Decision No. 226/QD-TTg approving the national nutrition strategy for the 2011-2020 period, with a vision toward 2030

OFF1CIAL GAZETTe: Issue nos04..{)SlMarch 2012 ,~ ~ .• J(;(jng BaD IIOS 179-1!!!.)/,14arrh I. 2(12) THE PRIME MINISTER Decisiqa.No. 226/QD-TTg ofFebruary 22, 20~, approving the national nutrit~ strategy for the 2011-2020 period, with a vision toward 2030 THE PRIME MINISTER Pursuant to the December 25, 2001 Law on Organizqiion ofthe Government; Purstmht to the national strategy for socio economic.development during 201J-2020; At the proposal of the Minister ofHealth, DEClDES: Article 1. To approve the national nutrition strategy for the 2011-2020 period, with a vision toward 2010, with the following major contents: 1. Viewpoints aJ Improving the nutritional status is the responsibility of all levels, sectors and citizens: bl Balanced and proper nutri tionis essential for achieving comprehensive development of Vietnamese people's stature, physical strength and intellect and improved quality of life; c/ To increase intersectoral coordination In nutrition activities under the leadership and direc tion of Party commi tte e s and administrations of all levels, to mobilize participation of all social organizations and citizens, to prioritize poor, disadvantaged and ethnic minority areas, mothers and children. 2. Objectives aJGeneral objectives By 2020, the people's diet will be increased in quantity, more balanced in quality and safe and hygienic. Child malnutrition, especially stunting, will be reduced dramatically, contributing to raising the stature and physical strength of Vietnamese. To effectively control overweight and obesity, contributing to reducing nutrition-related non-communicable chronic diseases; bl Specific objectives Objective 1: To further improve the people's diet in terms of quantity and quality. Targets: + To reduce the rate of households with per capita food consumption below 1,800 kcal to 10% by 20iS and 5% by 2020. + To increase the rate of households with a bala need diet (with the protein-lipid-g, lucid ratio Issue nos 04-0S/March 2012 (Cong 8801105 /79-180IMarch 1.2012) OFfiCIAL GAZETTE of 14: 18:68) to 50% by 2015 and 75% by 2020. Objective 2: To improve the nutritional status of mothers and children. Targets: + To reduce the chronic energy deficiency rate among women of reproductive age to 15% by 201 S and under 12% by 2020. + To reduce the rate of underweight infants (born under 2,500 grams) to under 10% by 2015 and under 8% by 2020. + To reduce the rate of stunted children under 5 to 26% by 2015 and 23% by 2020. + To reduce the rate of underweight children under 5 to 15% by 2015 and 12.5% by 2020. +To raise the height of five-year-old children by 1.5-2 em for both boys and girls and of young people by 1-1.5 em by 2020 from 2010. + To keep the rate of obese children under 5 at under 5% in rural areas and under 10% in big cities and maintain such rate by 2020. Objective 3: To improve the micronutrient status. Targets: + To reduce the rate ot under-a children with low serum Vitamin A «O.7IlmollL) to under JO% by 2015 and under 8% by 2020. + To reduce the rate of anemic pregnant women to 28% by 2015 and 23% by 2020. + To reduce the rate of anemic children under 5 to 20% by 2015 and 15% by 2020. + By 2015 t to reach a rate of househol ds with sufficient daily consumption of iodized salt for disease prevention (2:20 ppm) of over 90%, to maintain the median urinary iodine level in mothers with under-5 children at between 10 and 20 I-ig/dl by 2015 and to 2020. Objective 4: To step by step effectively control overweight and obesity and risk factors of nutrition-related non-communicable chronic diseases among adults. Targets: + To control the rate ofoverweigssendobese adults at under 8% by 2015 and a~der 12% by 2020. + To keep the rate of adults withjligh blood cholesterol (>5.2 rnrnol/L) at unde! 28% by 2015 and at under 30% by 2020. Objective 5: To improve kllowJed~eand practices of proper nutrition. Targets: r The rate of exclusi vely brea~ infants during the first six months will re!eti 27% by 2015 and 35% by 2020. +The rate of mothers with propesnutrition knowledge and practices for caring~ children will reach 75% by 2015 and 85% ~.2020. + The rate of young womeJl.,~ceiving nutrition and maternal training wllJreach 60% by 2015 and 75% by 2020. Objective b: To increase ca.i2~city and effecti veness of nutrition ne't~orks in communities and health establishments. Targets: + By 2015, to assure that 75% and 50% of full-time nutrition officers at provincial and district levels respectively will receive community