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Journal of Biosocial Science. 2003 July; 35(3):335-351.Improved child health and survival are considered universal humanitarian goals. In this respect, understanding the nutritional status of children has far-reaching implications for the better development of future generations. The present study assessed, first, the nutritional status of children below 5 years using the three anthropometric measures weight-forage, height-for-age and weight-for-height in two states of India, Kerala and Goa. Secondly, it examined the confounding factors that influence the nutritional status of children in these states. The NFHS-I data for Kerala and Goa were used. The results showed that the relative prevalence of underweight and wasting was high in Kerala, but the prevalence of stunting was medium. In Goa, on the other hand, the relative prevalence of wasting and underweight was very high, and that of stunting was high. Both socioeconomic and family planning variables were significantly associated with malnutrition in these states, but at varied levels. The study recommends more area-specific policies for the development of nutritional intervention programmes. (author's)
WHO Programme in Maternal and Child Health and Family Planning. Report of the second meeting of the WHO Programme Advisory Committee in Maternal and Child Health, Geneva, 21-25 November 1983.
[Unpublished] 1984. 95 p. (MCH/84.5)The objectives of the 2nd meeting of the Program Advisory Committee (PAC) for the World Health Organization's (WHO's) Program in Maternal and Child Health, including Family Planning (MCH/FP) were to 1) assess the MCH/FP program's achievements since the 1st PAC meeting in June, 1982, 2) determine the level of scientific and financial resources available for the program, and 3) to examine the role of traditional birth attendants (TBAs) in the delivery of MCH/FP services. The committee reviewed the activities and targets of the program's 4 major areas (pregnancy and perinatal care, child health, growth, and development, adolescent health, and family planning and infertility), and developed a series of recommendations for each of these areas. Specific recommendations were also made for each of the major program areas in reference to the analysis and dessimination of information and to the development and use of appropriate health technologies. Upon reviewing the role of TBAs in the delivery of MCH/FP services, PAC recommended that all barriers to TBA utilization be removed and that training for TBAs should be improved and expanded. PAC's examination of financial support for MCH/FP activities revealed that for a sample of 26 countries, the average annual amount allocated to MCH activities was less than US$3/child or woman. This low level of funding must be taken into account when setting program targets. International funding agencies did indicate their willingness to increase funding levels for MCH programs. The appendices included 1) a list of participants, 2) an annotated agenda, 3) detailed information on the proposed activities of the program's headquarters for 1986-87, and 4) a description of the the function, organizational structure, and technical management of the MCH/FP program. Also included in the appendices was an overview of the current status of MCH and a series of tables providing information on infant, child, and maternal health indicators. Specifically, the tables provided information by region and by country on maternal, child, and infant mortality; causes of child deaths; maternal health care coverage; contraceptive prevalence; infant and child malnutrition; the number of low weight births; adolescent health; teenage births; breast feeding prevalence and duration; and the proportion of women and children in the population.
Use of a simple anthropometric measurement to predict birth weight. WHO Collaborative Study of Birth Weight Surrogates.
BULLETIN OF THE WORLD HEALTH ORGANIZATION. 1993; 71(2):157-63.The study was undertaken in 22 centers throughout the world to collect data on a consecutive sample of 400 births. 3 measurements were made for each baby: birth weight, mid-arm circumference, and chest circumference. In addition, the baby's sex and gestational age at birth were recorded. The main problem with data quality was a tendency for weights to be recorded in round hundred grams and circumferences in whole centimeters. The primary objective was to identify cut-off points below which a baby is diagnosed to be at risk for conditions associated with low birth weight. Centers in South Asia, such as Delhi and Chandigarh, had the lowest average birth weight and anthropometric measures, whereas those in Europe, such as St. Petersburg (Russia), Szeged (Hungary), and Yerevan (Armenia) has some of the highest. In 18 of the 22 centers, the correlations between birth weight and chest circumference were greater than those for arm circumference. Regression analyses demonstrated that the best model in each center was birth weight predicted by chest circumference. However, a different regression equation had to be estimated for each center. The estimated regression coefficients varied between the extremes of Islamabad and Chandigarh, where an increase of 1 cm in chest circumference predicted birth weight increases of 260 and 156 gm, respectively. For practical use in developing countries, cut-off points for chest circumference and end-points for birth weight need to be defined for the prediction of low birth weight. Therefore, the standard WHO end-point of 2500 gm was adopted, and babies below this were defined as having low birth weight. Cut-off points of 29 and 30 cm are proposed. Babies with a chest circumference <29 cm would be diagnosed as highly at risk, and they should be referred to a health center immediately. Those with a chest circumference of 29-30 cm would be diagnosed as at risk, and their progress should be monitored carefully.
Improving child survival and nutrition. The Joint WHO/UNICEF Nutrition Support Programme in Iringa, Tanzania.
Dar es Salaam, Tanzania, UNICEF, 1989. , 20 p.The June-October 1988 evaluation of the Joint WHO/UNICEF Nutrition Support Programme (JNSP) in the Iringa Region of Tanzania demonstrated substantial improvement in the nutritional status of infants and children and a decrease in child deaths since 1984. Prevalence rates of underweight children were 38% in the 2nd quarter of 1988 as compared with 56% in 1984. In addition, prevalence rates of severely underweight children in the 2nd quarters of 1988 and 1984 were 1.8% and 6.3% respectively. This was accomplished because of an enhanced awareness of nutrition among all the people in the region and decision makers consciously considered the growth and development of children as an objective in their daily work. Specifically, the JNSP targeted activities that increase and sustain people's ability to address nutrition problems. These activities included increasing accessibility to nutrition information, establishment of the village based nutritional status and death monitoring system done by existing village health committees and village health workers, and integrated training. These activities concentrated on maternal and child health, water and environmental sanitation, household food security, child care and development, income generating actions, research, and management and staff. This approach in Iringa can be adapted and transferred to other areas of Tanzania.
New York, New York, UNICEF, . 42 p.In the last 12 months, world-wide support has been gathering behind the idea of a revolution which could save the lives of up to 7 million children each year, protect the health and growth of many millions more, and help to slow down world population growth. This document summarizes case studies which illustrate the techniques which make this revolution possible. These techniques are: oral rehydration therapy (ORT); growth monitoring; expanded immunization using newly improved vaccines to prevent the 6 main immunizable diseases which kill an esitmated 5 million children a year and disable 5 million more (measles, whooping cough, neonatal tetanus, polio, diphtheria and tuberculosis); and the promotion of scientific knowledge about the advantages of breastfeeding and about how and when an infant should be given supplementary foods. Results are summarized from Guatemala, Papua New Guinea, Brazil, Egypt, Indonesia, Barbados, the Philippines, Nicaragua and Honduras, Malawi, China, Nepal, Bangladesh, Colombia, and Ethiopia. The impact of economic recession and female education on childrens' health is discussed, and basic statistics for developed and underdeveloped countries are given.