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Food and Nutrition Bulletin. 2003; 24 Suppl 4:S99-S103.Iron deficiency is considered to be one of most prevalent forms of malnutrition, yet there has been a lack of consensus about the nature and magnitude of the health consequences of iron deficiency in populations. This paper presents new estimates of the public health importance of iron-deficiency anemia (IDA), which were made as part of the Global Burden of Disease (GBD) 2000 project. Iron deficiency is considered to contribute to death and disability as a risk factor for maternal and perinatal mortality, and also through its direct contributions to cognitive impairment, decreased work productivity, and death from severe anemia. Based on meta-analysis of observational studies, mortality risk estimates for maternal and perinatal mortality are calculated as the decreased risk in mortality for each 1 g/dl increase in mean pregnancy hemoglobin concentration. On average, globally, 50% of the anemia is assumed to be attributable to iron deficiency. Globally, iron deficiency ranks number 9 among 26 risk factors included in the GBD 2000, and accounts for 841,000 deaths and 35,057,000 disability-adjusted life years lost. Africa and parts of Asia bear 71% of the global mortality burden and 65% of the disability-adjusted life years lost, whereas North America bears 1.4% of the global burden. There is an urgent need to develop effective and sustainable interventions to control iron-deficiency anemia. This will likely not be achieved without substantial involvement of the private sector. (author's)
UN Chronicle. 1986 Apr; 23: p..So begins a special report, Within Human Reach: A Future for Africa's Children, prepared by the United Nations Children's Fund (UNICEF). According to UNICEF, neglect of the human costs of the African crisis has obscured a full understanding of the "scenario for disaster' that has been unfolding on that continent over the past two decades. "In its day-to-day work in the continent, UNICEF is faced with the maluntrition and ill health which claim the lives of nearly 4 million African children each and every year--even when there is no drought, no famine, no camps, no epidemics, and no media coverage', states UNICEF Executive Director James P. Grant in a preface to the report. "This is the "silent emergency' which, exacerbated by war and drought, has suddenly become the "loud emergency' of which all the world has heard'. However, adds Mr. Grant, "the first priority for action is to protect the lives and the normal growth of children. In times of emergency, the immediate, human argument for "children first' is an obvious one. But there is also a longer-term and more hard-headed case to be made. For there is a profound connection between the mental and physical development of the children and the social and economic development of their nations.' (excerpt)
New York, New York, UNICEF, 2000. 116 p.What happens during the very earliest years of a child’s life, from birth to age 3, influences how the rest of childhood and adolescence unfolds. Yet, this critical time is usually neglected in the policies, programmes and budgets of countries. Drawing on reports from the world over, The State of the World’s Children 2001 details the daily lives of parents and other caregivers who are striving – in the face of war, poverty and the HIV/AIDS epidemic – to protect the rights and meet the needs of these young children. Choices to be made: The opening section makes the case for investing in the earliest years of childhood, before the age of three, when brain development is most malleable and rights are most vulnerable. It sets out the options governments have about where and when to make investments to ensure that children under three have their rights protected and their needs met. And it introduces the importance of early childhood development programmes, not only for children, their parents and caregivers, but for the progress of nations as a whole. A necessary choice: Attention to the youngest children is most needed where it is most difficult to guarantee: in countries where the seemingly intractable grip of poverty, violence and devastating epidemics seriously challenge parents’ hopes and dreams for their children. This section argues that early childcare can act as an effective antidote to cycles of violence, conflict, poverty and HIV/AIDS. The only responsible choice: Parents struggle, often against great odds, to do right by their children. In industrialized and developing countries alike they find advice and aid from informal support networks and community agencies with innovative childcare programmes. The final section describes these experiments and experiences and makes the case why, in the long run, investment in ECD pays off. (excerpt)
NURSING JOURNAL OF INDIA. 1990 Oct; 81(10):322.Due to a deteriorating economic situation, India has adopted a policy of Selective Primary Health Care (SPHC), a strategy to target the population which can benefit the most from low cost health care--women and children in rural communities. India has set the goal of Health for All by the Year 2000. But the country has been grappling for a way to achieve long-run sustainability of accelerated health programs. Considering that economic conditions have reduced available resources, SPHC represents a realistic program that accurately reflects the health care priorities of the country. 80% of India's population lives in rural areas. Every year, 14 million people die from preventable diseases such as diarrhea, measles, and neonatal tetanus. In 1988 alone, diarrhea and measles cost the lives of 5 million children. SPHC program is goal-specific, and it follows the model by UNICEF's own selective intervention program -- GOBIFFF (Growth monitoring, Oral rehydration, Breastfeeding, Immunization, Female education, Food supplements, and Family planning). SPHC also emphasizes success. The programs has established targets and has monitored results. In 1981, less than 20% of all children were immunized, and less than 1% of all children were treated with oral rehydration solutions (ORS). But by 1987, 50% of all children were immunized against the 6 childhood immunizable diseases, and the number of children treated with ORS increased to over 50%. Although it would be better to combine SPHC with a Comprehensive Primary Health Care program, the current level of commitment and resources are not sufficient. Therefore, SPHC remains the realistic approach.