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Children. 2018 May 4; 5(5)Pakistan has one of the highest prevalences of child malnutrition as compared to other developing countries. This narrative review was accomplished to examine the published empirical literature on children’s nutritional status in Pakistan. The objectives of this review were to know about the methodological approaches used in previous studies, to assess the overall situation of childhood malnutrition, and to identify the areas that have not yet been studied. This study was carried out to collect and synthesize the relevant data from previously published papers through different scholarly database search engines. The most relevant and current published papers between 2000(-)2016 were included in this study. The research papers that contain the data related to child malnutrition in Pakistan were assessed. A total of 28 articles was reviewed and almost similar methodologies were used in all of them. Most of the researchers conducted the cross sectional quantitative and descriptive studies, through structured interviews for identifying the causes of child malnutrition. Only one study used the mix method technique for acquiring data from the respondents. For the assessment of malnutrition among children, out of 28 papers, 20 used the World Health Organization (WHO) weight for age, age for height, and height for weight Z-score method. Early marriages, large family size, high fertility rates with a lack of birth spacing, low income, the lack of breast feeding, and exclusive breastfeeding were found to be the themes that repeatedly emerged in the reviewed literature. There is a dire need of qualitative and mixed method researches to understand and have an insight into the underlying factors of child malnutrition in Pakistan.
Effect of exclusive breastfeeding on selected adverse health and nutritional outcomes: a nationally representative study.
BMC Public Health. 2017 Nov 21; 17(1):889.BACKGROUND: Despite growing evidence in support of exclusive breastfeeding (EBF) among infants in the first 6 months of birth, the debate over the optimal duration of EBF continues. This study examines the effect of termination of EBF during the first 2, 4 and 6 months of birth on a set of adverse health and nutritional outcomes of infants. METHODS: Three waves of Bangladesh Demographic and Health Survey data were analysed using multivariate regression. The adverse health outcomes were: an episode of diarrhea, fever or acute respiratory infection (ARI) during the 2 weeks prior to the survey. Nutritional outcomes were assessed by stunting (height-for-age), wasting (weight-for-height) and underweight (weight-for-age). Population attributable fraction was calculated to estimate percentages of these six outcomes that could have been prevented by supplying EBF. RESULTS: Fifty-six percent of infants were exclusively breastfed during the first 6 months. Lack of EBF increased the odds of diarrhea, fever and ARI. Among the babies aged 6 months or less 27.37% of diarrhea, 13.24% of fever and 8.94% of ARI could have been prevented if EBF was not discontinued. If EBF was terminated during 0-2 months, 2-4 months the odds of becoming underweight were 2.16 and 2.01 times higher, respectively, than babies for whom EBF was not terminated. CONCLUSION: Children who are not offered EBF up to 6 months of their birth may suffer from a range of infectious diseases and under-nutrition. Health promotion and other public health interventions should be enhanced to encourage EBF at least up to six-month of birth. TRAIL REGISTRATION: Data of this study were collected following the guidelines of ICF International and Bangladesh Medical Research Council. The registration number of data collection is 132,989.0.000 and the data-request was registered on September 11, 2016.
Complementary Feeding Interventions Have a Small but Significant Impact on Linear and Ponderal Growth of Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.
