Review of Trends, Policies and Programmes affecting Nutrition and Health in Egypt (1970−1990) Table of Contents Review of Trends, Policies and Programmes affecting Nutrition and Health in Egypt (1970−1990).........1 UNITED NATIONS ADMINISTRATIVE COMMITTEE ON COORDINATION − SUBCOMMITTEE ON NUTRITION (ACC/SCN).................................................................................................................1 FOREWORD..........................................................................................................................................2 ACKNOWLEDGMENT............................................................................................................................3 I. INTRODUCTION.................................................................................................................................3 Objectives of the Study....................................................................................................................3 Background of the Study..................................................................................................................3 Theoretical Framework....................................................................................................................4 II. MAIN HEALTH AND NUTRITION PROBLEMS: A TREND ANALYSIS OF THE SITUATION...........7 Neo−Natal, Post−Neonatal, Infant Child Mortality Rates and Maternal Mortality Rates..................7 Protein Energy Malnutrition (PEM) and Growth Pattern................................................................10 Anemia (Iron Status)......................................................................................................................30 Over Nutrition.................................................................................................................................32 Other Problems..............................................................................................................................33 Functional Consequences of Malnutrition......................................................................................36 III. BASIC SOCIO−ECONOMIC CHARACTERISTICS OF EGYPT.....................................................38 Main Political Trends in Egypt........................................................................................................38 Demographic Characteristics.........................................................................................................39 Development Strategy and Policies...............................................................................................42 IV. DETERMINANTS OF HEALTH AND NUTRITION STATUS IN EGYPT.........................................47 Section One: Dietary Practices......................................................................................................47 Supply of Food: (Household Food Security)..................................................................................47 Government Policies in Egyptian Agriculture.................................................................................47 Agricultural Policy Instruments.......................................................................................................47 Investment Allocation Pattern in Agriculture..................................................................................47 Impact of the Agricultural Policy and Investment Allocation Pattern on the Nutrition Status of Egyptians................................................................................................................................48 The Contribution of Selected Food Groups to Dietary Energy Supply "DES"................................52 Egyptian Rationing and Food Subsidy...........................................................................................53 Agricultural Policy Reforms 1986−1988.........................................................................................55 Major Agricultural Policy Reform Objectives in the Period 1990−1993..........................................55 Expected Impact of Agricultural Policy Reform on Agricultural Production....................................56 Demand on Food and Health Services..........................................................................................56 Incomes..........................................................................................................................................56 Income Effects of the Reform in the Agricultural Policy.................................................................61 Income Effects for Urban Households...........................................................................................61 Prices of Food and the Egyptian Ration System and Subsidies....................................................63 Food Consumption and Intake.......................................................................................................66 Nutrient Intake and Variation with Different Factors.......................................................................69 Infection in Egypt............................................................................................................................72 Health System in Egypt..................................................................................................................75 Health Policies and Priorities in the Seventies and Eighties..........................................................77 Effects of the Changes in the Health Policies Over the Seventies and Eighties on the Health Sector.....................................................................................................................................78 Main Health Interventions..............................................................................................................83 Impact on Cases of Severe Dehydration Among Children.............................................................83 Impact on Infant and 1−4 Year Child Mortality Due to Diarrhea.....................................................83 Child Survival Project (CSP)..........................................................................................................84 Family Health History (Caring Capacity)........................................................................................85 Caring Capacity..............................................................................................................................85 Caring Capacity Within the Society................................................................................................90 Environment...................................................................................................................................91 Infant and Child Feeding................................................................................................................92 Family Planning Policies and Child Spacing..................................................................................94 Nutritional and Health Interventions Affecting Family Health.........................................................95 V. ASSESSMENT OF HEALTH AND NUTRITION STATUS IN EGYPT OVER THE 1970s AND 1980s...................................................................................................................................................97 Main Findings of the Study.............................................................................................................97 Major Trends in the Health and Nutrition Status............................................................................97 i Table of Contents Review of Trends, Policies and Programmes affecting Nutrition and Health in Egypt (1970−1990) Socio−Economic Characteristics....................................................................................................99 Trends in the Determinants of Health and Nutrition Status in Egypt..............................................99 Demand of Food and Consumption Pattern.................................................................................100 Infection and Accessibility of Health Services..............................................................................101 Family Health History and Caring Capacity.................................................................................101 Trend Analysis.............................................................................................................................102 Summary of Trends in Nutritional and Health Status Over the 1970s and 1980s (Incidence−Impact Analysis).................................................................................................102 Functional Consequences of Malnutrition in Egypt......................................................................103 Basic Socio Economic Characteristics Impact.............................................................................103 Assessment of the Main Findings................................................................................................107 Relative Importance of the Different Components: Food Security, Accessibility to Health Services and Caring Capacity..............................................................................................107 Nutritional Aspects in the Socio−economic Plans in Egypt..........................................................108 Policy Recommendations (Futuristic Approach)..........................................................................109