ASSESSMENT OF THE FOOD AND NUTRITION SITUATION IRAQ

In memory of Yusuf Abdilleh, Administrative Officer and Marewan Mohammed Hassan, Data Specialist FAO, Baghdad

Summary

An FAO/WFP/WHO Mission visited Iraq from 1 - 27 May 2000. The objective of the mission was to assess the current food supply and nutrition situation in the country, particularly after two consecutive years of drought, and to compare the results with the findings of the previous assessment missions of 1993, 1995 and 1997.

Two consecutive years of severe drought and inadequate availability of essential agricultural inputs have severely affected the Iraqi agriculture. Reflecting a substantial reduction in plantings and yields, cereal production in 2000 fell to 794,000 tons, some 47 percent below the 1999 poor harvest and 64 percent lower than the previous five years average. Drought conditions also drastically reduced the water resources in rivers, dams, lakes and canals, some of which have virtually dried up. As a result, prospects are unfavorable for the upcoming irrigated summer crops, vegetables and fruits.

Cereal imports since 1997/98 under the oil-for-food deal have led to significant improvements in the food supply situation. In 1995/96 per person cereal consumption was down 63 percent from the 1984/85-1988/89 average. This year (2000/01) it is projected to be 90 percent of that level. However this is 4 percent less than 1997/98. Furthermore, problems of delays in the flow of food imports continue to be reported since the 1997 Mission, leading to repeated cases of low levels of MOU commodity stocks.

The UN has implemented a series of important measures since the end of 1999 to remedy this situation. Contract approval procedures have already significantly improved following the implementation of Security Council Resolution 1284 (1999) which includes provisions for accelerated approvals of contracts for foodstuffs, as well as of basic or standard health, agricultural and educational supplies. These contracts no longer require to be submitted to the Security Council Sanctions Committee for approval, but rather are notified to the Secretary-General. Efforts have also been made, and should continue to be made, by the UN to make contract-processing procedures more efficient. Unless there is timely submission of applications by the Government of Iraq, efficient contract processing by the UN and opportune delivery of food imports under MOU contracts, shortfalls are likely to result in an increase in the frequency of not being able to meet food basket targets. Similarly, unless agricultural inputs, such as appropriate seeds, are delivered in time for the next season, a production recovery will not be achieved.

The effective nation-wide rationing system set up by the Government of Iraq in 1991 prevented famine but with the decline in the energy content of the GOI ration and the reduction in food available outside the rationing system, malnutrition and mortality of young children dramatically increased. The high levels of malnutrition documented by the 1995 mission were an important catalyst for the reaching of an agreement on the implementation of the Oil-for-Food Programme established through Security Council Resolution - SCR 986 in April 1995. Under the SCR 986 programme the distribution of humanitarian supplies to all the Iraqi population is undertaken by the Government of Iraq (GOI) in the centre/south and by the UN Inter-Agency Humanitarian Programme on behalf of the GOI, in the three northern Governorates. The subsequent increased humanitarian supplies provided under SCR 986 since 1997 and the high level of UN and NGO activity in the north arrested further nutrition decline.

Despite significant increases in the food ration since SCR 986, child malnutrition rates in the centre/south of the country do not appear to have improved significantly and nutritional problems remain serious and widespread. Wasting in under five-year-olds is unacceptably high at around 10%. The indication of high levels of malnutrition supports UN findings that infant and child mortality have more than doubled since the end of the 1980s. Classical recognisable signs of severe malnutrition such as marasmus and kwashiorkor continue to be observed in hospital paediatric wards. The nutritional status of school children aged 5-8 years based primarily on stunting and those aged 9-15 years based on low BMI is a cause for concern especially for those from rural areas and poor households. Micronutrient deficiencies are common and iron deficiency anaemia is high. In addition, the high rate of obesity in adults is a cause for concern with heart disease, hypertension and diabetes the major reported causes of death in adults.