nutrition training for between I and e VIETNAM W& LEGAL FORUM OFFICIAL GAZETTE Issue nos 04·0SlMarch 2012 (Gong Hila lJos179-180/Man:/i J. 2012) 3 months. The rates will be respectively 100c'i{, and 75% by 2020. + By 2015, to assure that 100% of full-time nutrition officers at commune level and nutrition collaborators will be trained and updated ill nutt itiulldl care. This rate will be maintained to 2020. + By=lS, 90% of central hospitals, 70% ofprovi~I-levelhospitals and 30% of district level ho~als will have dieticians. By 2020, the ratttVwiJI be 10WYo, 95% and 50% respeetiC'. + ByNI5, 90% of central hospitals, 70% ofprovine;I-level hospitals and 20% of district level hosrrrtuls will provide counseling on and ~ prescribt;,;proper nutritional regimes for certain groups o~seasesand target groups, including elderly ~pJe, HIV/AIDS and tuberculosis patients.~ 2020, the rates will be 100%,95%....... and 50%~pectJvely. +To G.1re that 50% and 70% of provinces will be c"rlb1e to pcrfoi III nutrition surveillance by 20l?J!!1d 2020 respectively. To conduct nub:itio~rveillance in emergency cases in disaster-prone provinces and provinces with .", malnutruicn rates higher than the national average. c/Vi~ toward 2030 By mo, to strive to reduce the child malnutrition rate below the level of public health significance (stunting rate of under 200/" and underweight rate of under 10%), to remarkably raise the stature of Vietnamese. To improve public awareness about and behaviors in proper nutrition for the prevention of nutrition-related chronic diseases. which are on the rise. To step by step supervise daily food consumption in order to have nutritionally balanced and rational diets, ensuring food safety and hygiene, meeting nutrrnon needs and contributing to improving the quality of life for all people, especially school children. 3. Major solutions a/ Policies To further focus on directing the fulfillment of the target to reduce underweight. To 300n introduce the target to reduce the rate of stunting as a socio-economic development indicator of the country and each locality. To increase examination and monitoring of the fulfillment of nutrition targets; To finalize the intersectoral coordination mechanism, especially for close coordination between the Ministry of Health and the Ministry of Agriculture and Rural Development, the Ministry of Education and Training, the Ministry of Culture, Sports and Tourism and the Ministry ot Labor, War Invalids and Social Affairs in implementing solutions for improving the nutritional status. To adopt policies and solutions to involve mass organizations and businesses in the implementation of the national nutrition strategy; To elaborate and finalize policies and regulations on nutrition and food. To issue regulations on the production, trading and use of nutritional products for small children; food fortification with micronutrients; and policies on proper maternity leave, breastfeeding promotion; to study and propose policies to support school nutrition, firstly for preschool and primary school children; to encourage @ VIt:TNAM LAW & lEGAL FORUM Issue nos04-051March 2012 (Gong Baonos J79-J80IMo,.ch J, 2012) OfFICIAL GAZETTE 11 businesses to invest in the production and supply of specialized nutritional products for poor, disadvantaged and ethnic minority areas, especially for pregnant women, under-5 children and children in special circumstances. bl Resources To develop human resources: +To extensively train and effectively employ leading nutritionists, dieticians and food safety specialists, + To train nutntron specialists (post graduates, bachelors and technicians in nutrition and dietetics). + To consolidate and develop nutrition workers, especially the. network of full-time nutrition workers and nutrition collaborators at the grassroots level. To build capacity to manage nutrition programs for nutrition officers from central to local levels and of related ministries and sectors, + To diversify forms of training to meet the society's training needs, prioritizing training for ethnic minority groups, disadvantaged regions and areas and areas with high malnutrition prevalence in appropriate forms (training with selection-based enrolment, training by customers' order or based on market needs); to increase international cooperation in training for the nutrition sector, Financial resources: + To socialize and diversify financial resources and step by step increase investment in nutrition activities, Funds for implementation include central and local budgets, international support and other lawful funding sources of which state