THE 1000 MOST
CRITICAL DAYS
BY
MR MUKUBESA M
AMAZING GRACE
DEFINITION OF THE 1000 MOST
CRITICAL DAYS
- The 1,000 most critical days is a period
between a woman’s pregnancy and her
child’s 2nd birthday.
- It is a period when we promote actions and
investments to improve nutrition for mothers
and children in the 1,000 days from a
woman’s pregnancy through her child’s 2nd
birthday, when better nutrition can have a
life-changing impact on a child’s future and
help break the cycle of poverty.
AMAZING GRACE
SITUATION IN ZAMBIA
- The Government of the Republic of Zambia
recognizes malnutrition as a serious public
health problem.
- Over one million children under five years
and 10 % of women of the reproductive age
are malnourished.
AMAZING GRACE
SITUATION IN ZAMBIA
- The common nutrition problems in these
children include chronic malnutrition
(45%), underweight (15%), wasting (5%)
and low birth weight (10%).
- Micronutrient deficiencies in children
under five years include vitamin A (54%)
and iron deficiency anaemia (53 %).
(Zambia first 1000 most critical daysProgramme).
AMAZING GRACE
SITUATION IN ZAMBIA
- With 45% stunting, Zambia has one of the
highest rates of childhood (6 to 59 months)
under-nutrition in the world- higher than
the 42% average for Africa.
- Other forms of under-nutrition in Zambia
include wasting or acute malnutrition, with
5% of children under 5 being wasted, and
underweight, with15% (Zambia first 1000
most critical days-Programme).
AMAZING GRACE
SITUATION IN ZAMBIA
In addition 54% of children have vitamin A
deficiency and 53% have iron deficiency
anaemia and 9.3 % of children are born
with low birth-weight, indicating poor
maternal nutrition (Zambia first 1000 most
critical days-Programme).
AMAZING GRACE
SITUATION IN ZAMBIA
AMAZING GRACE
RATIONALE OF 1000 MOST
CRITICAL DAYS
- When women have poor nutrition or are
malnourished during pregnancy they are
more likely to give birth to low birth
weight infants.
- If nutrition is not corrected in these
infants with low birth weight they grow up
stunted.
AMAZING GRACE
RATIONALE OF 1000 MOST
CRITICAL DAYS
Based on the situation in Zambian which is
available in the First 1000 Most Critical Days
Programme report, the Government of the
Republic of Zambia has fully endorsed the
1000 Most Critical Days as a key strategy for
scaling up nutrition interventions to prevent
stunting in children less than two years of age.
AMAZING GRACE
RATIONALE OF 1000 MOST
CRITICAL DAYS
Evidence shows that when right nutrition is
given during the 1,000 most critical days it
can:
- Save more than one million lives each year
- Significantly reduce the human and
economic burden of diseases such as
tuberculosis, malaria and HIV/AIDS
- Reduce the risk for developing various noncommunicable diseases such as diabetes, and
other chronic conditions later in life
AMAZING GRACE
RATIONALE OF 1000 MOST
CRITICAL DAYS
- Improve an individual’s educational
achievement and earning potential
Increase a country’s Gross Domestic
Product (GDP) by at least 2-3 percent
annually.
- If current levels of stunting remain
unchanged in Zambia, the country is
expected to lose US$775million in
economic production.
AMAZING GRACE
INTERVENTIONS
- These are essential actions that the
government has put in place for the
attainment of optimal nutrition status
during the First 1000 most critical days and
to prevent stunting in children less than two
years of age.
- These nutrition interventions are the best
effective strategies to save lives and
enhance human development.
AMAZING GRACE
INTERVENTION ONE
1. DEVELOPMENT OF AN INTEGRATED
MATERNAL, INFANT AND YOUNG CHILD
FEEDING OPERATIONAL STRATEGY
- The strategy was intended to provide
guidance to government and include maternal
nutrition and to focus on both the mother and
child in the continuum of care.
- This strategy has the potential to make a
strong impact on reducing stunting in Zambia
if applied in a coordinated and collaborative
manner.
AMAZING GRACE
INTERVENTION TWO
2. IMPROVED NUTRITION DURING
PREGNANCY
- Pregnancy makes enormous physical
demands on a woman. Therefore, good
nutrition during pregnancy is essential to
avoid nutritional depletion, ensuring the
baby is born healthy and can be
successfully breastfed.
AMAZING GRACE
INTERVENTION TWO
PERIOD
Improved
nutrition
during
pregnancy
INTERVENTION
- Give Tetanus toxoid immunisations
- Maternal nutrition: Encourage extra meals
- Give Iron and folic acid supplements
- Give family Planning and breastfeeding
counselling and weight monitoring
- Insecticide treated bed-net promotion and use
and appropriate hygiene practices
- Give intermittent preventive treatment of
malaria and de-worming
- Prevention of Mother To Child Transmission
for HIV positive women
- Safe delivery
byGRACE
trained personnel
AMAZING
INTERVENTION THREE
3. IMPROVING NUTRITION DURING THE
FIRST 6 MONTHS OF INFANCY
- The focus of this intervention is to
encourage early initiation and exclusive
breastfeeding up to six months and
continued breastfeeding up to 24 months
- Encourage mothers on healthy eating to
keep them healthy and strong.
AMAZING GRACE
INTERVENTION THREE
- The Baby Friendly Hospital Initiative
(BFHI) should be revived to help ensuring
that all babies are fully breastfed from birth
and establish closer links with communities.