Journal of Nutrition. 2017 Nov; 147(11):2169S-2178S.Background: World Health Assembly member states have committed to ambitious global targets for reductions in stunting and wasting by 2025. Improving complementary diets of children aged 6-23 mo is a recommended approach for reducing stunting in children <5 y old. Less is known about the potential of these interventions to prevent wasting.Objective: The aim of this article was to review and synthesize the current literature for the impact of complementary feeding interventions on linear [length-for-age z score (LAZ)] and ponderal [weight-for-length z score (WLZ)] growth of children aged 6-23 mo, with the specific goal of updating intervention-outcome linkages in the Lives Saved Tool (LiST).Methods: We started our review with studies included in the previous LiST review and searched for articles published since January 2012. We identified longitudinal trials that compared children aged 6-23 mo who received 1 of 2 types of complementary feeding interventions (nutrition education or counseling alone or complementary food supplementation with or without nutrition education or counseling) with a no-intervention control. We assessed study quality and generated pooled estimates of LAZ and WLZ change, as well as length and weight gain, for each category of intervention.Results: Interventions that provided nutrition education or counseling had a small but significant impact on linear growth in food-secure populations [LAZ standardized mean difference (SMD): 0.11; 95% CI: 0.01, 0.22] but not on ponderal growth. Complementary food supplementation interventions with or without nutrition education also had a small, significant effect in food-insecure settings on both LAZ (SMD: 0.08; 95% CI: 0.04, 0.13) and WLZ (SMD: 0.05; 95% CI: 0.01, 0.08).Conclusions: Nutrition education and complementary feeding interventions both had a small but significant impact on linear growth, and complementary feeding interventions also had an impact on ponderal growth of children aged 6-23 mo in low- and middle-income countries. The updated LiST model will support nutrition program planning and evaluation efforts by allowing users to model changes in intervention coverage on both stunting and wasting. (c) 2017 American Society for Nutrition.
Levels and trends in child malnutrition. UNICEF/ WHO / World Bank Group joint child malnutrition estimates: key findings of the 2017 edition.
New York, New York, UNICEF, 2017. 16 p.The inter-agency team released new joint estimates for child stunting, overweight, underweight, wasting and severe wasting (May 2017 edition) using the same methodology as in previous years. These new estimates supersede former analyses results published by UNICEF, WHO and the World Bank Group. Given that country data are at maximum available from surveys conducted in the year previous to when the modelling exercise takes place, in 2017 the joint estimates were derived up to 2016 with extrapolation for stunting until 2025.
The state of food security and nutrition in the world 2017: building resilience for peace and food security.
Rome, Italy, FAO, 2017. 133 p.This report has been jointly published by the Food and Agriculture Organization of the United Nations (FAO), the International Fund for Agricultural Development (IFAD), the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP) and the World Health Organization (WHO). The 2017 edition marks the beginning of a new era in monitoring efforts to achieve a world without hunger and malnutrition within the framework of the Sustainable Development Goals (SDGs). The report will henceforth monitor progress towards the targets on both ending hunger (SDG Target 2.1) and ending all forms of malnutrition (SDG Target 2.2). It will also include analyses of how food security and nutrition are related to progress on other SDG targets.
Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016).
PloS One. 2017; 12(5):e0177338.BACKGROUND: Sub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa. METHODS: Cross-sectional data from the most recent Demographic and Health Surveys (2006-2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2. RESULTS: Stunting was highest in Burundi (57.7%) and Malawi (47.1%) in East Africa; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa. CONCLUSION: The prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target of improving maternal, infant and young child nutrition by 2025.
Geneva, Switzerland, WHO, 2015. 124 p.The report delivers both promising and disappointing messages about the situation in low- and middle-income countries. Within-country inequalities have narrowed, with a tendency for national improvements driven by faster improvements in disadvantaged subgroups. However, inequalities still persist in most reproductive, maternal, newborn and child health indicators. The extent of within-country inequality differed by dimension of inequality and by country, country income group and geographical region. There is still much progress to be made in reducing inequalities in RMNCH.
Efficacy of World Health Organization guideline in facility-based reduction of mortality in severely malnourished children from low and middle income countries: a systematic review and meta-analysis.
