ﻤﻨﻅﻤـﺔ ﺍﻟﺼﺤـﺔ ﺍﻟﻌﺎﻟﻤﻴـﺔ ﺝ٧/٥٩ ٤ﺃﻴﺎﺭ /ﻤﺎﻴﻭ ٢٠٠٦ A59/7
ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﺘﺎﺴﻌﺔ ﻭﺍﻟﺨﻤﺴﻭﻥ ﺍﻟﺒﻨﺩ ٣-١١ﻤﻥ ﺠﺩﻭل ﺍﻷﻋﻤﺎل ﺍﻟﻤﺅﻗﺕ
ﺍﻟﺘﻐﺫﻴﺔ ﻭﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﺘﻘﺭﻴﺭ ﻤﻥ ﺍﻷﻤﺎﻨﺔ ﺤﺙ ﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ ١٤-٥٧ﺍﻟﺩﻭل ﺍﻷﻋﻀﺎﺀ ﻋﻠﻰ ﺃﻥ ﺘﻘﻭﻡ ،ﻋﻠﻰ ﺴﺒﻴل ﺍﻷﻭﻟﻭﻴﺔ ،ﺒﻤﺘﺎﺒﻌـﺔ ﺍﻟـﺴﻴﺎﺴﺎﺕ -١ ﻭﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﺍﻟﺘﻲ ﺘﻌﺯﺯ ،ﻓﻴﻤﺎ ﺘﻌﺯﺯﻩ ،ﺇﺩﺭﺍﺝ ﺍﻟﺘﻐﺫﻴﺔ ﻀﻤﻥ ﺍﻻﺴﺘﺠﺎﺒﺔ ﺍﻟـﺸﺎﻤﻠﺔ ﻟﻸﻴـﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ. ﻭﺃﻋﺭﺏ ﺍﻟﻤﺠﻠﺱ ﺍﻟﺘﻨﻔﻴﺫﻱ ،ﺇﺒﺎﻥ ﻤﻨﺎﻗﺸﺔ ﻤﻭﻀﻭﻉ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ،ﻓﻲ ﺩﻭﺭﺘﻪ ﺍﻟـﺴﺎﺩﺴﺔ ﻋـﺸﺭﺓ ﺒﻌـﺩ ﺍﻟﻤﺎﺌﺔ ،ﻋﻥ ﺩﻋﻤﻪ ﻟﻠﺘﻭﺼﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﻼﺯﻤﺔ ﻭﺍﻟﺘﻲ ﺃﺼﺩﺭﺘﻬﺎ ﺍﻟﻤﺸﺎﻭﺭﺓ ﺍﻟﺘﻘﻨﻴﺔ ﺍﻟﺘﻲ ﻋﻘﺩﺘﻬﺎ ﺍﻟﻤﻨﻅﻤﺔ ﻓﻲ ﺃﻓﺭﻴﻘﻴﺎ ﺒﺸﺄﻥ ﺍﻟﺘﻐﺫﻴﺔ ﻭﺍﻷﻴﺩﺯ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ )ﺩﻭﺭﺒﺎﻥ ،ﺠﻨﻭﺏ ﺃﻓﺭﻴﻘﻴﺎ ١٣-١٠ ،ﻨﻴﺴﺎﻥ /ﺃﺒﺭﻴل ١.(٢٠٠٥ ﻨـﺎﺕ ﺍﻟﻌﻠﻤﻴـﺔ ﺒـﺸﺄﻥ ﻭﺍﺴﺘﻨﺩﺕ ﺘﻠﻙ ﺍﻟﺘﻭﺼﻴﺎﺕ ﺇﻟﻰ ﺃﻫﻡ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﺘﻲ ﺨﻠﺹ ﺇﻟﻴﻬﺎ ﺍﺴﺘﻌﺭﺍﺽ ﻤﻔﺼل ﻷﺤﺩﺙ ﺍﻟﺒﻴ ﺍﺤﺘﻴﺎﺠﺎﺕ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﺍﻷﻴﺩﺯ ﻤﻥ ﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﻜﺒﻴﺭﺓ ﺍﻟﻤﻘﺩﺍﺭ ﻭﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﻤﻘﺩﺍﺭ ،ﻭﻤـﻨﻬﻡ ﺍﻟﺤﻭﺍﻤـل ل ﻋﻥ ﺍﻷﻴـﺩﺯ ﺍ ﻟﻠﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻘﻬﻘﺭﻴﺔ .ﻭﻓﻲ ﻤﺅﺘﻤﺭ ﺩﻭﻟﻲ ﻤﻜﻤ ﺎ ﻤﻀﺎﺩﹰ ﻭﺍﻟﻤﺭﻀﻌﺎﺕ ﻭﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻴﺘﻠﻘﻭﻥ ﻋﻼﺠﹰ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻟﻐﺫﺍﺀ ﻭﺍﻷﻤﻥ ﺍﻟﻐﺫﺍﺌﻲ )ﺩﻭﺭﺒﺎﻥ ،ﺠﻨﻭﺏ ﺃﻓﺭﻴﻘﻴﺎ ١٦-١٤ ،ﻨﻴﺴﺎﻥ /ﺃﺒﺭﻴـل ،(٢٠٠٥ﻋﻘـﺩﻩ ﻨﺎﺕ ﺍﻟﺘﻲ ﺒﺩﺃﺕ ﺘﺘﺯﺍﻴـﺩ ﺒـﺸﺄﻥ ﺍﻟﻤﻌﻬﺩ ﺍﻟﺩﻭﻟﻲ ﻟﺒﺤﻭﺙ ﺴﻴﺎﺴﺎﺕ ﺍﻷﻏﺫﻴﺔ ﻓﻭﺭ ﺍﻨﺘﻬﺎﺀ ﺍﻟﻤﺸﺎﻭﺭﺓ ،ﺘﻡ ﺍﺴﺘﻌﺭﺍﺽ ﺍﻟﺒﻴ ﺍﻟﺼﻼﺕ ﺒﻴﻥ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻷﻤﻥ ﺍﻟﻐﺫﺍﺌﻲ ﻭﺁﺜﺎﺭﻫﺎ ﻋﻠﻰ ﺘﺨﻁﻴﻁ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺒﺭﺍﻤﺞ. ﺎ ﻟﻸﻨﺸﻁﺔ ﺍﻟﻭﻁﻨﻴﺔ ﻭﺍﻹﻗﻠﻴﻤﻴﺔ ﻭﺍﻟﺩﻭﻟﻴﺔ ﺍﻟﻤﺘﺨﺫﺓ ﻓﻴﻤﺎ ﻴﺨﺹ ﺍﻟﺘﻐﺫﻴﺔ ﻭﺍﻷﻴـﺩﺯ ﻭﺘﻭﺭﺩ ﺍﻟﻔﻘﺭﺍﺕ ﺍﻟﺘﺎﻟﻴﺔ ﺸﺭﺤﹰ -٢ ﺫﻟﺕ ﻓﻲ ﻫﺫﺍ ﺍﻟﻤﺠﺎل ﻤﻨﺫ ﺃﻴﺎﺭ /ﻤﺎﻴﻭ .٢٠٠٤ﻭﻟﻘـﺩ ﺘﻌـﺯﺯﺕ ﻫـﺫﻩ ﺎ ﻟﻠﺠﻬﻭﺩ ﺍﻟﺘﻲ ﺒ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺘﻭﻀﻴﺤﹰ ﺍﻷﻨﺸﻁﺔ ﺒﻔﻀل ﺍﻟﺘﻭﺼﻴﺎﺕ ﺍﻟﺼﺎﺩﺭﺓ ﻋﻥ ﻤﺸﺎﻭﺭﺓ ﺩﻭﺭﺒﺎﻥ ﻭﻤﻨﺎﻗﺸﺎﺕ ﺍﻟﻤﺠﻠﺱ ﺍﻟﺘﻨﻔﻴﺫﻱ ،ﻭﺍﻟﺘـﻲ ﺸـﻜﻠﺕ ﻗﺎﻋـﺩﺓ ﻟﺘﺤﺩﻴﺩ ﺃﻭﻟﻭﻴﺎﺕ ﺍﻟﻌﻤل ﻭﺭﺴﻡ ﺨﻁﻁﻪ ﻟﺘﺴﺘﺭﺸﺩ ﺒﻬﺎ ﺃﻋﻤﺎل ﺍﻟﻤﻨﻅﻤﺔ ﻓﻲ ﻫﺫﺍ ﺍﻟﻤﺠﺎل. ﺎ ﺒﻨﻁﺎﻕ ﺍﻟﻌﻤل ﻭﺒﺎﻟﺘﻘﺩﻡ -٣ ﻭﻨﺎﻗﺵ ﺍﻟﻤﺠﻠﺱ ﺍﻟﺘﻨﻔﻴﺫﻱ ﺍﻟﺘﻘﺭﻴﺭ ﻓﻲ ﺩﻭﺭﺘﻪ ﺍﻟﺴﺎﺒﻌﺔ ﻋﺸﺭﺓ ﺒﻌﺩ ﺍﻟﻤﺎﺌﺔ ﻭﺃﺤﺎﻁ ﻋﻠﻤﹰ ﺍﻟﻤﺤﺭﺯ ﻓﻲ ﻫﺫﺍ ﺍﻟﻤﺠﺎل٢. ﺍ ﻟﻌﺩﻡ ﻭﺠﻭﺩ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻟﻤﻌﺎﻟﺠﺔ ﺃﺜﺭ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻋﻠـﻰ ﺍﻟﺩﻋﻡ ﺍﻟﺘﻘﻨﻲ ﻭﺍﻟﺒﺭﻤﺠﻲ .ﻨﻅﺭﹰ -٤ ﺍﻟﻐﺫﺍﺀ ﻭﺍﻷﻤﻥ ﺍﻟﻐﺫﺍﺌﻲ ،ﺘﺘﻌﺎﻭﻥ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻵﻥ ﻤﻊ ﺴﺎﺌﺭ ﻤﺅﺴﺴﺎﺕ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻭﻋﺩﺩ ﻤﻥ ﺍﻟﺸﺭﻜﺎﺀ ﺍﻟﻤﻌﻨﻴﻴﻥ ﻤﻥ ﺃﺠل ﺇﺘﺎﺤﺔ ﺍﻟﻔﺭﺹ ﺃﻤﺎﻡ ﺍﻟﺩﻭل ﺍﻷﻋﻀﺎﺀ ﻟﺼﻭﻍ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺭﺴﻡ ﺍﻟﺨﻁﻁ ﺍﻟﻘﻁﺎﻋﻴﺔ ﺍﻟﺸﺎﻤﻠﺔ ﺒـﺸﺄﻥ ﹸﻅﻤﺕ ﺤﻠﻘﺎﺕ ﻋﻤﻠﻴﺔ ﺘﺩﺭﻴﺒﻴﺔ ﺍﻟﻐﺫﺍﺀ ﻭﺍﻟﺘﻐﺫﻴﺔ ﻭﺘﻌﺯﻴﺯﻫﺎ ﻭﺘﻨﻔﻴﺫﻫﺎ ﺒﻐﺭﺽ ﻤﻌﺎﻟﺠﺔ ﺃﺜﺭ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ .ﻭﻨ ﻓﻲ ﺍﻹﻗﻠﻴﻡ ﺍﻷﻓﺭﻴﻘﻲ ﻭﺇﻗﻠﻴﻡ ﺠﻨﻭﺏ ﺸﺭﻕ ﺁﺴﻴﺎ ﻭﻤﻨﻁﻘﺔ ﺸﺭﻕ ﺍﻟﻤﺤﻴﻁ ﺍﻟﻬﺎﺩﺉ. ١ﺍﻨﻅﺭ ﺍﻟﻭﺜﻴﻘﺘﻴﻥ ﻡ ﺕ ١٢/١١٦ﻭﻡ ﺕ /٢٠٠٥ /١١٦ﺴﺠﻼﺕ ،١ /ﺍﻟﻤﺤﻀﺭ ﺍﻟﻤﻭﺠﺯ ﻟﻠﺠﻠﺴﺔ ﺍﻟﺜﺎﻨﻴﺔ )ﺍﻟﻨﺹ ﺍﻹﻨﻜﻠﻴﺯﻱ(.
٢ﺍﻨﻅﺭ ﺍﻟﻭﺜﻴﻘﺔ ﻡ ﺕ /٢٠٠٦ /١١٧ﺴﺠﻼﺕ ،٢ /ﺍﻟﻤﺤﻀﺭ ﺍﻟﻤﻭﺠﺯ ﻟﻠﺠﻠﺴﺔ ﺍﻟﺭﺍﺒﻌﺔ )ﺍﻟﻨﺹ ﺍﻹﻨﻜﻠﻴﺯﻱ(.
