Public Health emphasizes the plurality of the determinants of health of individuals, families and communities. Nutrition, as a major determinant of health, is itself influenced by a multitude of determinants that are under the purview of several agencies. Thus, inter-sectoral collaboration among the relevant agencies is imperative for promoting optimal health and nutrition such a partnership is manifested in the development and implementation of the National Plan of Nutrition (NPAN) of Malaysia pursuant to the International Conference on Nutrition (ICN) held in 1992. While the overall coordination of NPAN is at the Family Development Division in the Ministry of Health, the body that sees to the coordination is again a multi-agency group in the form of the National Coordinating Committee for Food and Nutrition (NCCFN). The NCCFN has representation for the nine thrust areas of NPAN that cut across various sectors including health, agriculture, education, community development and economic planning. Capacity building is a central strategy in the NPAN through the creation of positions and special budgetary allocations, and the implementation of activities including research, training, development of dietary guidelines and the National Nutrition Policy. This policy will be a major driving force for strengthening and building of capacity for nutrition-related activities, and more importantly it will facilitate a coordinated and coherent approach to capacity building, including sharing of resources.
The advantages and benefits of breastfeeding and the scientific basis for them are already well-documented and made known to the health and related professions, policy makers as well as the lay public. The role of breastfeeding in child survival, protection, growth and development has been the focus of several international deliberations, including the Convention of the Protection, Promotion and Support of Breastfeeding (August 1990) and The World Summit for Children (October 1990). Follow-ing the World Summit, our Prime Minister, on 18 July 1991, signed the World Declaration for Child Survival, Protection and Development. (Copied from article).
Citation: Awin N. A Review of Primary Health Care in Malaysia. A Report for the World Health Organization Western Pacific Region. Manila: World Health Organization Western Pacific Region; 2001
BACKGROUND: Iron deficiency and its consequent anemia constitute the commonest micronutrient deficiency in the world.
OBJECTIVE: We investigated whether long-term, weekly iron-folate supplements administered at school would improve hemoglobin and ferritin concentrations in adolescent girls, including those with mild-to-moderate anemia and hemoglobin concentrations indicating borderline anemia.
DESIGN: Subjects were 266 girls with hemoglobin concentrations of 80-119.9 g/L (group A) and 358 girls with hemoglobin concentrations of 120-130 g/L (group B) who were otherwise healthy. Two hundred sixty-six girls in group A and 268 girls in group B were randomly assigned to receive either 60 or 120 mg Fe plus 3.5 mg folic acid weekly for 22 wk. Ninety of the girls in group B were randomly assigned to receive only 5 mg folic acid weekly. Capillary hemoglobin and plasma ferritin were measured at baseline and after 12 and 22 wk of supplementation.
RESULTS: By the end of the study, 2% of the girls had dropped out and > 96% had taken > or = 20 of the 22 tablets; side effects were minimal. Mean plasma ferritin increased significantly in all iron-supplemented groups, independently of initial hemoglobin values and iron doses. Ferritin concentrations decreased in the girls supplemented with folic acid only. As expected, hemoglobin responses to iron were higher in group A than in group B and increases were positively correlated with initial plasma ferritin. Hemoglobin failed to respond to folate supplementation if initial plasma ferritin concentrations were low. Mean hemoglobin increased significantly and consistently in relation to the length of treatment.
CONCLUSION: Long-term, weekly iron-folate supplementation was found to be a practical, safe, effective, and inexpensive method for improving iron nutrition in adolescent schoolgirls.
Comment in: Picciano MF. Iron and folate supplementation: an effective intervention in
adolescent females. Am J Clin Nutr. 1999 Jun;69(6):1069-70. PubMed PMID:
10357724. https://academic.oup.com/ajcn/article/69/6/1069/4714856
Study site: 3 secondary schools, Samarahan district, Sarawak, Malaysia