Journal of Paediatrics and Child Health. 2017 May; 53(5):474-479.Aim: Globally more than 19 million under-five children suffer from severe acute malnutrition (SAM). Data on efficacy of World Health Organization's (WHO’s) guideline in reducing SAM mortality are limited. We aimed to assess the efficacy of WHO’s facility-based guideline for the reduction of under-five SAM children mortality from low and middle income countries (LMICs). Methods: A systematic search of literature published in 1980–2015 was conducted using electronic databases. Additional articles were identified from the reference lists and grey literature. Studies from LMICs where SAM children (0–59 months) were managed in facilities according to WHO’s guideline were included. Outcome was reduction in SAM mortality measured by case fatality rate (CFR). The review was reported following the Grading of Recommendations Assessment Development and Evaluation and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and meta-analyses done using RevMan 5.3®. Results: This review identified nine studies, which demonstrated reductions in SAM mortality. CFR ranged from 8 to 16% where WHO guideline applied. High rates of poverty, malnutrition, severe co-morbid condition, lack of resources and differences in treatment practices played a key role in large CFR variation. Most death occurred within 48 h of admission in Asia, between 4 days and 4 weeks in Africa and in Latin America. CFR was reduced by 41% (odds ratio: 0.59; 95% confidence interval: 0.46–0.76) when WHO guideline were applied. A 45% reduction in CFR was achieved after excluding human immunodeficiency virus positive cases. Dietary management also differed among WHO and conventional management. Conclusion: Children receiving SAM inpatient care as per WHO guideline have reduced CFR compared to conventional treatment.
New York, United Nations System Standing Committee on Nutrition, 2017 Apr. 32 p.The paper aims to present the centrality of nutrition in the current sustainable development agenda. It provides an overview of the numerous and inter-related nutrition targets that have been agreed upon by intergovernmental bodies, placing these targets in the context of the SDGs and the UN Decade of Action on Nutrition. As such, this paper does not give a full technical analysis of the nutrition landscape but rather connects the dots between the various identified areas for policies and action. It aims to inform nutrition actors, including non-traditional ones, regarding opportunities to be engaged and connected in a meaningful way.
An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding, and Wasting.
Washington, D.C., International Bank for Reconstruction and Development / The World Bank, 2017 Apr. 258 p.The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets -- especially those for reducing stunting in children and anemia in women -- are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends -- not only for children directly affected but also for us all in the form of more robust societies -- that will drive future economies.
Prevalence of Malnutrition and Associated Factors among Hospitalized Patients with Acquired Immunodeficiency Syndrome in Jimma University Specialized Hospital, Ethiopia.
Ethiopian Journal of Health Sciences. 2016 May; 26(3):217-26.BACKGROUND: HIV/AIDS predisposes to malnutrition. Malnutrition exacerbates HIV/AIDS progression resulting in increased morbidity and mortality. The magnitude of malnutrition in HIV/AIDS patients has not been well studied in Ethiopian setup. Our objective was to assess the prevalence of malnutrition and associated factors among HIV/AIDS patients admitted to Jimma University Specialized Hospital (JUSH). METHOD: A cross-sectional study was conducted to assess the nutritional status of 109 HIV/AIDS patients admitted from November 2013 to July 2014. Cohort design was also used for outcome assessment. Serum levels of hemoglobin, albumin and CD4 counts were determined. Data were organized, coded, cleaned, entered into a computer and analyzed using SPSS version 16.0. Descriptive analysis was done initially. Those variables in the bivariate analysis with P-value < 0.25 were then considered as candidates to be included in the multivariable logistic regression model. A P-vale of < 0.05 was considered as statistically significant. RESULTS: The mean age of the patients was 32.7+/-8.12 with male to female ratio of 1:1.9. Patients were in either clinical stage, 3(46.8%), or stage, 4(53.2%). Forty nine (45%) of the respondents had a CD4 count of < 200 cells/microL. The overall prevalence of malnutrition was 46.8% (BMI<18.5kg/m2) and 44.1% (MUAC= 20cm). Eighty four (77.1%) of the patients had a serum albumin level of =3.5g/dl while 76 (69.6%) of the patients had anemia (Hg<12g/dl). CONCLUSION: The prevalence of malnutrition was found to be high. WHO Stage 4 disease and CD4 count <200cells/microl were independent predictors of malnutrition.
WASH’Nutrition: A practical guidebook on increasing nutritional impact through integration of WASH and nutrition programmes for practitioners in humanitarian and developent contexts.