A59/7
ﺝ٧/٥٩
ﻭﻜﺠﺯﺀ ﻤﻥ ﺴﻠﺴﻠﺔ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﻤﻌﺎﻟﺠﺔ ﻭﺍﻟﺩﻋﻡ ﻟﻠﻨﺴﺎﺀ ﺍﻟﻤﺘﻌﺎﻴﺸﺎﺕ ﻤﻊ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ ﻓـﻲ -٥ ﺍﻟﺒﻴﺌﺎﺕ ﺍﻟﺸﺤﻴﺤﺔ ﺍﻟﻤﻭﺍﺭﺩ ،ﺼﺩﺭ ﻓﻲ ﻋﺎﻡ ٢٠٠٤ﺩﻟﻴل ﻋﻥ ﺘﻐﺫﻴﺔ ﺍﻟﻨﺴﺎﺀ ﻭﺃﻁﻔﺎﻟﻬﻥ ﻤﻥ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ١.ﻭﻗﺩﻤﺕ ﻓﺭﻗﺔ ﺍﻟﻌﻤل ﺍﻟﻤﺸﺘﺭﻜﺔ ﺒﻴﻥ ﺍﻟﻭﻜﺎﻻﺕ ﺍﻟﻤﻌﻨﻴﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻤـﻥ ﺍﻟﺤﻭﺍﻤـل ﻀﻊ ﻓﻲ ﻋﺩﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻷﻓﺭﻴﻘﻴﺔ .ﻭﺴـﺎﻫﻤﺕ ﺎ ﺒﺸﺄﻥ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻐﺫﻴﺔ ﺍﻟﺭ ﺎ ﺘﻘﻨﻴﹰ ﻭﺍﻷﻤﻬﺎﺕ ﺇﻟﻰ ﺍﻷﻁﻔﺎل ﺩﻋﻤ ﹰ ﺍﻟﻤﻨﻅﻤﺔ ،ﻓﻲ ﻋﺎﻡ ،٢٠٠٤ﺒﺘﻘﺩﻴﻡ ﻤﺩﺨﻼﺕ ﻟﻠﺘﻭﺠﻴﻪ ﺍﻟﻌﻤﻠﻲ ﺒﺸﺄﻥ ﺇﺩﺭﺍﺝ ﺒﺭﺍﻤﺞ ﺨﺎﺼﺔ ﺒﺎﻟﻐﺫﺍﺀ ﻭﺍﻟﺘﻐﺫﻴﺔ ﻓﻲ ﺃﻨﺸﻁﺔ ﺩﻋﻡ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻓﻲ ﺃﻭﺴﺎﻁ ﺍﻟﻼﺠﺌﻴﻥ ﻭﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﺘﻲ ﺘﺴﺘﻘﺒﻠﻬﻡ .ﻭﺘﻡ ﻭﻀـﻊ ﻭﺤـﺩﺓ ﻨﻤﻭﺫﺠﻴﺔ ﺘﺩﺭﻴﺒﻴﺔ ﻋﻥ ﺘﻐﺫﻴﺔ ﺍﻟﺭﻀﻊ ﻓﻲ ﺤﺎﻻﺕ ﺍﻟﻁﻭﺍﺭﺉ ،ﻭﺫﻟﻙ ﻟﺘﺩﺭﻴﺏ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﻐﺫﻴﺔ ،ﻭﺍﻟﺫﻱ ﻴﺸﻤل ﻱ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ. ﺨﻴﺎﺭﺍﺕ ﻟﺘﻐﺫﻴﺔ ﺍﻟﺭﻀﻊ ﻓﻲ ﺒﻴﺌﺎﺕ ﺘﺘﻴﺴﺭ ﻓﻴﻬﺎ ﻭﺴﺎﺌل ﺘﺤﺭ -٦ ﻭﻗﺎﻡ ﻋﺩﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻷﻓﺭﻴﻘﻴﺔ ﺒﺘﺤﺩﻴﺙ ﺃﻭ ﻭﻀﻊ ﺩﻻﺌل ﺒﺸﺄﻥ ﺍﻟﺘﻐﺫﻴﺔ ﻭﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ،ﻭﺫﻟﻙ ﺒﺎﻻﺴﺘﻔﺎﺩﺓ ﻤﻥ ﻨﺘﺎﺌﺞ ﺍﻟﻤﺸﺎﻭﺭﺓ ﺒﺸﺄﻥ ﺍﺤﺘﻴﺎﺠﺎﺕ ﺍﻟﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻷﻴـﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ ﻤـﻥ ﺍﻟﻤﻐـﺫﻴﺎﺕ٢ ﻭﺘﻭﺼﻴﺎﺕ ﻤﺸﺎﻭﺭﺓ ﺩﻭﺭﺒﺎﻥ .ﻭﺃﺼﺩﺭﺕ ﻜﻴﻨﻴﺎ ﺩﻻﺌل ﻟﻔﺎﺌﺩﺓ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺇﻴﺘﺎﺀ ﺍﻟﺨﺩﻤﺎﺕ ﻓﻲ ﺍﻟﺨﻁﻭﻁ ﺍﻷﻤﺎﻤﻴﺔ ﻓﻲ ﻗﻁﺎﻋﺎﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺯﺭﺍﻋﺔ ﻭﺍﻟﺘﻌﻠﻴﻡ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ. -٧ ﻭﻗﺩ ﻨﻅﻡ ﻓﻲ ﺁﺫﺍﺭ /ﻤﺎﺭﺱ ٢٠٠٦ﺍﺠﺘﻤﺎﻉ ،ﺒﺎﻟﺘﻌﺎﻭﻥ ﻤﻊ ﺍﻟﺼﻨﺩﻭﻕ ﺍﻟﻌﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤـﺔ ﺍﻷﻴـﺩﺯ ﻭﺍﻟـﺴل ﺍ ﻤﻥ ﻤﻘﺘﺭﺤﺎﺕ ﺍﻟﺘﻤﻭﻴل ﺍﻟﻭﻁﻨﻴﺔ. ﻭﺍﻟﻤﻼﺭﻴﺎ ،ﺍﺠﺘﻤﺎﻉ ﻋﻥ ﺍﻟﺘﻐﺫﻴﺔ ﺒﺎﻋﺘﺒﺎﺭﻫﺎ ﻋﻨﺼﺭﹰ ﻭﺴﺘﺸﺎﺭﻙ ﺍﻟﻤﻨﻅﻤﺔ ﻤﻊ ﻭﻜﺎﻻﺕ ﺃﺨﺭﻯ ﻓﻲ ﺘﻘﻴﻴﻡ ﺍﻟﺩﻻﺌل ﺍﻟﺘﻘﻨﻴﺔ ﺍﻟﺤﺎﻟﻴﺔ .