As Africa marked the Day of the African Child on 16 June, the Kenyan government launched an eight-year strategy aimed at delivering efficient and effective health services to improve the lives of women and children. ‘It [the strategy] aims at contributing to the reduction in health inequalities and reversing the downward trend in health-related indicators with a focus on child survival and development,’ Beth Mugo, the Minister for Public Health and Sanitation, said in Nairobi when she launched the ‘Child Survival and Development Strategy 2008–2015’. The ministry developed the strategy with other line ministries as well as representatives of civil society, academia, the donor community and general population. Kenya has one of the highest numbers of newborn deaths in Africa, with a neo-natal mortality rate of 33 per 1,000 live births – approximately 43,600 deaths every year.
Poverty and health
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.
The aim of this study was to describe current infant growth patterns using World Health Organization 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 with 723 mother-infant pairs. The prevalences of wasting and stunting were 4.2% and 16.7%, respectively. The adjusted analysis for stunting showed associations with age and gender – it was more prevalent among boys than girls (58.7% versus 41.3%). Sub-optimal infant feeding practices after birth, poor household wealth, age, gender and family size were associated with growth among Ugandan infants.
Globally, research on social determinants of health has built a considerable knowledge base over the last decade. Still, not much of this research has been carried out in the extremely poor areas of the world, like for instance Africa south of the Sahara. In very poor ruralities, classic indicators of socioeconomic status are not well suited. Few people have any education, monetary income is not a good measure of material standing and people cannot be classified by occupation as they make their livelihood from a variety of activities. For efforts towards health equity to benefit the poorest of the poor, more suitable indicators of social health determinants must be identified. Health research might benefit from knowledge developed in neighbouring fields like development research, anthropology and sociology.
The Moving Out of Poverty study, carried out in 15 countries, is one of the few large-scale comparative research attempts to analyse mobility out of poverty rather than poverty alone. This book is about local realities and the urgent need to develop poverty-reducing strategies informed by the lives and experiences of millions of poor people in communities around the world. The report notes the diversity of experience across households in their movement in and out of poverty within countries. It points to the need to examine the local realities of communities rather than countries and to move beyond assumptions and beliefs about poor people to identify the underlying causes of poverty and to inform development plans, policies and actions that address poverty.
Dehydration caused by severe diarrhoea is a key cause of infant deaths in Zambia, a country with one of the highest child morality rates in the world, according to a new report by Zambia’s health department. This will not change until government makes a major effort to improve access to clean water and sanitation throughout the country, health experts say. Diarrhoea accounts for one fifth of all deaths among children under five. The symptom makes children more susceptible to other illnesses, such as malnutrition and respiratory infections, which are also among the leading causes of child mortality in Zambia. Diarrhoea can easily be avoided or reduced by improved sanitation. But sanitation remains a major problem in Zambia. According to the Lusaka-based Central Statistical Office (CSO), less than 60% of the population have access to adequate sanitation and safe water.
The Swazi government's slow response to a fast-growing tuberculosis epidemic has eroded the possibility of controlling it, says the National TB Control Programme manager. There has been a nearly ten-fold increase in the last 20 years from about 1,000 TB cases per year in 1987 to over 9,600 cases in 2007, exacerbated by the world's highest HIV prevalence rate – 80% of the TB cases are also co-infected with HIV. The country is falling short of meeting the World Health Organisation's TB treatment rate of 85% with a treatment success rate of 42%. The report points to higher rates of default on treatment when patients feel the TB treatment takes long, when they are also taking antiretroviral drugs and when they take drugs on an empty stomach.
This report provides the first summary by the UN of how climate change, water stress, invasive pests and land degradation may impact world food security, food prices and how we may be able to feed the world in a more sustainable manner. It offers short-, mid- and long-term recommendations for improving food security, such as regulating food prices and providing safety nets for the impoverished by reorganising the food market infrastructure and institutions that regulate food prices and provide food safety nets, avoiding biofuels that compete for cropland and water resources, reallocating cereals used in animal feed to human consumption, supporting small-scale farmers, increasing trade and market access, limiting global warming by promoting climate-friendly agricultural production systems and land-use policies, and raising awareness of the ecological pressures of increasing population growth and consumption.
Research into childhood diarrhoea has declined since the 1980s, keeping pace with dwindling funds for a disease that nonetheless accounts for 20% of all child deaths, the WHO said. Funds available for research into diarrhoea are much lower than those devoted to other diseases that cause comparatively few deaths. Nearly two million children die of diarrhoea each year, even though treating the ailment is relatively simple. WHO estimates some 50 million children have been saved thanks to the Oral Rehydration Solution mixture (salt, sugar, cleam water), which costs about (US)25c per child. The international Red Cross also warned that diarrhoeal diseases, such as cholera, are on the rise and increasingly a major cause of diseases and deaths throughout the world.
Kenyan anti-poverty campaigners have launched the Piga Debe for Women Rights Campaign at a well-attended concert held at the Carnivore grounds in Nairobi as part of mobilisation for International Women’s Day. The Piga Debe concert was organised by the United Nations Millennium Campaign Africa Office, Kijiji Records and the Global Call to Action Against Poverty (Kenya) and started a month-long awareness campaign seeking to draw attention of African governments to the outrageous fact that thousands of women continue to die needlessly during child birth. Millennium Development Goals will not be realised unless and until women’s empowerment, rights and development are achieved. Addressing inequalities based on gender greatly reduces poverty and increases levels of well-being for the entire population.