Poverty and health

Petition to promote breast feeding in developing nations
One Million Campaign: February 2008

The One Million Campaign report that babies below 3 years were fed milk powder contaminated with melamine, an industrial chemical used in fertilisers and plastic production. If they had been fed on their mother’s milk, they could have been saved from this unnecessary catastrophe. The One Million Campaign seeks signatories to support women to breastfeed and stop the push towards feeding babies with milk formula.

Researchers in Zimbabwe developing new ways to purify water
Bafana Band Kharsany Z: IPSNews, 25 March 2009

Scientists at Bulawayo's National University of Science and Technology (NUST) have embarked on research to develop simple and affordable water purification methods, as more than a billion people live without safe drinking water in developing countries. They are currently investigating if a powder made from the seeds of a tree, Moringa oleifera, commonly known as the drumstick or horseradish tree, can be used as a filter to purify water. So far, the treatment of water with Moringa seed powder has proven to be an effective method of reducing water-borne diseases and correct pH. Test results also showed that household bleach is a very strong disinfectant and raised the levels of free and total chlorine in the water, while the simple filtration columns resulted in almost 85% reduction in total suspended solids. Further research is needed, however.

Gender equality linked to poverty reduction and economic growth
Commonwealth Secretariat, 12 February 2009

Gender equality is essential for poverty reduction and sustained economic growth, yet lack of money remains one of the greatest impediments to achieving it. In a new compilation of essays from around the world, gender experts and development practitioners examine how to ensure that sufficient financial resources are available to make the changes that not only affect the lives of millions of women, but also impact on society as a whole. One of the biggest impediments to gender equality is lack of money. Although countries have signed up to the Monterrey Consensus and have developed plans of action for women, national and state budgets have not reflected the same priorities. The Monterrey Consensus is distinguished by its recognition of both the need for developing countries to take responsibility for their own poverty reduction and the necessity for rich nations to support this endeavour with more open trade and increased financial aid. Lack of access to land, credit, information, lack of participation in decision-making within the family and community and their reproductive role mean that women's capacity to take advantage of economic opportunities is inhibited. Although it has been recognised that these issues have serious costs to society, there has not been solid progress in formulating and implementing policies and programmes that are gender-sensitive. The paper calls for governments, bilateral and multilateral organisations to scale up their commitments to financing gender equality, making a real difference to the lives of women, reduce poverty and promote sustainable development.

Lessons from African experience with tackling chronic poverty and food insecurity
Development Gateway Communities, 26 February 2009

Unlike the other developing regions of the world where poverty has been on the decline, the proportion of people living below the poverty line in Africa increased from 42.6 percent in 1980 to 44.1 percent in 1990 and 45.7 percent in 2003. Consequently, an increasing number of Africans have suffered from insufficient income and capacity to access food and other basic amenities such as potable water, minimum health care and education. The poor performance of the continent in achieving sustained economic growth and poverty reduction is also manifest in that, although most African economics remain essentially agrarian with about 60 percent of the total labor force being employed in agriculture, the continent has failed to feed its growing population. This paper attempts to understand how the African continent found itself into this loop of poverty. The author analyses the causes that have brought Africa to its present state of poverty and food insecurity.

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?
FotsoJ-C, Ezeh A and Oronje R: Journal of Urban Health 85(3), May 2008

Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility- and individual-level data collected in the slums of Nairobi, Kenya to: describe the provision of obstetric care in the Nairobi informal settlements; describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services and that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low. Household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. There is a strong link between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya’s Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services.

What does Access to Maternal Care Mean Among the Urban Poor? Factors Associated with Use of Appropriate Maternal Health Services in the Slum Settlements of Nairobi, Kenya
Fotso J-C, Ezeh A, Madise N, Ziraba A and Ogollah R: Maternal and Child Health Journal 13(1), January 2009

The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings by identifying factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and “appropriate” health facilities. Methods The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either “inappropriate” or “appropriate”. Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy 'wantedness', and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women.

Determinants of infant growth in Eastern Uganda: A community-based cross-sectional study
Engebretsen IMS, Tylleskar T, Wamani H, Karamagi C and Tumwine JK: BMC Public Health 22 December 2008

The aim of this study was to describe current infant growth patterns using WHO Child Growth Standards and to determine the extent to which these patterns are associated with infant feeding practices, equity dimensions, morbidity and use of primary health care for the infants. A cross-sectional survey of infant feeding practices, socio-economic characteristics and anthropometric measurements was conducted in Mbale District, Eastern Uganda in 2003; 723 mother-infant (0-11 months) pairs were analysed. The adjusted analysis for stunting showed stunting was more prevalent among boys (58.7% versus 41.3%). Having brothers and/or sisters was a protective factor against stunting, but replacement or mixed feeding was not. Lowest household wealth was the most prominent factor associated with stunting with a more than three-fold increase in odds ratio. In conclusion, stunting is related to sub-optimal infant feeding practices after birth, poor household wealth, age, gender and family size.

Impact of low nutrient intake on infant mortality rate in sub-Saharan Africa
Ijaiya GT and Yahaya AA: AJFAND 8(4): 406-416, 2008

Using a cross-country data, drawn from sub-Saharan Africa and a multiple regression analysis, this paper examines the extent to which low nutrient intake has impacted on infant mortality rate in sub-Saharan Africa. The results indicate that low nutrient intake has a significant influence on infant mortality rate, thus fulfilling the a-priori expectation that the lower the nutrient intake, the higher the rate of infant mortality rate in sub-Saharan Africa. Given this, measures such as, increase in food availability, macro-economic stability (especially, a reduction in inflation rate and exchange rate stability), improved nutrition through micro-nutrients fortification and supplementation, ensuring good governance and combating ethnic/religious/ civil conflicts and HIV/AIDS are suggested as possible solutions to improving nutrient intake in sub-Saharan Africa.

Towards food sovereignty: Reclaiming autonomous food systems
Pimbert M: 2008

Pimbert’s book covers a range of topics related to food sovereignty. He looks at local food systems, livelihoods and environments, and the ecological basis of food systems before explaining how the current multiple crises in food, agriculture and environment arose, in terms of the social and environmental costs of modern food systems. The book concludes with the author’s vision of a way forward: He presents food sovereignty as an alternative paradigm for food and agriculture and discusses how to promote national policies and legislation and global multilateralism and policies that promote food sovereignty.

WHO position paper on oral rehydration salts to reduce mortality from cholera
World Health Organization: December 2008

Cholera can rapidly lead to severe dehydration and death if left untreated. Oral rehydration salts (ORS) can successfully treat 80% of cholera patients - both adults and children –and should be given early at home to avert delays in rehydration and improve survival. WHO outlines in the report that it does not see any contradiction in making ORS packages available to households and non-medical personnel outside health care facilities. In contrast, making ORS available at household and community levels can avert unnecessary deaths and contributes to diminishing case fatality rates, particularly in resource-poor settings. Providing nutritious food as well as continuing breastfeeding for infants and young children should continue simultaneously with administering appropriate fluids or ORS.

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