The existing food rations do not provide a nutritionally adequate and varied diet. Although since their effective implementation in 1997 they have halted further deterioration in the nutritional situation, they have not by themselves been able to reverse this trend. In spite of the fact that the ration is reasonably adequate in energy and total protein, it is lacking in vegetables, fruit, and animal products and is therefore deficient in micronutrients. With only one quarter of the planned ration of pulses distributed due to gaps in the submission of applications for procurement, the protein quality of the diet has also been poor.

The monthly food basket lasts up to three weeks depending on the type of ration. This deficit has to be made up by food purchases, further straining resources. Many households cannot afford to supplement their diet with an adequate variety of non-ration foods and intakes of micronutrients such as iron and vitamin A remain far below requirements. Adequate amounts of items such as meat, milk and vegetables are too costly for many families to purchase to supplement their diet given the parallel decline in the economy and the effects of the current drought on the availability of crops and horticultural products. Consequently a significant portion of the population requires special attention, particularly the most vulnerable population groups whose coping strategies are quickly being eroded.

However it would appear that despite shortfalls in the ration, some segments of the population can supplement their diet with market purchases, albeit at considerable cost. While it is important to note that more information is needed on how households use the ration and acquire other needed foods in order for estimates of food consumption to be more reliable (as ration items may be sold/exchanged to acquire other items including foods not available in the ration), mission findings indicate that the combination of the average daily per person energy availability provided by the SCR 986 food ration combined with that obtained through complementary food purchases, results in a total per person energy availability of around 2,500 kcal/person/day. This is confirmed by the high prevalence of overweight in adults as more than half the adult population of Iraq is considered to have some degree of overweight.

In contrast the implementation of SCR 986 in the north of the country, where the United Nations Inter-Agency Humanitarian Programme is responsible for implementation on behalf of the GOI, has been accompanied by significant improvements in the nutritional situation. In children under five, wasting has almost been eliminated and there have been significant declines in the prevalence of stunting and underweight. Infant and child mortality rates have also fallen. Amongst the reasons for the north-centre/south differences are that the northern region is more self-sufficient in food, far greater assistance per capita has been received than the remainder of the country, and the north has benefited from the greater flexibility the use of cash gives agencies for the more effective operation and management of programmes. In addition, specific focus has been placed on enhancement of the food basket, targeted nutrition and food production, as well as growth promotion and the early detection of malnutrition among children under the age of five.

The mission recognises that malnutrition is often caused by factors other than those related to food. Poor water supply both in quality and quantity as well as inadequate sanitation are key causative factors of frequent and repeated infection resulting in infant and child malnutrition throughout the country. Infections in infants are often associated with the decline in breast-feeding, the too-early introduction of infant formula and an increase in bottle-feeding. Other important factors include the lack of general nutrition and health education, overcrowding and poverty. These factors have had more of a negative impact in the centre/south than in the north with the beneficial effects of increased family rations being offset by the combination of these adverse conditions.

Recommendations are provided by the mission for improving the food, health and nutrition situation in Iraq. These include accelerating the process of approval of SCR 986 contracts and ensuring the timely delivery of humanitarian imports including food, medicines and inputs for the rehabilitation of agriculture, particularly seeds and materials for water conservation, control and irrigation management. With poor water and sanitation a major cause of malnutrition and excessive morbidity and mortality, the mission considers the maintenance and rehabilitation of the water and sanitation system a priority for meeting basic needs.

Improving dietary intakes is another top priority. Recommendations include diversifying the food rations with protein and micronutrient rich foods such as pulses, vegetables, fruit, and animal products as well as providing additional complementary food for young children and fortifying wheat flour with iron and vegetable oil with vitamin A. Local production of foods for including in the ration as well as for use in special feeding programmes is proposed.

Given the harmful effects of the too early introduction of added fluids or milk to infants and the need to encourage breast-feeding, infant formula in the ration should be restricted to children 6 months and above. The resultant decline in infant food would be more than off-set by the proposed increases in complementary foods. Agencies and health professionals need to campaign vigorously to convince GOI and mothers to accept this. Advocacy with policy makers should be intensified, training and motivation of health workers as well as school teachers on best practices in health, food and nutrition should also be improved.