budget funds shall be allocated mostly to national target programs and projects. + To effectively manage and coordinate financial resources, ensuring fairness and equality in nutritional care tor all people. To increasingly inspect, supervise and evaluate the effectiveness of budget use, . cl Nutrition advocacy, education and communication To promote advocacy to raise leaders' and managers.' knowledge on the importance of nutrition to the comprehensive development of the stature, physical strength and jMe+lect of children; To carry out mass communicatiQlUctivities using various forms, methods and.contents suitable to each region, area and targa-,group to improve nutrition knowledge and~ctices, especially for the prevention ofslunt~,control of overweight and obesity and nutriti.clllt-related non-communicable chronic diseases for aU people; To continue nutrition and-physical education in the school system (froI1l'preschool to uui versity): To elaborate and implmm:l1t the school nutrition program (to stetrbY step introduce dietetic menu and provide-milk for children in preschools and primary s~ols).To develop appropriate models for each region, area and target group. dJ Technical solutions To study and elaborate programs, projects and solutions for special intervention to improve the nutritional status and raise the height and physical strength of people which are suitable e VIETNAM LAW & leGAL FORUM 11 OFFICIAL GAZEnE Issuenos04·05/March2012 (GongBaD IIOJI!Y,18UIMarch I, 2.UI2) to each region and area, prioritizing pOOf, disadvantaged and ethnic minority areas and other at-risk target groups; To provide proper nutrition for mothers before, during and after delivery. To promote exclusive breastfeeding during the first six months and appropriate complementary feeding for undc=Wo children; To t1ise nutrition and food surveillance (;~pacit~ the ce.nrral level ann rf'gional- and provinc1i+llevel hospitals to systematical! y supervirlood consumption and nutritional ~. status tn11'ds;,..... To d':;elop, and raise the effectiveness of,..... the netwosk of nutrition services, counseling and reh$itation; To ~rsify the production, processing and-use of 1~IlY available food, To develop the f'co-modPotof gardens, fishponds and breeding-facilities '(VAC), ensuring the production,-circulatil!; distribution and use of safe food, To prom!}» daily consumption of fish, milk and vegetabl~ To-establish a system for monitoring and early waV11ng of food insecurity at national and hou5ehct:ttsvc!s. To develop a plan to promptly respondse-emergency cases. eI Sc~ce and technology and international cooperation To raise the nutrition and food scientific research capacity. To encourage research, development and transfer of technologies to select and create new breeds and seeds with appropriate nutrients; to study the production and processing of nucrunuu ieru-fortifled food, nutri tiona! products and specialized nutritional products suitable to each target group; To prornnte computerization and develop a database on nutrition and food safety; To increasingly use information and scientific evidence in the formulation of nutrition policies, plans, programs and projects at different levels, especially in the prevention of stunting and micronutrient deficiency; To apply nutrition experience and scientific achievements in the prevention of obesity, metabolic syndrome and nutrition-related non communicable chronic diseases; To proactively cooperate with advanced countries and institutes and universities in the region and world in the field of research and training in order to quickly access regional and global advanced scientific and technological standards and develop and improve the quality of human resources in the nutrition sector; To increase comprehensive cooperation with international organizations to support and promote: the strategy imptemt'ntJtion; To incorporate international cooperation projects into activities of the national nutrition strategy to fulfill the strategy's objectives, 4. Implementation phases aJ Phase 1 (2011-2015): To implement key activities for nutrition improvement, paying attention to education, training and human resource development and supplementation of policies to support nutrition and institutionalize state direction for nutrition activities, To continue implementing target programs effecti vely; , . C V\mAM LAW & LEGAL FORUM Issue nos M-05/March 2012 (Gong Beo I/OS 179-180/March 1,2(12) OFFICIAL GAZETTE 13 b/ Phase 2 (2016-2020): Based on the evaluation of the implementation of phase l (2011-2015), to adjust policies and make appropriate interventions for comprehensive implementation of solutions and tasks in order to successfully fulfill the strategy's objectives. To promote the exploitation and use of the nutrition database for planning purposes. To sustain and comprehe nsi vely evaluate the strategy impl ementation. 