Poverty and health

Characteristics of households experiencing under- five deaths: A case of Tropical Institute of Community Health and Development (TICH) partnership districts
Oindo C, Otieno C, Okeyo N, Olayo R, Muga R and Kaseje C: African Journal of Food, Agriculture, Nutrition and Development: 2009

In this paper, child mortality and its relationship to specific variables relating to background and proximate factors were considered. Between 2006 and 2007, proportions of households with child deaths declined in all the districts and the proportions of health facility deliveries decreased in households that experienced under-five deaths. Measles vaccination coverage was lower among households with child deaths and so was use of insecticide-treated nets (ITNs). Households living in poor conditions experienced the highest proportions of child mortality. Education of mothers remains a significant determinant of child mortality along with health facility delivery. No difference in child mortality was realized between mothers having primary education and those that had none. Better health-seeking behaviour should be encouraged to help stem the high child mortality rates.

Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: Data from the third round of UNICEF's Multiple Indicator Cluster Survey (2005–2006)
Gottlieb CA, Maenner MJ, Cappa C and Durkin P: The Lancet 374(9704): 1831–1839, 28 November 2009

This study examined child disability screening and its association with nutrition and early learning in countries with low and middle incomes. Cross-sectional data for the percentage of children screening positive for or at risk of disability were obtained for 191,199 children aged 2–9 years old in 18 countries. Screening results were descriptively analysed according to social, demographic, nutritional, early-learning and schooling variables. A median 23% of children aged 2–9 years old screened positive for disability. For children aged 2–4, screening positive for disability was significantly more likely in children who were not breastfed and who did not receive vitamin A supplements. Children aged 6–9 who did not attend school screened positive for disability more often than did children attending school. These results draw attention to the need for improved global capacity to assess and provide services for children at risk of disability. Further research on childhood disabilities is needed in countries with low and middle incomes to understand and address the role of nutritional deficiencies and restricted access to learning opportunities.

Child health now: Together we can end preventable deaths
World Vision: October 2009

The epicentre of the child health emergency is sub-Saharan Africa and South Asia but, without a concerted and sustained effort in their countries, there’s little prospect of Millennium Development Goal 4 being met at a global level. The causes of this emergency vary according to the local context, and will require tailored responses by governments, donors and international institutions. Examples of good leadership exist in countries like Liberia, where President Ellen Johnson Sirleaf has used the peace dividend to triple health spending, withdraw user charges and focus on the prevention of malaria. The first tier of healthcare for children is the household level, and beyond that the immediate community. Yet relatively little attention is paid by most governments to low-cost and easy-to-deliver measures that can be taken at this level, which can have a decisive impact on child health, from hand washing and breastfeeding to early identification of pneumonia. World Vision estimates that a comprehensive package of family and community care alone could prevent 2.5 million child deaths each year. What’s needed is a redefinition of health systems to incorporate family- and community-level care, in tandem with a fundamental rebalancing of public spending placing much greater emphasis on prevention. Safe water and sanitation and basic hygiene are necessary to achieve this aim – the World Health Organization estimates that they could together save US$7 billion in health care costs each year.

Child Nutritional Status And Household Patterns In South Africa
Bomela N: African Journal of Food, Agriculture, Nutrition and Development 7(5): 1684-5374, 2007

The influence of person-related and household related characteristics on the nutritional status of children were assessed, taking into account variables such as, gender of household head, de jure and de facto household head, relationship of child to household head, size of household, type of toilet facility and type of dwelling. Chronic malnutrition and underweight were significantly pronounced in children from households with de jure household heads.

Child poverty in Africa: An overview
Tsegaye S: African Child Policy Forum, 2008

This book aims to give a bird’s eye view of the situation of child poverty in Africa. It highlights the paradox of countries that have an abundance of natural resources, especially oil and diamonds, yet whose populations largely suffer from poverty, such as Angola, Equatorial Guinea and Nigeria. The book points to a symbiotic relationship between poverty and armed conflicts as Africa is slowly extricating itself from the intertwined problems of conflict, poverty, hunger and illiteracy. The book argues that improved governance and increased investments in key social sectors have created an unprecedented sense of optimism. Nevertheless, millions of African children still struggle on the margins. At least 600 million children under the age of 18 are surviving on less than US$1 a day worldwide and 40% of these children live in developing countries.

