This special report found that national burdens of disease, undernutrition, ill health, illiteracy and many protection abuses are concentrated in the most impoverished child populations. It argues that providing these children with essential services through an equity-focused approach to child survival and development has great potential to accelerate progress towards the Millennium Development Goals and other international commitments to children. An equity-focused approach could bring vastly improved returns on investment by averting far more child and maternal deaths and episodes of undernutrition and markedly expanding effective coverage of key primary health and nutrition interventions. Nearly 1.8 billion people have gained access to improved drinking water in the past two decades. HIV prevalence appears to have stabilized in most regions, and deaths from AIDS have fallen since 2004. And despite the global economic crisis, progress is still being made in reducing income poverty.
Poverty and health
In response to food price riots in early September, the Mozambican government has laid on a range of price cuts and subsidies to make life easier for the poor, and has promised to do some belt tightening of its own. On 21 September 2010, two weeks after the first riots, it was reported that registered bakers would receive a subsidy for wheat flour and other relief measures included halving water connection fees for low-consumption households, considerably reducing the cost of piped water to the poor, and giving free electricity to low-consumption households consuming 100 kwh or less. Food prices for some basic items were also reduced and customs duties lowered on vegetable imports from South Africa. Analysts argue that a better long-term strategy to fight poverty and the rising cost of living would be for Mozambique to grow its own food, instead of relying on imports from South Africa. An increase in agricultural output would shelter the country’s food supply from volatile international markets.
This paper considers previous systematic assessments of educational attainment, and estimated the contribution of improvements in women's education to reductions in child mortality in the past 40 years. The authors compiled 915 censuses and nationally representative surveys, and estimated mean number of years of education by age and sex. They found that the global mean number of years of education increased from 4.7 years to 8.3 years for men and from 3.5 years to 7.1 years for women. For women of reproductive age (15-44 years) in developing countries, the years of schooling increased from 2.2 years to 7.2 years. By 2009, in 87 countries, women aged 25—34 years had higher educational attainment than had men in the same age bracket. Of 8.2 million fewer deaths in children younger than five years between 1970 and 2009, the paper estimates that 4.2 million (51.2%) could be attributed to increased educational attainment in women of reproductive age. In conclusion, the substantial increase in education, especially of women, and the reversal of the gender gap have important implications not only for health but also for the status and roles of women in society. The continued increase in educational attainment even in some of the poorest countries suggests that rapid progress in terms of Millennium Development Goal 4 might be possible.
According to this report, malnutrition levels in pastoralist districts of northeastern Kenya have remained high, despite recent rains that boosted livestock productivity, the mainstay of the local economy. Improvements in household food security have not translated into a decisive reduction in rates of child malnutrition in the northeastern districts, suggesting that causal factors of the unacceptably high rates go beyond availability of food at the household level. The Ministry of Health and its partners found Global Acute Malnutrition (GAM) levels above the World Health Organization's 15% emergency threshold in Mandera Central Districts, Wajir South and Wajir East. Mandera West recorded GAM rates above 25%. High illiteracy levels may mean that parents do not ensure their children receive a balanced diet, resulting in malnutrition. The report also emphasises the growing problem of urban poverty, with an estimated 3.5‐4.1 million (or up to 20%) out of 13.5 million urban households situated in high-density areas that are suffering various degrees of food insecurity. Further assessment of urban poverty in Kenya is already underway, according to the Ministry.
In the run-up to the United Nations’ (UN) three-day summit on the Millennium Development Goals (MDGs), held in New York from 20–24 September 2010, UN Member States underlined the vital role that democracy plays in reducing poverty. Democracy remains central to any development approach, Joseph Deiss, President of the General Assembly, told a meeting at UN Headquarters. He identified the pursuit of the MDGs – which include reducing poverty, fighting disease, halting environmental degradation and boosting health – along with UN reform and the promotion of environmentally sustainable development as key areas of focus for the Summit. In particular, he argued that stakeholders must bridge the gaps in the fight against hunger, child mortality and maternal health. He called for a sincere commitment from all world leaders taking part in the Summit and a genuine plan of action to ensure that the MDGs are reached. Member States are expected to come prepared to put forward concrete commitments on what they will do over the next five years to reach the MDGs.
