This document discusses malnutrition in Latin America and the Caribbean. It provides details on Guyana's efforts to address malnutrition through various policies and strategies. Some key points: - Guyana is fully committed to reducing malnutrition through the Regional Hunger-Free Initiative and has aligned its own timeline with this initiative's goal of eliminating hunger in Latin America and the Caribbean by 2025. - Guyana's food and nutrition security strategy has goals around sustainable employment, nutrition education, and institutional coordination to improve food and nutrition security. - Guyana recognizes malnutrition as a multi-sector problem and is taking a multi-partnership approach involving sectors like health, agriculture, and economics to develop solutions. - Specific strategies mentioned

1. Public policies to address Malnutrition in Latin
America and the Caribbean
Exchange for national experience
Hon. Dr. Leslie Ramsammy
Minister of Agriculture, Guyana

2. Population of 751,223
Land mass of 214,970 sq. km
Life expectancy: 68 years (men), 72 years (women)
(UN)
GDP per capita: US$3,600
Debt/GDP : 43%
Member of CARICOM
Member of RIO Group of Countries
Member of CELAC
Agriculture accounts for 23% of GDP
Agriculture accounts for 33% employment
Food Import Bill = $US150 per capita

3. Guyana is fully committed to the Regional Hunger-Free Initiative.
We enthusiastically embrace the goals of the Hunger-Free
Initiative and Guyana’s own timeline is consistent with the
Hunger-Free Initiative for Latin America and the Caribbean by
2025.
THIS IS A PILLAR OF THE DEVELOPMENT PROGRAM FOR GUYANA

4. Guyana’s Strategic Direction
• Consolidate Guyana’s Food Security status
• Achieve Nutrition Security
• Ensure reduction of food imports, such as corn, soya, potato, garlic, onion and spices
• Increase exports of rice and sugar, as both bulk and value-added agriculture commodities
• Increase export of non-traditional crop products
• Meet the local demand for milk and dairy products through local production
• Reach export level production for meats, such as beef and small ruminant meat
• Increase agro-processing for the local and export markets
• Transform agriculture to a F5 strategic direction, accomplishing its target for food and fiber (nutrition) security,
but playing a significant role in fuel production, fashion and medicine and furniture and other commodities
• Achieve an annual growth of greater than 5%

5. Overall Goal of the Food and Nutrition Security Strategy
To improve the health and well-being of all persons living in
Guyana through enhanced food and nutrition security. In the
development and implementation of policies and programmes to
achieve this overall goal, measures will be taken that will impact
the entire population. However, specific focus will be given to the
section of the population that lives in poverty and is therefore
considered vulnerable to food and nutrition insecurity.

6. Facing up to the challenge – Globally
http://www.wfp.org/hunger/stats

7. 1990
MAIN CAUSES OF DEATH IN THE CARIBBEAN
1980 (%) Nutrition Causes = 53% 2000’s (%) Nutrition Causes = >60%
Heart Disease 20 Heart Disease 16
Cancer 12 Cancer 15
Stroke 11 Stroke 10
Injuries 08 Diabetes 10
Hypertension 06 Injuries and Violence 07
ARI 05 HIV/AIDS 06
Diabetes 04 Hypertension 06

8. Facing up to the challenge – Globally
• 842 million people in the world do not have enough to eat. This number has fallen by 17 percent since
1990.
• The vast majority of hungry people (827 million) live in developing countries, where 14.3 percent of the
population is undernourished.
• Asia has the largest number of hungry people (over 500 million) but Sub-Saharan Africa has the
highest prevalence (24.8 percent of population).
• If women farmers had the same access to resources as men, the number of hungry in the world could
be reduced by up to 150 million.
• Poor nutrition causes nearly half (45%) of deaths in children under five - 3.1 million children each year.
• One out of six children -- roughly 100 million -- in developing countries is underweight.
• One in four of the world's children are stunted. In developing countries the proportion can rise to one in
three.
• 80 percent of the world's stunted children live in just 20 countries.
• 66 million primary school-age children attend classes hungry across the developing world, with 23
million in Africa alone.
• WFP calculates that US$3.2 billion is needed per year to reach all 66 million hungry school-age children.
http://www.wfp.org/hunger/stats

