jordan - bvsde.paho.org · statistics in a standard format. ... data presented in the ncp are...

FOOD AND AGRICULTURE ORGANIZATION

OF THE UNITED NATIONS

FAO - NUTRITION COUNTRY PROFILES

JORDANJORDAN

Nutrition Country Profiles – JORDAN August, 2003 FAO, Rome, Italy

Nutrition Country Profiles – JORDAN 1

Note for the reader

The objective of the Nutrition Country Profiles (NCP) is to provide concise analytical summaries describing the food and nutrition situation in individual countries with background statistics on food-related factors. The profiles present consistent and comparable statistics in a standard format. This pre-defined format combines a set of graphics, tables and maps each supported by a short explanatory text. Information regarding the agricultural production, demography and socio-economic level of the country are also presented. In general, data presented in the NCP are derived from national sources as well as from international databases (FAO, WHO...). Technical notes giving detailed information on the definition and use of the indicators provided in the profile can be obtained from ESNA upon request. An information note describing the objectives of the NCP is also available. Useful suggestions or observations to improve the quality of this product are welcome. The data used to prepare the maps are available in Excel upon request at:

E-mail: [email protected]

Nutrition Country Profile of Jordan

prepared for the Food and Agriculture Organization of the United Nations by Dr. Hamed Takruri; Dept. Nutrition and Food Technology Faculty of Agriculture; University of Jordan in collaboration with Rosanne Marchesich (ESNA-FAO).

The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers .

FAO, 2003

mailto:[email protected]


Table of contents

SUMMARY----------------------------------------------------------------------------------------------- 3

TABLE 1: GENERAL STATISTICS OF JORDAN -------------------------------------------- 4

I. OVERVIEW ------------------------------------------------------------------------------------------- 5

1. Geography ..........................................................................................................5 2. Population ...........................................................................................................5 3. Level of development: poverty, education and health .........................................6 4. Agricultural production, land use and food security.............................................7 5. Economy .............................................................................................................8

II. THE FOOD AND NUTRITION SITUATION -------------------------------------------------- 9

1. Trends in energy requirements and energy supplies ........................................9 2. Trends in food supplies ...................................................................................10 3. Food consumption...........................................................................................12 4. Infant feeding practices...................................................................................15 5. Anthropometric data........................................................................................15 5. Micronutrient deficiencies ...............................................................................20

REFERENCES-----------------------------------------------------------------------------------------25

MAPS are presented after the <REFERENCES> General map of Jordan Map 1a: Prevalence of stunting for females less than 5 years old by governorate in Jordan in 1991 Map 1b: Prevalence of stunting for males less than 5 years old by governorate in Jordan in 1991 Map 2: Prevalence of goitre among school children (8 to 10 years) by governorate in Jordan in 2000 Map 2: Prevalence of anaemia among women (15 to 49 years) by governorate in Jordan in 1996 Graphs, tables and maps can be visualised by clicking on the words in bold and underline, only in the “Full profile” pdf file.


SUMMARY Jordan is an Arab state situated on the east bank of the Jordan River. Jordan has

borders with Syria, Iraq, Saudi Arabia and Palestine (General Map). The population density is concentrated in the governorates of the middle region (where the capital Amman is located) and the northern region.

Wheat is the staple food of Jordanian people. The major percentage of energy comes from cereals, then fresh fruits and vegetables. The animal products contribute to more than one third of protein. The intake of sweeteners has a relatively high contribution of total energy (DOS, 1992; 1997; FAOSTAT, 2002).

The total expenditure that is spent on food is higher for the poor (48%) compared to 42% for the non-poor. Under the social welfare policies and programmes, the government has implemented a series of programmes aimed at poverty alleviation by providing a better source of income to the poor and the unemployed (UN Resident Coordinator, 2002).

More than 95% of Jordanian mothers breast-feed their children in the first 3 months, 85% breast-feed until age 6 month and 69% breast-feed for 7-9 months (MOH, 1993b).

There has been an improvement in the nutritional status of children less than five years of age from 1991 to 1997 at the national level. According to the most recent studies, stunting, wasting and underweight among children less than five years old are considered to be low according to WHO standards (DOS, 1998b). However, data at the governorate level shows a high prevalence of stunting in Mafraq for males and a medium prevalence of stunting in Mafraq and Tefeeleh for females (MOH, 1993b).

Overweight does not appear to be a problem among children and adolescents. However, a recent sub-national study, in the governorate of Amman, found that more than one quarter of women (20 to 25 years) were either overweight or obese (BMI>25 kg/m2)(Ahmad et al., 2002) (Table 4c).

Iodine deficiency is a serious problem among Jordanian children. One-third of school children, aged 8-10 years, have goitre (TGR) with differences between governorates (MOH, 2001) (Map 2). Plus, more than one quarter of women (15 to 49 years) have haemoglobin levels below 12 g/dL with prevalences varying according to age and governorate (Map 3). Vitamin A deficiency is not a serious health problem.

The majority of births take place in hospitals and virtually all children of 12-23 months age are vaccinated against DPT and polio. Infant mortality rate and the under five mortality rate are relatively low, and maternal mortality rate has decreased. The average life expectancy for both males and females has increased to 71 years (Table 1). Infectious diseases are moderate with varying degrees in the governorates (MOH, 2001).

Last updated: 18/08/2003 Indicator (§) Year Unit Indicator (§) Year Unit

A. Land in use for agriculture G. Average Food Supply1. Agricultural land 2000 ha per person 0.2402. Arable and permanent crop land 2000 ha per person 0.079 1. Dietary Energy Supply (DES) 1998-2000 kcal/caput/day 2824

B. Livestock1. Cattle 1998-2000 thousands 642. Sheep & goats 1998-2000 thousands 24443. Pigs 1998-2000 thousands _4. Chickens 1998-2000 millions 23

C. Population1. Total population 2000 thousands 66692. 0-4 years 2000 % of total pop. 15.53. 5-14 years 2000 % of total pop. 24.64. 15-24 years 2000 % of total pop. 21.05. >= 60 years 2000 % of total pop. 4.56. Rural population 2000 % of total pop. 25.87. Annual population growth rate, Total 2000-2005 % of total pop. 2.98. Annual population growth rate, Rural 2000-2005 % of rural pop. 1.09. Projected total population in 2030 2030 thousands 13019

10. Agricultural population 2000 % of total pop. 11.411. Population density 2000 pop. per km2 55.1

D. Level of Development1. GNP per capita, Atlas Method 1998 current US$ 1 1502. Human Development Index rating (new) 1999 min[0] - max[1] 0.7143. Incidence of poverty, Total 1998 % of population 14.44. Incidence of poverty, Rural or Urban _ % of population _ % Energy from:5. Life expectancy at birth (both sexes) 2000-2005 years 71.0 2. Protein 1998-2000 % of total energy 10.86. Under-five mortality rate 2000 per 1,000 live births 34 3. Fat 1998-2000 % of total energy 25.2