Supplementary and therapeutic feeding programmes which target the most vulnerable need strengthening and both GOI and donors are encouraged to provide increased support. The use of cash in centre/south Iraq to improve programme effectiveness is recommended similar to that currently enjoyed in the north. Support is also identified for the rehabilitation of the food industry and for improving food safety.

Other recommendations include support for nutrition and health services, in particular the rehabilitation of health services infrastructure, better information for monitoring the food, nutrition and health situation, and promoting appropriate diets, feeding practices and healthy lifestyles.

M A P

ACRONYMS AND ABBREVIATIONS

I. Introduction

An FAO/WFP/WHO Mission visited Iraq from 1 to 27 May 2000. The objective of the mission was to assess the current food supply and nutrition situation in the country, particularly after two consecutive years of drought, and to compare the results with the findings of the previous assessment missions of 1993, 1995 and 1997.

The Mission received full co-operation from the staff of the UN agencies (FAO, UNDP, UNICEF, WFP, WHO) based both in Baghdad and in the Northern Governorates as well as from the Government of Iraq which gave its support to the Mission. However obtaining reliable statistics from various ministries was difficult and information requested from Government was often lacking. Extensive travel was undertaken by the Mission in all areas of the country including the Northern Governorates, with visits to farms, warehouses, mills, schools, health facilities and urban and rural households. The mission reviewed available data on weather, crops, food supply, nutrition and health status from Governmental and United Nations sources including the extensive survey data from UNICEF on both nutrition and child mortality, and the routine observation of food deliveries by WFP.

In collaboration with the Nutrition Research Institute of the Ministry of Health, a household nutrition survey was conducted in urban and rural centres (Baghdad, Kerbala and Diala) to collect information on the nutritional status of children and adults, including qualitative data on food consumption. The survey collected data on 838 children under five years of age, 2,534 aged 5 to 19 years and 3,157 adults. A nutritional assessment was also conducted on more than 2,000 primary and intermediate schools students, with a sub-sample examined for clinical signs of malnutrition. Questions on foods purchased by households outside the 986 ration were added to the routine WFP observation of households receiving the food ration.

The multi-disciplinary nature of the inter-agency collaborative mission broadened the scope of the mission beyond that of 1997 and allowed for information to be collected on a larger sample than hitherto had been possible. Aspects which were considered include the food and agriculture sector along with an assessment of crop production in the light of the ongoing drought, the procurement and delivery of food, medical and other humanitarian supplies under SCR 986, and issues related to access to food, water and sanitation, health and nutritional status.

The mission members were:

• Peter L. Pellett, Emeritus Professor of Nutrition, University of Massachusetts, USA.

• Ezzat Khamis Amine, Dean, School of Public Health, University of Alexandria, Egypt.

• Alfred Zerfas, International Health Consultant, Rockville, Maryland, USA.

• Madhy M. Bamba, Global Information and Early Warning Service, FAO, Rome

• Omar Bula Escobar, Programme Coordinator, World Food Programme, Cairo, Egypt.

• Pieter Dijkhuizen, Senior Programme Advisor: Public Health and Nutrition, World Food Programme, Rome

• Zakir Husain, Medical Officer (consultant) World Health Organization, Baghdad, Iraq.

Assisting the Mission in Iraq:

• Radwan Abdul Halim. FAO National Programme Officer, Baghdad, Iraq.

• Muhammed Manzoor Khan, UNOCHI, Baghdad, Iraq

• Pushpa Acharya, WFP, Erbil, Iraq.

Assisting the Mission at FAO/HQ in Rome:

• Brian Thompson, Senior Officer, Food and Nutrition Division, FAO Rome.

• Shukri Ahmed, Economist, Global Information and Early Warning Service, FAO Rome

• Abdur Rashid, Chief, Global Information and Early Warning Service, FAO Rome

II. Crop Production and Food Availability

Food availability data for Iraq as reported by FAO Food Balance Sheets show a steep rise following the arrival of SCR 986 food supplies. Between 1991 and 1996 total dietary energy supplies had been about 2,250 kcal/person/day but rose to 2,396 kcal in 1997 and 2,419 kcal/person/day in 1998. This rise in dietary energy supplies was mirrored by that for protein availability, which rose from a low of 46 g/person/day in 1996 to 53 g/person/day in 1998. Substantial as this jump is, the foods available for consumption are still considerably below what they were prior to 1991.

