The Food and Nutrition Policy and Plan of Action for Belize
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THE FOOD AND NUTRITION POLICY AND PLAN OF ACTION FOR BELIZE Belmopan February 2010 The Food and Nutrition Policy and Plan of Action for Belize Prepared by The Food and Nutrition Security Commission of the Government of Belize With technical support from Caribbean Food and Nutrition Institute Pan American Sanitary Bureau, Regional Office of the Pan American Health Organisation Belmopan February 2010 ii TABLE OF CONTENTS PAGE GLOSSARY … … … … … … … … … v EXECUTIVE SUMMARY … … … … … … … vi 1. INTRODUCTION … … … … … … 1 1.2 Demographic Characteristics … … …… … 3 1.3 The Political Context … … … … … 6 1.4 The Economy … … … … … 8 1.5 Food and Nutrition Policy Imperative … … … 12 2. NUTRITION AND HEALTH STATUS … … … ... 13 2.1 General Health Conditions … … … … … 14 2.2 Children Under Five Years … … … … … 24 2.3 Children Five Years and Over … … … … 26 2.4 Pregnant and Lactating Women … … … … 28 2.5 Adults and the Elderly … … … … … 29 2.6 Patterns and Levels of Physical Activity … … … 32 3. EDUCATION STATUS … … … … … … 34 3.1 Formal Education … … … … … … 35 3.2 Community Education / Health Promotion … … 37 4. FOOD AVAILABILITY, HOUSEHOLD ACCESS, AND SAFETY … … … … … … … 39 4.1 Food Production … … … … … … 40 4.2 Food Availability … … … … … … 40 4.3 Food Manufacturing and Processing … … … 40 4.4 Household Food Accessibility … … … … 40 4.5 Food Quality and Safety … … … ... .... 40 5. REVIEW OF EXISTING POLICIES AND PROGRAMMES AFFECTING FOOD AND NUTRITION … 44 5.1 Macroeconomic Policies and Programmes … … 45 5.2 Trade Policies and Programmes … … … … 45 i 5.3 Agricultural and Agro-Industrial Policies and Programmes…… 45 5.4 Health Policies and Programmes … … … … 45 5.5 Social Development Policies and Programmes … … 49 5.6 Education Policies and Programmes … … … 49 5.7 Policies and Programmes of Non-Governmental and other Agencies … … … … … … 49 6. SUMMARY OF PROBLEMS TO BE ADDRESSED … … 50 7. PROPOSED POLICIES AND PROGRAMMES … … … 56 7.1 Information, Education and Communication on Food Production, Preparation, and Nutrition … 58 7.2 Diversified Food Production, Food Processing, Marketing, Storage and Credit Mobilization … 60 7.3 Maternal and Child Care, School Feeding and Caring for the Socio-economically deprived and Nutritionally vulnerable … … … … 60 7.4 Creation of Employment and Income Generating Opportunities at the Local level … … … 61 7.5 Food Safety … … … … … … 62 7.6 Analysis and Reform of National Policies for Food and Nutrition … … … … … … 63 8. PLAN OF ACTION … … … … … … … 67 8.1 Goal … … … … … … … … 68 8.2 Projects and Action Plan ... … … … … 68 9. IMPLEMENTATION AND CO-ORDINATION … … 87 9.1 Responsibilities … … … … … … 89 9.2 Composition and Organizational Structure and Relationship with Government … … … … 90 ii LIST OF TABLES 1. Table 1: Belize Mid-year Population by Age-group and Sex – 2009 Table 1.1: Belize Mid-year Population by Age-group and Sex – 2009 2. Table 2: Structure of Belize Economy and Sectoral Change, 1980- 2005 3. Table 3: Morbidity and Mortality 2008 4. Table 4: Distribution of Underweight Children 0-4 years (Low Birth) Weight by Age) by District (2002 LSMS) 5. Table 5: Distribution of Children 0-4 years with STUNTING (Low Height for Age) by District (2002 LSMS) 6. Table 6: Distribution of Children 0-4 years with WASTING by District (2002 LSMS) 7. Table 7: Prevalence of soil-transmitted helminthes infections by age and sex 8. Table 8: Prevalence of Anaemia among Pregnant Women LIST OF FIGURES 1. Figure 1: Real GDP Growth in Belize and the Caribbean, 1996- 2006 2. Figure 2: Hospitalization of Diabetes by Age Group 3. Figure 3: Hospitalization of Diabetes by Sex 4. Figure 4: Hospitalization of Hypertension by Age Group 5. Figure 5: Hospitalization of Hypertension by Age Group 6. Figure 6: Percentage of Children with Stunting, wasting, and Overweight by Quintile Consumption (LSMS, Belize 2002) 7. Figure 7: Percentage of Children with Stunting, wasting, and Overweight in Rural and Urban Areas (LSMS, Belize 2002) 8. Figure 8: Prevalence of Anaemia (Hb<11mmg/dl) among Pregnant Women in Belize 9. Figure 9: Total Number of Food Borne Diseases in Belize 2004-2009 10. Figure 10: Food Borne Disease Cases by District, Belize 2004-2009 11. Figure 11: Food Borne Disease Cases by Age Group, Belize 2004-2009 iii GLOSSARY AIDS – Acquired Immune Deficiency Syndrome BAHA – Belize Agricultural Health Authority BHIS - Belize Health Information System BZ$ - Belizean dollar CAMDI - Central American Diabetes Initiative CARICOM – Caribbean Community CFNI - Caribbean Food and Nutrition Institute CHW - Community Health worker CNCDs - Chronic Non-communicable Diseases EU - European Union FAO – Food and Agriculture Organization FBD – Food Borne Diseases FNS – Food and