E. Food Trade 4. Proteins 1998-2000 g/caput/day 741. Food Imports (US $) 1998-2000 % of total imports 17.3 5. Vegetable products 1998-2000 % of total proteins 70.52. Food Exports (US $) 1998-2000 % of total exports 11.4 6. Animal products 1998-2000 % of total proteins 29.53. Cereal Food Aid (100 t) 1998-2000 % of cereals imports 14.5

H. Food InadequacyF. Indices of Food Production 1. Total population "undernourished" 1997-99 millions 0.2

1. Food Production Index 1998-2000 1989-91=100 137.1 2. % population "undernourished" 1997-99 % of total pop. 5.02. Food Production Index Per Capita 1998-2000 1989-91=100 93.7

TABLE 1: GENERAL STATISTICS OF JORDAN

- Data not determined. § see References for data sources used

Percentage of DES by major food groups

53.3%

1.3%

11.4%

4.0%

4.2%

13.8%

5.2%5.1%

Cereals (excl. beer)Starchy rootsSweetenersPulses, nuts, oilcropsFruits & VegetablesVegetable oilsAnimal FatsMeat & offalsFish & seafoodMilk & EggsOther


JORDAN

I. OVERVIEW

1. Geography

Jordan is an Arab state located in Southwest Asia. It covers an area of 89 297 km2, including the Dead Sea. Jordan is situated on the East Bank of the Jordan River, and after the peace treaty with Israel in October 1994, the Palestinian National Authority (PLO) was given authority of West Bank (previously part of Jordan).

Jordan shares borders with Syria in the north, Iraq in the east, Saudi Arabia in the east and south, and the occupied West Bank on its western border.

Jordan has a Mediterranean climate, with a hot, dry summer, a cool, wet winter and two short transitional autumn and spring seasons. Seventy five percent of the country can be described as having a desert climate with less than 100 mm rainfall annually (Royal Jordanian Geographic Centre, 2001). It is sunny from May to October and during autumn (October-November) the weather becomes mild and dry. Winter season (November-March) is relatively mild but cold in high areas.

Jordan is divided into three natural and climatic areas. They are the Jordan valley, the mountain heights plateau and the eastern desert or Badia region which forms 75% of the total area (General Map).

2. Population

There are several agencies which are concerned with population density and population policy. The Ministry of Health and Health Care (MOHHC) and its directorates provide free family planning services as an unofficial and indirect intervention of the population policy (DOS, 1998b). In 1993, the government approved the national birth-spacing programme as an official population policy. As a result, the annual population growth rate is estimated to be 2.9% for the 2000 to 2005 year period compared to 4.1% from 1980 to 1999. The total population was 2.2 million in 1980, 6.6 million in 2000 and is expected to reach 13 million by the year 2030 (WB, 2001; UN, 2001) (Table 1).

The population density in Jordan varies according to governorates and regions. For example, in the middle region density is 206 persons/km² and it is only 11 persons/km² in south region (DOS, 2001).

Jordan has a relatively young demographic structure with a population median age of 19.3 year (DOS, 2001). Sixty one percent of the population is less than 24 years and 5% is greater than 60 years (UN, 2001).

The official religion in Jordan is Islam. Sunni Moslems form the majority, and approximately 4% are Christians. Arabs forms the major ethnic group in Jordan, with minority groups of Circassians, Shishan, Armenian and Druzes (UNDP, 2001).


Population Pyramid, 2001

Source: UNAIDS/WHO 2002.

3. Level of development: poverty, education and health In 1998, the gross national product (GNP) of Jordan was US$1150. The percentage of households living below the poverty lines was 15% in 1991 (AMO, 2001; WB, 2002) (Table 1).

There has been a decline in the real per capita income, a decline in per capita consumption and a sharp drop in living standards. In 1987 the percentage of household living below the absolute poverty line was 19% and increased from 1992 to 1996 from 21% to 26%, respectively. Absolute poverty was measured using a cut-off point of 313.5JD per person per year (IJD=US$1.42). Twenty seven percent of families live on a monthly income of less than 120 JD (Human Development Report, 2001).

The total expenditure on both education and health is only 3.5% for the poor (about 12 JD annually). The poor resort to free or subsidized education and health services provided by the government and UN organizations.

Jordan has a human development index (HDI) of 0.714, indicating substantial achievements in development (Table 1). Under the social welfare policies and programmes, the government has implemented a series of programmes aimed at poverty alleviation by providing a better source of income to the poor and unemployed in particular. The programmes implemented are free education and primary health care, business training for micro and small enterprises, social productivity programmes, and enhancing employment opportunities for women.

With political stability and continuing socio-economic development, the country has achieved significant gains in the health sector. The under-five mortality rate is low compared to other countries in the region at 34 per 1000 live births in the 2000-2005 period. The infant mortality rate has fallen from 97 in 1960 to 27 deaths per 1000 live births in 2000 (UNICEF, 2002). Maternal mortality has also decreased from 800 in 1979 to 41 per 100 000 live births in 1995 (DOS, 2001; UNAIDS/WHO, 2002). These decreases are the result of maternal and child health activities, increased vaccination coverage rates, improvements in education, birth spacing, sanitation, expanded antenatal care, and access to clean water (DOS, 2001).

Health infrastructure has improved over the last two decades and the number of hospitals has increased from 35 in early 1980s to 86 in the year 2001 (DOS, 2001).


The major cause of infant and child mortality is diarrhoea. The prevalence of diarrhoea among children under five years of age in 1997 was more than double its level in 1990. However, there was a drop in the number of cases in 2000 (MOH, 2001). In adults, cardiovascular diseases accounted for 42% of total deaths in 1992 for both sexes, then cancer accounting for 13% of total deaths and accidents accounting for 11% of total deaths (MOH, 1996).

The estimated number of adults living with HIV/AIDS at the end of 2001 was less than 1000 for adults (15 to 49 years) with 150 being women. No children were reported (UNAIDS/WHO, 2002).

By the year 2000, the literacy rate in Jordan was 85% for both sexes at the age of 15 and more. In 1998, the number of universities and colleges was 17, and more than 94 146 students were enrolled in higher education (DOS, 1998c). Eleven percent of the total government budget was allocated to education in the year 2000 (DOS, 2001).

4. Agricultural production, land use and food security

Agriculture contributed substantially to the economy from the time of Jordan's independence, but in the last two decades industrial and other sectors have expanded and the contribution of agriculture as a percentage of GDP has decreased from 8% in 1990 to 4% in 1998. The Jordanian employment in agriculture is only 6% of the active labour force and most of the workers in the agriculture field are immigrant workers (DOS, 1998c).

