a holistic officials, health and agricultural workers, MAF/MLSNR/ between food, environment and health. view of health. teachers and the community on the close NGOs/ Private interrelationship:: between nutrition, the enterprise • MOE schools teach environment and environment and disease, using all available health. on-going means and mixed media. • CPD-future workshops to raise awareness. • MLSNR-environmental awareness in school children. 4.4.2 Conduct an environmental impact NFNC/ MAF need to consider if these are necessary. assessment (EIA) under the auspices of NFNC. 4.4.2. 1 Study the feasibility of establishing an NFNC/ CPD/ " EIA Unit within the NFNC. MLSNR/ MAF 4.4.2.2 Develop c,ppr~priate EIA criteria for " health and nutrition activities. #19 # #20 # !. Activity Who . ·Outcomes Timeiine 'Ber efits/risks 4.4.3 Improve anc sustain measures to ensure Town & local • MOH - check all water. on-going Public protection. safe potable wate ·, safe food, safe waste Councils/ disposal e.g. by encouraging people to use tanks MOH/ MAF/ - all food premises registered - permit. and similar measures. MOE/ MLSNR etc. - city garbage collection 1500-2000 on-going homes. - sewarage to treatment works. • MOE/MOH - school curriculum. 4.4.4 Encourage a 'health- MAF/MOH/ • MOH - smoking ban in Vaiola Hospital. Make ; healthy promoting'enviror ment i.e. an environment in CLD/NGOs choic 1 available. which the healthy choices are the easy choices • NFNC must advise government on health e.g. by not havin~ tobacco advertising etc. promotion, especially smoking. ,· ,.,.:--· ,;,--;, -·· ·- OUTPUT 5: BREAST-FEEDING PROMOTED {BF). 5.1 Virtually all women will be breast-feeding their infants. ,;iv,r .... I Activity Who Outcomes Timeline Benefits/risks, . : ', 5.1.1 Encourage all mothers to breast-feed their MOH/NGOs/ 1 monthly maternity leave - not enough. on-going Helps to protect I • I I children exclusively for four to six months and to TNCC/MOE infc :its from I i continue breast-leeding, with appropriate • 50% {1 - 3 months) of mothers are breast 1995 infection. I complementary foods well into the second year. feeding. I I I 5.1.2 Increase a1,vareness of mothers and the MOH/NGOs/ • NFNC - to action maternity leave to be I " I community on th 3 critical importance of breast- TNCC/MOE extended to 2 months with pay. I feeding by on-going radio health programmes, on-going I • MOH, radio, clinics, IEC. I development of I EC materials and the conduct of relevent workshcps. 5. 1.3 Empower 211 women to breast feed and to • not started. Public acceptance promote a community environment which of 8'F as protection supports this empowerment. for infants. 5. 1.4 Organize a :tivities for Breast-feeding Week MOH/NGOs/ • radio - BF week orqr.1nised for 1997. 1997 pub! c increases i on a regular, annual basis including such TNCC/MOE/ knov1ledge of the activities as a be:;t (breast-fed) baby contest. Media • enlighted the princess in the promotion of 1992 benEfits of BF. breast feeding. # 21 # # 22 # c:::? •.! ··- The USE: of b:-ec.-:,:::;t~mi!k substitutes will have been reduced, . ·- -~ .. --.- . .,~ .. ·-··-~E~~y ity·--·· ·---·-- ~. - "-""' 2. 1 Pi c1: :10\c und erstanding of CO!",munity and i for breast-1e0cing through overnmcnt suppo all tr1e rnixed medi cl and by workshops. strengthen the, prov:sio11 o: the . of the WHO International 5.2.2 Enforce and Tongan adaptatior Code on the Appr Milk Sub~;titutes. opriate Marketing of Breast- 5.2.3 Promote bre tax on imported m bottles. ---- ast-feeding by increasing the ilk substitutes ;::;r:d feeding Who Outcomes -- -~-1<---- . ij.,.. -~ MOH/MOE/ • MOH. NGOs ~ f\leed for a BF survey also child mortality survey (40 children < i yr in i 995) have died. ~~FNC/MOH/ > adopted by Tonga (voluntary) MOE/NGOs • needs to be strengthened. MOH/NFNC/ . NFNC to investigate . MFN • not attempted yet. - Timeline ,,,...,.,... ·- '1995 8.