Comprehensive Micronutrient Strategy in Honduras

Currently PHC is working with the Honduran government, chairing their national micronutrient consultative committee responsible for the design, evaluation and monitoring of a comprehensive micronutrient program which includes food fortification.

Originally invited by the Honduran government in 2000 to review the existing health conditions for infants and children related to birth defects and micronutrient deficiencies, PHC conducted a series of studies including the first ever country-wide survey of Honduran births in public health hospitals, which established a base line to measure future progress. Subsequently PHC collected data on food consumption and nutritional habits of rural and urban Honduran women, thus providing the necessary data to design effective fortification and education strategies. At the same time, we conducted a cost analysis for providing services to children born with birth defects related to folic acid deficiencies. The results of this study were presented to the Minister of Public Health who approved the use of folic acid for all women of reproductive age. The cost study was repeated in Guatemala in conjunction with the Epidemiologic Research Center in Reproductive Health. These results, the first of their kind in the region, demonstrated the enormous economic benefits of food fortification and supplementation.

In order to explore possible alternatives to supplementation strategies, PHC, partnered with the CDC and the Honduran Ministry of Health in a double blind study to test the effect of a five milligram weekly dose of folic acid versus one milligram daily dose. The results of this study were presented at the First Central American Workshop for Prevention of Neural Tube Defects associated with Folic Acid Deficiency in Costa Rica, October 2005. The workshop, sponsored by PHC, CDC, PAHO, INCAP and March of Dimes, was the originating point of the IDB Initiative.