5. Major programs, plans and projects for the. strategy implementation aI Project on nutrition communication and education and training Responsible agency: The Ministry of Health: Coordinating agencies: The Ministry of Education and Training, the Ministry of Information and Communications, Vietnam Television, related ministries, sectors, agencies and organizations, and provincial-level People's Committees. b/ Project on mother and child malnutrition control and stature improvement Responsible agency: The Ministry of Health; Coordinating agencies: Related ministries, sectors, agencies and organizations, and provincial-level People's Committees. cl Project on micronutrient deficiency control Responsible agency: The Ministry of Health; Coordinating agencies: The Ministry of Agriculture and Rural Development, the Ministry of Industry and Trade, the Ministry of Education and Training, the Ministry of Inforruauou ami Coruuiuu icat ious , related ministries, sectors, agencies and organizations, and provincial-level People's Committees. dI Program on school nutrition Responsib!e agency: The Mini!';tryof Health; Coordinating agencies: The MWistry of Education and Training, related..ft!jnistries, sec tors, agencies and organizations, and provincial-level People's Committees. eJ Project on overweight, oo~sity and nutr ition-related non-conrrnuuicabse chronic disease control ....' The Ministry of Health shall ~ume the prime responsibility for, and coordfuate with related ministries, sectors, ag~ies and organizations, and provincial-Iev~eople's Committees in, carrying out aclj'.yities in hospitals and communities; , The Ministry of Education am! Training shall assume the prime respom.libil;"" for, and coordinate with the Ministry of Heatth, related ministries, sectors, agencies and org:!trizations, and provincial-level People's Committees in, . ! carrying out activities in the school 06YStem. eJ Program on nutrition secu,rity and household food improvement ana-~utrition response in emergency cases Responsible agency: The Ministry of Agriculture and Rural Development; Coordinating agencies: The Ministry of Health, related ministries, sectors, agencies and organizations, and provincial-level @ VIETNAM LAW &LEGAL FORUM 14 OFFICIAL GAZETTE Issue nQS Q4-05/March 2012 (Gong Baa nos 179~J8D;M{[rch J, 20J2) People's Committees. g/ Project on nutrition surveillance Responsible agency: The Ministry of Health; Coordinating agencies: The Ministry of Agriculture and Rural Development, the MinistrY.-Qf Planning and Investment (the General ,matistics Office), related ministries, ,;. . . sectors, agencies and orgamzatrons, and provinc~evelPeople's Committees. Arti~ 2. Organization of the strategy-implementation 1. Th~inistry of Health sh::tll assume rhp. primeresponsibilityfor, and coordinate with the Ministr;;f Planning and Investment, the Ministrf'tK Finance, related ministries and-sectors, pwvincial-Ievel People's Committees and soci6;olilical organizations in, plauning and org£ffz.ing the strategy implementation-nationw~, ensuring close association with related ~ategies, programs and plans; elaborat~ubmitto competent authorities for approv~r,and implement projects and plans in line with-the strategy's objectives; guide, inspect and revi~ the strategy implementation for regular ra';;rting to the Prime Minister; conduct a preliIl'1iMtlry review in late 2015 and a final revie~ late 2020 of the strategy implementation. 2. The Ministry of Planning and Investment shall arrange funds for the strategy activities under annual budget plans approved by the National Assembly, and raise domestic and overseas funds for nutrition work. 3. The Ministry of Finance shall assume the prime responsibility for, and coordinate with the Ministry of Planning and Investment in, based on the capacity of state budget and annual budget plans approved by the National Assembly, allocating budget funds to implement approved nutrition programs and projects; guide, inspect and supervise the use of funds in accordance with the State Budget Law and current regulations; coordinate with the Ministry of Health and related ministries and sectors in elaborating financial mechanisms and policies to promote socialization, raise non-state budget funds, and encourage organizations and individuals to invest in the nutrition sector. 