Agricultural land in Jordan has increased as a result of implementing several agricultural policies in late 1980s. The strategy was to increase the total area under cultivation by better harnessing water resources to increase irrigation in the arid desert area for the cultivation of cereal crops. The irrigated area has increased from 71 thousand ha in 1993 to 75 thousand ha in 1999. In 2000, agricultural land represented 0.240 ha per person and arable and permanent crop land was 0.079 ha per person (FAOSTAT, 2002).

In 2001, the total production of cereals increased (65 300 t) which includes wheat, barely, maize and sorghum in the north and central area. However, production is still insufficient to meet domestic demands. This area also produces lentils and chickpeas. In the more fertile areas of the Jordan River Valley fruits and vegetables, including tomato, cucumber, potato, eggplants, citrus fruits and melons, are often produced in surplus amounts. In the mountain areas, olives are produced in sufficient amounts. From 1980 to 1996 per capita food production increased by 13% (UNDP, 1998).

At the household level, food security is determined by income and fluctuating prices. The low income households are insecure regarding food, and the lower the income level of the household, the higher the proportion of its total expenditure on food. The total expenditure that is spent on food is higher for the poor (48%) compared the non-poor (42%). Among the poor, cereals are the main and cheapest source of energy for those with an annual household expenditure of less than 1200JD. Cereals contribute to 70% of their total energy intake (UN Resident Coordinator, 2002; DOS, 1997). ). From 1998-2000 Jordan received 15% of cereal imports as food aid (Table 1) (FAOSTAT, 2002). Food subsidizing by the government has been gradually lifted since 1989 and now only barley and bran are subsidized.


5. Economy Jordan is classified as a lower-middle income country based on the GNP value (WB, 2001). As a developing country in an arid region with high growth rate, Jordan depends on central planning. Numerous government projects were initiated and private investment was encouraged. However, the socio-economic development has been influenced by instability due to war and refugee flow. The budget deficit has increased from -3.5 in 1990 to -5.8 in 1998 (WB, 2001).

Agriculture contributes to 6% of GPD whereas that of manufacturing, services and industry contributes to 56%, 5% and 6%, respectively (WB, 2001). The economic reform in Jordan is based on increased efficiency in agricultural water use, international donation assistance programs, foreign and emigrant investment, new income tax law and the use of open business reform and privatization policies (WB, 2001).


II. THE FOOD AND NUTRITION SITUATION

1. Trends in energy requirements and energy supplies Per caput energy requirements1 increased from 1965 to 2000 and are expected to increase further by 2030. In the year 2000, the per caput energy requirement in rural areas was 2159 kcal/caput/day and in urban areas it was 2055 kcal/caput/day. At national level, trends in food requirements reflect the changes in population structure and in particular in the age, sex and urban-rural distribution of the population. The percentage of people living in urban centres has increased from 46% to 74% from 1965 to 2000, and the total population more than tripled in the same time period. The per caput dietary energy supply (DES) has followed population growth and the trends in energy requirements, increasing from 2152 kcal/caput/day in 1965 to 2824 kcal/caput/day in 2000, exceeding per caput energy requirements (Table 2) (FAOSTAT, 2002).

Table 2: Total population, urbanisation, energy requirements and dietary energy supplies (DES) per person and per day in 1965, 2000 and 2030

a Source: James and Schofield, 1990. b Source: FAOSTAT, 2002. Three-year average calculated for 1964-66 and 1998-2000

1 Per caput energy requirements are calculated on the basis of the sex and age distribution of the population, using references for body size, physical activity levels (higher among the rural population, lower among the urban), energy needs for pregnancy and lactation. The method of calculation is derived from James & Schofield (1990). The requirements are expressed per average person of the country. Thus requirements are low in young and/or urbanized populations and higher in older or rural populations.

Year 1965 2000 2030

Total population (thousands) 1962 6669 13019

Percentage urban (%) 46.3 74.2 83.5

Per caput energy requirements (kcal/day) a 2069 2085 2154

Per caput DES (kcal/day) b 2152 2824 __

Figure 1: Share of protein, fat and carbohydrate in D ietary Energy Supply Trends from 1998-2000

70.7 68.4 69.4 69.1 66.3 67.0 64.0

10.810.911.410.511.011.310.6

25.222.122.320.419.620.318.7

0

500

1000

1500

2000

2500

3000

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

DES

kca

l/cap

ut/d

ay

Carbohydrates Protein Fat Source: FAO STAT


Figure 1 shows the carbohydrate, protein and fat supply. The share of fat in total DES has increased from 19% to 25% in the period 1964-2000 while the percentage of carbohydrates decreased from 71% to 64% during the same period (Figure 1). The share of protein in total DES has remained fairly constant over the 36 year period (FAOSTAT, 2002).

The high share of carbohydrate in total DES is characteristic for developing countries. However the increasing share of fat and the decreasing share of carbohydrate in total DES reflect the trend of urbanization in the country.

2. Trends in food supplies

Quantity: The main cereal supplied in Jordan is wheat of which 4% is locally produced. The second most important cereal is rice, which is entirely imported. Between 1964–66 and 1998–2000, there has been an increase in the supply of cereals (mainly wheat) from 131 to 176 kg/caput/year (Figure 2). This increase is due mainly to the increase in wheat imports. In the same period there has been a decrease in the supply of fruits and vegetables from 290 to 136 kg/caput/year for the 36 year time period with an all time low of 103 kg/caput/year from 1974-1976. There has been an increase in the supply of milk and eggs (from 50 to 74 kg/caput/year), sweeteners (from 28 to 33 kg/capita/year), and meat and offals (from 10 to 34 kg/caput/ year). This is largely due to the increase of imports and wealth among people particularly in the period 1975 to 1990. Other food group supplies remained fairly constant (FAOSTAT, 2002).

Energy: Cereals provide the main source of energy in Jordan. They provided 53% of total DES from 1996–1998. This was followed by vegetable oil and sweeteners (14% and 11%, respectively), then by meats and offals (5%), milk and eggs (5%) and pulses, nuts and

Figure 2: Supplies of m ajor food groups (in kg/caput/year)Trends from 1964-66 to 1998-2000

0

25

50

75

100

125

150

175

200

225

250

275

300

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

kg/c

aput

/yea

r

Cereals (excl. beer)Starchy rootsSweetenersPulses, nuts, oilcropsFruits & VegetablesVegetable oilsAnimal FatsMeat & offalsFish & seafoodM ilk & EggsOther

Source: FAOSTAT


oilcrops (4%). Meat and offals as a percent of total DES doubled over the entire 36 year period. Fruits and vegetables on the other hand decreased by 75% over the same time period. As a result, the percent of energy, protein and fat supplied by vegetable products decreased and the supply of energy, protein and fat supplied by animal products increased. From 1996–1998 animal products contributed 12%, 30% and 27% of total energy, protein and fat supplies respectively (Figure 3) (FAOSTAT, 2002).