-::,n .. ., ......... As~,un of gov suppo ··t / . . en s n: .. ,~-:: JS the pubiic ,;rnmeni 11 for BF. Assur of intE % ths pub:ic ·national suppc, 1 tor BF. RUK: mothE cannc affects ,rs who >t BF. r::: ~ ,,.J,v All hosp tals, and maternal and child health facilities, will have continued to function as 'baby-fri : d!y' as defined in the ten steps on UNICEF/WHO. Activity Who Outcomes Timeline Bene its/risks ..:~- ..... 5.3.1 Disseminate and promote the 10 steps to MOH • 4 workshops on 10 steps. 1995 Attemp s to ensure all hospitals, health centres, health workers etc. hospitc s improve using all the mixed r1edia. • not ready yet. the he, Ith and wellbei ~g of • posters in Tongan on the 10 steps. infants · 5,3.2 Further promcte breast-feeding by ending MOH/MLCI • BF substitutes are very expensive in Infant! rotection distribution of free or low cost breast-milk Tonga. from a inade- substitutes in' all maternity wards and in the quate iet. hospitals. • No free distritution of formula allowed in Ii Tongan Hospitals. i # 23 # #24 # 5.4 Growth of all infants will be routinely monitored up to 2 years. Activity Who Outcomes Timeline. Benefits/risks 5.4. 1 Increase the awareness and training of all MOH • on-going activity before NPAN and on-going Enables staff to health workers 01 growth promotion. continues. pas~ on knowledge to ott1ers. 5.4.2 Provide apJropriate equipment and MOH/NGOs • MOH provides in hospitals, esp MCH. on-going Pro'v ides staff with facilities. appropriate tools. 5.4.3 Promote health education on growth MOHfTNCC/ • School health training . on-going Allows the public to promotion to all mothers and the community in NGOs/MOE mak3 informed general, includin;i high schoois and tertiary • Medical officer appointed . 1997 choi,:::es about education students, recognizing them as heal:h. potential mother:; and parents. • workshop on health esp. for youth. 1996 • MOE, secretary, tertiary health education. on-going 5.4.4 Analyse existing data on infant and child MOH .. not achieved. Provides policy growth that have been collected by current mak,:irs with monitoring. • collection of data on-going. sufficient data to mak,3. decisions. • needs for a growth monitoring survey. • need for a consultant to organise the survey. OUTPUT 6: SOCIO-ECONOMICALLY DEPRIVED AND NUTRITION VULNERABLE CARED FOR. 6.1 Apprcfpriate and relevant elements of nutriton with routinely taught in school curricula starting, from primary school. Activitv -.. ,. . '.(Jutcomes Timeltne ,i <'Be ~efits/risks ,. 'Who <, .. •;, 6.1.1 Strengthen health studies programme in MOE • continuing. Heal h incorporate primary schools. into ( ~rriculum. • nutrition taught in primar; and secondary on-going : schools. 6.1.1.1 Target schools in the newly settled areas MOE/NGOs/ • interagency cooperation required. on-going Maki health of Tongatap·u anc the outer islands. MOH studi ies available to al :students. 6.1.2 Integrate health and nutrition in other • primary schools - parents greatest on-going lncre ~sed public subject areas, including involving parents during influence. kno\l ~ledge about PT A meetings. heal h. 6.1.2.1 Ensure schools. • no action yet. Ensf e a minimum stan ard of food • canteens in schools need attention by and • utrition NFNC. quadty for school chil ren. • education campaign need to be mounted I on ( 1) overnutrition (2) undernutrition in ! school children. ; I # 25 # # 26 # 6.2 Better public health and nutrition education with particular focus on women will have been prq>moted. Activity Who Outcomes Timeline BE nefits/risks 6.2. 