Table 2 Policy options of the final model for malnutrition prevention among children under 5 years old in Iran

Structural

Strengthening the activates of the Supreme Council for health and Children Nutrition through structural reform

Making the ministry of health to operate the leadership completely as a policymaker and chief responsible for the children nutrition

Strengthening the staff structure to improve the community nutrition at the health deputy of Health Ministry

Strengthening the line structure in executive agencies of the cities, such as health networks and nutrition experts for more coordination

Strengthening the capacity of the PHC system to solve the nutritional problems of mothers and children

Establishing the community-based structures in the processes of food security level promotion at the Ministry of Health

Increasing the public participation in implementing operational programs through participation in the executive body

Using more expert personnel in the field of production, processing and food health

Intersectoral

More coordination for nutrition-related policies in beneficiary organizations

Using the graduates of management and policy making in the field of nutrition

Increasing the linkages between research centers and the institutions of policy making and decision making

Strengthening the effective participation of the scientific community to implement the programs of children nutrition

Strengthening the effective participation of private sector to implement the programs of children nutrition

Making the related organizations such as TV, Ministry of Culture and NGOs more sensitive to the topic of children nutrition

Implementing the approved health plans with more commitment by beneficiary organizations

Political

Increasing the share of food and nutrition in macro policy makings of the health sector

Activating the committees of supreme council for health more to run the existing laws better

Paying more attention to evidence-based policy making on policies of children nutrition in related organizations

Decentralized regional policy making for more adaptation to the different regions of the country

Proper implementation of some nutrition laws that are not properly implemented, such as National Document of Nutrition and Food Security

Formulating the comprehensive planning for production, consumption and demand with the participation of all organizations involved in this field

Prohibiting radio, television and other mass media from advertising heath threatening food products

Putting taxes on health threatening food products

Economic

Absorbing the financial resources completely by the organizations, which have a credit for the children nutrition.

Receiving more financial resources from international organizations which are active in the field of nutrition and poverty

Reforming the laws and programs related social justice to balance the distribution of per capita income in the country and the improve the poor condition

Identifying the groups under the poverty line complete and being committed to support their nutrition fully

Employment and income generation for unemployed, young, low-income and poor people through formal plans

Making food subsidies purposeful based on differences in economic conditions of different regions

Making production subsidies purposeful and applying as well as modifying the price tools

Increasing the credit of per capita for a hot meal in rural kindergartens

Supporting micro-industries, particularly in agriculture and food to increase rural finance capacity

Supporting rural development projects to improve the economic conditions of the village and its residents

Providing facilities and subsidies to private sector to invest in producing healthy food products

Providing a milk subsidy appropriate with desired food basket to increase the per capita consumption of milk and its products

Financial support for educational programs, and advertisements related to health and nutrition of mother and child health in TV

Sanitary

Reducing agricultural crops by monitoring the responsible organizations and continuous evaluation of products

Removing unauthorized additives in the processing and maintaining of food

Supporting the projects of food safety promotion at industrial units

Paying special attention to the elimination of health problems in deprived areas with insecure food

Teaching families about the principles of food hygiene in providing and maintaining child food

Teaching families on hygiene (hand wash, sanitary waste and ...)

Teaching families on parasitic diseases and their transfer and cure

اIncreasing public health measures to prevent intestinal parasitic infection among children

Training to reduce the consumption of unhealthy and low value food by children through media, health and educational centers

Health oriented

More access to health care, especially in areas with poor economic status

Complete children health care, especially in the first 1000 days of life

The possibility of children’s access to foods full of micronutrient in all regions of the country

Facilitating the access to fresh and natural food, especially fruits and vegetables for mothers and children

Identification of nutritious and proper native food to feed children and develop the culture of its supply and consumption

Emphasis on the proper various dietary for mother and the child and to receive the nutrients they need

Complete implementation of breastfeeding programs, especially during the first six months

Complete implementation of complementary nutrition programs after the first six months

Supporting the promotion of breastfeeding and proper supplemental nutrition with appropriate training and incentives.