Nutrition Security GDP – Gross Domestic Product H/A – Height for Age Hb - Haemoglobin HECOPAB – Health Education and Community Participation Bureau HFLE - Health and Family Life Education HIV – Human Immunodeficiency Virus IICA – Inter American Institute for Corporation on Agriculture IMF - International Monetary Fund IMR - Infant Mortality Rate INCAP - Institute of Nutrition for Central America and Panama IU - International Units LBW - Low Birth Weight LSMS - Living Standards Measurement Survey MAF – Ministry of Agriculture and Fisheries MDGs - Millennium Development Goals MICS - Belize Multi Cluster Survey MoH – Ministry of Health iv NCDs - Non-Communicable Nutrition-related Diseases NEMO – National Emergency Management Organization NFNSC – National Food and Nutrition Security Commission NGO – Non Governmental Organization NHDAC - NHI – National Health Insurance NPAN - National Plan of Action on Nutrition OIRSA – International Regional Organization for Animal Health PAHO – Pan American Health Organization PE - Physical Education PLWHA – Persons Living with HIV/AIDS QADS - Quality Assurance and Development Services REAP – Rural Education and Agricultural Project SIB - Statistical Institute of Belize SPS – Sanitary and Phytosanitary Standards TCC – Technical Cooperation among Countries UNICEF – United Nations Children Fund US$ - United States of America dollar VAT - Value-Added Tax W/A – Weight for Age W/H – Weight for Height WHO – World Health Organization WTO – World Trade Organization v EXECUTIVE SUMMARY vi EXECUTIVE SUMMARY Purpose This Document entitled 'The Food and Nutrition Security Policy and Plan of Action for Belize 2010 - 2015' is intended to serve as a framework for policy decisions by the Government of Belize and for the implementation of programmes to ensure food and nutrition security for all Belizeans. Background In February 2001, the Government of Belize ratified a Food and Nutrition Security Policy for Belize which outlined key strategies to ensure the sustainable supply, accessibility, and use of safe, high quality, nutritious, diversified, and culturally- accepted foods for all Belizeans to improve their well-being and quality of life. From this plan a five year National Plan of Action on Nutrition (NPAN) (2005- 2010) was developed. In November 2009 the Government of Belize requested that the policy be revised and the NPAN subsequently updated. The present document is the result of that request. Physical Description of Belize Belize is on the Caribbean coast of Central America, bordered on the north and part of the west by Mexico and on the south and remainder of the west by Guatemala, with a total area of 22,966 square kilometres including mainland and cayes and 22,806 square kilometres mainland. Arable and permanent cropland total some 89,000 hectares. Much of the remainder is marsh, mangrove swamp, and steep hilly areas. The arable and cultivated area is capable of supplying the local market and producing a surplus, especially in grains, for export. Political Description Belize is a sovereign democratic state, the former British Crown Colony of British Honduras. Belize gained independence from Great Britain on 21 September 1981, and has a parliamentary system of government modeled on the Westminster system. There are six administrative districts: Belize, Cayo, Corozal, vii Orange Walk, Stann Creek, and Toledo. The former capital, Belize City, remains the commercial centre of the country. A new capital city, Belmopan, was chartered in 1970. Population and Poverty The following information comes from the Belize Country Poverty Assessment Draft Final Report compiled in November, 2009: Total Population 330,715 Prevalence of Poverty by Household Indigent - 8,539 that is 10% of the total number of households Poor not Indigent 18,270 that is 22% of the total number of households All Poor 26,809 33% of the total number of households Prevalence of Poverty by Population Indigent - 52,185 that is 16% of the total population Poor not Indigent 90,678 that is 27% of the total population All Poor 142,861 that is 43% of the total population In its summary of the change in poverty since the last Poverty Assessment in 2002, the 2009 Draft final report has this to say: 'Poverty has increased substantially in Belize since the previous CPA was carried out in 2002. Household poverty has increased from 25% to 33% and individual poverty from 34% to 43%. Indigence or severe poverty has also increased from 8% to 10% (households) and 11% to 16% (population). Poverty and indigence have increased in all districts except Toledo where there has been a decrease, although it still remains the poorest district in the country with by far the highest level of indigence. The sharpest increase has been in Corozal which now has the second highest level of poverty after Toledo. Poverty