Roles and capacity of duty bearers in the realization of the human right to adequate food in Uganda

The right to adequate food recognised under international law provides a strong foundation for eradicating hunger and malnutrition in all nations. Uganda ratified the International Covenant on Economic, Social, and Cultural Rights (ICESCR) in 1987 and thereby committed itself to ensure the realization of the right to adequate food recognised under Article 11 of the Covenant. This study analysed the roles and capacity of duty bearers in the realization of the right to adequate food in Uganda. Structured interviews were held with purposefully selected duty bearers from 11 districts in the country between February and July 2007. Districts were selected by criterion based sampling. Relevant policies, budgets, and legislation were also reviewed, particularly with state obligations on human rights, and capacity of duty bearers in mind. Although this right is expressly recognised in the Food and Nutrition Policy of 2003 in which a multi-sectoral approach is proposed, sector-specific roles are not explicitly defined in Uganda’s institutional and policy framework. Most duty bearer (63%) considered the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) as being responsible for the delays in implementing the relevant actions for the right to food. The Uganda Human Rights Commission (UHRC) reported receiving inadequate budget resources to support the right to food. Only 20% of duty bearers had knowledge of the General Comment 12, which is an important United Nations instrument that defines and elaborates on the human right to adequate food. Duty bearer’s knowledge of the right to food in the national Constitution had a significant (X2 = 0.003; P<0.05) positive correlation (R=0.283) with membership status to an adhoc Uganda Food and Nutrition Council (UFNC). A proposed Food and Nutrition Bill had taken over 10 years without being presented to the National Parliament for the process of enactment into law. As such, most of the support for this right came from development partners. Whereas the ministry of health and MAAIF are line ministries in the implementation of food and nutrition policy, the right to food roles of the various duty bearers in Uganda need to be well defined. Capacity development is also needed, particularly related to integrating right to food sector-specific roles into the theoretical development and practical implementation of food and nutrition security programmes at all levels in the country

Iodine-induced goitre and high prevalence of anaemia among Saharawi refugee women

Objective: The main objective was to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women. Design: A cross-sectional survey was performed during January–February 2007. Tvol was measured by ultrasound and iodine concentration was analysed in spot urine samples and in household drinking water. Anthropometry and Hb concentration were measured and background variables were collected using pre-coded questionnaires. Setting: The survey was undertaken in four long-term refugee camps in the Algerian desert. Subjects: Non-pregnant women (n 394), 15–45 years old, randomly selected. Results: Median (25th percentile–75th percentile (P25–P75)) UIC was 466 (294–725)mg/l. Seventy-four per cent had UIC above 300mg/l and 46% above 500mg/l. Median (P25–P75) Tvol was 9?4 (7?4–12?0) ml and the goitre prevalence was 22 %. UIC was positively associated with iodine in drinking water and negatively associated with breast-feeding, and these two variables explained 28% of the variation in UIC. The mean (SD) Hb level was 11.8 (2.4) g/dl. In total 46% were anaemic with 14 %, 25% and 7%, classified with respectively mild, moderate and severe anaemia. Conclusions: The Saharawi women had high UIC, high levels of iodine in drinking water and increased Tvol and probably suffered from iodine-induced goitre. The high prevalence of anaemia is considered to be a severe public health concern. To what extent the excessive iodine intake and the anaemia have affected thyroid function is unknown and should be addressed in future studies. Keywords Excess urinary iodine Iodine-rich drinking water Saharawi refuge women Iron deficiency Women’s micronutrient status is of particular importance since it affects not only their own health, but also the health of their children(1). Deficiencies of iodine and Fe remain major public health problems, affecting .30% of the global population(2,3). Insufficient iodine intake as well as excess iodine intake may cause thyroid diseases(4). Fe deficiency is the most common and widespread micronutrient deficiency worldwide(3) and may have multiple adverse effects on thyroid metabolism(5). Refugees from Western Sahara have been settled in the Algerian desert since 1975 and they are totally dependent on food aid in the harsh, resource-poor desert environment. The refugee population is experiencing a number of challenges related to their food, nutrition and health situation(6). Endemic goitre has been reported among Saharawi schoolchildren and this is probably caused by iodine excess(7–10), but further studies are required to understand the aetiology. The main objective of the present paper is to assess iodine status (thyroid volume (Tvol) and urinary iodine concentration (UIC)) and their determinants in Saharawi refugee women of childbearing age. The secondary objective is to assess their prevalence of anaemia

Capacity development in food composition database management and nutritional research and education in Central and Eastern European, Middle Eastern and North African countries

