The International Baby Food Action Network, through its campaign called ‘One Million Campaign: Support Women to Breastfeed’, submitted a petition to the President of World Health Assembly, Mr. NS de Silva, which was signed by more than 45,000 people from 161 countries. The petition demanded concrete support systems for breastfeeding women and urged the Assembly to adopt a resolution in 2010 to deal with four key issues: to prepare a specific plan of action on infant feeding, which is budgeted and coordinated in the same way as action plans for immunisation; to ensure the end of promotion of baby milks and foods intended for children under two years old in a time-bound manner, that is, by 2015; to end partnerships in the area of infant and young child feeding and nutrition with commercial sector corporations that present conflicts of interests; and to create support and maternity entitlements for women both in the formal and informal sectors, so that mothers and babies can stay close to each other for six months at least.
Poverty and health
On the occasion of the Day of the African Child, 16 June 2009, the Africa Public Health Alliance and 15%+ Campaign called on African governments to end the ‘5 by 5 Tragedy’ by stopping the estimated five million African children under the age of five from dying annually of preventable, manageable or treatable health causes. The campaign blames the existing situation on a failure of government policy on child health and protection in particular, and health development and financing in general. [To] meet the Millennium Development Goal 4 on reversing and ending child mortality, African governments are called on to meet their pledge to allocate 15% of national budgets to health, and significantly increase per capita investment in health. Strategic investment in vaccinations, health systems, human resources for health and social determinants of health, such as clean water, sanitation, food security and nutrition, must also be implemented.
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.
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.