9. Facing up to the challenge – Globally
• In 2010, it is estimated that 171 million children (167 million in developing
countries) were stunted.
• Globally, childhood stunting decreased from 39.7 (95% CI 38.1, 41.4) % in
1990 to 26?7 (95% CI 24?8, 28?7) % in 2010.
• This trend is expected to reach 21.8 (95% CI 19?8, 23?8) %, or 142 million,
in 2020.
• While in Africa stunting has stagnated since 1990 at about 40% and little
improvement is anticipated,
• Asia showed a dramatic decrease from 49% in 1990 to 28% in 2010, nearly
halving the number of stunted children from 190 million to 100 million.
• It is anticipated that this trend will continue and that in 2020 Asia and
Africa will have similar numbers of stunted children (68 million and 64
million, respectively). Rates are much lower (14% or 7 million in 2010) in
Latin America.
http://www.who.int/nutgrowthdb/publications/stunting1990_2020/en/

10. Facing up to the challenge – Guyana
Multiple Burden – The Hunger Challenge
– Over and under- nutrition in young children
– Overweight and obesity as well as under nutrition among adults.
– Micro-Nutrient Deficiency
– Nutrition-Related causes linked to more than 60% deaths overall
– Nutrition-related causes linked to increasing non-communicable
disorders such as cardiovascular disease, hypertension and diabetes.

11. THE STORY OPF GUYANA
• STUNTING AT AGE 12 TO 59 MONTHS = 4%
• SEEVRE WASTING FOR UNDER 5 YEARS OLD = <1%
• ANEMIA IN CHILDREN UNDER 5 YEARS OLD = 24%, FROM >
70% IN 1990
• AMENIA IN ADOLESCENTS = 20%, FROM >70%IN 1990
• ANEMIA OF PREGNANT WOMEN = 41 FROM >78% IN 1990

12. Facing up to the challenge – Guyana -- Adolescents
Global School Based Health Survey 2010

13. Facing up to the challenge – Guyana -- Adults
• 11% of women were underweight (BMI <18.5)
• with more than half of these below the age of 15 - 29 year.
• 48% OF WOMEN WERE Overweight and obese (BMI ≥25.0), highest in
older women 30 – 49 years (DHS Report 2009)
• 12% of men were underweight (BMI <18.5) with about 47% of
these being men 15-19 years old and 38% from 20-29 years
old.
• 24% of men were overweight (BMI 25.0-29.9) while 9% were
obese (BMI 30.0 or higher).
Demographic Health Survey 2009

14. Facing up to the challenge – Guyana
Micro nutrient Study 2013
Table 1 – Comparative analysis of National Average of Anaemia Prevalence
Table 2 Anaemia Prevalence by target populations and Geographic Locations 2012
Year < 5 years >5 – 16 years Pregnant Women
1997 47.9 56.7 52.0
2012 24.0 20.8 41.3
Locations < 5 years >5 – 16 years Pregnant Women
Urban 21.8 22.1 40.9
Coastal Rural 25.9 22.4 45.1
Hinterland 26.6 15.3 34.1

15. Multi-Sector, Multi-Partnership Approach
• Guyana recognizes that the problem is not
– Health
– Agricultural
– Economical
Solutions lies in a multi-sectoral, multi-
partnership approach

16. Food and Nutrition Security Strategy
• Goals
– Goal 1: To facilitate sustainable and stable employment-generating
opportunities that would increase availability of and accessibility to
food, especially among vulnerable groups.
– Goal 2: To promote Information, Education and Communication /
Dissemination systems for use and consumption of healthy foods for
improved nutrition of all Guyanese and especially of vulnerable
groups
– Goal 3: Promote increased institutional coordination and functioning
for improved food and nutrition security.