1 Promote better public health and nutrition NFNC/ MOE/ • more taught to buy and girls in schools. lnte irates nutrition ed 1Jcation with pa11icular focus on women MOH/ NGOs into home econo- (especially those in deprived areas) but ideally • NFNC radio program each week. on-going mics increases inciuding home economics education for both awareness. boys and girls. • MOH radio program each week. 6.2.1.1 Reinforce the need for both boys and • MOE - company health studies in grade Nutr~on study girls in forms 1 and 2 to study Health Studies and 1 and 2 in Government schools Home avai ble to school to extend this to the upper levels as well. ec. elective. children. 6.2.1.2 Produce information sheets for the MOH/ NFNC • produce information sheets in local on-going Nutrition informa- community in the local language. language: tion ~asily avai~ble at the vill~~e level. '-'-·-- - .: 6.3 Malnut1·ition of children under 5 years will not be a public health problem. Activity Who Outcomes Timeline Ben,~fits/risks 1:1111--------- -- WW . .. - . 6.3. 1 Improve matmnal diets and nutrition MOH/MOE/ • 1986 survey results used by on-going Maximises health through health promotion and education using MAF/NGOs NFNC/MOH, MOE and NGO's. of infa1-1ts. the mixed media and various formats. 6.3.2 Ensure ail mothers have adequate ante- M0!7 .. high rates of attendance at MOH clinics. I on-going Maxlrrises health I I natr-d care. of mothers, • need to know the rates . 6.3.3 Promote bre:1st feeding as a means of MOH/MOE/ • MOH and NFNC do . on-going Reduces health reducing malnutrition. NGOs/TNCC risks for infants. ---·· 6,3,4 Increase t1ec: Ith and nutrition education on MOH/NFNC/ • MOH/MOE/NFNC do as on-going on-going Gives children the timing and typ(~ of complementary foods and NGOs activity. better opportunities later diets for children. for increased health. 6.35 Fu!·t!'Jer strerigthen the control e.nd MOH/ MLSNR need to knov•! the rates of food borne I on-going i Protects pubiic i ~ management of food borne diseases. disease. from f,)od borne disem;es. ·--- ,. ·--· I 6.3.6 Further redL ce severe as well moderate MOH • 1986 rates below 1 % in children . on-going lncre2.ses health of malnutrition among children. children. ! 0 need further survey to fina present rates. # 27 # #28 # OUTPUT 7: SPECIFIC MICRONUTRJENT DEFICIENCIES PREVENTED CONTROLLED. 7 .1 Micro nutrient status of national diets will be adequate. - !~ - . "· - · Activitv Who Outcomes Timeline Benefits/risks l . , .. . ........ ~ ,,,,,.,.,, ~.~·------~z::x;;i.~;;;r~;,:.·~~~~- -~-idll I 7. 1. 1 lrnprove or maintain micronutrient MAF/MOH/ ,. MAF - improve nutrltionai quailty through Eventt.:al infor- j 1 (ir;c\uding iron) con1ent of diets by nutrition NFNC/NGOs/ cooking and storage program. mation of \l iitforrr:c.ti:: ,(: and i·1ecdth 2duc:ation thrcugh MOE on-going microrutrient ; ' " MOE/NGOs have similar programs. deficiencies. posters, charts and pamphlets and by training, ~ with emphasis on including traditional Tongan foods. ----------· 7.1.1.1 Promote micronutrient awareness in on-going villages through on-going programmes of MAF and MOE. I I , 7.1.1.2 Utilize private sector lnvolvement (e.g. .. NFNC involvement with bakery. on-going ' b2keries, restaurants) to sponsor better food and nut,ition. i I - ! 7.1.2 Improve awareness of iron content of diets, MAF/MOH • MAF Women's section has a nutrition on-going bioiogical availab,11ty of :rnn in different food awareness program at the village level - combinations and dietary enhances and almost 200 groups of women in Tonga. inhibitors to iron absorption, by wider - dissemination of nutrition information. --- - --- Activity Who Outcomes Timeline Benefits/risks --·--------------.. --111111 ~- . 7.1.2.1 Continue o distribute iron (and folate) MOH • MOH ante-natal clinics and health on-going supplements to prngnant women and monitor centres. iron levels for pre3nant women. 7.1.3 Investigate 'easibility of iron fortification of MAF/MLC!