[EQ] What works? Interventions for maternal and child undernutrition and survival

            The Lancet Series, Maternal and child undernutrition

 

What works? Interventions for maternal and child undernutrition and survival

Zulfiqar A Bhutta,  Tahmeed Ahmed,    Robert E Black,   Simon Cousens  Kathryn Dewey, Elsa Giugliani,   Batool A Haider ,  Betty Kirkwood,   Saul S Morris,  HPS Sachdev   and   Meera Shekar,   for the Maternal and Child Undernutrition Study Group

The Lancet, Volume 371, Number 9610, 2 February 2008

Full text available online at: http://www.thelancet.com/journals/lancet/article/PIIS0140673607616936/fulltext

[Free subscription required]

“…..We reviewed interventions that affect maternal and child undernutrition and nutrition-related  outcomes. These interventions included promotion of breastfeeding; strategies to promote complementary feeding, with or without provision of food supplements; micronutrient interventions; general supportive strategies to improve family and community nutrition; and reduction of disease burden (promotion of handwashing and strategies to reduce the burden of malaria in pregnancy). We showed that although strategies for breastfeeding promotion have a large effect on survival, their effect on stunting is small.

 

In populations with sufficient food, education about complementary feeding increased height-for-age Z score by 0•25 (95% CI 0•01–0•49), whereas provision of food supplements (with or without education) in populations with insufficient food increased the height-for-age Z score by 0•41 (0•05–0•76). Management of severe acute malnutrition according to WHO guidelines reduced the case-fatality rate by 55% (risk ratio 0•45, 0•32–0•62), and recent studies suggest that newer commodities, such as ready-to-use therapeutic foods, can be used to manage severe acute malnutrition in community settings.

 

Effective micronutrient interventions for pregnant women included supplementation with iron folate (which increased haemoglobin at term by 12 g/L, 2•93–21•07) and micronutrients (which reduced the risk of low birthweight at term by 16% (relative risk 0•84, 0•74–0•95). Recommended micronutrient interventions for children included strategies for supplementation of vitamin A (in the neonatal period and late infancy), preventive zinc supplements, iron supplements for children in areas where malaria is not endemic, and universal promotion of iodised salt.

 

We used a cohort model to assess the potential effect of these interventions on mothers and children in the 36 countries that have 90% of children with stunted linear growth. The model showed that existing interventions that were designed to improve nutrition and prevent related disease could reduce stunting at 36 months by 36%; mortality between birth and 36 months by about 25%; and disability-adjusted life-years associated with stunting, severe wasting, intrauterine growth restriction, and micronutrient deficiencies by about 25%.

To eliminate stunting in the longer term, these interventions should be supplemented by improvements in the underlying determinants of undernutrition, such as poverty, poor education, disease burden, and lack of women's empowerment….”

 

 

Maternal and child undernutrition: consequences for adult health and human capital

Cesar G Victora, Linda Adair, Caroline Fall, Pedro C Hallal,  Reynaldo Martorell, Linda Richter, Harshpal Singh Sachdev
Maternal and Child Undernutrition Study Group

The Lancet, Volume 371, Number 9609, 26 January 2008

 

Available online at; http://www.thelancet.com/journals/lancet/article/PIIS0140673607616924/fulltext

 

 

Maternal and child undernutrition: global and regional exposures and health consequences

 

Robert E Black, Lindsay H Allen,  Zulfiqar A Bhutta, Laura E Caulfield, Mercedes de Onis, Majid Ezzati, Colin Mathers, Juan Rivera
Maternal and Child Undernutrition Study Group

The Lancet,  Volume 371, Number 9608, 19 January 2008

 

Available online at: http://www.thelancet.com/journals/lancet/article/PIIS0140673607616900/fulltext

 

 

 

 *      *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------

PAHO/WHO Website: http://www.paho.org/

EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

 

 

    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.