17. POLICY COHESION AND INTEGRATION
BRINGING THE SECTORS AND PARTNERS TOGETHER
• The National Food and Nutrition Security Council
– Inter-sector collaboration
– Greater national accountability
– ANNUAL FOOD AND NUTRITION SECURITY REPORT CARD
– Annual Sector Work Plans
– FOOD AND NUTRITION SECURITY MONITORING AND EVALUATION
– FAO, IICA, UNDP, UNICEF, UNFPA, UNADIS, UNESCO, PAHO

18. NATIONAL AND GLOBAL GOALS ALIGNED
GUYANA COGNIZANT OF REGIONAL AND GLOBAL RESPONSIBILTIES
• MDG
• HUNGER FREE INITIATIVE
• CELAC DECLARATION – END POVERTY
• POST 2015 SUSTAINABLE DEVELOPMENT AGENDA
• CARICOM FOOD AND NUTRITION SECURITY GOALS
• JAGDEO INITIATIVE
• FAO AND WORLD FOOD PROGRAM GOALS

19. PURSUING ZERO HUNGER
SOME OVERARCHING STRATEGIES
• INCREASE VEGETABLES AND FRUIT CONSUMPTION
 MORE THAN 60% OF ADULTS COMSUME LESS THAN 200G/DAY
• REDUCE DIETARY TRANS FAT, SALT AND SUGAR
 REDUCE FOOD IMPORT AND ESTABLISH FOOD STANDARDS
• ENCOURAGE CROP DIVERSITY AND LOCAL PRODUCTION
• PROMOTE FAMILY FOOD PRODUCTION
• FORMALIZE INTEGRATED SCHOOL FARMS
• SCHOOL FEEDING PROGRAMS
• INFANT AND PREGANT WOMEN SPRINKLES

20. Producing for our people
• Production of ADEQUATE AMOUNT AND VARIETY OF food
• Meeting cereal and grain needs of our people
• Improving cassava production as direct food source
• Surpassing vegetables and fruit: Supply/Demand = >1
• Fish Protein = 58kg per capita annually
• Meat Protein 60 kg per capita annually

21. The Agriculture Sector
Providing Remedies and Solutions

22. Production of Rice
2014 Total 2013 Total
Area Harvested (ha) 180,723 164,983
Yields (bags/ha) 165 158
Paddy Production (mt) 944,760 823,930
Rice Production (mt) 614,095 535,555
EXPORTS (MT) 475.000 394,988
Value of Exports 270,000.000 239,826,390
For HY 2014
• Rice and Paddy production is 15. 4 %
higher in 2014 than 2013
• Exports is 23.4 % higher in 2014 than
in 2013

23. Production of Other Crops
Selected Crops 2011 2012
2013
Coconut (dry) - 000 nuts 18,800 17,068 23,216
Pumpkin MT 5,546 4,834 9,623
Hot Pepper MT 3,675 3,461 7,969
Pineapple MT 2,47 3,035 6,113
Watermelon MT 5,380 2,329 2,191
Papaw MT 5,990 4,712 4,980
2013 Exports for non-traditional fresh and
processed commodities 12,700MT (~G$
1,416,307,967)
COMMODITY
EXPORT VOLUME EXPORT VALUE
MT $G
2012 2013 2013
Coconut (dry) 8,630 10,213 612,801,840
Copra 971 755 133,170,213
Heart of Palm 320 386 211,813,852
Crude(coconut oil) 334 289 79,502,572
Mango 182 163 40,988,094
Pumpkin 189 146 26,135,174
Watermelon 84 116 19,510,190
Coconut (Water) 132 94 21,206,100
Eddo 61 89 30,433,402
Pineapple 52 71 26,580,688
Copra Meal 0 61 19,939,770
Sauces 35 54 36,899,750
Pepper (wiri wiri) 41 42 32,588,938
Lime 21 29 14,697,882
Breadnut (Katahar) 12 22 13,731,761
Other Exports 116 169 96,307,741
TOTAL 11,186 12,700 1,416,307,967