/ e not achieved. appropriate foods and conduct relevant research MOH if feasible. " needs to be revised by NFNC. ·- #29 # #30 # OUTPUT 8: APPROPRIATE DIETS AND HEAL THY LIFESTYLES PROMOTED. B. i Tc-ngan dietary guidelines will have been developed and disseminated. 1r·---------':.::-'"'·------ -===============,========;::================:;========r==========n :~ Ac\lvlty I \A/ho Outcomes Timeline Benefits/risks 1-~r:l~::~~~==:~~';::ions ., -~~~~~~~: ... ~;p~~v~~~~ ~~~~;ygui~""'s""'m""'a""'d"""e=f-o=r-+-=------19 9 6 -i,-,---~-----;i '1 ".' - ' " . . . ' ' i ,,1 "-' ,::sser:;:n::::.te ti-:2rr1 th:-cugn parnpn1ets to guard against rnicronutrient deficiencies. B. 1.2 Promote traclitional foods through all means including training and demonstrations. 8.1.3 Encourage v1ise food choices by increasing ; lnforrn;ition anrl availability. NFNC/MOH/ .. NGO's conduct projects called "Food MOE/NGOs NFNC/MAF/ MOH/NGOs/ Savers" project. ~ NFNC - provision of information on healthy food choices. on-going on-going \1 l MOE 1 • lb,- -- ================±! =====::.::!l=================:===============l 8.2 A majority of Tongans will be convinced of the need for healthy diets. Activity Who Outcomes Timeline Benefits/risks 8.2. 1 Promote nutrition and health education NFNC/MOH/ • MOH using all available mean to promote on-going Ensure a more promotion, including counselling, through all NGOs/TNCC/ nutrition. informed public. available avenues e.g. schools, sporting clubs, MAF churches etc. and using all available media. • MOE in primary, secondary schools. 8.2. 1. 1 Strengthen currently on-going nutrition , working with other sectors. on-going programmes. • NGO recognise nutrition as a PHC issue. • MOH radip program voted the most listened to in 1995. 8.2.2 Discourage importation of and NFNC/MOH/ • NGO's - NFNC has achieved some on-going Guides public to a consumption of le~;s nutritious foods. MAF success in raising awareness of less more :ippropriate nutrition foods. diet. 8.2.2. 1 Study feasibility of differrential (heavier) • Mutton Flaps papper to be presented to on-going Pr0tec:tion of local taxing on importec "less nutritious" foods. Cabinet by NFNC in 1997. industry. lmpro11es quality of diet for Tongans. 8.2.2.2 By consurr er education, increase • NFNC. on-going demand for health er foods such as leaner meat. #31 # #32 # Activity Who ·:··:,.;' ···. . ,:Qufoomes . 'Timeline . JBerietitsirisks :: 8.2.3 Encourage the, consumption of local foods NFNC/MAF/ • NFNC. on-going by marketing and otner support for local foods MLCI e.g. by identifying trem in the market, by import quotas etc. 8.2.4 Offer dietary c1dvice and diet counselling MOH Dietition at hospitals plus nutritionist at on-going Inform the.public. services, including through radio programmes, as NFNC. well as on a one to one basis and by training for those counseiiing. 8.3 A majority of Tongans of all ages wilt be taking regular appropriate exercise at all levels. \I Activity Who Outcomes Timeline I enefits/ris ks 8.3.1 Encoura£e appropriate exercise, at all NFNC/ MOE/ 0 NFNC - Japanese Volunteer Fitness 1997 levels for all ag3s (including the different stages NGOs/ instructor enrolled. of life - childhood, adolescence, adulthood and Scouts/ old age). Guides/ • most successful Tongan program was I ! TNCC/ weight loss program in 1995-96. on-going Sporting clubs 8.3.1.1 Use all fJrms of exercise including • All agencies involved in on-going on-going walking, physicc.l education classes, exercise projects. music/movemert/aerobic classes etc. #33 # #34 # 8.4 Levels of overweightness, obesity and noncommunicable diseases in the community will have stabilised. Activity 'Who :, \,, i:>ufoomes Timel,ne '~se nefits!r.iiks 8.4.1 Widely diss13minate health and nutrition NFNC/MOH/ • overweight issues included in all on-going education/promotion, focussing on energy input MOE/MAF/ programs. and output to combat overwieghtness, obesity NGOs and noncommuni::able diseased in the • for all agencies. community. 