Table II.1:    Energy, Protein and Fat Supply 1986-1998

Two consecutive years of severe drought and inadequate supply of essential agricultural equipment and inputs, including spare parts, fertilizers, pesticides and herbicides, have gravely affected the Iraqi agriculture sector. Reflecting a substantial reduction in plantings and yields, cereal production in 2000 is estimated by the Mission at a record low volume of 794,000 tons, some 47 percent down over last year's poor harvest and 64 percent below the previous five years average.

Table II.2:  Iraq: Area, Production and Yield of Cereal Crops, 1998-2000

a)  Iraq

b) Central / Southern Regions

c) Northern Governorates

Drought conditions started in the 1998-99 crop season, with total rainfall ranging from one half to a third of normal levels (between 28-126 mm) in central/southern parts of the country. As this was largely insufficient for crops to reach maturity, an estimated 70 percent (about 1.0 million ha) of wheat and barley crops in the rainfed zones failed to germinate. Similarly in the irrigated areas, more than 100,000 ha suffered crop losses due to irrigation water rationing and continuing power cutoffs. In the most affected centre/south areas, not only were the plantings reduced, but also some 75 percent of the cropped area under wheat and barley was heavily damaged and mostly used as grazing area for livestock. Conditions were also inadequate in the northern Governorates with insufficient and erratic rainfall during much of the season. Dry conditions continued during much of the 1999/2000 crop season, with only one-third of the normal rainfall received in most of the center/south and in parts of the three northern Governorates.

Drought conditions also drastically reduced the water resources in rivers, dams, lakes and canals, some of which have virtually dried up. The Tigris River is reported to be flowing at 40% of its normal flow and the Euphrates also has very low water levels. Under the prevailing drought conditions and the limited availability of irrigation water, the area to be planted under rice and maize in the upcoming summer season (May-September), is expected to be seriously reduced. Farmers have been advised to use the scarce water supplies primarily for human consumption and livestock, and for the preservation of existing orchards.

The production of other foodcrops has also been adversely affected by the drought. In view of the limited availability of irrigation water, the area planted to vegetables in 2000 is expected to be reduced to 400,000 ha in the center/south, compared to 500,000 ha in 1997. The decrease also reflects limited supply of agricultural machinery, seeds, fertilizers, and pesticides. Total production of vegetables is estimated at 1 million tons, 33 percent below the 1997 level. In the northern Governorates where conditions have been relatively better, area planted to vegetables is expected to increase to about 48,000 ha in 2000 as against 42,000 ha in 1998 but production may decrease to 240,000 tons as against 300,000 tons on account of water rationing.

This year's fruit production in the country is estimated at 1.3 million tons (1.0 million tons from the center/south and 0.3 million tons from the northern Governorates). This is 13 percent below the 1997 level, a result of the combined effect of drought and difficulties to maintain productivity. In recent years, replacement of missing trees and establishment of new orchards have become virtually impossible and old parent stocks are being lost. The production of dates is estimated at about 600,000 tons, slightly below the 1997 level. The sector benefited from aerial sprayings provided under FAO supervision in the No-Fly zones of Iraq to combat crop pest on rainfed wheat and barley, date palms and sugar cane despite constraints related to the timely availability of spraying materials.

Although there are no reliable estimates of livestock numbers, the recent countrywide campaign against foot-and-mouth-disease estimated the animal population in 2000 at 14 million head. This is some 50 percent over the 1997 level but remains below the 1986-90 average size of 15.8 million head. Differences with earlier estimates may be explained by differences in evaluation methods. Some 9.5 million head are now accounted for in the centre/south against 4.5 million head in the northern Governorates. Shortage of imported feedstuffs, overgrazing and inadequate veterinary services have been major constraints to the normal development of the livestock sector.