24. Production of Livestock
Products 2011 2012 2013 Growth (2013-2012)
Poultry Meat (MT) 25,573 30, 412 29,280 -3.7
Beef (MT) 2,153 1,635 2,262 38.3
Pork (MT) 203 199 572 187.4
Mutton (MT) 167 129 125 -3.1
Egg (‘000) 23,508 21,234 17,965 -15.4
Milk (‘000 Litres) 34,176 39,271 46,484 18.4

25. Harvesting of Fisheries
0 100,000 200,000 300,000 400,000 500,000 600,000
2009
2010
2011
2012
2013
KG
Aquaculture
0
10,000
20,000
30,000
40,000
50,000
60,000
2007 2008 2009 2010 2011 2012 2013
MT
Marine Fisheries
Total Shrimp Total Fish
2013 Exports for Fish, Prawns and
Fish products 21,403 MT (~G$
14,888,541,000)
Shrimp include: prawns, seabob, whitebelly
Fish include: finfish (industrial and artisanal) and
red snapper
Aquaculture include: Tilapia, Mullet, Querriman,
Bashaw, Black Shrimp, Tambaqui and Hassar

26. 26
• Global average for imported food - $US70 per capita.
• LAC average - $US170.
• Guyana’s Food Import Bill - $US200 per capita
• imported food bill $US200M or $G40B annually.
Addressing dependency on food imports

27. REDUCING COST OF PRODUCTION FOR MEAT
PRODUCING CHEAPER STOCKFEED
• PRODUCING OUR OWN CORN AND SOYABEANS
• REDUCING COST OF IMPORTATION AND REDUCING STOCKFEED
COST BY MINIMUM 20%
• GENERATING EMPLOYMENT FOR VULNERABLE POPULATIONS
• FIST COMMERCIAL CROPS IN 2014

28. Addressing dependency on food imports
HIGH FOOD IMPORT BILL IS A FOOD SECURITY RISK
•MILK = $US 32M
•WHEAT = $US32M
•POTATO =$US8M
•CARROTS, GARLIC, ONION = $US10M
•CORN = $US25M
•SOYA = $US20M
•CANNED FOOD = $US40M
•CHICK PEAS AND PALM OIL = $US5M

29. Import Substitution (Export Promotion)
• Initiate cultivation of imported commodities including carrots,
beet, chickpea and onions, POTATO,
• Develop production of culinary herbs such as cilantro, celery,
and parsley.
• Expanding the cultivation of rambutan and soursop.
• Develop management strategies for the control of pests and
diseases especially BSD, Red Palm Mite and diamond back
moth.
Addressing dependency on food imports

30. The case of milk
• Milk Production = 46,483,931 L
• 20% of Local consumption
• Milk Imports = $US34,812,894
• Projection reduce milk imports by 15% by 2020

31. Value Chain
• Expand Guyana’s Agro-processing industry
• Reduce post-harvest losses
• Replace importation of processed products
• Generate employment and income for rural and hinterland
communities
• Replace use of sugary carbonated drinks with fruit and
vegetable juices

32. Value Chain: Food Safety
• Building of a veterinary laboratory
• Establishing training programs in agro-processing
• Creating an incubator hub for agro-processing
• Promoting standards for food safety
• Helping fledgling agro-processors with labeling and packaging
• Development of Food Safety legislation

33. Integrated School Farms
• Demonstration farms created for community based
organizations
• Integrated farm programme (Healthy Practices Project, St. Ignatius
Secondary School, Lethem, Reg. 9: Improving Food Security and Healthy Diets While
Adapting to Climate Change)
– Ministry of Agriculture
– Ministry of Education
– Ministry of Health
– PAHO
– FAO
– UNICEF

34. Grow More Food Campaign (2009)
• The Grow More Campaign was implemented to ensure that
Guyanese had adequate food available for themselves and excess
to export to Caribbean countries as well as other outside
territories.
• This campaign encouraged and facilitated all households to have a
kitchen garden in their backyards.
• The MOA through the New GMC distributes seeds on a daily basis
to civil society encourage them to farm so that each household
within Guyana can achieve food security through self sufficiency.