Preventing from the reduction of the quantity and quality of the food basket due to poverty, inflation and food prices

Preparation of desired food baskets in accordance with culture, tradition and the status of different regions

Providing comprehensive nutrition program to deal with micronutrients deficiency, especially Vitamin A, D, Iron, and Zinc

Changing the composition of supply pattern to reduce the consumption of salt, oil and sugar

Strengthening family planning and proper birth spacing

Focus on mother’s nutrition prior to pregnancy

The mother and child nutritional treatment system at the Ministry of Health, especially in hospitals and private clinics

Establishing and strengthening of the nutritional counseling units in health centers

Establishing and strengthening of intensive care unit for children with severe malnutrition in all hospitals

Supportive measures to the cure the children having diseases due to malnutrition

Encouraging and supporting the production and consumption of nutritional supplements among susceptible and sick children and mothers

Strengthening the children’s growth monitoring program at community health centers

Strengthening the supplemental programs of micro-nutrition for children emphasizing on family education

Research

Development of research capacities and interdisciplinary specialties in universities

Studying on applied researches related to children’s nutrition problems

Studying on enriching major nutrient with a variety of micronutrients more powerful

Research studies on the causes of malnutrition in different regions of the country

Use of research findings from other countries to address the causes and problems of child nutrition

Educational/Cultural

Acceleration of absolute illiteracy reduction, especially in deprived regions faster

More use of new promotional tools such as social networks for proper advertisements and training on health related topics

Promoting the nutritional culture and literacy through the huge potential of social media

Proper implementation of nutritional labeling system to aware consumers

Increasing the knowledge and skills of general practitioners as the first level of nutrition care in the community

Training and retraining of health workers in the field of family proper nutrition, especially mother and child

Training and retraining of health care staff, especially nurses in pregnancy and pediatrics departments

Teaching mothers and girls, especially high school girls, about mother and child nutrition

University educations on proper food and nutrition based on community needs

Cultivation to limit the production and consumption of low-value and harmful food

Cultivation and promotion of using vegetables and fruits based on the desired food basket

Use of cultural and traditional tools of communities to educate and promote the nutritional literacy

Presenting food and nutrition education for personnel (at the beginning, during or work retraining)

Including food and nutrition in different steps of reviewing and editing textbooks

Public education about the nutritional value of milk and its products to increase its per capita consumption

Planning and implementing the comprehensive nutritional education program for mothers

Informing parents about nutritional, supplement and labeling standards which are proper for the children

Enhancing the empowerment and participation of people in implementing the programs related to removing children malnutrition and appropriate nutrition

Evaluation

Exact evaluation of the nutrition activities for children and presenting report to the supreme Council for Health

Launching the monitoring system of micronutrient and the nutritional status for children and pregnant mothers in health centers

Continuous monitoring of food and nutrition status through electronic registration systems

Continuous monitoring of educational and promotional food related to nutrition programs, especially in the mass media

Strengthening the monitoring and control system on the import of food and raw materials in the food industry

Strengthening the monitoring system of diseases caused by food among children

Update and standardize the growth monitoring system to measure the anthropometric status of children

Production

Paying attention to the production of food products which support the health of children by producers and supervisory organizations

Paying more attention to quality rather than only the quantity in agricultural and food products

Reducing food waste based on general education and culture making

Formulating and revising the standards of food, raw materials and packaging standards

Reducing the production costs and food prices

Supporting the development of service centers in the agriculture and food industries

Supporting the business development projects in small-scale food industries by the Ministry of Industry

Reducing the excessive use of chemical pesticides and supporting the biological methods to control pests

Promotion of planting vegetables and consuming them, especially in rural regions

Organizing and optimizing the traditional production units of milk and its products

Supporting the production of organic foods

Supporting the production of probiotic foods

infrastructures

Development of infrastructures such as health network, transportation and communications to have access to more food, health services and health facilities.

Technology developing in the specialty fields of food and nutrition and adaptation to advanced technologies

Promoting the level of technology in the food chain, from production to consumption

Strengthening and equipping food labs in provincial health centers to control the quality of food products

Legal

Providing the comprehensive national document for nutrition in the country

Enforcing the observatory laws on the quality and health of foods

Development and continuation of the national program for the enriching the flour with iron and folic acid

Complete implementation of the laws which prohibit the promotion of harmful food

Developing and enforcing the laws which protect of high-quality food producers