Major food imports and exports: Food imports were mainly represented by cereals. The import of cereals as a percent of DES has increased from 35% to 116% or from 176 558 t/year to 1 815 768 t/year from 1964–1966 to 1996–1998. (Figure 4). The import of sweetener dropped slightly from 16% to 14% of total DES even though imports increased from 31 849 t/year to 162 893 t/year. Vegetable oils, the third major imported major food group contributed only 5% of total DES (69 982 t/year) from 1964–1966 and increased to 32% (188 818 t/year) of total DES from 1998–2000 (FAOSTAT, 2002). The introduction of non-traditional vegetable oils in the local diet, particularly soybean oil and corn oil, contribute to this increase.

Jordan has been less competitive in the world food market. Most of the food consumed is imported. Food exports peaked from 1979–1981 mainly due to an increase in vegetables, and fruits and cereal export (Figure 5). The export of vegetable oils increased from 1998–2000 and represented 16% of total DES, even though it was below 1% for the previous years. This is explained by the fact that some imported raw vegetable oil is exported and also that olive oil production has increased in the last 3 decades (FAOSTAT, 2002).

Figure 3: Share of major food groups in Dietary Energy SupplyTrends from 1964-66 to 1998-2000

0

500

1000

1500

2000

2500

3000

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

kcal

/cap

ut/d

ay

Cereals (ex cl. beer)

Starchy roots

Sw eeteners

Pulses, nuts, oilcrops

Fruits & Vegetables

Vegetable oils

Animal Fats

Meat & offals

Fish & seafood

Milk & Eggs

Other

Jordan Source: FAOSTAT


3. Food consumption

In Jordan, food consumption surveys are rarely conducted due to their cost but the Department of Statistics in Jordan (DOS) conducts national household expenditure and income sample surveys every five years. The data on household food expenditure is analyzed by sectors (urban and rural) and as a total is presented for the whole country (DOS, 1992; 1997).

Over the last three decades the budget has fluctuated, however the share of household expenditure on different food groups has not changed. The household expenditure on foods and beverages has slightly increased from 41% in 1992 to 44% in 1997. Household expenditure on cereals has increased from 3% in 1992 to 6% in 1997 of total expenditure on foods. The expenditure on milk products decreased from 5% in 1992 to 4% in 1997 (DOS, 1992; 1997).

Figure 4: Major food imports as a percentage of Dietary Energy SupplyTrends from 1964-66 to 1998-2000

0

50

100

150

200

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

% o

f DES

Cereals (excl. beer)SweetenersVegetable oils

Jordan Source: FAOSTAT

Figure 5: M ajor food exports as a percentage of D ietary Energy SupplyTrends from 1964-66 to 1998-2000

0

5

10

15

20

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

% o

f DES C erea ls (excl. beer)

F ru it (excl. w ine)V egetab lesV egetab le o ils

Jordan Source: FA O S TA T


In 1997, the average household expenditure on meat and fruits and vegetables was about 11% and 5%, respectively. Cereals, mainly wheat and rice, constituted the highest amount of food consumed (210 kg/caput/year) (Table 3). The intake of rice and bread has decreased by 1% each from 1992 to 1997 (DOS, 1992; 1997). This slight decrease is due to the phasing out of bread price subsidies in 1996, plus the phasing out of rice, sugar and powdered milk price subsidies in 1997.

Vegetables and fruits constitute the next largest volume of food consumed (184 kg/caput/year). The consumption of at least two to three vegetables and fruits per day is common. The type of fruit and vegetable consumed varies with the availability and prices. For example, tomato, potato and cucumber were the most available and consumed vegetables in 1992 and 1997 (DOS 1992; 1997). Their consumption in 1997 was 40 kg/caput/year for tomato, 19 kg/caput/year for potato, and 11 kg/caput/year for cucumber. The most consumed fruits in 1997 were citrus fruits, melons and apples (19, 16 and 8 kg/caput/year respectively) (DOS, 1997).

Poultry consumption has increased from 29 kg/caput/year in 1992 to 31 kg/caput/year in 1997. The consumption of milk and its products was maintained at 30 kg/caput/year in 1992 and 1997 (Table 3). Thirteen percent is derived from yogurt (DOS, 1992; 1997).

The share of major foods as a percentage of total energy intakes: Cereals present the main source of energy in the Jordanian diet, providing 48% of total energy intake (Table 3). In the Jordanian diet the intake of sweeteners was relatively high contributing to 14% of total energy intake. Fats and oils ranked third and contributed 11% of total energy intake. The intake of fat and oils was greater in urban than rural areas for both years. Fats and oils are generally used in the Jordanian diets for cooking and seasoning purposes along with traditional dishes.

On the other hand, pulses provided less than 2% of total energy. Milk products and meats provided 4% and 5% of total energy, respectively. Seven percent of total energy came from fruits and vegetables in 1997. There was very little variation of the share of major food groups in total energy intake from 1992 to 1997 (DOS, 1992; 1997).

The percentage of energy provided by protein was 12% in 1992 compared to 13% in 1997. In 1992, 35% of protein came from animal products and in 1997 it increased slightly to 36%. The percentage of energy provided by fat was 25% in 1992 and 24% in 1997.

Although adequate food energy is available at the national level, parts of the population do not have an adequate food energy intake. The lower the income level of a household the higher the proportion of its total expenditure on food; particularly cereals and other staples (DOS, 1992; 1997). Thus, the quantity and quality of food consumed is highly affected by household annual expenditure. Poor families have a higher consumption of affordable energy sources, such as cereals, which lack many essential nutrients (UN Resident Coordinator, 2002).


Table 3: Food consumption surveys

Note: - Data not determined.

Source/ Location Sample Average food intakeYear

of surveyNumberhousehold

s

Sex AgeYears

Major Food Groups (kg/caput/year)

Cereals Roots/Tubers Pulses

Fruits/Vege-tables

Oils/Fats Meat Fish Milk

prod.Sweet-eners Other

DOS,1997 National 6048 M/F All 209.9 _ 6.9 183.6 22.3 44.2 3.3 30.3 39.4 58.0

Urban 194.9 _ 6.6 182.5 23.7 47.8 4.0 32.1 42.3 68.6

Rural 224.8 _ 7.3 185.1 20.8 40.5 2.6 28.5 36.5 46.7

DOS, 1992 National 8000 M/F All 201.1 _ 6.9 188.0 22.6 44.5 4.0 29.6 44.5 48.9

Urban 189.8 _ 7.7 189.0 25.6 48.2 4.4 31.8 48.5 59.5

Rural 212.4 _ 5.8 187.3 19.7 40.9 3.7 27.4 40.2 38.0

Nutrient Intake (person/day)

Energy(kcal)

%Protein

%Fat

Protein(g)

%Animal

products

Fat(g)