35. • Existing facilities upgraded to double or triple current
production levels.
• Knowledge, technical capacity and entrepreneurial ability of
farmers enhanced.
• Farmers enabled to adopt new and innovative technologies
and to engage in safe practices.
Other FNS Programmes

36. • Utilization of crates and container by farmers boxes for the
transport of fruit and vegetables.
• Improved and appropriate handling of fruits and
vegetables for trade in the local and export markets for fewer
post-harvest losses.
• Relevant training provided to agro processors. Improved
quality of processed products.
Other FNS Programmes

37. Pesticide and Toxic Chemicals Control Board
• PTCCB is mainly mandated for the Management of all Pesticides & Toxic Chemicals and
as such is responsible for all Import, Export, Vending, Use & Disposal of same.
• Guyana signatory to the following Conventions on Chemicals Management:
– Rotterdam Convention
– Stockholm Convention
– Strategic Approach to International Chemicals Management
– Coordinating Group of Pesticides Control Board of the Caribbean
• Awareness Programmes
• Pesticide Storage Cabinet Project
• Construction of Pesticides Storage Facility
• Training of farmers on the safe use of toxic chemicals

38. Hydrometeorological Services
• Improve and develop a Monthly Farmers Weather Bulletin
• Expand network of Automatic Agromet Weather Stations - 2
automatic agromet by end of 2014
• Install automatic rain gauges in areas which are flood prone
• Expand its network of manual rain gauges by 20 by the end of 2014.

39. Drainage and Irrigation
• Improved drainage and irrigation infrastructure in key
production areas.

40. National Programmes and
policies focused on utilization
Ministry of Health
Ministry of Education
Ministry of Human Services and Social Security
Ministry of Culture Youth and Sports

41. Maternal and Child Health Programme
• Safe Motherhood Initiative
• National Breast Feeding Programme
• National Immunization Programme
– Maintained national coverage immunization for all routine antigens,
with no region under 85% coverage
• Deworming of children was scaled up to a national
programme that includes everyone in households

42. Early Childhood Development Programme
– Lead by the Ministry of Human Services and Social Security – Child
Protection Unit
– Inter sector Early Childhood Development Policy developed and to be
endorsed
– Early Childhood Development Practitioners course at University of
Guyana
– Licensing of day care facilities to ensure that Caribbean Regional
Standards are met

43. Basic Nutrition Programme
1. Distribution of micronutrient supplement (Sprinkles) to all children 6-24
months of age and to pregnant women attending MCH clinics.
2. Use of WHO growth cards to monitor the nutritional status of children
using WHO indicators for wasting and stunting.
3. Iron and folic acid tablets provided routinely for all pregnant women.
4. Screening for anaemia twice during pregnancy and at postnatal clinics.
5. Health education and nutrition counselling for mothers.
6. De-worming treatment for pregnant mothers in the second trimester.
7. Use of inferon and or blood transfusions to correct severe anaemia in
certain hospital settings.

44. National School Feeding Programme
Lead by the Ministry of Education
 supplies of Biscuits and fruit drinks
 Targets : All Nursery (years 1 &2 ) and Primary Level Schools
 Hinterland School Feeding Programme ( i.e.(3) out of the ten (10)
regions of Guyana

45. Guyana’s Hinterland School Feeding Programme
• Collaboration between Ministry of Education, Ministry of Health and Ministry of Agriculture
• Project began in 2006
– Aim – to strengthen capacity in areas of :
 community based participation in schools
 improving school attendance
 school performance
 nutritional status in Primary level school aged
children in the hinterland regions
Progress Report
Total number of participating schools -92
# of children benefiting – approximately 16,000 out of a total of 19,000

