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addition, in order to protect children at high risk of vitamin A deficiency associated blindness and death, the project would provide, on a national Ievel, medicai supplementation of infants and young children suffering. from persistent diarrhea, acute upper respiratory infection and measles. Iron and folie acid supplementation will be carried out through the prenatal clinics; iron and folie acid have just been included in the list of essential drugs. Iodized oil capsule campaigns will be carried out in the provinces with goiter prevalence greater than 20% during the firet three years. During the project mid-term review, an assessment will be madę as to the satisfactory attainment of objectives and coverage will then be extended to provinces with 10%-20% prevalence. However, distribution of iodine capsules will be halted if, and when, iodized salt becomes available to target groups. Iodized oil capsules will also be madę available, along with other essential drugs in district health facilities, for treatment of mild goiter prevalence (below 10%) starting in year 4 of the project.

3.30 Health workers are often unaware of the severity and consequences of micronutrient malnutrition, and of practical rontrol measures available. Hence, training and monitoring will be crucial activities within the nutrition component. The project (CFDS in collaboration with DSF) will train health workers to utilize integrated supervision guidelines and algorithms for supplementation. During negotiations, the Govemment gave assurances that it would integrate micronutrients in the algorithms, supervision manuals, training curricula of CFDS, patient cards, and ongoing training sessions of MCI and EPI services by October 31, 1994. Assurances were also given that the detailed implementation plan of the micronutrient component for the first year of the project would be provided by Project Launch Workshop.

3.31 The project will finance drugs (micronutrient supplementation) to be delivered to the target populations, information and education campaigns (sensitization of decision makers on the distribution of micronutrients), services (baseline data collection and evaluation), training and operating costs (mainly for supervision of health workers). The DSF will also be strengthened in its management and planning capacities. However, this institutional strengthening activity will be financed under IDA's Population and AIDS Control Project which is currently under preparation (para. 2.49).

(b) Deyełopment of long-term stratesies (US$631,000)

3.32 Objectiyes and Description. In addition to the short-łerm actions to rapidly reduce severe deficiencies, the project would help in the development and implementation of a longer term, morę cost-efficient national strategy based on food fortification and modiiication of dietary habits as opposed to medicinal doses. Improvement in the ability of the MOH to plan, monitor, and evaluate the component will help in providing for sustainability. The long-term strategy will include EEC messages aimed at changing food habits. Training of District Teams in nutrition would take place and monitoring and evaluation capabilities of DSF and the District Teams will be strengthened.

3.33 A feasibility study on the possibility of speeding up the importation of iodized salt will be undertaken by the Goverament and financed by UNICEF. The terms of reference of this study will include the designing of monitoring and evaluadon activities for iodized salt distribution. The terms of reference will be approved by EDA. The results of the study will be reviewed jointly by the Govemment, UNICEF, and IDA. During negotiations, the Goverament gave assurances that based upon the results of this feasibility study, ąppropriate actions would be taken to promote importation of iodized salt, according to WHO standards, by March 31, 1996, and that appropriate legał regulations would be implemented thereto.