%Animal

products

DOS, 1997 National 6048 M/F All 3161 12.7 23.8 100.0 35.8 83.7 24.6

Urban 2989 13.6 25.7 101.4 35.7 85.2 24.3

Rural 3204 12.3 21.6 98.7 34.8 77.0 26.0

DOS, 1992 National 8000 M/F All 3459 11.5 25.0 99.5 35.0 96.3 30.0

Urban 3881 10.8 19.4 105.2 30.4 83.5 26.4

Rural 2905 13.6 30.0 98.8 36.7 86.7 30.7

Share of major food groups in total energy intake (%)

Cereals Roots/Tubers Pulses

Fruits/Vege-tables

Oils/Fats Meat Fish Milk

prod.Sweet-eners Other


Urban 45.9 _ 2.1 7.4 11.5 5.8 0.4 5.0 12.5 9.2

Rural 62.1 _ 1.7 7.3 9.7 5.6 0.2 4.1 4.1 5.1


Urban 57.6 _ 1.2 5.0 9.4 5.2 0.3 1.8 15.7 3.6

Rural 55.7 _ 2.1 4.9 8.7 7.9 0.6 4.8 7.0 8.2


4. Infant feeding practices

More than 95% of Jordanian mothers breast-feed their children in the first 3 months, 85% breast-feed until age 6 month and 69% breast-feed for 7-9 months. Most newborn infants were given colostrum (86%), but only 60% were put to the breast within 6 hours of birth (MOH, 1993b). Exclusive breast-feeding rate was 32% (DOS, 1998a).

The average age for introducing breastmilk substitutes is 3.7 months. Twenty percent of infants were given a bottle before their first month of life and 31% were bottle feed before 12 months. Twenty percent of mothers diluted the formula, which is a major cause of bottle-fed infants failure to thrive and 73% of mothers boiled the water used to prepare the formula (Zou’bi et al, 1992).

The introduction of complementary foods was 23%, 54% and 23% for children 0-3 months, 4 to 5 months and less than 6 months respectively (MOH, 1993b). Supplementary food was given to 13% of infants between 2 and 3 months, including those which were breast-fed. This includes, bread, eggs, legumes, rice and yoghurt. Caffeinated beverages, such as teas and sodas were also high and regarded as nutritive foods among mothers. From 4 to 6 months infants where given commercially canned foods. Also, sugar consumption was high; since it is being added to milk, water, tea and juice (Zou’bi et al. 1992).

The number of hospitals/maternities officially designated by UNICEF as “Baby Friendly,” having fulfilled 10 criteria supportive of breastfeeding is 3 of 56. The length of maternity leave is 10 weeks and cash benefits for maternity leave as a percentage of their wage is 100%. This is paid by the employer. The women’s share of the adult labour force (age 15 and above) is 21% (UNICEF, 1999).

5. Anthropometric data

Child anthropometrics The 1997 Jordan Population and Family Health Survey assessed the nutritional status of children less than five years using 3 indices: weight-for-height which reflects acute growth disturbances, height-for-age which reflects long-term growth faltering and weight-for-age which is a composite indicator of both long- and short-term effects. Weights and heights of children are compared with the reference standards and the prevalence of anthropometric deficits are usually expressed as a percentage of children below a specific cut-off points such as minus 2 standard deviations from the median value of the international reference data (e.g. NCHS/CDC/WHO) (WHO, 1993).

According to the 1997 national survey conducted on 5492 children less than five years the prevalence of stunting in all of governorates was 8%. The prevalence of wasting was 2% and the prevalence of underweight was 5%. The nutritional status, indicated by the above indicators, was better in children less than 6 months but it worsened with age. The prevalence of wasting among boys and girls did not differ (2%) and the prevalence of stunting (8% and 7%) and underweight (5% and 6%) only differed by 1% ( Table 4a-1). The nutritional status was better in urban than in rural areas. The prevalence of stunting among rural children was 14% and only 6% in urban areas. The prevalence of underweight was also higher in rural areas (9% rural and 4% urban), however there was no difference in the prevalence of wasting (2%). The south region had the highest prevalences for all indicators of nutrition status which were similar to rural results (DOS, 1998). According to WHO classification of malnutrition, the prevalence of wasting, stunting and underweight is low and is not considered a public health problem in Jordan (WHO, 1995).


According to the 1991 survey conducted in 8 governorates which included 8113 children the prevalence of stunting and underweight was the highest in Mafraq governorate followed by Tafeeleh and Ma’an. The prevalence of wasting was highest in the Irbid governorate (3% and 2% for males and females, respectively. At the governorate level the prevalence of underweight and wasting is low and therefore consistent with the WHO classification at the national level. However, although stunting is not a national health problem, the governorate of Mafraq has a medium and high prevalence according to WHO classification of malnutrition for males and females, respectively (Map 1a and Map 1b). For example the prevalence of stunting in Mafraq was 33% among males and 24% among female (MOH, 1993b).

Results of a third nutritional survey conducted in 1990 show that there has been an improvement in the nutritional status of children since 1997 (Zou`bi et al, 1992). For example, the prevalence of stunting in 1990 was 16% compared to 8% in 1997 (Table 4a-1 and Table 4a-2). The prevalence of underweight and wasting at the national level has also improved slightly. The 1990 survey confirms the results of a previous survey regarding the higher prevalence of malnourished children in rural areas than in urban areas (Zou`bi et al, 1992). It is difficult to compare the 1990 prevalences of stunting and underweight in Ma’an, Tefeeleh and Mafraq to the 1997 study since results for these goverorates have been combined with other locations.

However, the overall improvement of the nutritional status, as indicated are associated with the promotion of maternal and child health activities. For example, the number of Maternal Child and Health (MCH) centers increased by 214% from 1990 to 2000. Plus, an increased vaccination coverage rate, and improvements in education, birth spacing and sanitation help to explain the drop in infant and under five mortality rates mentioned earlier.