In May 2010, the World Health Assembly adopted Resolution EB126.R11, its Global Strategy to Reduce the Harmful Use of Alcohol, based in part on an extensive amount of evidence on both alcohol's contribution to the global burden of disease and the policies capable of ameliorating the harm it causes. Now that the strategy has been adopted, this article calls for public health science to take on two new challenges. The first is to expand the evidence base so that it applies not just to the developed countries where most of the world's alcohol consumption is concentrated, but also to the low- and middle-income countries where alcohol consumption is increasing and where the policy response is still weak. The second challenge is to use scientific research to guide the adoption of effective alcohol policies at the national and international levels. The author of the article urges for a systematic investigation of the alcohol industry itself as a vector for alcohol-related disease and disability. Aggressive marketing of alcoholic beverages in low-consumption developing countries needs to be monitored, as does industry compliance with its own codes for responsible advertising. More stringent measures to protect young people from exposure to irresponsible advertising need to be considered, as self-regulation codes are easily circumvented and not enforceable.
Consumer anxieties over the rising cost of food in rich and poor countries alike are stoking fears of social unrest in impoverished parts of the world once again. On 1 September 2010, at least six people - including two children - were killed during violent demonstrations over soaring prices for basic necessities, including bread and fuel, in and around Maputo, the capital of Mozambique, one of Africa's poorest countries. The government has increased bread prices by 30% and protestors complained that they are struggling to feed themselves and their families. The violence echoes the food price crisis of 2007-2008, which helped push the number of hungry people in the world above a billion, and sparked protests and riots in nearly 40 countries. Surging wheat prices - mainly due to Russian restrictions on sales following a major drought there - drove international food prices up 5% in August, the biggest month-on-month increase since November 2009, according to the Food and Agricultural Organization (FAO). The FAO's Food Price Index - a basket of meat, dairy, cereals, oils, fats and sugar - has reached its highest level since September 2008, but is still 38% below its peak in June 2008. The FAO says the forecast for world cereal production this year has been lowered by 41 million tons to 2,238 million tons since June, but that would still be the third highest annual amount on record and above the five-year average.
According to this article, the absence of a threshold in the association between maternal education and child survival suggests that the obvious causal pathway - increased understanding of disease causation, prevention, and cure - might only be part of the explanation. This has led to investigations of many possible behavioural links, including better domestic hygiene, more intense mother-child interactions, and greater maternal decision-making power among mothers who are more educated than among those who are less educated. However, the use of child health services offers the strongest empirical support. Exposure to primary schooling increases a mother's propensity to seek modern preventive or curative services for her children. Schooling seems to engender in adults an increased identification with health institutions, and the confidence and skills to access services and comply with advice. It is likely that the symbiotic effect of schooling and health-service use indicates that improvements in the education of women of reproductive age might account for half of the reduction in mortality in children aged under five years. This contribution is far greater than increased income, a finding that is consistent with previous studies. Income and educational increases are only slightly correlated. Analyses of states that achieved high life-expectancies despite low-income levels (eg: China, Costa Rica, Kerala, and Sri Lanka) revealed a common characteristic: sustained political commitment to equitable access to primary schooling and health care for both sexes.
This study’s objective was to evaluate mortality and morbidity among internally displaced persons (IDPs) who relocated in a demographic surveillance system (DSS) area in western Kenya following post-election violence. In 2007, 204 000 individuals lived in the DSS area, where field workers visited households every four months to record migrations, births and deaths. Between December 2007 and May 2008, 16,428 IDPs migrated into the DSS, and over half of them stayed six months or longer. In 2008, IDPs aged 15–49 years died at higher rates than regular residents of the DSS. A greater percentage of deaths from HIV infection occurred among IDPs aged ≥ 5 years (53%) than among regular DSS residents (25–29%). Internally displaced children < 5 years of age did not die at higher rates than resident children but were hospitalised at higher rates. In conclusion, HIV-infected internally displaced adults in conflict-ridden parts of Africa were found to be at increased risk of HIV-related death. Relief efforts should extend to IDPs who have relocated outside IDP camps, particularly if afflicted with HIV infection or other chronic conditions.
New data on the nutritional status of Zimbabwe’s children reveals that more than one third of Zimbabwe’s children under the age of five are chronically malnourished and consequently stunted. Zimbabwe’s current food production remains too low to meet national requirements. Years of persistent droughts and the downturn of the Zimbabwean economy over the past decade have adversely affected food availability in many homes in Zimbabwe. The report calls for accelerated action to reverse chronic malnutrition and maintain the low levels of acute malnutrition highlighted by the report. Chronic malnutrition poses long-term survival and development challenges for Zimbabwe. The survey also shows plummeting exclusive breastfeeding rates. However, the low and stable rates of severe acute malnutrition that were found are a sign that the food security programmes supported by the international community are reaping benefits. The report also acknowledges the tremendous coping mechanisms of the Zimbabwean people at a time of great difficulty.