ﻭﻤﻥ ﺍﻟﺜﻐﺭﺍﺕ ﺍﻟﺘﻲ ﺘﻡ ﺍﻟﺘﻌـﺭﻑ -٨ ﻋﻠﻴﻬﺎ ﺤﺘﻰ ﺍﻵﻥ ﻋﺩﻡ ﻭﺠﻭﺩ ﺩﻻﺌل ﻟﻠﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻤﺘﻭﺴﻁ ﺒﺸﺄﻥ ﺭﻋﺎﻴـﺔ ﺍﻟﺘﻐﺫﻴـﺔ ﻭﺩﻋﻤﻬـﺎ ﻟﻠﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ؛ ﻭﻟﻠﺘﺩﺒﻴﺭ ﺍﻟﻐﺫﺍﺌﻲ ﻓﻲ ﺍﻟﻤﺴﺘﺸﻔﻴﺎﺕ ﻟﻠﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴـﺩﺯ، ﻭﺨﺎﺼﺔ ﺍﻷﻁﻔﺎل ﻤﻨﻬﻡ ،ﻭﻟﺩﻋﻡ ﺍﻟﺘﻐﺫﻴﺔ ﻓﻲ ﺤﺎﻻﺕ ﺍﻟﻁﻭﺍﺭﺉ ﻟﻠﺴﻜﺎﻥ ﺍﻟﺫﻴﻥ ﺘﺭﺘﻔﻊ ﻤﻌﺩﻻﺕ ﺘﻔﺸﻲ ﻓﻴﺭﻭﺱ ﺍﻷﻴـﺩﺯ ﺒﻴﻨﻬﻡ؛ ﻭﺃﺩﻭﺍﺕ ﺍﻟﺘﻘﻴﻴﻡ ﻭﺍﻟﺩﻋﻡ ﺍﻟﻤﺒﺴﻁﺔ ﻟﻠﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴـﺩﺯ؛ ﻭﻋﺩﻡ ﻭﺠﻭﺩ ﺘﻭﺼﻴﺎﺕ ﺒﺸﺄﻥ ﺘﺩﺒﻴﺭ ﺴﻭﺀ ﺍﻟﺘﻐﺫﻴﺔ ﺍﻟﺤﺎﺩ ﻓﻲ ﺇﻁﺎﺭ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﻤﺤﻠﻴﺔ ،ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺘﻐﺫﻴﺔ ﺍﻷﻁﻔـﺎل ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ .ﻭﺘﺘﻌﺎﻭﻥ ﺍﻟﻤﻨﻅﻤﺔ ﻤﻊ ﺒﺭﻨﺎﻤﺞ ﺍﻷﻏﺫﻴﺔ ﺍﻟﻌﺎﻟﻤﻲ ﻋﻠﻰ ﻭﻀﻊ ﻨﻬﺞ ﻟﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﻭﻨﺔ ﺍﻟﻐﺫﺍﺌﻴﺔ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﻌﻼﺝ ﻟﻐﺭﺽ ﺘﻤﻜﻴﻥ ﻤﻭﻅﻔﻲ ﺍﻟﺒﺭﻨﺎﻤﺞ ﺍﻟﻌـﺎﻟﻤﻲ ﻤـﻥ ﺍﻟﺘﻌـﺎﻭﻥ ﻤـﻊ ﺍﻟﻤـﻭﻅﻔﻴﻥ ﺍﻟﺴﺭﻴﺭﻴﻴﻥ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻴﺘﻠﻘﻭﻥ ﻋﻼﺠﹰ ﺍ ﻟﻠﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻘﻬﻘﺭﻴﺔ ،ﻭﻤﻊ ﺍﻷﻓﺭﻗﺔ ﺍﻟﻌﺎﻤﻠﺔ ﺎ ﻤﻀﺎﺩﹰ ﻓﻲ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﻤﺤﻠﻴﺔ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﺍﻟﺩﻋﻡ ﻟﻠﻤﺭﻀﻰ ﻭﺃﺴﺭﻫﻡ. ﻭﺘﺘﻌﺎﻭﻥ ﺍﻟﻤﻨﻅﻤﺔ ﻤﻊ ﺒﻌﺽ ﺍﻟﻤﺅﺴﺴﺎﺕ ﻓﻲ ﺍﻟﻭﻻﻴﺎﺕ ﺍﻟﻤﺘﺤﺩﺓ ﺍﻷﻤﺭﻴﻜﻴﺔ ﻋﻠﻰ ﺍﺴﺘﻨﺒﺎﻁ ﺃﺩﺍﺓ ﻟﻠﻔﺭﺯ ﺘﺸﺘﻤل -٩ ﻋﻠﻰ ﻁﺎﺌﻔﺔ ﻤﻥ ﺍﻷﺴﺌﻠﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺘﻨﺎﻭل ﺍﻟﻐﺫﺍﺀ ﻭﺍﻟﻘﻴﺎﺴﺎﺕ ﺍﻟﺒﺸﺭﻴﺔ ﻭﺘﻘﺩﻴﺭﺍﺕ ﻟﻤﺎ ﻴﻠﺯﻡ ﻤـﻥ ﺒﻌـﺽ ﺍﻟﻤﻐـﺫﻴﺎﺕ. ﻭﺴﻴﺠﺭﻱ ﺍﺨﺘﺒﺎﺭ ﺍﻷﺩﺍﺓ ﻭﺘﻭﺯﻴﻌﻬﺎ ﻓﻲ ﻋﺎﻡ ،٢٠٠٦ﻭﻫﻲ ﻤﺨﺼﺼﺔ ﻟﻼﺴﺘﻌﻤﺎل ﻓﻲ ﻤﺭﺍﻓﻕ ﺍﻟﺨـﺩﻤﺎﺕ ﺍﻟـﺼﺤﻴﺔ ﻭﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻤﻨﻔﺫﺓ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﻤﺤﻠﻴﺔ ﻟﺘﺤﺩﻴﺩ ﺍﻟﺒﺎﻟﻐﻴﻥ ﻭﺍﻷﻁﻔﺎل ﺍﻟﻤﻌﺭﻀﻴﻥ ﻟﺴﻭﺀ ﺍﻟﺘﻐﺫﻴﺔ ﻤﻥ ﻀﻤﻥ ﺍﻟﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﺃﻭ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﻤﺎ.
Nutrition counselling, care and support for HIV-infected women: Guidelines on HIV-related care, treatment ١ and support for HIV-infected women and their children in resource-constrained settings: Geneva, World Health Organization, 2004. Nutrient requirements for people living with HIV/AIDS: Report of a technical consultation, World Heath Organization, Geneva, 13-15 May 2003, Geneva, World Health Organization, 2003.