4. The Ministry of Agriculture and Rural Development shall: Ass ume the prime responsi bi li ty for elaborating plans on and solutions to assure food security. Coordinate with related ministries and sectors in implementing plans to assure national food security. Assume the prime responsibility, for elaborating polices to assure food security and processing and develop the ceo-model of gardens, fishponds and breeding facilities (VAC), and develop and implement programs to supply clean water for rural areas. 5. The Ministry of Education and Training shall : Assume the prime responsibility for developing nutrition and physical education programs from preschool to university levels (to increasingly provide meals and milk for preschool and primary school children; build e VIETNAM LAW &LEGAL FORUM Issue nos 04-05!M.an.-h 2012 (Gong Baa /lOS 179-180/Mal"ch 1,2012) OFFICIAL GAZETfE 15 up school nutntron models; and direct the improvement of the quality of care and education of preschool children nnd quality of school canteens); step by step introduce nutrition education into school curriculums of all educational levels; coordinate with the Ministry of Health in carrying out nutrition communication and education in schools. Assume the prime responsibility for, and coordinate with the Ministry of Health in, planning and organizing the training and development of human resources forperfonning the tasks of the national nutrition strategy. 6. The Ministry of Labor, War Invalids and Social Affairs shall assume the prime responsibility for, and coordinate with the Ministry of Health and related ministries and sectors in, implementing policies on nutrition support for the poor and inhabitants in disadvantaged areas. 7. The Ministry of Information and Communications shall: Assume the prime responsibility for, and coordinate with the Ministry of Health and related ministries and sectors in, directing and organizing activities to provide nutrition information and communication, paying attention to information on proper nutrition. Coordinate with the Ministry of Health and related ministries and sectors in controlling advertisements on nutrition and related to food. R Ministrie.s, ministerial-level ;l[';t,:ncies and government-attached agencies shall implement the strategy within their assigned functions and tasks. 9. Provincial-level People's Committees shall implement the strategy in their localities under the guidance' of the Ministry of Health and ministries and functional sectors; elaborate and implement annual and five-year action plans on nutrition in line with the national nutrition strategy and their local socio-economic de ve l up me n t p la ns of the same-period; proactively and actively mobilize reseerces for the strategy implementation; i~~ate the national nutritlon strategy in ot~'er related strategies in their localities for effective implementation; enhance in tersectoral coordination; incorporate nutri tion C8IMMlts into local soc io-cconornic development policies; regularly inspect the strategy implementation in their localities; and make annual reports on the strategy implementation in theis localities under current regulations. 10.To request the central Vietnarrrwomen's Union, based on the Ministry of Health's professional guidance and communication orientations, to disseminate health ;md proper nutrition knowledge for its members and mothers, and mobi lize the community ¥.:l closely coordinate with the health sector in eealthcare and nutrition activities to improve tnmernal and child nutrition. 11.To request the Central Commitfee of the Vietnam Fatherland Front, Vietnam General Confederation of Labor, VIetnam Farmers Association, Ho Chi Minh Communist Youth Union, Vietnam Association of the Flrlf'rly. professional associations and other social organizations, based on the Ministry of Health's professional guidance and communication © VIETNAM LAW & LE L FORUM . OFFICIAL GAZETIE orientations, to disseminate proper nutrition knowledge for their members; and closely coordinate with the health sector and related agencies in socializing nutrition activities and fulfilling the objectives and tasks of the strategy. Article 3. This Decision takes effect on the dateof its.signing. Artil1e 4. Ministers, heads of ministerial • level ag.-ies, heads of government-attached agencieif heads at related agencies and organiz;;;ns, and chairpersons of provincial level pe~'sCommittees shall implement this Decisiort'" For the Prime Minister Deputy Prime Minister NGUYEN Tfl1DN NHAN I It) VIETNAM LAW & LEGAl ORUM Issue nos 04·05/March 2012 (Cona 8ao 11m' 179-1801March I, 2(12)