Child survival in sub-Saharan Africa: the role of CAPGAN and regional child health practitioners and scientists
Heikens GT, Manary M, Sandige H and Kalilani L: Malawi Medical Journal 21(3): 94–95, September 2009

In a statement, the Commonwealth Association of Paediatric Gastroenterology and Nutrition (CAPGAN) calls for maternal, neonatal and child health to be more closely linked to improve child survival from HIV, diarrhoea and malnutrition. Colleges of Health Sciences, Nursing and Medicine should become important backbones of maternal and child health systems, through education and implementation research, and through training and retaining of their staff in HIV, diarrhoea and malnutrition in the widest sense. The statement presents that leadership, collaboration and country-capacity support, development of evidence-based guidelines and systems must be stimulated, to ensure coverage and monitoring of equity and progress in achieving Millennium Development Goals 4 and 5.

Children are on the brink of death in northeast Kenya
AllAfrica.com: 23 September 2009

The drought that has ravaged parts of northeastern Kenya, killing a large number of livestock, has affected the availability of milk, in turn undermining child nutrition, say officials. Most of the rural population in the areas where Save the Children is working is heavily dependent on relief food and many children are eating only one meal a day, of corn porridge. ‘This poor diet means they are missing out on vital nutrients, which can mean they grow up stunted and their brains and bodies can suffer permanent damage,’ the organisation said. Since July, the number of severely malnourished children seeking treatment at its northeastern emergency feeding centres has increased by 25%. ‘The government and donors need to be aware of the changing climate now and in future, and shape their policies accordingly,’ Philippa Crosland-Taylor, head of Oxfam in Kenya, said in August. ‘Emergency aid is urgently needed now, but in the long term we need to rethink policies to focus on mitigating the risks of droughts before they occur, rather than rushing in food aid when it is too late.’

Chronic Poverty Report 2004-2005

The Chronic Poverty Research Center's latest report examines what chronic poverty is and why it matters, who the chronically poor are, where they live, what causes poverty to be persistent and what should be done. A section of regional perspectives looks at the experience of chronic poverty in sub-Saharan Africa, South Asia, Latin America and the Caribbean, transitional countries and China. The report argues that the chronically poor need targeted support, social assistance and social protection.

Civil conflict and sleeping sickness in Africa in general and Uganda in particular
Berrang Ford L: Conflict and Health 1:6, 29 March 2007

Conflict and war have long been recognized as determinants of infectious disease risk. Re-emergence of epidemic sleeping sickness in sub-Saharan Africa since the 1970s has coincided with extensive civil conflict in affected regions. Sleeping sickness incidence has placed increasing pressure on the health resources of countries already burdened by malaria, HIV/AIDS, and tuberculosis. In areas of Sudan, the Democratic Republic of the Congo, and Angola, sleeping sickness occurs in epidemic proportions, and is the first or second greatest cause of mortality in some areas, ahead of HIV/AIDS. In Uganda, there is evidence of increasing spread and establishment of new foci in central districts. Conflict is an important determinant of sleeping sickness outbreaks, and has contributed to disease resurgence. This paper presents a review and characterization of the processes by which conflict has contributed to the occurrence of sleeping sickness in Africa.

Climate change and the threat to African food security: Adapting to the impact of climate change on African food security
Arid Lands Information Network (ALIN): 2009

This collection of articles includes an article on food security in Kenya. Since 2006, the rains in Kenya’s Central Highlands have become less reliable. The March and April rains regularly arrive late, and the season is much shorter. In 2008, there were only four days of rain. The seasonal rivers that provide water for irrigation, livestock and domestic uses have mostly dried up, leading to water and food shortages. These burgeoning problems are pointing in one direction – poverty, malnutrition and health problems for the nation’s poor. Declining production, and the limited access and affordability of imported food, mean food security has declined, with many impacts. The government should store grain during bumper harvests to provide food in poor seasons; processing this surplus can also add value and avoid wastage.

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