National micro-nutrient deficiency prevention and control guideline

Abstract

Micronutrient deficiency is often referred to as “Hidden Hunger” as adequate food may be present, but the diet contains insufficient amounts of certain vitamins and minerals. Micronutrient deficiencies (MNDs) are now recognized as one component of the triple burden of malnutrition (MrimiID, Palmeirim et al. 2022) contributing to the global burden of disease. In Africa, mineral deficiency risks were highest for calcium (Ca) (54% of the population),followed by zinc(Zn) (40%), selenium(Se) (28%) (Joya, Anderb et al. 2014). In Sub-Saharan Africa (SSA), Deficiencies ofvitamin A, iodine, zinc, calcium and selenium were 53%, 36%, 66%, 75% and 62% respectively. Moreover, iron-deficiency anemia (IDA) affects 26 to 31% of women of reproductive age (Galani , Orfila et al. 2022). Hypertension in pregnancy is one of the causes of morbidity, long term disability and death among mothers and their babies.Worldwide, they account for approximately 14% of all maternal deaths, whereas in Latin America and the Caribbean, they contribute to approximately 22% of all maternal deaths (WHO 2021). The consequences of MNDs could range from morbidity, disability, mortality and reduced physical growth and cognitive development (Robert , Allen et al. 2008). Pregnant and lactating women and children under 5 are at the highest risk of MNDs including iron, iodine, folate, vitamin A, and zinc (Bailey et al., 2015). All these MNDs are common contributors to poor growth, intellectual impairments, perinatal complications, and increased risk of morbidity and mortality. Moreover, MNDs are also significantly important in special situations such as emergency, military, internally displaced populations (IDPs) and refugee camps (Bailey et al., 2015). The MNDs of public significance include deficiencies of vitamin A, iron, iodine, folate, zinc, calcium and vitamin D. Deficiencies of micronutrients such as magnesium, selenium thiamin, niacin and vitamin B12 are emerging micronutrient problems that have also public health significance (Bailey et al., 2015). The global prevalence of vitamin A deficiency (VAD) in the form of night blindness for preschool-age children and pregnant women was 0.9 % and 7.8% respectively while the prevalence of serum retinol <0.70 μmol/l for preschool-age children and pregnant women was 33.3%and 15.3% respectively (WHO 2009). In Ethiopia, evidence showed that the pooled prevalence of sub-clinical VAD among preschool children was 8.3% which is well above the threshold of 20% indicating its public health significance (Sahile, Yilma et al.