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.
Poverty and health
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.
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.
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.
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.’
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.
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.
Worldwide, more than two million people die every year from diarrhoeal diseases. Poor hygiene and unsafe water are responsible for nearly 90 per cent of these deaths and mostly affect children. A study by the World Bank Group, UNICEF and the World Health Organization estimates that extending basic water and sanitation services to unserved households would cost US$28.4 billion per year from 2015 to 2030, or 0.1 per cent of the global product of the 140 countries included in its study. The economic impact of not investing in water and sanitation costs 4.3 per cent of sub-Saharan African GDP. The paper recommends that civil society organizations work to keep governments accountable, invest in water research and development, and promote the inclusion of women, youth and indigenous communities in water resources governance.
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.
Since April 2011, the humanitarian community has been gearing up to deploy a new mechanism aimed at combining expertise on food aid and agricultural assistance to boost food security and make food insecure communities hit by a disaster more resilient. The tool, which is deployed by aid workers in emergency responses, is the "cluster approach", first implemented in 2005. A "cluster" consists of groupings of UN agencies, NGOs and other international organisations around a sector or service provided during a humanitarian crisis. The cluster approach currently encompasses 11 clusters or sectors such as logistics, water and sanitation, early recovery and nutrition. Agriculture as a separate cluster will cease to exist under the new scheme. The new cluster is led jointly by the UN Food and Agriculture Organization (FAO) and the World Food Programme (WFP). The tool is aimed at implementing a proper `early recovery' approach by introducing recovery and development aspects into relief work as early as possible and strengthening transition.