Every year, an estimated 350 children die from micronutrient deficiency-related diseases in the Dominican Republic. 400 children are born with folate deficiency, which results in neural tube birth defects. Only nine percent of the Dominican Republic has access to fortified sugar and flour as a micronutrients supplement. Vitamin A deficiency increases the risk of birth complications and maternal death. Iron deficiency reduces children learning capacity. In adults, it reduces productivity as it drains the energy level of workers. Fortification of sugar and flour with iron and other vital micronutrients is a proven, low-cost way of addressing the micronutrients deficiency in children and pregnant women. We must expand the national food fortification program especially in rural areas of San Cristobal and Monte Plata where there are high cases of micronutrient deficiency-related deaths. We must also launch public education campaign in every part of the country to inform the public on the need for micronutrients in the human body. I have expounded on these issues in the following sections.
The nature and magnitude of Micronutrient Deficiencies
Every year, 400 children are born with iron deficiency, leading to increased cases of birth and spinal cord defects in young children in the Dominican Republic. 350 deaths in children have been directly related to vitamin A deficiency. In essence, the micronutrient deficiencies issue is a health problem facing the Dominican Republic and requires immediate attention. Over 5% of Dominican Republic children have a goiter, 23% of children between the age of 1 and 5 suffer from low serum retinol, an indication of vitamin A deficiency and 31% of children between the age of 1 and 14 have low hemoglobin, or anemic from iron deficiency. Although vitamin and mineral deficiencies are preventable, they continue to cause irrevocable damage such as blindness.
Who is at Risk?
Over 3.5 million children and adolescents, Lactating mothers and pregnant women are at the greatest risk of micronutrient deficiencies in the Dominican Republic. These three groups have a greater need for minerals and vitamins and are more vulnerable to the detrimental consequences of micronutrient deficiencies. The risk is relatively greater in pregnant women as it may result in death during birth. In some cases, the newborn is underweight or impaired mentally. The micronutrient status of a lactating mother determines the development and health of the infant, especially during the first year when the child is breastfeeding. In young children and adolescents, the risk of death from infectious diseases increases with micronutrient deficiencies. It also contributes to impaired mental and physical development.
Factors contributing to Micronutrient deficiencies
Most women and adolescents in the Dominican Republic have very low literacy, they don’t actively participate in the labor force and they are not involved in both household and social decision making. This puts them at a disadvantage in health outcomes since they have limited access to health information and healthy diets. During the last trimester, the demand for micronutrients like vitamin A from both the unborn child and the mother is very high. This puts pregnant women at a high risk of micronutrient deficiency.
Most households in the Dominican Republic have low incomes and many families are living in poverty. Most of these households are headed by female who does not have the right information on the benefits and sources of micronutrients rich food. This in turn puts the children in those households at risk of micronutrient deficiencies since they are not provided with enough food, rich in essential nutrients.
Social and Economical consequences of Micronutrients Deficiencies
The social effects of micronutrients include functional outcomes, mental performance, growth and development, morbidity, working capacity, mortality and overall reproduction of the people in the Dominican Republic. Member of society who suffers from diseases such as blindness and other related disability depend on other people for their day-to-day survival. This dependency creates a huge burden on the society’s wellbeing. Micronutrients deficiencies increase the risk of death from infectious diseases due to reduced immune defenses and compromising normal development. These diseases put a lot of pressure on the Dominican Republic health sector.
According to Kul Gautam, the Deputy Executive Director of UNICEF, mineral and vitamin deficiencies cause ‘hidden hunger’ and malnutrition. “The ‘hidden hunger’ due to micronutrient deficiency does not produce hunger as we know it. You might not feel it in the belly, but it strikes at the core of your health and vitality. It remains widespread, posing devastating threats to health, education, economic growth and to human dignity in developing countries”. According to the World Food Program, folate deficiency has been shown to increase cases of maternal deaths and childbirth complications, reducing productivity and reduced learning capacity for young children and adolescent.
Micronutrients deficiencies are responsible “for estimated annual economic losses of 0.4 percent of the country’s Gross Domestic Product (GDP)”. The cost of treating diseases related to micronutrients deficiencies put a huge burden on both families and the government of Dominican Republic. Those suffering from diseases related to micronutrients deficiencies do not participate in the workforce, leading to reduced production. The death of productive adolescents and adults also has a direct impact on the economical wellbeing of a family and the larger society.
The solution to address Micronutrients Deficiencies
Food fortification program is the most effective way of addressing micronutrients deficiencies in the Dominican Republic. Through this program, sugar and flour milled for consumption will be fortified with folic acid, iron, vitamin A and B complex. Through this program, families will have access to food that contains necessary nutrients, hence reducing the rate of anemia, vitamin A and Folic Acid deficiency-related diseases by 27%. The number of birth defects like spinal cord and brain injury will also decrease by approximately 20%. Flour mills and sugar mills throughout the Dominican Republic will participate in this program. The government should introduce laws making the fortification of sugar and wheat a mandatory process in the production of food for domestic consumption.
Public education programs will also play a greater role in solving the issue of micronutrients deficiencies. The ministry of health will work closely with the ministry of education, Standards regulation organizations, local government, food processing companies, research groups , consumer’s association’s groups, UNICEF and WHO in educating the general public on the importance and source of minerals in their body. Public education has been proven as a successful way of addressing micronutrients deficiencies in countries like Nicaragua, Zambia, Chile and USA. Currently, there is a pilot program promoting the importance of the consumption of iodized salt in the Western region of the Dominican Republic. The program makes includes radio series produced in local languages targeting mostly women.
FAO. “Dominican Republic.” 2010. Nutrition and Consumer Protection. Web.
Bruno Benoist. “Preventing and controlling micronutrient deficiencies.” 2007. UNHCR. Web.
UNICEF. “Micronutrients and Hidden Hunger.” 2010. UNICEF Dominican Republic. Web.
Darnton-Hill, Ian, Patrick Webb and Philip WJ Harve. “SUPPLEMENT: WOMEN AND MICRONUTRIENTS.” 2005. American Journal of Clinical Nutrition. Web.
Paz, Alejandra De La. “Dominican Republic Launches National Food Fortification Program to Reduce Vitamin and Mineral Deficiency.” 2007. The World Bank. Web.
6 Trowbridge, Frederick. Surveillance of micronutrient deficiency. Bulletin. Tokyo: The United Nations University Press, 1994.