Notable progress has been made since 1998 in the rehabilitation of the poultry sector which has benefited from substantial Government interventions with funds generated from the oil-for-food deal. Poultry industries are currently operating in most Governorates and production is rapidly increasing for both poultry meat and eggs, as illustrated by a 40 percent drop in market prices between 1998 and 2000. The sector is also rapidly expanding in the northern Governorates with about 430 farms currently in operation compared to 25 farms prior to the embargo. There are also 13 hatcheries and 5 slaughterhouses now functioning compared to only one and 5 respectively, a few years ago.

A 1998 fishery survey conducted by the Government with FAO assistance indicated that out of 1,016 fish farms listed across the country, only 22 percent were still fully operational, 17 percent were partially operational and 61 percent were no longer operational. In addition, under the current general condition of sanctions and economic difficulties faced by the country, only one hatchery is now partially operating from 18 hatcheries operating before the embargo. Marine fishery has also been facing a general lack of suitable diesel engines, spare parts, boats and fishing nets.

Due to restrictions in the country’s capacity to acquire foreign exchange and import food commercially, there have been attempts to boost domestic food production to meet the country’s food needs. These have been compromised by inadequate supply of agricultural equipment and inputs, including spare parts, fertilizers, pesticides and herbicides. The situation has been exacerbated by two consecutive years of drought, which has further constrained food production.

The sharp decline in cereal production this year strongly underlines the importance of timely food imports under SCR 986. While the size of Government stocks was not provided by the GOI, two consecutive years of drought-induced shortfalls in domestic cereal production suggest a reduced stock level in Government warehouses. Furthermore, considering the need for distributing, under the MOU, an average monthly amount of 250,000 tons of wheat and 60 000 tons of rice across the country, an examination of stock levels for these and other products points to frequent low MOU stock levels in recent months. By most accounts, the procedures for contracting and approval of MOU commodities is rather slow and cumbersome, partly because of the absence of standard commercial penalty clauses in the contracts. This has at times affected the quality of both the products and the services delivered. Although no serious supply shortages have so far surfaced, partly due to borrowing arrangements with the Government, the situation is unlikely to be sustained due to low stocks and serious shortfall in cereal production. Therefore, there is need to ensure urgent and timely delivery of imports under MOU contracts.

Under the current conditions of drought-reduced production and assuming no changes in overall stock levels, the projected level of imports for 2000/01 could allow a per person cereal food use of 172 kg/year. This is 42 percent higher than the 1995/96 level, prior to the oil-for-food deal, but remains 4 percent below the 1997/98 level and 10 percent below the average for 1984/85-1988/89. This suggests that cereal imports under the oil-for-food deal have led to significant improvements in the food supply situation but per person cereal food consumption remains below the pre-1990 levels and may even be deteriorating compared to 1997/98.

Table II.3: Iraq - Cereal Balance Sheet for 1984/85 to 1988/89, 1995/96, 1997/98 and 2000/01 (‘000 tons)

The drought-reduced harvests also suggest that local availability of quality seeds will pose a serious problem for the next growing season. It is therefore also important to ensure that adequate quantities of appropriate seeds are available on time for the next season, failing which a production recovery will not be achieved.

Since the implementation of SCR 986, market prices of food products such as wheat flour, rice, vegetable oil and sugar which are part of the food ration, dropped significantly at the beginning of the programme and have remained generally low. However, market prices of commodities not included in the ration continued to be high and above the means of a large section of the population with low purchasing power. As a result of the collapse of personal incomes and very low salary levels, particularly in the public sector, the effective demand for food products not included in the SCR 986 ration, particularly meat and vegetable products, is sharply reduced. This has serious consequences for the nutritional well being of the population, especially for children and other vulnerable population groups.

Food Industry

The food industry has been in decline since 1991 when most of the factories were closed due to lack of hard currency for importing new machinery, spare parts, raw materials and other supplies. The industry has shown some resurgence since the signing of the MOU in 1996 when the Government lifted restrictions on the manufacture of products using sugar. Shops and manufacturing outlets started to produce Arabic sweets, biscuits and chocolate bars, juices, soft drinks, jams, jelly, and ice-cream. Many of these products are manufactured using outdated equipment and low quality ingredients, often under poor hygienic and sanitary conditions, that threaten the health of the consumer. Lack of power supply, water availability and sewerage disposal has further limited the development of a safe food industry.