- HIV positive mothers will need special
support by proving them with ART and
educate them on early initiation and
exclusive breastfeeding up to six months and
continued breastfeeding up to 24 months
AMAZING GRACE
INTERVENTION THREE
PERIOD
0-6 months
INTERVENTION
- Immediate initiation of exclusive
breastfeeding one hour after delivery
- Scale up Baby Friendly Hospital Initiatives
- Growth monitoring & Promotion
- Bed-net promotion and use
- Immunisation for baby
- Ratify the International Labour Organisation
(ILO) maternity protection convention 183
- Review the Food and Drugs regulations on
Code of Marketing of Breast milk substitutes
AMAZING GRACE
INTERVENTION FOUR
4. NUTRITION IN EARLY CHILDHOOD 6–24
MONTHS
- This intervention focuses on the critical period
6-24 months, when a child relies increasingly on
adequate and nutritious food, and yet at this
stage, the child is also very vulnerable to
malaria, helminths and many other lifethreatening diseases, such as diarrhoea and
pneumonia.
- Children who are HIV positive are even more
vulnerable and need special attention and
treatment.
AMAZING GRACE
INTERVENTION FOUR
PERIOD
6-24
months
INTERVENTION
- Appropriate complementary foods for baby at 6
months, locally produced when possible
- Continued breastfeeding plus family planning
- Community growth monitoring and promotion
clinic-based growth monitoring
- Treated bed-net promotion and use
- 6 monthly de-worming and Vitamin A
supplementation for babies
- Appropriate and timely management of
severely and moderately malnourished children
- Correct feeding of sick child
- PMTCT for HIV
positive
women
AMAZING
GRACE
INTERVENTION FIVE
This intervention focus on promoting food
based fortification, alternative livelihood
support to enhance food security and
nutrition at household level and the
management of acute malnutrition
AMAZING GRACE
INTERVENTION FIVE
NATIONAL FOOD FORTIFICATION
This involves fortification of staple foods
such as maize meal, wheat flour, cooking
oil, cassava, sugar and salt with
micronutrient mix
AMAZING GRACE
INTERVENTION FIVE
•
•
•
•
•
Maize meal
Wheat flour
Cassava
Sugar
cooking oil
• Salt
Fortified with Vit A
Fortified with iodine
AMAZING GRACE
INTERVENTION FIVE
MANAGEMENT OF ACUTE MALNUTRITION
- Focus is on early detection and management
of acute malnutrition.
- Referral mechanisms should be strengthened
- Guideline development on the management
and treatment of moderate acute malnutrition
and social protection interventions should be
supported
AMAZING GRACE
INTERVENTION FIVE
TO ENHANCE FOOD SECURITY
The focus is on maximal emphasis on
household food preservation and storage in
Zambia to increase food security.
AMAZING GRACE
LINKAGES
MINISTRY OF HEALTH
- This ministry plays an important role in
effecting improvements in nutrition.
-A lot of nutrition programmes are
implemented directly by the ministry or
through it. These include primary health
care activities like immunizations, growth
monitoring and promotion, micronutrient
supplementation, breastfeeding and
complementary and supplementary feeding
AMAZING GRACE
LINKAGES
MINISTRY OF AGRICULTURE AND
LIVESTOCK
- It is one of the key ministries directly
responsible for food and nutrition
improvement.
- It covers the production of food and to
some extent its utilization, storage and
preservation.
AMAZING GRACE
LINKAGES
MINISTRY OF FINANCE AND NATIONAL
PLANNING
- It is responsible for allocation of
resources to the various Government
wings, including grants to the statutory
institutions
- It coordinates the planning,
implementation, monitoring and evaluation
of the national development plans
AMAZING GRACE
LINKAGES
MINISTRY OF LOCAL GOVERNMENT
AND HOUSING
- The Ministry is involved in the provision
of essential social services such as housing,
health, education, safe water and sanitation.
- These services have a strong bearing on
health and nutritional status.
AMAZING GRACE
LINKAGES
MINISTRY OF EDUCATION, SCIENCE,
VOCATIONAL TRAINING & EARLY
EDUCATION
This ministry provides the best opportunity
for nutrition education and ultimately
influence nutrition behaviour of the
population.
AMAZING GRACE
LINKAGES
MINISTRY OF LABOUR
- The Ministry is responsible for ensuring
appropriate working conditions for
employees the minimum wages take account
of the nutritional requirements
- The Ministry is also responsible for
regulating issue of maternity protection to
ensure promotion, protection and support of
breastfeeding among the working women
AMAZING GRACE
LINKAGES
MINISTRY OF COMMERCE, TRADE AND
INDUSTRY
This Ministry plays a part in the
importation of foodstuffs.
All imported foods should meet the set
nutritional standards and safety regulations.
AMAZING GRACE
LINKAGES
MINISTRY OF COMMUNITY
DEVELOPMENT, MOTHER AND CHILD
HEALTH
- It takes roles for maternal and child care
- It is responsible for the general welfare
including food and nutrition security of the
vulnerable groups which include infants,
young children and women of child bearing
age and single/female-headed households.
AMAZING GRACE
LINKAGES
• Ministry of Chiefs and Traditional Affairs
• National AIDS Council
AMAZING GRACE
LINKAGES
UNITED NATIONS CHILDREN'S FUND
The organization ensures that basic
nutrition, health, and education needs of
children are met, helps provide millions of
children with clean drinking water and
sanitary living conditions
AMAZING GRACE
LINKAGES
WORLD FOOD PROGRAMME
- The purpose of the Programme is to
expedite relief work in emergency or
natural-disaster areas.
- The World Food Programme distributes
food supplies after disasters and provides
cash for emergencies and for wages of
workers on rescue or rehabilitation projects
AMAZING GRACE
LINKAGES
UNITED STATES AID FOR
INTERNATIONAL DEVELOPMENT
(USAID)
It provides food aid and emergency
humanitarian assistance. The agency also
supports such health-care programs as
vaccination and immunization, AIDS prevention,
child and maternal nutrition, and familyplanning services.
AMAZING GRACE