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A59/7
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ﻀﻊ ﻭﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻤﻥ ﺍﻷﻡ ﺇﻟـﻰ ﺍﻟﻁﻔـل. -١٠ﺒﻨﺎﺀ ﺍﻟﻘﺩﺭﺍﺕ ﻟﻐﺭﺽ ﺘﺤﺴﻴﻥ ﺘﻐﺫﻴﺔ ﺍﻟﺭ ّ ﺘﻡ ﺨﻼل ﻋﺎﻤﻲ ٢٠٠٣ﻭ ٢٠٠٤ﻭﻋﻠﻰ ﻨﻁﺎﻕ ﻭﺍﺴﻊ ،ﺘﻭﺯﻴﻊ ﺇﻁﺎﺭ ﻟﻸﻋﻤﺎل ﺫﺍﺕ ﺍﻷﻭﻟﻭﻴﺔ ﻓﻲ ﻤﺠـﺎل ﺍﻟﻌـﺩﻭﻯ ﻨﺎﺕ ،ﻭﺩﻻﺌل ﻋﻠﻰ ﺍﻟﻤـﺴﺅﻭﻟﻴﻥ ﻭﻤـﺩﻴﺭﻱ ﺍﻟﺭﻋﺎﻴـﺔ ﺍﻟـﺼﺤﻴﺔ ﻀﻊ ،ﻭﺍﺴﺘﻌﺭﺍﺽ ﻟﻠﺒﻴ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻭﺍﻟﻤﺸﺭﻓﻴﻥ ﻋﻠﻴﻬﺎ ،ﺒﺎﻹﻀﺎﻓﺔ ﺇﻟﻰ ﻜﺘﻴﺏ ﻋﻥ ﺍﻟﺒﺤﻭﺙ ﺍﻟﻤﻴﺩﺍﻨﻴﺔ ١.ﻭﺘﻡ ﻓﻲ ﻋﺎﻡ ٢٠٠٤ﺇﻨﺘﺎﺝ ﻤﻌﻴﻨﺎﺕ ﻓـﻲ ﻤﺠـﺎل ﺍﻟﺘﻨﺎﺼﺢ ﺍﺸﺘﻤﻠﺕ ﻋﻠﻰ ﻟﻭﺤﺎﺕ ﻗﻼﺒﺔ ﻭﺃﺩﻟﺔ ﺘﻭﺠﻴﻬﻴﺔ ﻭﻤﺭﺠﻌﻴﺔ ﻭﻤﻨﺸﻭﺭﺍﺕ ﻟﺘﻭﺯﻴﻌﻬﺎ ﻋﻠﻰ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺍﻟﺨﻁـﻭﻁ ﺍﻷﻤﺎﻤﻴﺔ. -١١ﻭﻗﺩﻡ ﺩﻋﻡ ﻤﺎﻟﻲ ﻟﺘﻨﻅﻴﻡ ﺩﻭﺭﺍﺕ ﻟﺘﺩﺭﻴﺏ ﺍﻟﻤﺩﺭﺒﻴﻥ ﻋﻘﺩﺕ ﻓﻲ ﻋـﺎﻤﻲ ٢٠٠٤ﻭ ٢٠٠٥ﻓـﻲ ﻋـﺩﺩ ﻤـﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻷﻓﺭﻴﻘﻴﺔ ﻟﻀﻤﺎﻥ ﺘﻘﺩﻴﻡ ﺍﻟﺘﻭﺠﻴﻪ ﺍﻟﻤﻼﺌﻡ ﻟﻸﻤﻬـﺎﺕ ﺒـﺸﺄﻥ ﺍﻹﺭﻀـﺎﻉ ﻓـﻲ ﺴـﻴﺎﻕ ﺍﻷﻴـﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ .ﻭﻴﻘﻭﻡ ﻋﺩﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻷﻓﺭﻴﻘﻴﺔ ﺒﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺘﺩﺭﻴﺏ ﻟﻴﺸﻤل ﺍﻷﻗﺎﻟﻴﻡ ﻭﺍﻟﻤﻘﺎﻁﻌـﺎﺕ ﻭﺫﻟـﻙ ﻟﺘﺯﻭﻴـﺩ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﺒﺎﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﻼﺯﻤﺔ ﻟﺩﻋﻡ ﺍﻷﻤﻬﺎﺕ ،ﺒﻤﻥ ﻓﻴﻬﻥ ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ،ﻭﺫﻟـﻙ ﻤـﻥ ﺃﺠل ﺍﺨﺘﻴﺎﺭ ﻭﺘﻁﺒﻴﻕ ﺃﻨﻤﺎﻁ ﺍﻟﺘﻐﺫﻴﺔ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻷﻁﻔﺎﻟﻬﻥ ﺍﻟﺭ ﻀﻊ .ﻭﻗﺎﻤﺕ ﺒﻠﺩﺍﻥ ﺃﺨﺭﻯ ﺒﺘﻨﻘﻴﺢ ﺍﻟـﺴﻴﺎﺴﺎﺕ ﻭﺍﻟـﺩﻻﺌل ﻀﻊ ،ﻭﺠﺭﻯ ﺘﻭﺯﻴﻌﻬﺎ ﻋﻠـﻰ ﻨﻁـﺎﻕ ﻭﺍﺴـﻊ ﻋﻠـﻰ ﺍﻟﻌـﺎﻤﻠﻴﻥ ﺍﻟـﺼﺤﻴﻴﻥ ﺍﻟﺨﺎﺼﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻭﺍﻻﺠﺘﻤﺎﻋﻴﻴﻥ. -١٢ﻭﺍﺸﺘﺭﻜﺕ ﺍﻟﻤﻨﻅﻤﺔ ،ﻤﻊ ﺍﻟﻴﻭﻨﻴﺴﻴﻑ ﻭﺸﺒﻜﺔ ﺍﻟﻌﻤل ﺍﻟﺩﻭﻟﻲ ﻤﻥ ﺃﺠل ﺃﻏﺫﻴﺔ ﺍﻷﻁﻔﺎل ﻭﻤﺅﺴﺴﺔ ﻫﻴﻠﻴﻥ ﻜﻴﻠـﺭ ﺍﻟﺩﻭﻟﻴﺔ ﻭﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﻟﻐﺭﺏ ﺃﻓﺭﻴﻘﻴﺎ ،ﻓﻲ ﺘﻨﻅﻴﻡ ﺤﻠﻘﺔ ﻋﻤﻠﻴﺔ )ﻜﻭﺘﻭﻨﻭ ،ﺸﺒﺎﻁ /ﻓﺒﺭﺍﻴﺭ (٢٠٠٥ﺘﻨﺎﻭﻟﺕ ﺨﻁـﻁ ﺍﻟﻌﻤل ﺍﻟﺨﺎﺼﺔ ﺒﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻀﻊ ﻓﻲ ﺴﻴﺎﻕ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ. -١٣ﻭﺘﺘﻌﺎﻭﻥ ﺍﻟﻤﻨﻅﻤﺔ ﻤﻊ ﺍﻟﻴﻭﻨﻴﺴﻴﻑ ﻋﻠﻰ ﺘﻨﻘﻴﺢ ﺩﻟﻴل ﺍﻟﺘﺩﺭﻴﺏ ﻭﺃﺩﻭﺍﺕ ﺍﻟﺘﻘﻴﻴﻡ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻓـﻲ ﻤﺒﺎﺩﺭﺘﻬﻤـﺎ ﺍﻟﻤﺸﺘﺭﻜﺔ ﻟﻠﻤﺴﺘﺸﻔﻴﺎﺕ ﺍﻟﺼﺩﻴﻘﺔ ﻟﻸﻁﻔﺎل ،ﻭﺫﻟﻙ ﻓﻲ ﻀﻭﺀ ﺠﺎﺌﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ .ﻭﺘﻡ ﺍﺨﺘﺒﺎﺭ ﺍﻟﻜﺘﻴـﺏ ﻭﺍﻷﺩﻭﺍﺕ ﻓﻲ ﺯﻤﺒﺎﺒﻭﻱ ﻋﻘﺩﺕ ﺒﻌﺩﻩ ﺤﻠﻘﺔ ﻋﻤﻠﻴﺔ ﺍﺴﺘﻐﺭﻗﺕ ﺜﻼﺜﺔ ﺃﻴﺎﻡ ﻟﺘﻭﺠﻴﻪ ﻤﺴﺅﻭﻟﻲ ﺍﻻﺘﺼﺎل ﺍﻟﻘﻁﺭﻴﻴﻥ ﺒـﺸﺄﻥ ﺃﻫﻤﻴﺔ ﺇﺤﻴﺎﺀ ﺍﻟﻤﺒﺎﺩﺭﺓ ﻓﻲ ﺴﻴﺎﻕ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ )ﻫﺭﺍﺭﻱ ،ﺘﺸﺭﻴﻥ ﺍﻟﺜﺎﻨﻲ /ﻨﻭﻓﻤﺒﺭ .(٢٠٠٥ ﻀﻊ ﻭﺼﻐﺎﺭ ﺍﻷﻁﻔـﺎل -١٤ﻭﻁﻭﺭﺕ ﺍﻷﻤﺎﻨﺔ ﺩﻭﺭﺓ ﺘﺩﺭﻴﺒﻴﺔ ﻤﺘﻜﺎﻤﻠﺔ ﻤﺩﺘﻬﺎ ﺨﻤﺴﺔ ﺃﻴﺎﻡ ،ﻭﻫﻲ ﺘﻌﻨﻲ ﺒﺘﻐﺫﻴﺔ ﺍﻟﺭ ﺎ ﻓﻲ ﻏﺎﻨـﺎ ﺎ ﻟﻠﻤﺭﺸﺩﻴﻥ ﺍﻟﻌﺎﺩﻴﻴﻥ ﻤﺘﺎﺒﻌﺘﻬﺎ .ﻭﺒﻌﺩ ﺘﺠﺭﺒﺔ ﺍﻟﺩﻭﺭﺓ ﻤﻴﺩﺍﻨﻴﹰ ﻭﺘﺭﻜﺯ ﻋﻠﻰ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ،ﻭﻴﻤﻜﻥ ﺃﻴﻀﹰ ﹸﺭﻉ ﻓﻲ ﺘﻁﺒﻴﻘﻬﺎ ﻓﻲ ﺴﺒﻌﺔ ﺒﻠﺩﺍﻥ ﻤﻥ ﺇﻗﻠﻴﻡ ﻏﺭﺏ ﺍﻟﻤﺤﻴﻁ ﺍﻟﻬﺎﺩﺉ. ﻭﺠﺎﻤﺎﻴﻜﺎ ﻭﺠﻨﻭﺏ ﺃﻓﺭﻴﻘﻴﺎ ﺸ ـﻊ، ﺎ ﻭﺼﻐﺎﺭ ﺍﻷﻁﻔﺎل ،ﺒﻤﻥ ﻓﻴﻬﻡ ﺍﻟﺭﻀ ﻀﻊ ﺍﻷﻜﺒﺭ ﺴﻨﹰ -١٥ﻭﺘﻡ ﻨﺸﺭ ﺩﻻﺌل ﺒﺸﺄﻥ ﺴﻴﺎﺴﺎﺕ ﻭﺒﺭﺍﻤﺞ ﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻤﻥ ﺃﺒﻨﺎﺀ ﺍﻷﻤﻬﺎﺕ ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ،ﺍﻟﺫﻴﻥ ﻻ ﻴﺭﻀﻌﻭﻥ ﺃﻤﻬﺎﺘﻬﻡ ،ﻭﺫﻟﻙ ﺒﻌﺩ ﺍﺠﺘﻤﺎﻉ ﺠﺭﺕ ﻓﻴـﻪ ﻨﺎﺕ٢. ﻤﻨﺎﻗﺸﺔ ﺍﻟﻨﺘﺎﺌﺞ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﺍﻟﻤﺴﻨﺩﺓ ﺒﺎﻟﺒﻴ
HIV and infant feeding: framework for priority actions. Geneva, World Health Organization, 2003; Newell ١ M-L, HIV transmission through breastfeeding: a review of available evidence. Geneva, World Health Organization, 2004; UNICEF/UNAIDS/WHO/UNFPA, HIV and infant feeding: Guidelines for decision-makers. Geneva, World Health Organization, 2003; HIV and infant feeding: a guide for health-care managers and supervisors. Geneva, World Health Organization, 2003. Guiding principles for feeding non-breastfed children 6-24 months of age. Geneva, World Health Organization, 2005.
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A59/7
ﺝ٧/٥٩
-١٦ﻭﻜﺜﻔﺕ ﻤﻜﺎﺘﺏ ﺍﻟﻤﻨﻅﻤﺔ ﺍﻹﻗﻠﻴﻤﻴﺔ ﺩﻋﻤﻬﺎ ﻓﻲ ﻤﺠﺎل ﺘﺨﻁﻴﻁ ﺍﻟﺒﺭﺍﻤﺞ ﻭﺒﻨﺎﺀ ﺍﻟﻘـﺩﺭﺍﺕ .ﻭﻨﻅـﻡ ﺍﻟﻤﻜﺘـﺏ ﺍﻹﻗﻠﻴﻤﻲ ﻷﻓﺭﻴﻘﻴﺎ ﺍﺠﺘﻤﺎﻋﺎﺕ ﺒﺸﺄﻥ ﺍﻟﺘﺨﻁﻴﻁ ﻟﻠﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻁﻘﺔ ﺒﺎﻹﻨﻜﻠﻴﺯﻴﺔ ﻭﺍﻟﻔﺭﻨﺴﻴﺔ ﻭﺍﻟﺒﺭﺘﻐﺎﻟﻴﺔ ،ﻭﺫﻟﻙ ﺒﺎﺴـﺘﺨﺩﺍﻡ ﻀﻊ ،ﻭﻗﺩﻡ ﺩﻋﻤﻪ ﻟﺩﻭﺭﺍﺕ ﺘﺩﺭﻴﺏ ﺍﻟﻤﺩﺭﺒﻴﻥ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺍﻟﻨﺼﺎﺌﺢ ﺒـﺸﺄﻥ ﺃﺩﻭﺍﺕ ﺘﺘﻌﻠﻕ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻀﻊ ﻓﻲ ١٩ﺒﻠﺩﹰ ﺘﻐﺫﻴﺔ ﺍﻟﺭ ﺎ ﻭ ٢٠٠٠ﻋﺎﻤل ﺼـﺤﻲ. ﺍ .ﻭﻓﻲ ﻨﻬﺎﻴﺔ ﻋﺎﻡ ٢٠٠٤ﺘﺠﺎﻭﺯ ﻋﺩﺩ ﺍﻟﻤﺘﺩﺭﺒﻴﻥ ٢٥٠ﻤﺩﺭﺒﹰ ﻀﻊ ﻓﻲ ﺴـﻴﺎﻕ ﺍﻷﻴـﺩﺯ، ﻭﻗﺩﻡ ﺍﻟﻤﻜﺘﺏ ﺍﻹﻗﻠﻴﻤﻲ ﻟﻸﻤﺭﻴﻜﺘﻴﻥ ﺩﻋﻤﻪ ﻟﻠﺘﺩﺭﻴﺏ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺍﻟﻨﺼﺎﺌﺢ ﺒﺸﺄﻥ ﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻭﺃﺠﺭﻯ ﺍﺠﺘﻤﺎﻋﺎﺕ ﺘﺨﻁﻴﻁﻴﺔ ﻟﺒﻠﺩﺍﻥ ﻤﻥ ﺃﻤﺭﻴﻜﺎ ﺍﻟﻭﺴﻁﻰ ﻭﻤﻨﻁﻘﺔ ﺍﻟﺒﺤﺭ ﺍﻟﻜﺎﺭﻴﺒﻲ ﻭﺍﻟﻤﺨﺭﻭﻁ ﺍﻟﺠﻨﻭﺒﻲ ﻭﻋﺩﺩ ﺁﺨﺭ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ .ﻭﻨﻅﻡ ﺍﻟﻤﻜﺘﺏ ﺍﻹﻗﻠﻴﻤﻲ ﻟﺠﻨﻭﺏ ﺸﺭﻕ ﺁﺴﻴﺎ ﺩﻭﺭﺓ ﺘﺩﺭﻴﺒﻴﺔ ﺸﺎﺭﻜﺕ ﻓﻴﻬﺎ ﺴﺒﻌﺔ ﺒﻠﺩﺍﻥ ،ﻭﺘﻨﺎﻭﻟﺕ ﺍﻟﺩﻭﺭﺓ ﻀﻊ .ﻭﺘﻭﻟﻰ ﺍﻟﻤﻜﺘـﺏ ﺍﻹﻗﻠﻴﻤـﻲ ﻤﻭﻀﻭﻉ ﺍﻟﺭﻀﺎﻋﺔ ﺍﻟﻁﺒﻴﻌﻴﺔ ﻓﻲ ﺴﻴﺎﻕ ﺍﻷﻴﺩﺯ ﻭﺘﻘﺩﻴﻡ ﺍﻟﻨﺼﺎﺌﺢ ﺒﺸﺄﻥ ﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻷﻭﺭﻭﺒﺎ ﺘﻨﻅﻴﻡ ﺩﻭﺭﺍﺕ ﺘﺩﺭﻴﺒﻴﺔ ﻤﻼﺌﻤﺔ ﻟﻺﻗﻠﻴﻡ ﺍﺴﺘﻐﺭﻗﺕ ﻜل ﺩﻭﺭﺓ ﻤﻨﻬﺎ ﺜﻼﺜﺔ ﺃﻴﺎﻡ ﻭﺘﻨﺎﻭﻟﺕ ﻤﻭﻀﻭﻉ ﺍﻟﺭﻀـﺎﻋﺔ ﺍﻟﻁﺒﻴﻌﻴﺔ ﻭﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻐﺫﻴﺔ ﺍﻟﺭ ﻀﻊ .ﻭﺃﻋﺩ ﺍﻟﻤﻜﺘﺏ ﺍﻹﻗﻠﻴﻤﻲ ﻟﺸﺭﻕ ﺍﻟﻤﺘﻭﺴﻁ ﻤﻭﺍﺩ ﺘﺩﺭﻴﺒﻴﺔ ﺒﺎﻟﻠﻐﺔ ﺍﻟﻌﺭﺒﻴـﺔ، ﺎ ﻟﻤﺩﻴﺭﻱ ﺤﻠﻘﺎﺕ ﺍﻟﺘﺩﺭﻴﺏ ﺍﻹﻗﻠﻴﻤﻴﺔ .ﻭﻓﻲ ﺇﻗﻠﻴﻡ ﻏﺭﺏ ﺍﻟﻤﺤﻴﻁ ﺍﻟﻬﺎﺩﺉ ،ﺘﻡ ﺘﺩﺭﻴﺏ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟـﺼﺤﻴﻴﻥ ﻭﺃﻨﺸﺄ ﺘﺠﻤﻌﹰ ﻀﻊ. ﻋﻠﻰ ﺘﻐﺫﻴﺔ ﺍﻟﺭ -١٧ﺒﻨﺎﺀ ﺍﻟﻘﺩﺭﺍﺕ ﻤﻥ ﺃﺠل ﺘﺤﺴﻴﻥ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﺩﻋﻡ ﺍﻟﻤﻘﺩﻤﻴﻥ ﻟﻠﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ. ﻼ ١ﻭﺃﻋﺩﺘﺎ ﺩﻭﺭﺓ ﻗـﺼﻴﺭﺓ ﺍﻷﻤـﺩ ﺃﺼﺩﺭﺕ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻭﻤﻨﻅﻤﺔ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻟﻸﻏﺫﻴﺔ ﻭﺍﻟﺯﺭﺍﻋﺔ ﺩﻟﻴ ﹰ ﻟﺘﺯﻭﻴﺩ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﺒﺎﻟﻤﻌﺎﺭﻑ ﺍﻟﻌﻤﻠﻴﺔ ﻋﻥ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺘﻐﺫﻭﻴﺔ ﻭﺩﻋﻡ ﺍﻟﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ .ﻭﻋﻘﺩﺕ ﺍﺠﺘﻤﺎﻋﺎﺕ ﺇﻗﻠﻴﻤﻴﺔ ﻓﻲ ﺠﺎﻜﺎﺭﺘﺎ )ﺘﺸﺭﻴﻥ ﺍﻷﻭل /ﺃﻜﺘﻭﺒﺭ (٢٠٠٥ﻭﺠﻭﻫﺎﻨﺴﺒﺭﻍ )ﺘﺸﺭﻴﻥ ﺍﻟﺜﺎﻨﻲ/ ﻨﻭﻓﻤﺒﺭ (٢٠٠٥ﻟﺘﺯﻭﻴﺩ ﺍﻟﻤﺩﺭﺒﻴﻥ ﻤﻥ ﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺒﺎﻟﻤﻌﻠﻭﻤﺎﺕ ﻭﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺃﺴﺭﻫﻡ ﺒﺎﻟﻤﻭﺍﺩ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺘﻐﺫﻭﻴﺔ ﺍﻟﻌﻤﻠﻴﺔ ﻭﻟﺩﻋﻡ ﺍﻟﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ. ّﻨﺎﺕ .ﺭﻜﺯﺕ ﺍﻟﺒﺤﻭﺙ ﺍﻷﺨﻴﺭﺓ ﺍﻟﺘﻲ ﺘﺤﺼل ﻋﻠﻰ -١٨ﺍﻟﺒﺤﺙ ﺍﻟﻌﻤﻠﻲ ﻭﺍﻟﺴﺭﻴﺭﻱ ﻟﺩﻋﻡ ﺍﻟﺒﺭﻤﺠﺔ ﺍﻟﻤﺴﻨﺩﺓ ﺒﺎﻟﺒﻴ ﻀﻊ ﻤـﻥ ﺃﺒﻨـﺎﺀ ﺍﻟﻤـﺼﺎﺒﺎﺕ ﺩﻋﻡ ﺍﻟﻤﻨﻅﻤﺔ ﻭﺍﻟﺠﺎﺭﻴﺔ ﻓﻲ ﺸﺘﻰ ﺍﻟﺒﻠﺩﺍﻥ ﻋﻠﻰ ﺘﻭﻀﻴﺢ ﺍﻟﻤﺴﺎﺌل ﺍﻟﻤﺘﺼﻠﺔ ﺒﺘﻐﺫﻴﺔ ﺍﻟﺭ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ،ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺘﻘﻴﻴﻡ ﻨﻭﻋﻴﺔ ﺍﻟﻨﺼﺢ ﺍﻟﻤﻘﺩﻡ ﺒﺸﺄﻥ ﺍﻟﺘﻐﺫﻴﺔ ﻤﻥ ﺃﺠل ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴـﺩﺯ ﻤﻥ ﺍﻷﻡ ﺇﻟﻰ ﺍﻟﻁﻔل ،ﻭﻭﻀﻊ ﺍﻟﺘﻭﺼﻴﺎﺕ ﺍﻟﺘﻲ ﺘﺭﻜﺯ ﻋﻠﻰ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ،ﻭﺍﻟﻌﻭﺍﻤل ﺍﻟﺘﻲ ﺘﺅﺜﺭ ﻋﻠﻰ ﻤﻤﺎﺭﺴﺎﺕ ﺍﻟﺘﻐﺫﻴﺔ ﻟﺩﻯ ﺍﻷﻤﻬﺎﺕ ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ .ﻭﻟﻠﺩﺭﺍﺴﺔ ﺍﻷﺨﻴﺭﺓ ﺃﻫﻤﻴﺔ ﺤﺎﺴﻤﺔ ﻓﻲ ﻓﻬﻡ ﻨﺎﺕ ﺍﻟﺠﺩﻴﺩﺓ ﺇﻟﻰ ﺃﻥ ﺍﻻﻗﺘﺼﺎﺭ ﻋﻠﻰ ﺃﺴﻠﻭﺏ ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﺍﻟﻤﺭﺘﺒﻁ ﺒﺄﻨﻤﺎﻁ ﺍﻹﺭﻀﺎﻉ ﺍﻟﻁﺒﻴﻌﻲ .ﻭﺘﺸﻴﺭ ﺍﻟﺒﻴ ﺍﻟﺭﻀﺎﻋﺔ ﺍﻟﻁﺒﻴﻌﻴﺔ ﻗﺩ ﻴﺅﺩﻱ ﺇﻟﻰ ﺘﻘﻠﻴﺹ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﺇﻟﻰ ﻤﺴﺘﻭﻯ ﺃﻗل ﻤﻥ ﻤﺴﺘﻭﺍﻩ ﻋﻨﺩ ﺍﺘﺒـﺎﻉ ﺃﺴـﻠﻭﺏ ﺍﻟﺘﻐﺫﻴﺔ ﺍﻟﻤﺨﺘﻠﻁﺔ ٢.ﻭﺴﺘﺘﺎﺡ ،ﻓﻲ ﻋﺎﻡ ،٢٠٠٦ﻨﺘﺎﺌﺞ ﺩﺭﺍﺴﺎﺕ ﻤﻤﺎﺜﻠﺔ ﻭﺩﺭﺍﺴﺎﺕ ﺃﺨﺭﻯ ﺘﺘﻨﺎﻭل ﻤﻭﻀﻭﻉ ﺍﻷﻤﻬﺎﺕ ﺎ ﺸﺩﻴﺩ ﺍﻟﻔﻌﺎﻟﻴﺔ ﻀﺩ ﺍﻟﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻘﻬﻘﺭﻴﺔ. ﺍﻟﻤﺭﻀﻌﺎﺕ ﺍﻟﻼﺌﻲ ﻴﺘﻠﻘﻴﻥ ﻋﻼﺠﹰ ﺜل ﻨﻘﺹ ﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﻤﻘﺩﺍﺭ ﻤﺸﻜﻠﺔ ﻜﺒﺭﻯ ﻟﻠﻤﺘﻌﺎﻴﺸﻴﻥ ﻤـﻊ ﺍﻷﻴـﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ. -١٩ﻭﻴﻤ ﹼ ﻭﻟﻜﻥ ﺍﻟﻤﻌﺎﺭﻑ ﻤﺎﺯﺍﻟﺕ ﻤﺤﺩﻭﺩﺓ ﺒﺸﺄﻥ ﺍﻟﺘﻔﺎﻋﻼﺕ ﺒﻴﻥ ﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﻤﻘﺩﺍﺭ ﻭﺍﻟﺤﺎﻟﺔ ﺍﻟﻔﺴﻴﻭﻟﻭﺠﻴﺔ ﺃﻭ ﺒـﺸﺄﻥ ﺃﺜﺭ ﻫﺫﻩ ﺍﻟﻤﻐﺫﻴﺎﺕ ﻋﻠﻰ ﺘﻁﻭﺭ ﺍﻟﻤﺭﺽ .ﻭﻴﺤﺘﺎﺝ ﺍﻟﻤﺼﺎﺒﻭﻥ ﻭﺍﻟﻤﺘـﺄﺜﺭﻭﻥ ﺒﺎﻷﻴـﺩﺯ ﻭﺒﺎﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ ﺇﻟـﻰ ﺎ ﻨـﺎﺕ ﺍﻟﻤﺘﺎﺤـﺔ ﺤﺎﻟﻴـﹰ ﻨﺎﺕ ﻗﺎﻁﻌﺔ ﻀﻤﻥ ﺍﻟﺒﻴ ّ ﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﻤﻘﺩﺍﺭ .ﻭﻻ ﺘﻭﺠﺩ ﺒﻴ ﻜل ﻨﻅﺎﻡ ﻏﺫﺍﺌﻲ ﻴﺅﻤﻥ ﻟﻬﻡ ﹸ ﺒﺸﺄﻥ ﺃﺜﺭ ﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﻤﻘﺩﺍﺭ ﺍﻹﻀﺎﻓﻴﺔ ﻋﻠﻰ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻁﻭﺭﻩ ﻋﻨـﺩ ﻋـﺩﻡ ﻭﺠـﻭﺩ ﻋـﻭﺯ Living well with HIV/AIDS. A manual on nutritional care and support for people living with HIV/AIDS. ١ Geneva, World Health Organization and Rome, Food and Agriculture Organization of the United Nations, 2002. Iliff PJ et al. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 19:699-708, 2005.
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ﻏﺫﺍﺌﻲ ﻤﻌﻴﻥ .ﻭﺒﻌﺩ ﺍﺴﺘﻌﺭﺍﺽ ﻟﻠﻤﻌﻁﻴﺎﺕ ﺍﻟﻌﻠﻤﻴﺔ ﺍﻟﻤﺘﺎﺤﺔ ،ﺃﻭﺼﺕ ﺍﻟﻤﻨﻅﻤـﺔ ﺒـﺄﻥ ﻻ ﺘﺘﺠـﺎﻭﺯ ﺍﻟﻜﻤﻴـﺔ ﺍﻟﺘـﻲ ﻴﺘﻨﺎﻭﻟﻬﺎ ﺍﻟﻤﺘﻌﺎﻴﺸﻭﻥ ﻤﻊ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻤﻥ ﺍﻟﻤﻐﺫﻴﺎﺕ ﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﻤﻘﺩﺍﺭ ﻜﻤﻴﺔ ﻭﺍﺤﺩﺓ ﻤﻥ ﺍﻟﻜﻤﻴﺎﺕ ﺍﻟﻴﻭﻤﻴﺔ ﺍﻟﻤﻭﺼﻰ ﺒﻬﺎ١.
ﺍﻹﺠﺭﺍﺀ ﺍﻟﻤﻁﻠﻭﺏ ﻤﻥ ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﻤﺩﻋﻭﺓ ﺇﻟﻰ ﺍﻟﻨﻅﺭ ﻓﻲ ﻤﺸﺭﻭﻉ ﺍﻟﻘﺭﺍﺭ ﺍﻟﻭﺍﺭﺩ ﻓﻲ ﺍﻟﻘﺭﺍﺭ ﻡ ﺕ١١٧ﻕ.٢ -٢٠
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Nutrient requirements for people living with HIV/AIDS.
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5