Background/Objectives: Capacity development (CD) in food and nutrition is much more than formal training and includes human resource development, and organisational, institutional and legal framework development with the aim of enhancing nutrition-relevant knowledge and skills to support infrastructural development. The goal of the European Food Information Resource (EuroFIR) Network of Excellence has been to develop and integrate food composition data throughout Europe. EuroFIR joined forces in CD with the United Nations (UN) University and UN System Standing Committee on Nutrition, the Network for Capacity Development in Nutrition in Central and Eastern Europe, the Central and Eastern European Countries Food Data Systems network and with the Middle East and North African Capacity Building Initiative. The aim of this paper is to discuss an inventory of the status of food composition databases (FCDBs) and the training needs of compilers in non-EuroFIR countries in Central and Eastern Europe (CEE) and in the Middle East and North Africa (MENA), and to present the CD achieved through EuroFIR and other network collaborations. Subjects/Methods: Two online questionnaires were created addressing the FCDB status and specific training needs in countries of the targeted regions. Data were collected during 2006-2008 and then analysed. Subsequently, CD activities were organised. Results: Contacts were established in 19 CEE and 7 MENA countries, of which several had national food composition tables, but no electronic versions. Education, training, workshops, networking and the sharing of experiences were uniformly requested. Subsequently, CD activities in EuroFIR were organised focussing on food composition courses, exchange visits, workshops and individual training for PhD students, junior scientists and other staff categories, as well as conferences linked to food composition research and food information. To facilitate CD activities, EuroFIR has signed a Memorandum of Understanding with the Czech Republic, Hungary, Slovenia, Croatia and Estonia. Conclusions: EuroFIR has created training activities that complement national activities. Collaboration with other networks has provided an overview of FCDB status and training needs, providing directions for CD activities in those countries. This provides a platform for new funding and further development and networking for CD, which would be conducive to European Commission objectives and public health strategies for CD. European Journal of Clinical Nutrition (2010) 64, S134-S138; doi:10.1038/ejcn.2010.22

Opposite Associations of Trunk and Leg Fat Depots with Plasma Ferritin Levels in Middle-Aged and Older Chinese Men and Women

Background: Few data have been published on the associations of ferritin with trunk and leg fat depots. We aimed to investigate these associations in a Chinese population. Methodology: Trunk fat mass and leg fat mass were determined in a cross-sectional sample of 1,150 Chinese (479 men and 671 women) aged 50–70 years by dual-energy X-ray absorptiometry scan. Fasting plasma ferritin was measured. Principal Findings: Plasma ferritin was positively correlated with waist circumference, waist-to-hip ratio, total body fat and trunk fat mass, but inversely correlated with leg fat mass in men (r = 0.16, 0.26, 0.19, 0.22 and 20.12, respectively, all P,0.05) and women (r = 0.16, 0.16, 0.08, 0.17 and 20.12, respectively, all P,0.05). Multivariate regression analysis showed that ferritin levels increased with larger trunk fat mass (b = 0.33 6 0.08 for men and b = 0.21 6 0.05 for women, both P,0.001) while decreased with larger leg fat mass (b = 20.12 6 0.09, P = 0.15 for men; and b = 20.14 6 0.05, P = 0.005 for women). Moreover, plasma ferritin levels decreased with increasing tertile of leg fat mass among each tertile of trunk fat mass. Conclusion: This is the first study to report the opposite associations of trunk and leg fat depots with plasma ferritin levels

Crisis? What Crisis? The Normality of the Current Food Crisis

The 2005–8 food crisis was a shock to political elites, but in some respects the situation was normal. Food policies are failing to respond adequately to the squeeze on land, people, health and environment. Strong evidence of systems failure and stress, termed here New Fundamentals, ought to reframe twenty-first century food politics and effort. Yet so far, international discourse is too often narrow and technical. The paper suggests that 2005–8 reinforced how the dominant twentieth century productionist policy paradigm is running out of steam. This assumed that producing more food would resolve social problems. Yet distortions in markets, access and culture remain. At national and international levels of governance, despite realization of the enormity of the challenge ahead, there is still a belief in slow incremental change

Data quality and practical challenges of thyroid volume assessment by ultrasound under field conditions - observer errors may affect prevalence estimates of goitre

<p>Abstract</p> <p>Background</p> <p>The ultrasonographic estimation of thyroid size has been advocated as being more precise than palpation to diagnose goitre. However, ultrasound also requires technical proficiency. This study was conducted among Saharawi refugees, where goitre is highly prevalent. The objectives were to assess the overall data quality of ultrasound measurements of thyroid volume (Tvol), including the intra- and inter-observer agreement, under field conditions, and to describe some of the practical challenges encountered.</p> <p>Methods</p> <p>In 2007 a cross-sectional study of 419 children (6-14 years old) and 405 women (15-45 years old) was performed on a population of Saharawi refugees with prevalent goitre, who reside in the Algerian desert. Tvol was measured by two trained fieldworkers using portable ultrasound equipment (examiner 1 measured 406 individuals, and examiner 2, 418 individuals). Intra- and inter-observer agreement was estimated in 12 children selected from the study population but not part of the main study. In the main study, an observer error was found in one examiner whose ultrasound images were corrected by linear regression after printing and remeasuring a sample of 272 images.</p> <p>Results</p> <p>The intra-observer agreement in Tvol was higher in examiner 1, with an intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.91, 0.99) compared to 0.86 (95% CI: 0.60, 0.96) in examiner 2. The ICC for inter-observer agreement in Tvol was 0.38 (95% CI: -0.20, 0.77). Linear regression coefficients indicated a significant scaling bias in the original measurements of the AP and ML diameter and a systematic underestimation of Tvol (a product of AP, ML, CC and a constant). The agreement between re-measured and original Tvol measured by ICC (95% CI) was 0.76 (0.71, 0.81). The agreement between re-measured and corrected Tvol measured by ICC (95% CI) was 0.97 (0.96, 0.97).</p> <p>Conclusions</p> <p>An important challenge when using ultrasound to assess thyroid volume under field conditions is to recruit and train qualified personnel to perform the measurements. Methodological studies are important to assess data quality and can facilitate statistical corrections and improved estimates.</p