8.4.1.1 Disseminate information on obesity, • radio used MOH, NFNC. on-going diabetes, and oth:ir noncommunicable diseases by all means; pamphlets, charts, radio spots etc. • other media used by other agencies 8.4.2 Develop programmes for community MOH • MOH - screening programs in on-going outreach for diagnosis and mcinagement of the communities noncommunicable diseases, including diabetes. 8.4.2.1 Conduct t ·aining workshops for health MOH • Diabetes clinic - daily. on-going workers and the community as well as disseminating information and conducting • Hypotention clinic - weekly. screening in the community. ,, • CVD Clinic - weekly held. 8.4.3 Promote Ccmmunity activities, NFNC/ MOH/ • NFNC healthy not IOCs comp. on-going competitions (e.g. weight loss, beauty contests, MOE/ NGOs/ aerobics, marathons etc.) and other incentives to Local • NFNC community aerobic lose or maintain v1eight. Councils/ Private enterprise 8.4.3.1 Feature energy balance (weight control) • NFNC activity involved every year. on-going as one aspect of World Food Day activities (October 16). : 8.5 The leve:I of risk factors for the noncommunicable disease (such as smoking and consumption of high energy diets and alcohol) will have been reduced. Activity Who Outcomes Timeline Benefits/risks 8.5.1 Reduce unhea I thy lifestyle behaviours MOH/MLCI/ • MOH - draft bill to prohibit selling tobacco on-going Protecting the leading to increased levels of NCO risk factors by TNCC/NGOs/ products to children and also to prohibit health of young health education/prcimotion to reduce people's MOE smoking in Government building. Tonga1s. demand for cigarettes, alcohol and drugs, with specific gearing towards young non-smokers. 8.5.1.1 Conduct actvities on World No Tobacco • MOH and MOE intend joint survey at 1997 Demonstrate Day (May 1 ), and o1her NCO risk factors. school children. Tonga's support. 8.5.2 Encourage th1:; adoption of legislation that MOH/MLCI/CL • MOH document on healthy lifestyles. on-going Rece~tive and supports healthy lifestyles. D/CPD/TNCC/ supportive Health NGOs Minist,:ir. (lobbying) 8.5.2.1 Review exding legislation. • review on tobacco done only. 1995 Find (;aps in legislation. 8.5.2.2 Adopt and adapt WHO Action Plan on • MOH, agencies, esp. MOH, using WHO 1996 Tobacco or Health 1995 that uses incentives, plan. persuasion and le~ islation e.g. banning of smoking in public ~,laces. restaurants etc. #3.5 # #36 # Activity Who Outcomes Timeline s.~nefits/risks I 8.5.3 Try innovative incentives e.g. by CP0/MFN/ Tobacco and alcohol taxed by Tongan on-going Discourage introducing a spEcial tax on cigarettes and MOH/NGOs government, but funds go into general exc,:issive tobacco alcohol. the proci;eds of which would be used for (lobbying) revenue. and alcohol use. ' I health promotion activities. 8.5.4 Train the trainee and councelling serves for MLCI/MOH/ • funds available from government. those with NCO risk factors be made available. NFNC/NGOs/ TNCC • NFNC to coordinate. 8.6 The results of the 1992 Nutrition/NCO survey will have been analysed and released for genera 1 I information and use. Activity Who Outcomes Timeline Benefits/risks 8.6.1 Finalize a11alysis and compilation of results. MOH * Chairman of NFNC to apply to Minister of 1997 Health to release the information on 1992 dietary survey. 8.62 Dissemination of results. MOH/NFNC/ MOE - 8.6.3 Convene NCO workshop for policy makers. MOH • not achieveable until the result of the survey are known. #37 # #38 # OUTPUT 9: NUTRITION SITUATION ASSESSED, ANALYSED MONITORED. 9.1 Surveys and research activities related to health nutrition will be processed through NFNC. Activity ,- ---- Who Outcomes Timeline Benefits/risks 9.1.1 Develop framework by which nutrition- CPD/NFNC/ • not achieved. Provides a basis related surveys and research can be reviewed, MOH/NFNC for pcicy decision ensuring plans ar,3 made for analysis and • need to collect all statistical, and nutrition making. disseminatio11. information from 1983 - to provide baselines. 