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Chronically Undernourished Mothers and Children


Home > Programmes > Chronically Undernourished Mothers and Children
 

 

 

Progress For Children: A Report Card on Nutrition



Chronically Undernourished Mothers and Children

 

Chronically Undernourished Children

Undernutrition contributes to the deaths of about 5.6 million children under five in the developing world each year. It can lead to poor school performance and dropout, it threatens girls' future ability to bear healthy children and it perpetuates a generational cycle of poverty. Progress for Children reports on the world's performance in improving nutrition in young children, a crucial step towards meeting the Millennium Development Goals.


 

Name: Chronically Undernourished Mothers and Children
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Theme: Region and Country: Maharashtra, India
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Deaths among children aged 28 days to 5 years - 6.6 million/year

Child deaths: Causes and epidemiological dimensions
Robert E. Black, M.D., M.P.H. - Johns Hopkins Bloomberg School of Public Health - Full text at The Lancet



Good nutrition is the cornerstone for survival, health and development for current and succeeding generations. Well-nourished children perform better in school, grow into healthy adults and in turn give their children a better start in life. Well-nourished women face fewer risks during pregnancy and childbirth, and their children set off on firmer developmental paths, both physically and mentally.

If mothers are this important to the welfare of children, it should be obvious that their physical and mental well-being should be safeguarded.

But the reality is different.  Fatigue is the commonest chronic health problem for women - not surprisingly. In the poor world, women produce at least 50% of the food, as well as being responsible for all the domestic tasks.  Childbearing adds a third workload; by the age of 30, a women has often spent 80% of her adult life pregnant or breastfeeding.

Hard work, childbearing and undernourishment lead to anemia.  In poor countries, half of all women, and two thirds of pregnant women, are anemic.

The value of women's unpaid labour in industrialised countries is estimated as 25 - 40% of GNP.  In the world as a whole, it is estimated as one -third of the world's economic product.

Discrimination by wealth begins even before birth. Poor, undernourished mothers are more likely to give birth to undernourished babies - and small, weak babies are more susceptible to illness and death.

Low birthweight babies are 4 - 6 times more susceptible to physical and mental handicap, and 8 - 10 times more likely to die in the first year of life.

Undernutrition is implicated in more than half of all child deaths worldwide. Undernourished children have lowered resistance to infection; they are more likely to die from common childhood ailments like diarrhoeal diseases and respiratory infections, and for those who survive, frequent illness saps their nutritional status, locking them into a vicious cycle of recurring sickness and faltering growth. Their plight is largely invisible: three quarters of the children who die from causes related to malnutrition were only mildly or moderately undernourished, showing no outward sign of their vulnerability.

Poverty, low levels of education, and poor access to health services are major contributors to childhood malnutrition, a complex issue that requires tackling on a wide number of fronts. To name only a few:

  • Ensuring food security for poor households, both enough food and the right kinds of food
     

  • Educating families to understand the special nutritional needs of young children, notably the value of breastfeeding and the importance of introducing suitable complementary foods at the right age
     

  • Protecting children from infections, by such measures as immunization against common childhood diseases and provision of safe water and sanitation;
     

  • Ensuring that children receive quality care when they fall ill
     

  • Shielding them from the micronutrient deficiencies that can bring death and disability, especially iodine, iron and vitamin A deficiencies
     

  • Paying special attention to the nutritional needs of girls and women, since chronically undernourished women tend to bear low-birthweight babies and so perpetuate the vicious cycle of undernutrition into the next generation

The underlying causes of undernutrition vary across regions. In many Asian countries poverty, the low status of women, poor care during pregnancy, high rates of low birth weight, high population densities, unfavorable child caring practices, and poor access to health care are underlying causes. In Sub-Saharan Africa, extreme poverty, inadequate caring practices for children, low levels of education and poor access to health services are among the major factors causing undernutrition. Conflicts and natural disasters in many countries have further exacerbated the situation. The increase in the number of undernourished children in Africa also reflects a rapid rate of population growth. In many countries in Africa, the devastating effects of HIV/AIDS, particularly in the second half of the decade, have reversed some of the gains made in the decade's early years.



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The great Vitamin A fiasco - World Nutrition - May 2010
Michael Latham

This commentary challenges the wisdom and validity of the current practice of providing to children between 6 months and 5 years, regular supplements of massive medicinal doses of vitamin A. Every year, roughly half a billion capsules are made to be distributed and to be given to around 200 million children in over 100 ‘targeted’ countries (1,2). One standard method of dosing of younger children is shown in the picture above, which appears on the cover of a United Nations Children’s Fund (UNICEF) working paper issued in 2005 (1). In most cases, this medicinal dosing is now being done in countries and areas where the vitamin A deficiency diseases xerophthalmia and blinding keratomalacia are now rare, and any clinical signs of vitamin A deficiency are now uncommon. download pdfpdf442 kb

Vitamin A saves lives. Sound science, sound policy
Keith P West Jr, Rolf DW Klemm, Alfred Sommer
 
Vitamin A deficiency can cause blindness, impair health, and be an underlying cause of death, in young children. Therefore, responsible debate about its public health importance, and the value of prevention, should be based on reliable evidence of the extent and severity of deficiency, and on the impact of interventions. download pdfpdf 315 kb

Universal Vitamin A Supplementation Programme in India: The need for a re-look  download pdfpdf 37 kb
The National Medical Journal of India - Vol. 23, No. 5, October 2010

20 Million US Dollars on Vitamin A Procurement : Out of 32 Million US Dollars of Annual Budget 2009-2010
The Indian scientists have raised their concern on over emphasis of Vitamin A supplementation to children. The recent research communications from Prof. Michael Latham and Prof. C. Gopalan have raised this issue with scientific evidence. These excerpts from the Annual Report of Micronutrients Initiatives India an International Non Government Organization, according to which out of 32 Million US Dollar available in the Annual Budget 2009-2010, more than 20 Million US Dollars were spent on Vitamin A Procurement and Interventions. A meager sum of 2.5 Million US Dollars were spent on Iron interventions.

Anaemia is most common nutritional deficiency disorders in the country. Almost vulnerable age groups have anaemia in the range of 60-90%. The health consequences of anaemia are highly detrimental to Maternal and Child Health. The prevalence of Vitamin A deficiency is less than one percent and is limited to selected geographical pockets in the country. The Keratomalacia and Nutritional Blindness have disappeared.

It is unfortunate but true that the agencies are trying to implement interventions for prevention and control of micronutrients disorders according to their mandate rather than the magnitude and health consequences.



 

 

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