Micronutrient Deficiencies, Over- and Undernutrition, and Their Contribution to Anemia in Azerbaijani Preschool Children and Non-Pregnant Women of Reproductive Age.

Data on the nutritional situation and prevalence of micronutrient deficiencies in Azerbaijan are scarce, and knowledge about anemia risk factors is needed for national and regional policymakers. A nationally representative cross-sectional survey was conducted to assess the prevalence of micronutrient deficiencies, over- and undernutrition, and to disentangle determinants of anemia in children and women in Azerbaijan. The survey generated estimates of micronutrient deficiency and growth indicators for children aged 0⁻59 months of age (6⁻59 months for blood biomarkers) and non-pregnant women 15⁻49 years of age. Questionnaire data, anthropometric measurements, and blood samples were collected to assess the prevalence of under- and over-nutrition, anemia, iron deficiency, and iron deficiency anemia, in both groups. In children only, vitamin A deficiency and zinc deficiency were also assessed. In women only, folate and vitamin B12 deficiencies and vitamin A insufficiency were assessed. In total, 3926 household interviews were successfully completed with a response rate of 80.6%. In the 1455 children, infant and young child feeding practices were relatively poor overall; the prevalence of wasting and stunting were 3.1% and 18.0%, respectively; and 14.1% of children were overweight or obese. The prevalence of anemia was 24.2% in 6⁻59 months old children, the prevalence of iron deficiency was 15.0% in this age group, and the prevalence of iron deficiency anemia was 6.5%. Vitamin A deficiency was found in 8.0% of children, and zinc deficiency was found in 10.7%. Data from 3089 non-pregnant women 15⁻49 years of age showed that while undernutrition was scarce, 53% were overweight or obese, with increasing prevalence with increasing age. Anemia affected 38.2% of the women, iron deficiency 34.1% and iron deficiency anemia 23.8%. Vitamin A insufficiency was found in 10.5% of women. Folate and vitamin B12 deficiency were somewhat more common, with prevalence rates of 35.0% and 19.7%, respectively. The main risk factors for anemia in children were recent lower respiratory infection, inflammation and iron deficiency. In women, the main risk factors for anemia were iron deficiency and vitamin A insufficiency. Anemia is a public health problem in Azerbaijani children and women, and additional efforts are needed to reduce anemia in both groups.

Universal salt iodization in the Central and Eastern Europe, Commonwealth of Independent States (CEE/CIS) Region during the decade 2000-09: experiences, achievements, and lessons learned.

BACKGROUND: By 2000, the global track record on universal salt iodization (USI) indicated 26% access to adequately iodized salt in the Central and Eastern Europe, Commonwealth of Independent States (CEE/ CIS) Region. OBJECTIVE: Aimed at extracting lessons learned, this study examined experiences, achievements, and outcomes of USI strategies in CEE/CIS countries during the subsequent decade. METHODS: Information from the design, timing, execution, outputs, multi-sector management and results of actions by national stakeholders yielded 20 country summaries. Analysis across countries used a LogFrame Analysis typical for public nutrition development. RESULTS: By 2009, USI strategies had reached the target and population iodine nutrition shown adequate levels in 9 countries, while in 6 others, USI was close and/or population iodine status showed only minor imperfection. True USI, i.e., iodization of salt destined both for the food industry and the household, had been made mandatory in 13 of these 15 countries. In the Balkan area, USI and iodine nutrition advanced more than in CIS. Of the 20 sample countries, 17 (85%) had exceeded the mark of 50% adequate access, while the overall regional score reached 55% by 2010. CONCLUSIONS: Experience from this region suggests that strong partnership collaboration, a new concept in post-Soviet societies, was a major success factor. Voluntary iodization or focusing on household salt alone was less likely conducive for success. Achieving optimum iodine nutrition required the setting of proper iodine standard Weak political leadership insistence in the Russian Federation and Ukraine to embrace USI is the main factor why the region remains behind in the global progress.