Paris, France, Action Contre la Faim [ACF], 2017. 156 p.Undernutrition is a multi-sectoral problem with multi-sectoral solutions. By applying integrated approaches, the impact, coherence and efficiency of the action can be improved. This operational guidebook demonstrates the importance of both supplementing nutrition programmes with WASH activities and adapting WASH interventions to include nutritional considerations i.e. making them more nutrition-sensitive and impactful on nutrition. It has been developed to provide practitioners with usable information and tools so that they can design and implement effective WASH and nutrition programmes. Apart from encouraging the design of new integrated projects, the guidebook provides support for reinforcing existing integrated interventions. It does not provide a standard approach or strict recommendations, but rather ideas, examples and practical tools on how to achieve nutrition and health gains with improved WASH. Integrating WASH and nutrition interventions will always have to be adapted to specific conditions, opportunities and constrains in each context. The guidebook primarily addresses field practitioners, WASH and Nutrition programme managers working in humanitarian and development contexts, and responds to the need for more practical guidance on WASH and nutrition integration at the field level. It can also be used as a practical tool for donors and institutions (such as ministries of health) to prioritise strategic activities and funding options. (Excerpt)
What can we learn from nutrition impact evaluations? Lessons from a review of interventions to reduce child malnutrition in developing countries.
Washington, D.C., World Bank, 2010 Aug.  p.This paper reviews recent impact evaluations of interventions and programs to improve child anthropometric outcomes- height, weight, and birth weight-with an emphasis on both the findings and the limitations of the literature and on understanding what might happen in a non-research setting. It further reviews the experience and lessons from evaluations of the impact of the World Bank-supported programs on nutrition outcomes. Specifically, the review addresses the following four questions: 1) what can be said about the impact of different interventions on children's anthropometric outcomes? 2) How do these findings vary across settings and within target groups, and what accounts for this variability? 3) What is the evidence of the cost-effectiveness of these interventions? 4) What have been the lessons from implementing impact evaluations of Bank-supported programs with anthropometric impacts? Although many different dimensions of child nutrition could be explored, this report focuses on child anthropometric outcomes-weight, height, and birth weight. These are the most common nutrition outcome indicators in the literature and the ones most frequently monitored by national nutrition programs supported by the World Bank. Low weight for age (underweight) is also the indicator for one of the Millennium Development Goals.
Washington, D.C., World Bank, 2004 May.  p. (Health, Nutrition and Population (HNP) Discussion Paper; World Bank Report No. 69106)This paper argues for more nuance in the interpretation of progress towards the Nutrition Millennium Development Goal indicator (halving the prevalence of underweight children, under 5 years old, by 2015). Interpretation of a country's performance based on trends alone is ambiguous, and can lead to erroneous prioritization of countries in need of donor assistance. For instance, a country may halve the prevalence by 2015, but will still have unacceptable high malnutrition rates. This paper analyses which countries are showing satisfactory and unsatisfactory progress using the Annual Rate of Change (ARC), and then introduces the World Health Organization-classification of severity of malnutrition in the analysis to provide more nuance. It highlights that a little less than half of the Bank's client population is likely to halve underweight by 2015. Although the paper uses national data only, it flags the risks and recommends that countries take regional disparities into their needs-analysis. The paper also argues for more attention to the other important nutrition indicators, stunting and micronutrient deficiencies, which remain enormous problems, and briefly discusses solutions to reducing underweight malnutrition.