Table 4a-1: Anthropometric data on children

Source/ Location Sample Percentage of malnutrition

Yearof survey

SizeNumber

Sex AgeYears

Underweight Stunting Wasting Overweight% Weight/Age % Height/Age % Weight/Height % Weight/Height

< -3SD < -2SD* < -3SD < -2SD* < -3SD < -2SD* > +2SDDOS, 1998b National 5492 M/F <5 0.5 5.1 1.6 7.8 0.2 1.9 2.8DHS, 1997 Central 3505 M/F <5 0.5 4.7 1.5 7.5 0.2 2.1 2.8

North 1633 M/F <5 0.4 5.2 1.6 7.2 0.1 1.2 2.8South 355 M/F <5 0.9 7.9 2.4 13.1 0.2 2.7 2.9

National 420 M/F 0-0.49 0.0 0.8 0.3 3.3 0.0 1.0 7.1National 595 M/F 0.5-0.99 0.9 4.8 1.5 5.6 0.2 1.6 5.2National 1132 M/F 1 0.6 6.5 2.3 10.6 0.1 2.7 3.3National 1119 M/F 2 0.7 4.9 1.9 6.1 0.2 2.0 1.6National 1151 M/F 3 0.1 5.4 1.2 8.2 0.1 1.2 1.4National 1075 M/F 4 0.7 5.1 1.5 9.0 0.5 2.1 1.9URBAN 4460 M/F <5 0.4 4.3 1.2 6.4 0.2 1.8 2.8RURAL 1032 M/F <5 1.0 8.5 3.2 13.7 0.1 2.1 2.6National 2780 M <5 0.5 4.6 1.8 8.1 0.1 1.7 3.0National 215 M 0-0.49 0.0 0.9 0.6 4.6 0.0 0.8 7.5National 297 M 0.5-0.99 0.6 4.5 1.1 6.5 0.4 2.1 4.1National 586 M 1 0.5 6.6 2.9 12.0 0.0 2.6 3.6National 571 M 2 0.7 4.1 2.0 6.1 0.1 2.1 1.8National 564 M 3 0.1 4.7 1.3 7.5 0.0 0.6 2.0National 548 M 4 0.7 4.7 1.9 8.9 0.4 1.6 2.2National 2712 F <5 0.5 5.5 1.3 7.4 0.3 2.0 2.6National 206 F 0-0.49 0.0 0.6 0.0 1.9 0.0 1.2 6.7National 298 F 0.5-0.99 1.2 5.0 2.0 4.7 0.0 1.2 6.3National 546 F 1 0.6 6.5 1.6 9.2 0.2 2.8 3.0National 548 F 2 0.7 5.8 1.7 6.1 0.2 1.9 1.4National 588 F 3 0.0 6.0 1.0 8.9 0.3 1.7 0.9National 527 F 4 0.7 5.6 1.1 9.1 0.6 2.6 1.7

MOH, 1993b National (8 gov.) 8113 _1991 All _ M <5 _ 8.9 _ 16.1 _ 1.9 _

Amman gov. _ M <5 _ 8.3 _ 15.0 _ 1.2 _Balqa'a gov. _ M <5 _ 9.6 _ 11.2 _ 0.8 _Irbid gov. _ M <5 _ 7.2 _ 14.4 _ 2.9 _

Karak gov. _ M <5 _ 9.7 _ 16.6 _ 1.7 _Mafraq gov. _ M <5 _ 13.5 _ 33.3 _ 2.6 _

Tafeeleh and Ma 'an gov. _ M <5 _ 11.7 _ 19.2 _ 2.8 _Zarka gov. _ M <5 _ 7.8 _ 12.3 _ 0.9 _

All _ F <5 _ 9.4 _ 15.7 _ 1.3 _Amman gov. _ F <5 _ 8.4 _ 14.2 _ 1.1 _Balqa'a gov. _ F <5 _ 10.6 _ 16.7 _ 0.4 _Irbid gov. _ F <5 _ 6.3 _ 11.2 _ 1.9 _

Karak gov. _ F <5 _ 9.9 _ 16.0 _ 1.2 _Mafraq gov. _ F <5 _ 12.0 _ 24.0 _ 1.3 _

Tafeeleh and Ma 'an gov. _ F <5 _ 11.9 _ 17.7 _ 2.1 _Zarka gov. _ F <5 _ 8.1 _ 10.4 _ 0.9 _

Notes: - Data not determined. Each index is expressed in terms of the number of standard deviations (SD) units from the median of the NCHS/CDC/WHO international reference population. * Includes children who are below -3 SD. Website at: http://www.who.int/nutgrowthdb/


Table 4a-2: Anthropometric data on children Source/ Location Sample Percentage of malnutrition

Yearof survey

SizeNumber

Sex AgeYears

Underweight Stunting Wasting Overweight% Weight/Age % Height/Age % Weight/Height % Weight/Height

< -3SD < -2SD* < -3SD < -2SD* < -3SD < -2SD* > +2SD

Zou'bi A et al., 1992 National 6602 M/F <5 0.8 6.4 4.3 15.8 0.6 3.1 5.7

DHS, 1990 Amman 2306 M/F <5 0.9 6.4 4.0 12.9 0.7 4.5 5.7Balqa 421 M/F <5 1.3 8.7 6.9 23.3 1.0 4.8 6.7Irbid 1827 M/F <5 0.9 5.6 3.6 16.3 0.4 1.8 5.8

South (Karak, Tafeeleh, Ma'an) 652 M/F <5 1.0 7.5 6.2 18.4 0.8 3.8 7.9Zarqa and Mafraq 1397 M/F <5 0.4 6.3 4.0 16.6 0.3 1.7 4.2

National 594 M/F 0-0.49 0.6 1.7 0.5 3.6 0.4 4.0 10.0National 704 M/F 0.5-0.99 1.9 6.0 4.5 14.7 0.9 4.6 12.8National 1409 M/F 1 1.1 7.3 6.2 22.6 0.8 3.4 7.6National 1374 M/F 2 0.7 6.8 4.4 14.7 0.3 2.4 2.5National 1339 M/F 3 0.4 7.4 4.5 16.9 0.4 2.6 3.2National 1183 M/F 4 0.7 6.3 3.3 14.6 0.6 2.9 3.5URBAN 4633 M/F <5 0.6 4.9 3.2 12.7 0.6 2.7 6.0RURAL 1969 M/F <5 1.3 9.8 6.8 23.1 0.6 4.0 4.8National 3308 M <5 1.0 6.6 4.7 16.2 0.8 3.7 5.1National 299 M 0-0.49 0.8 1.7 1.1 3.6 0.7 4.1 9.6National 337 M 0.5-0.99 1.7 5.2 3.8 12.6 0.6 5.2 11.3National 704 M 1 1.4 8.6 7.1 22.9 0.9 4.1 5.9National 713 M 2 1.1 6.8 4.4 13.9 0.5 2.9 2.7National 675 M 3 0.1 7.1 5.4 17.7 0.8 3.4 3.6National 580 M 4 1.0 6.6 3.9 17.7 0.9 3.7 3.0National 3294 F <5 0.7 6.2 3.8 15.5 0.4 2.5 6.2National 295 F 0-0.49 0.4 1.6 0.0 3.5 0.1 3.9 10.5National 367 F 0.5-0.99 2.1 6.8 5.1 16.6 1.2 4.1 14.2National 705 F 1 0.8 5.9 5.4 22.3 0.8 2.8 9.4National 660 F 2 0.2 6.7 4.4 15.7 0.1 1.8 2.1National 664 F 3 0.7 7.8 3.6 16.1 0.0 1.7 2.7National 603 F 4 0.3 5.9 2.7 11.6 0.2 2.1 4.0

Each index is expressed in terms of the number of standard deviations (SD) units from the median of the NCHS/CDC/WHO international reference population. * Includes children who are below -3 SD. Website at: http://www.who.int/nutgrowthdb/

Adolescent anthropometrics Some anthropometric data on adolescents are presented in (Table 4b). No study has been conducted at the national level. One study conducted in 2000 examines women between the ages of 10 to 19 years from North Badia in the Mafraq Governorate (Tukan et al, 2002) and another study from 1999 looks at women (11-<16 years) from the Zarqa Governorate (Asa`d, 1999). A difference in the mean body height among 11 year old females was found with 134.7 cm and 149.4 cm for North Badia and Zarka, respectively. Also the body mass index (BMI) were different (16.5 kg/m2 and 18.8 kg/m2 respectively) for both areas. However, in both North Badia and Zarqa BMI increased with age (Tukan et al., 2002; Asa’d, 1999).