Food control officials have been unable to adequately enforce food quality and safety regulations and standards. FAO is providing assistance in this area but more is needed to be done to rehabilitate the food industry and strengthen food control to enhance consumer safety and meet consumer needs. Initial support should be provided for the local production of processed foods under SCR 986 such as high protein biscuits or suitable weaning or complementary foods that could be used in child feeding programs or for enhancing the general ration.

While the GOI is concerned that some of the commodities sent to Iraq may not be in conformity with Iraqi standards, international food quality standards are also often not fully adhered to. The lack of trained government food quality inspectors and of adequate materials and equipment for proper testing makes verification difficult. The mission was informed that FAO and WFP were in the process of hiring a food quality consultant to look into this and other food quality issues, as the matter has been gaining increased relevance in the context of vulnerable group food assistance.

III. Food Sector

1. SCR 986

On 14 April 1995, the UN adopted Security Council Resolution 986 (SCR 986), allowing Iraq to export oil and use the proceeds to arrest the deterioration of the humanitarian situation in Iraq, in particular with regard to nutrition and health. On 20 May 1996, the Memorandum of Understanding (MOU) was signed between the Secretariat of the United Nations and the Government of Iraq, establishing the framework for SCR 986 implementation. The distribution of humanitarian supplies was undertaken by the Government of Iraq (GOI) in the centre/south and by the United Nations Inter-Agency Humanitarian Programme in the three northern Governorates on behalf of the GOI.

The programme is implemented in phases, each phase lasting a period of 6 months. The programme’s first phase was implemented during the first half of 1997. At the time of the mission, the programme was in its seventh phase. The purchase and distribution of food, humanitarian supplies and equipment are made within the framework of Distribution Plans (DPs) for each phase, submitted by the Government and approved by the UN Secretary-General. The composition of the food ration is set for each phase as a function of recommended nutritional levels, food pipeline prospects and in-country food stock availability. All Iraqi citizens are entitled to a monthly food ration for which they pay a nominal fee of ID 250 (US 12 cents) to the GOI.

Allocation for the food sector rose from US$ 870 million under DPs I – III, to US$ 1.018 billion under DP VI. A total amount of US$ 5.44 billion was allocated to the food sector under DPs I – VI for the purchase and delivery of basic food commodities, toilet soap and detergent. The food allocation for DP VII approved on 9 June 2000 is US$ 1.05 billion for the center/south and an additional US$ 152 million for the north. Phase VII commodities had not yet reached Iraq at the time of the mission. As at 30 April 2000, a cumulative total quantity of 14.7 million tons of food items, valued at US$ 4.9 billion was recorded as having been delivered to Iraq. In dollar terms this amount represents around 75% of the planned quantity.

Upon its inception, SCR 986 distributions were erratic, covering about 80% of the planned items in the ration in the first half of 1997. Since mid-1997 up to Phase VII, monthly distributions improved to cover about 95% of the target¹. However despite improvements in performance in covering the GOI monthly requirements, food basket targets were fully met in only 6 out of 38 monthly distribution cycles. In fact resource allocation was only adequate during DP VI due to increase in oil revenue as a result of increasing oil prices. Main reasons for shortfalls since 1997 have been delayed submission of contract applications for some items of the food basket by the GOI, delays in the processing of contracts by the UN and untimely delivery of goods by suppliers to Iraq. Delays in opening of Letters of Credit by the Banque Nationale de Paris have reportedly affected the delivery of goods by suppliers to Iraq, given international price variations during the period of contract processing and release. The absence of any performance guarantees in the contracts as to ensure the supplier’s commitment to timely delivery of commodities has also had a bearing on food availability. While the Government of Iraq, from its alternative resources, has contributed cereals and other commodities, on a loan basis, to cover the shortfalls of the 986 food basket, the UN has implemented a series of measures since the end of 1999 to remedy this situation and has called upon the GOI to expedite applications for the procurement of humanitarian items.