9.1.1.1 Evaluate usefullness and relevance of the • Results available. 1986 ProviJes a base- 1986 National Nutrition Survey. line at nutrition • OWT/charts and malnutrition results. data. • iron deficiency anaemia. 9.2 National Nutrition data will be available for policy making and other purposes. Activity Who Outcomes Timeline Benefits/risks 9.2.1 Conduct feasibility of plan to conduct a NFNC s 1994 SPC consultant used. Monitors the national nutrition ~;urvey, taking into account the effects of NPAN. 1986 survey and ·1992 NCO/Nutrition Survey. ~ need to complete 1992 survey. NFNC ask for the information - write to Minister of health. 9.2.2 Develop Planning Committee and propose • not established yet to be done in year 2. 1997 Formalises R & D methodology depending upon the result of the on ni;trition. review od earlier ~;urveys and clear through NFNC. 9.2.3 Develop methodology and analytical NFNC/MOH/ • methodology will be developed at 1996 EnSLi'8S framework, implernent survey, analyse and Media workshop. sustctinability of disseminate resul· s. food and nutrition R & D. #39 # #40 # 9.3 A simple functional National Nutrition Surveillance system will have been developed. ., 1, Activity Who Outcomes Timeffne. 8 !n"ef its/risks 9.3.1 Study feasibility and existing data already NFNC • need STC to organise. 1997 Pro 1 ides a being collected El.g. a review of the national baseline of health charts for children, and including an • limitation of NFNC. nutrition and health evaluation of information in the 1986 survey dat~. when considering a surveillance system. ! I 9.3.2 Using local expertise whenever possible, NFNC • needs to be established. 1997 En• .µres propose and develop a sustainable, cost- sustainability and effective plan. indcipendence of I nut ition research. 9.3.3 Implement, evaluate and modity to ensure NFNC • needs to be established. 1997 KeE I's nutrition A rapid dissemination of information to those using &[ up to date. such monitoring information. 9.4 Moni'.:oring and evaluation system to assess the effectiveness and usefulness of the NPAN will. have been develop1~d. Activity Who Outcomes Timeline Benefits/risks 9A.1 Develop appropriate methodology, NFNC • develop at 1996 workshop. Identifies nutrition including identification of appropriate indicators ind cators and and by a study o' data already available. trends for decision-making. 9.4.3 Modify NP,\N, once implemented and NFNC • STC given mandate to change subject to 1997 KeHps NPAN up to evaluated, as ne 3ded. approval by the NFNC. date. # 41 # List of Resource Persons : 1. Mrs. 'Ainise Fungavai -, Mrs. Lakai Koloamatangi 3. :'vlrs .Lavenita Fonua 4. Sr. Pisila Sovaleni 5. Nlr. Lelea Tu'itupou 6. Mr. Malakai 'Ofanoa 7. Ms. Mele 'Amanaki 8. Mrs. Nelisa Vatuvei 9. Mr. Vilimo Fakalo 10. Nlr. Sione Tukia 11. Mrs .Vaimoana Mafi 13. Mr. Siua Halavatau l 4. ivlrs. Rosemary Taufatofua 15. Mr. George Moengangongo 16. Mrs. Papiloa Foliaki 17. \1rs. Kato Latavao 18. Mr. Denis Wolff Facilit2.tor : 1 . Dr. Malakai 'Ake 2. Mrs. Vizo Halavatau 3. Mrs. Lois Englberger Consultant : l . Mr. Robert Hughes #42 # A.nnex 1 Ministry of Education Ministry of Education Ministry of Education Ministry of Health Ministry of Health Ministry of Health Ministry of Labour, Commerce & Industries. Statistics Department Ministry of Fisheries Ministry of Lands, Surveys & Natural Resources Ministry of Agriculture Ministry of Agriculture Central Planning Department Interested Member of the Community Supi Foliaki Foundation Red Cross Society of Tonga Tonga Trust/ FSP Ministry of Health Central Planning Department Central Planning Department World Health Organization