Table 4b: Anthropometric data on adolescents

Note: - Data not determined.

Adult anthropometrics The adult anthropometric data do not represent the whole country. The study conducted in Badia in the year 2000 compared women (20 to 25 years) from Amman and Badia of the Mafraq governorate (Ahmad et al., 2002). The 1999 survey done was conducted on a sample of Jordanian females (20 to 25 years) in the Jordanian University in Amman coming from different parts of the country (Abu Nimeh, 1999). The mean BMI of Badia females was higher than those from Amman and the university students (23.6 kg/m2, 22.9 kg/m2and 22.4 kg/m2 respectively). A higher percentage of Badia females were overweight or obese in comparison with Amman females (34% vs. 22%). The fact that more Badia women stay at home than Amman females may explain the difference between the two samples (Table 4c).

Source/ Location Sample Anthropometric status Year

of surveySize

NumberSex Age

Years

Height (cm)Body Mass Index

(kg/m2)mean SD median mean SD median

Tukan et al North Badia, 25 F 10 132.6 5.8 132.0 16.1 1.8 15.9

, 2002 Jordan 32 F 11 134.7 9.5 131.9 16.5 2.6 16.22000 31 F 12 141.7 6.7 142.7 17.4 2.4 17.6

37 F 13 149.0 7.6 149.9 18.2 3.4 17.426 F 14 152.5 7.0 153.4 20.7 3.3 19.833 F 15 152.7 5.5 152.0 20.8 3.5 20.815 F 16 155.1 6.5 155.5 21.1 2.6 20.731 F 17 153.1 8.5 153.1 23.4 3.7 22.535 F 18 154.5 5.9 155.1 23.1 3.1 22.628 F 19 156.7 5.5 157.5 24.2 4.4 23.9

Asa'd, 1999 Zarka 622 F 40847 _ _ _ _ _ _

1999 51 F 11 149.4 1.1 _ 18.8 0.4 _

261 F 12 152.8 0.5 _ 19.4 0.2 _

207 F 13 156.1 0.5 _ 20.2 0.2 _

78 F 14 158.6 0.9 _ 20.6 0.4 _

25 F 15 155.1 1.4 _ 20.2 0.4 _


Table 4c: Anthropometric data on adults

Source/ Location SampleYear

of surveySize

NumberSex Age

Years

Body Mass Index(kg/m2)

Chronic Energy Deficiency% BMI

Overweight% BMI

Obesity% BMI

mean SD median <16.0 16.0-16.9 17.0-<18.5 25.0 - 29.9 >30.0

Ahmad Amman 234 F 20-25 22.9 0.2 _ _ _ 5.6 18.4 3.4

et al , 2002 Jordan Badia 233 F 20-25 23.6 0.3 _ _ _ 8.2 27.0 6.9

Abu Nimeh Jordan University 276 F 20-25 22.4 0.2 _ _ _ _ _ _

, 1999 , Amman

and Percentage of malnutritionAnthropometric status

Note: -Data not determined.

5. Micronutrient deficiencies

Iodine deficiency disorders (IDD) Iodine deficiency disorders (IDD) are a public health problem in Jordan and include the clinical and sub-clinical manifestations of iodine deficiency. Iodine deficiency in pregnant women may cause irreversible brain damage in the developing foetus, whereas in infants and young children it may cause psychomotor retardation and intellectual impairment. Total goitre rate (TGR) is the proportion of the population with a prevalence of goitre for all grades combining both palpable and visible goitre.

The first national survey on iodine deficiency was conducted by the MOH in 1993 on school children aged 8-10 years (Table 5a). The prevalence of TGR in 2457 children representing all governorates was 38% with 16% for grade one and 22% for grade two levels. The prevalence was higher in rural than urban children (45% and 34% respectively) and slightly higher in females than in males (39% and 36% respectively). According to governorates, the prevalence was the highest in Tafeeleh (76%) followed by Ma’an (65%) and Irbid (55%). The lowest prevalence of TGR was in Mafrak (11%) and in Zarka (18%) (Table 5a). A TGR prevalence greater than 5% among primary children aged 8 to 10 years classifies IDD as a public health problem (MOH, 1993a).

In 1995, the government had a national salt iodization programme to combat IDD. In 2000, a new national survey was conducted on the same age group (8-10 years) to evaluate the iodine status 5 year after salt iodization (MOH, 2000) (Table 5a). The results showed that there was some improvement in TGR (34% in 2000 and 38% in 1993). There has been a drop in the prevalence of TGR among females (30% in 2000 and 39% in 1993). The prevalence of goitre among school children by governorate is illustrated in Map 2 (MOH, 2000).

The severity of goitre has been alleviated as the prevalence of grade two decreased from 22% in 1993 to 9% in 2000. An assessment study was conducted in Tafeeleh Governorate since this governorate had the highest TGR prevalence in 1993 (76%) (Saraira et al., 2002, MOH, 1993a). In the year 2000, the prevalence decreased to 32% which was lower than the prevalence of TGR found in the MOH study (42%). However, the small sample size used for Tafeeleh may contribute to the difference results. The prevalence of goitre among school children by governorate is illustrated in Map 2 (MOH, 2000).


Vitamin A deficiency

Vitamin A is an essential micronutrient required for normal health and survival. It is involved in several critical functions in the body including vision, immune system, reproduction, growth and development. Children under five years are most susceptible to vitamin A deficiency (VAD). The consequences of VAD are tragic: they include night blindness, irreversible blindness, growth retardation and increased susceptibility to infections. Pregnant women are also prone to VAD and their children are likely to become deficient.

A survey was conducted in 1997 (MOH, 1997) on children 6 months to 6 years of age from Mafraq, Jerash and Madaba. There was a 4% prevalence of VAD among all of these children using a serum retinol cut-off point of less than 20 µg/dL (<0.7 µmol/l). No subject had a serum retinol level less than 9.9µg/dL. However, 8%, 3% and 1% of subjects from Mafraq, Jerash and Madaba respectively, had serum retinol levels from 10 to 19.9 µg/dL (MOH, 1997) (Table 5b) .