Nutritional Content of the SCR 986 Food Ration

Prior to embarking in an analysis of the nutritional content of the SCR 986 food ration, an important distinction must be made between the different ration scales and the corresponding nutritional levels referred to within the context of SCR 986. Firstly, there is the Secretary General’s recommended nutritional level, which, based on the advice of UN nutritional experts, stands at 2,463 kcal/person/day and 63.6 g of protein/person/day since 1998.

The second level pertains to the previously referred to Distribution Plans and constitutes a planning level, calculated on the basis of forecasts of food imports and availability of in-country food stocks. This level, and the corresponding ration composition, are set in the process of submission of each DP by the GOI and its subsequent approval by the Secretary-General. DP levels in the first three phases of SCR 986 were 2,030 kcal/person/day and 47 g protein/person/day and reached 2,330 kcal/person/day and 52.5 g protein/person/day in Phase VII.

The third level is the one set by the GOI on a monthly basis, adjusted as a function of available monthly in-country stocks. The composition of the monthly food ration to meet the pre-determined nutritional level is announced publicly by the GOI through national the media prior to the beginning of monthly distributions. The GOI determined level is usually lower than the DP planned level (see figures and tables below). As an example, the level announced by the GOI for the month of March 2000 was 1,994 kcal/person/day and 42.8 g protein/person/day compared to the DPs 2,330 kcal/person/day and 52.5 g protein/person/day.

The energy content of the GOI ration in the pre-SCR 986 period of 1996 was calculated at 1,295 kcal/person/day. Since the implementation of the SCR 986 programme, the intake of energy and protein increased steadily, reaching an average of 2,000 kcal/person/day and 43.3 g protein/person/day in Phases IV through VI. The most recent data are for Phase VII under which 2,199 kcal and 48.2 g of protein per person were distributed. While these figures and the above–mentioned shortfalls may suggest a lower-than-projected nutritional intake (considering also the WHO recommended level of 2,210 kcal/person/day for emergency energy requirements), mission findings indicate that some segments of the population supplement their diet with market purchases. Indeed, the combination of the average daily per person energy availability provided by the SCR 986 food ration with that obtained through complementary food purchases, results in a total per person energy availability per day of around 2,500 kcal (see Household Nutrition Survey - section IV.2). This is confirmed by the high prevalence of overweight in adults as more than half the adult population of Iraq is considered to have some degree of overweight. Although only a nominal fee of ID 250 (US 12 cents) per person is paid to the GOI for the ration, for those who are too poor to supplement the ration from other sources, nutritional problems continue.

Of great concern is the the lack of a number of important vitamins and minerals such as vitamin A, C, riboflavin, folate and iron in the diet. Although the planned ration is reasonably adequate in energy and total protein, it is lacking in vegetables, fruit, and animal products and is therefore deficient in micronutrients (see section IV on micronutrient deficiencies).

The protein content of the ration has reached neither the planned SCR 986 DP ration levels nor that recommended by the Secretary-General. However with additional protein obtained from foods purchased outside the 986 ration estimated at 17 g protein/person/day, this brings the total availability to around 60 g protein/person/day, a level just below those recommended by the Secretary-General. Nonetheless, the high cost of protein-rich foods and the general lower-than-projected protein levels provided by the 986 ration imply the need to be vigilant and act upon ensuring the adequate provision of protein to the population. Reduced amounts of pulses and dairy products in the monthly food basket were the main contributing factors for the shortfalls in the targeted nutritional values. Amongst the main reasons for this reduced provision is the non-submission of applications for the purchase of pulses by GOI during a nine month period, applications having only resumed in late September 1999.

Figures III.1 and III.2 illustrate daily per person energy and protein availability provided by the 986 food ration compared with the Distribution Plan levels, the Secretary-General’s recommended levels and total availability including average supplementary energy and protein obtained from market food purchases. Tables III.1-3 and Figure III.3 show the composition of the planned food ration under the public rationing system since 1991.

Table III.1:

Table III.2:

DP Planned Ration vs. GOI Announced Ration per Phase