46. Guyana’s Hinterland School Feeding Programme
2007- 2009 evaluation report
“Nutritional findings revealed that children who were once considered malnourished and as a resulted had “stunted growth
conditions”, after being enrolled in the SFP , grew more by 0.8 centimeters when compared to those students who were not a
part of this initiative”
Additional achievements included
• Enhanced nutritional levels of pupils’ diet.
• Closer school and community collaboration.
• Enhanced agricultural activity within communities.
• Improved capacity in project management at the community level.
• Enhanced capacity at the community level in food handling and preparation.
• Income generation at the community level.
• Closer collaboration with the private sector and community administration, (village councils and private companies)
• Productive efforts at the school level with some schools engaging in food production and preservation.
• Collaboration between and among government ministries, (health, education, local government and agriculture, european
union micro projects programme).
• Improved pupil performance and responsiveness in the classroom.
• Improved school attendance.
• Increased school enrollment.

47. National Programmes – all levels of school
system – Students
 School Health Promotion – via Health Promoting Schools (PAHO/WHO) and Child Friendly
Schools Initiatives (UNICEF)
• Food Safety,
• Hygiene and Environmental Sanitation,
• Healthy Meal Preparation - training for Teachers, canteen workers, school dormitory
Administrators, etc
• Workplace and School Health Wellness Programmes that seek to promote healthy
behavioural practices and an awareness about NCDs
• Hand washing with soap awareness initiatives utilizing edutainment strategies
• Nutrition , diet and physical activity promotion programmes (e.g. curriculum
implementation,debates, quiz ,and cooking competitions,etc.)

48. Food Safety and Nutrition Promotion
Training and Promotion Programmes
• Regions targeted - 2,5,6,7,10 &
Georgetown
• # of Parents, teachers, canteen and
dorm staff trained – 382
• # of Workshops held – 8
• # of Primary Schools - 96
• Reporting period (2010- 2012)

49. Adolescent Health and Wellness Programme
• Secondary School Health Clubs
– Collaboration between the Ministry of Education and the Ministry of Health (adolescent Health Unit and
Maternal and Child Health Unit)
Promotion of adoption of healthy lifestyle choices
– Sexual and reproductive health
– Healthy eating and regular physical activities
• National peer education programme
– A cadre of adolescents trained and empowered to deliver information to their peers on
various topics
• Sexual and reproductive health
• Teenage pregnancy
• Diet
• Physical exercise
• Breast feeding practices

50. Complimentary Programmes
• Youth Friendly Programmes
– Youth Friendly Health Centres – hosted by the Ministry of Health
• Staff members trained to provide targeted information for adolescents
including teenage pregnancy prevention and healthy eating habits.
• Peer educators attached to the health centers trained to interact and provide
information to peers within the attached communities in an informative
manner
– Youth Friendly Community Centres – hosted by the Ministry of
Culture Youth and Sports.
• Adolescents within the communities are provided information on various
health topics and activities are guided by a community youth worker.

51. National Nutrition Programme
managed by the Food Policy Division Unit
Along with the Health Promotion Unit, Chronic Diseases Unit,
Maternal and Child Health Department
Love Life, Stay Healthy, Live Long Campaign
• Obesity Reduction
• Healthy Eating
• Regular physical activity

52. Nutrition Components of the Love Life, Stay
Healthy Live Long Campaign
• Who am I without my BMI
• Count Your Calories
• What’s in your shopping bag
• Healthy Meal Planning
• Million Mile Challenge for Health
• Weight No More
• Regular fitness walks

53. Programmes for the Elderly
• Social protection programmes
• Senior citizen clinics at primary health care level

54. Programmes for Vulnerable Population
• PLWHA
– Regular screening for amaemia for HIV positive pregnant women on
ART.
– Nutrition Guidelines for Persons Living with HIV/AIDS
– Food Bank Programme

55. THANK YOU