[Washington, D.C.], World Bank, 2010 Jun. 4 p. (en breve No. 157)Children in Haiti are born into some of the harshest conditions on the planet, and are left at a disadvantage in terms of growth, development, and potential to thrive. Malnutrition rates in Haiti are among the worst in the LAC region. Nearly one-third of all children under-five suffer from stunted growth and three-quarters of children 6-24 months are anemic. Malnutrition takes a serious and irreversible toll, making children more susceptible to disease and death and compromising their cognitive and physical development, which results in low human capital and diminished lifetime earnings. Yet, scaling up ten key nutrition interventions in Haiti is estimated to cost only $46.5 million per year, which is less than 1% of Haiti’s total GDP. (excerpt)
Washington, D.C., World Bank, 2006.  p. (Health, Nutrition, and Population Series)The prevalence of child undernutrition in India is among the highest in the world, nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity, and economic growth. Drawing on qualitative studies and quantitative evidence from large household surveys, this book explores the dimensions of child undernutrition in India and examines the effectiveness of the Integrated Child Development Services (ICDS) program, India’s main early child development intervention, in addressing it. Although levels of undernutrition in India declined modestly during the 1990s, the reductions lagged behind those achieved by other countries with similar economic growth. Nutritional inequalities across different states and socioeconomic and demographic groups remain large. Although the ICDS program appears to be well designed and well placed to address the multidimensional causes of undernutrition in India, several problems exist that prevent it from reaching its potential. The book concludes with a discussion of a number of concrete actions that can be taken to bridge the gap between the policy intentions of ICDS and its actual implementation.
Breastfeeding Medicine. 2015 Oct; 10(8):385-8.Add to my documents.
Maternal and Child Nutrition. 2016 May; 12 Suppl 1:12-26.Childhood stunting is the best overall indicator of children's well-being and an accurate reflection of social inequalities. Stunting is the most prevalent form of child malnutrition with an estimated 161 million children worldwide in 2013 falling below -2 SD from the length-for-age/height-for-age World Health Organization Child Growth Standards median. Many more millions suffer from some degree of growth faltering as the entire length-for-age/height-for-age z-score distribution is shifted to the left indicating that all children, and not only those falling below a specific cutoff, are affected. Despite global consensus on how to define and measure it, stunting often goes unrecognized in communities where short stature is the norm as linear growth is not routinely assessed in primary health care settings and it is difficult to visually recognize it. Growth faltering often begins in utero and continues for at least the first 2 years of post-natal life. Linear growth failure serves as a marker of multiple pathological disorders associated with increased morbidity and mortality, loss of physical growth potential, reduced neurodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. The severe irreversible physical and neurocognitive damage that accompanies stunted growth poses a major threat to human development. Increased awareness of stunting's magnitude and devastating consequences has resulted in its being identified as a major global health priority and the focus of international attention at the highest levels with global targets set for 2025 and beyond. The challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.
Comparison of WHO growth standards with Indian Academy of Pediatrics standards of under five children in an urban slum.
Indian Journal of Community Health. 2013 Jul-Sep; 25(3):277-280.Background: Child undernutrition is internationally recognized as an important public health indicator for monitoring nutritional status and health in populations. Prevalence of under nutrition is very high in India; especially in urban slums. Objective: To compare the prevalence of under nutrition among underfive children using WHO growth standards with IAP standards.Methods: Community based cross sectional study was done during November-2008 to December-2009 in urban field practice area of Medical College Pune, India. All the underfive children (336) were enumerated by house to house survey. Parents were informed about the objectives of the study and their written consent was obtained. Anthropometric measurements of the children who were available during the study period were carried out as per WHO guidelines and IAP standards. Various indices of nutritional status were expressed in standard deviation units (z scores) from the reference median. Epi-Info 2002 and Primer of Bio-statistics software package was used for statistical analysis.Results: Total 336 children were enumerated by house to house visit. Only 319 children were available during the study. Weights were recorded according to WHO and IAP standards. It was found that boys were more undernourished than girls by using WHO standards (P<0.005). When weights of girls were compared according to these two standards the girls were found to be more undernourished by WHO standards but difference was not statically significant.