Generally, the number of children having VAD is relatively low. The food habits include the consumption of many local and wild plants that are rich in vitamin A. These include foods such as spinach, mallow, vine leaves, mints, cress, water cress and rocket (Takruri and Hamdan, 1989). Iron deficiency anaemia The consequences of iron deficiency anaemia (IDA) include reduced physical work capacity and productivity, impaired cognitive functions and brain metabolism and reduced immuno-competence. The causes of IDA include low dietary intake in relation to the recommended dietary allowances (RDA), poor bio-availability of iron in the diet, malaria and a high prevalence of parasitic infestations.

A national survey conducted on 1790 females aged 15 to 49 years in 1996 included all of the governorates (Table 5c) (MOH/UNICEF, 1996). Using the WHO cut-off point, a haemoglobin level of less than 12 g/dL and less than 11 g/dL in pregnant and lactating women, there was a 29% prevalence of anaemia. The highest prevalence was in Tafeeleh governorate (39%) followed by Mafrak (35%) and the lowest was in Ajloon (16%) (Map 3). Women between 30 to less than 40 years had the highest prevalence of anaemia (35%). This could be due to the fact that at this age the women have had successive pregnancies and lactation periods especially in the rural areas. The lowest prevalence was among women between 15 and less than 20 years (23%). The prevalence of anaemia for women (15 to 49 years) did not vary when categorized according to income in Jordian dollars.


Table 5a: Surveys on micronutrient deficiencies

Source/ Deficiency Location Sample PercentageYear

of surveySize

NumberSex Age

Years

IodineMOH, 20002000 Grade zero National 1729 M/F 8-10 66.5

Grade one National 650 M/F '8-10 25.0Grade two National 222 M/F '8-10 8.5

TGR National 2601 M/F '8-10 33.5National 1455 M '8-10 36.6National 1142 F '8-10 29.7National 888 M/F 8 28.7National 888 M/F 9 35.7National 825 M/F 10 36.5

TGR Amman 832 M/F '8-10 28.4Irbid 450 M/F '8-10 51.1

Balka 193 M/F '8-10 38.3Ajloon 72 M/F '8-10 79

Madaba 77 M/F '8-10 22Zarka 448 M/F '8-10 17.9Karak 118 M/F '8-10 48.3Ma’an 68 M/F '8-10 34Aqaba 65 M/F '8-10 20Mafrak 133 M/F '8-10 36.1

Tafeelah 59 M/F '8-10 42Jarash 86 M/F '8-10 14

Saraira, 2000 Grade one Tafeeleh 66 M/F '8-10 252000 Grade two Tafeeleh 19 M/F '8-10 7

TGR Tafeeleh 85 M/F '8-10 32Tafeeleh 35 M '8-10 30Tafeeleh 82 F '8-10 58

MOH, 1993a TGR National 2457 M/F '8-10 37.71991 Grade one National 391 M/F '8-10 15.9

Grade two National 536 M/F '8-10 21.8TGR National 2457 M/F '8-10 37.7

Urban 1571 M/F '8-10 33.6Rural 886 M/F '8-10 44.9

National 594 M/F 8 31.8National 773 M/F 9 40.6National 1090 M/F 10 38.8National 1286 M '8-10 36.3National 1171 F '8-10 39.2

TGR Amman _ M/F '8-10 33.7Irbid _ M/F '8-10 54.6

Balka _ M/F '8-10 43.9Zarqa _ M/F '8-10 18.1Karak _ M/F '8-10 22.1Ma`an _ M/F '8-10 65.6Mafrak _ M/F '8-10 10.9

Tafeeleh _ M/F '8-10 76.1TOTAL 2457 M/F '8-10 37.7


Table 5b: Surveys on micronutrient deficiencies Source/ Deficiency Location Sample Percentage

Yearof survey

SizeNumber

Sex AgeYears

Vitamin AMOH, 1997 Serum Retinol 1997 <9.9 µg/dL Mafraq 134 M/F 0.5-6 0.0

Jerash 124 M/F 0.5-6 0.0Madaba 142 M/F 0.5-6 0.0

10.0-19.9 µg/dL Mafraq 134 M/F 0.5-6 8.2Jerash 124 M/F 0.5-6 2.6Madaba 142 M/F 0.5-6 1.4

<20.0 µg/dL All 400 M/F 0.5-6 4.0

<9.9 µg/dL National 19 M/F 1 0National 70 M/F 2 0National 78 M/F 3 0National 85 M/F 4 0National 67 M/F 5 0National 80 M/F 6 0

10.0-19.9 µg/dL National 19 M/F 1 11National 70 M/F 2 4National 78 M/F 3 5National 85 M/F 4 5National 67 M/F 5 2National 80 M/F 6 3

<9.9 µg/dL National 215 M 0.5-6 0.0National 285 F 0.5-6 0.0

10.0-19.9 µg/dL National 215 M 0.5-6 4.2National 285 F 0.5-6 3.8


Table 5c: Surveys on micronutrient deficiencies Source/ Deficiency Location Sample Percentage

Yearof survey

SizeNumber

Sex AgeYears

IronMOH/UNICEF, (Hb level)1996 <12.0 g/dL National 1790 F 15-49 28.6

<11.0 g/dLa Amman 477 F 15-49 27.1Balka 129 F 15-49 33.3Karak 162 F 15-49 25.8Mafrak 135 F 15-49 35.0Zarka 198 F 15-49 23.5

Madaba 74 F 15-49 21Aqaba 31 F 15-49 29Ajloon 45 F 15-49 16Jerash 79 F 15-49 19Ma'an 71 F 15-49 28

Tafeeleh 37 F 15-49 39Irbid 352 F 15-49 32.9

National 326 F 15-<20 23.0" 742 F 20-<30 26.0" 483 F 30-<40 34.8" 237 F 40-<50 31.0

<12.0 g/dL10-<120 JDb National 408 F 15-49 28.4120-<150 JDb " 285 F 15-49 29.5150-<250 JDb " 579 F 15-49 28.5

>250 JDb " 433 F 15-49 28.1

a For pregnant and lactating women bDistribution of anaemia (Hb level>12.0g/dL) according to income in JDs.


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AMO. 2001; WB. 2002. D.3-4

UNICEF. 2002. D.6

FAO. 2002. H


NCP of JORDAN MAPS

General map of Jordan Map 1a: Prevalence of stunting for females less than 5 years old by governorate in Jordan in 1991 Map 1b: Prevalence of stunting for males less than 5 years old by governorate in Jordan in 1991 Map 2: Prevalence of goitre among school children (8 to 10 years) by governorate in Jordan in 2000 Map 3: Prevalence of anaemia among women (15 to 49 years) by governorate in Jordan in 1996

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