The evolution of nutrition planning in Thailand And Nutrition strategy formulation THE EVOLUTION OF NUTRITION PLANNING IN THAILAND 8. REAL COMMUNITY-BASED NUTRITION PROGRAMS ( FUTURE ) 6. REORGANIZE GOV. STRUCTURES 7. DECENTRALIZE NUTRITION PROGRAMMING 2002 5. PROGRAMS ADDRESSING SOCIAL CHANGES ( DEVELOPING ) - over – nutrition - heath food market - food industries / agriculture - etc. 1982 4. SOCIAL CONTROL MEASURES - recommended dietary intake - national nutrition guidelines - legislations (iodated salt, nutrition labeling etc.) 3 . NATIONWIDE INTERVENTION PROGRAMS goiter control - protein-energy malnutrition 2. RESEARCH & DEVELOPMENT - school lunch - applied nutrition - nutrition surveillance - fortification technique - basic need fulfillment - food processing - vitamin A / iron fortification ( next ) - product development - etc. - etc. 1942 - 1. MANPOWER DEVELOPMENT - institution development school curricula degree levels grass- root level : village health volunteer local council START STRATEGY BASIC COMPONENTS • TARGET GROUP ( INDIVIDUALS ) • COMMUNITY • SERVICE PROVIDER / FACILITATOR • INTERVENTION MEASURE • VENUE OF INTERACTION ANALYSIS OF STRATEGIC COMPONENTS Following components may be analyzed by managerial areas to the right : 1. Intervention measures. 2. Reorienting organizations. 3. Rules and regulations. 4. Enabling / empowering. Managerial areas used to analyze each component : 1. Approach ( how ) 2. Actor ( by whom ) 3. Target ( for whom ) 4. Arena ( where ) 5. Procedure / tool ( what means ) 6. Expected outcome ( what ) BUILDING STRATEGIC FRAMEWORK From the analysis of various components of the strategy, it is possible to organize a framework that indicates the interrelationship among those components such as technical and social measures vis-a`-vis target group and venue of implementation ( see accompanying chart ) THE DEVELOPMENT OF NUTRITION STRATEGY ( source : Amorn Nondasuta ) Development tools POLICY/ AGENDA/ PRINCIPLE PUBLIC OPINION TECHNICAL INFORMATION PROGRAM EVALUATION Strategy framework TARGET GROUP high impact PROVIDER/ FACILITATOR MEASURES High risk Problem magnitude DEFINE AREA OF INTERVENTION DEFINE COVERAGE innovations categorized acc. to measures TECHNICAL categorized acc. to target DEFINE VENUE OF INTERACTION SOCIAL Individual - learning experience - skill training - early case detection - self care - environment protection - etc. community - surveillance - leadership - networking - advocacy - campaign - safety net - tax/ pricing policy - etc. REORIENT ROLES AND FUNCTIONS TRAINING AND SUPPORT incl. INFORMATION OPERATION/ EVALUATION/ FEEDBACK Administrative tools - budget/ finance - referral system - information system - resource/ technology transfer - legislation/regulation/ guidelines - supervision/ control - community involvement - research& development - inter/ intra- sectoral coordination - reward/ punishment SUBSYSTEMS CONDUCIVE TO PHC PROGRAM DEVELOPMENT 1. 2. 3. 4. 5. 6. 7. 8. 9. Community- based programs directed at the needy. Workable system for inter-sectoral collaboration. Effective systems of health financing. Health development network. Referral system for patients, technology and manpower. Cost- effective health market at all levels. Health service packages according to local needs. Relatively independent local and middle level health institutions. Proper social control of health behavior.