Journal of the College of Physicians and Surgeons Pakistan. 2014 Jul; 24(7):493-7.OBJECTIVE: To evaluate the efficacy of adopting WHO feeding guidelines on weight gain and case fatality rate in malnourished children. STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Dow University of Health Sciences, Karachi, from 2009 to 2010. METHODOLOGY: Patients above 6 months and less than 5 years of age with severe malnutrition were included during the study period, acute complications were treated and nutritional rehabilitation by WHO feeding formulae was done. Demographic details, clinical features, reasons for weight gain and risk factors of mortality were analyzed. RESULTS: A total of 131 children were included. Mean age of children was 22 +/- 18 months. There were 78% marasmic, 4% kwashiorkor and marasmic kwashiorkor 18% children. Resolution of edema took 8 +/- 4 days, dermatosis cleared in 11 +/- 3 days. Mean hospital stay was 10 +/- 8 days. Case fatality rate was 13%. Mean weight gain was 5.25 +/- 4.57 g/kg/day. Weight gain of > 5 gm/kg/day was associated with hospital stay of more than 7 days, acceptability and palatability of feed by the children and mothers and early clearance of infections. CONCLUSION: Implementation of WHO feeding guidelines resulted in adequate weight gain of inpatient malnourished children, however, adequate healthcare services are available at the therapeutic feeding centers.
World Health Organization. Comprehensive Implementation Plan on Maternal, Infant, and Young Child Nutrition. Geneva, Switzerland, 2014.
Advances In Nutrition. 2015 Jan; 6(1):134-5.Add to my documents.
BMC Public Health. 2013; 13 Suppl 3:S17.BACKGROUND: Current WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea. METHODS: We conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately. RESULTS: Evidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these analyses to studies where both intervention and control diets were lactose-free, weight gain in children with acute diarrhea was shown to be greater among those fed with a home-available diet. CONCLUSIONS: Among children in low- and middle-income countries, where the dual burden of diarrhea and malnutrition is greatest and where access to proprietary formulas and specialized ingredients is limited, the use of locally available age-appropriate foods should be promoted for the majority of acute diarrhea cases. Lactose intolerance is an important complication in some cases, but even among those children for whom lactose avoidance may be necessary, nutritionally complete diets comprised of locally available ingredients can be used at least as effectively as commercial preparations or specialized ingredients. These same conclusions may also apply to the dietary management of children with persistent diarrhea, but the evidence remains limited.
Geneva, Switzerland, WHO, 2014.  p. (WHO/NMH/NHD/14.2)Recognizing that accelerated global action is needed to address the pervasive and corrosive problem of the double burden of malnutrition, in 2012 the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified a set of six global nutrition targets that by 2025 aim to: achieve a 40% reduction in the number of children under-5 who are stunted; achieve a 50% reduction of anaemia in women of reproductive age; achieve a 30% reduction in low birth weight; ensure that there is no increase in childhood overweight; increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%; reduce and maintain childhood wasting to less than 5%. As part of its efforts, the World Health Organization (WHO) has developed a series of six policy briefs, linked to each of the global targets, to guide national and local policy-makers on what actions should be taken at scale, in order to achieve the targets. Recognizing that the six targets are interlinked, many evidence-based, effective interventions can help make progress toward multiple targets. The purpose of these briefs is to consolidate the evidence around which interventions and areas of investment need to be scaled up, and to guide decision-makers on what actions need to be taken in order to achieve real progress toward improving maternal, infant and young child nutrition. (Excerpts)
Geneva, Switzerland, WHO, 2014.  p. (WHO/NMH/NHD/14.3)In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified six global nutrition targets for 2025. This policy brief covers the first target: a 40% reduction in the number of children under-5 who are stunted. The purpose of this policy brief is to increase attention to, investment in, and action for a set of cost-effective interventions and policies that can help Member States and their partners in reducing stunting rates among children aged under 5 years. (Excerpts)
Geneva, Switzerland, WHO, 2014.  p. (WHO/NMH/NHD/14.8)In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition, which specified six global nutrition targets for 2025. This policy brief covers the sixth target: reduce and maintain childhood wasting to less than 5%. The purpose of this policy brief is to increase attention to, investment in, and action for a set of cost-effective interventions and policies that can help Member States and their partners to reduce and maintain the rate of childhood wasting. (Excerpts)