Malnutrition

Using the UNICEF framework, what are the basic causes of malnutrition?

Household access to resources, inadequate financial, human, physical and social resources, Socio-cultural, economic and political context.

Using the UNICEF framework, what are the underlying causes of malnutrition?

Household food insecurity, inadequate care and feeding practices, unhealthy household environment and inadequate health services

What are the causes of low birth weight?

Poor maternal health, inadequate diet before and during pregnancy, lack of micronutrient supplementation, multiple pregnancies - especially in quick succession

When was SUN launched?

2010

What is the reduction in child mortality if these child interventions are implemented at full coverage?

Breast feeding promotion 9.1%, Vitamin A supplementation 7.2%, Zinc supplementation 3.6%, Treatment of severe malnutrition 2.2%, Complementary feeding promotion/supplementation 1.5%

What are the effects of stunting?

Children smaller and shorter but appear to be normal, poor cognitive development, risk of disease, prevalence varies 20-60%

Why has SUN been so successful?

Countries and Politicians are backing this movement, examples are Ghana, Burkina Faso, Uganda, Tanzania. SUN supports the right aspects of this global problem: breastmilk, undernutrition, right to food and maternity protection.

What are the aims of SUN?

Create Political and Operational Platforms, Incorporate Best Practices into National Policies, Align Actions Across Sectors, Increase Resources and Monitoring Implementation

What is the reduction in child mortality if these maternal interventions are implemented at full coverage?

Energy/protein supplementation 2.9%, Malaria prevention 1.9%, Multiple micronutrients 1.6%

Using the UNICEF framework - discuss the immediate causes of child undernutrition

Inadequate dietary intake and disease

Define Morbidity

Incidence of illness in a population

Impact of under nutrition during pregnancy and early childhood?

Increased risk of dying from infectious diseases (1/3 of child deaths are from this), stunting associated with reduced school performance and income earning capacity, reduces GDP by 2-3%

What are the consequences for the child due to maternal malnutrition?

Increased risk of fetal and neonatal deaths, intrauterine growth retardation, LBW, pre-term birth, immunocompromised, birth defects, cretinism, reduced IQ

Discuss the consequences of maternal malnutrition

Increased risk of maternal death, increased infections, anaemia, immunocompromised, lethargy and weakness, lower productivity, lactational failure

What is low birth weight?

Less than 2,500 grams at birth

How is malnutrition measured and what is the preferred method and why is it not always used?

Low weight for age (underweight), indicator of choice to describe levels of malnutrition in a population, level of malnutrition in children under 5 years used to reflect nutritional status of entire population. Not always used because it includes both stunting and wasting.

Discuss the 2 main nutrition intervention programs. At what categories will these programs be most effective and why?

Nutrition-sensitive: most effective at underlying causes Agriculture, Clean Water & Sanitation, Education & Employment, Health Care, Support for Resilience Nutrition-specific: most effective at immediate causes Feeding Practices & Behaviors Fortification of foods Micronutrient supplementation Treatment of severe acute malnutrition

Define DALY

One lost year of "healthy" life

"Malnutrition is much more than just providing food". Discuss some immediate child and maternal intervention that needs to be done at full coverage in order to reduce child mortality.

Provide supplements to address specific or multiple deficiencies; Diversify diets to increase the quantity and variety of food sources; Fortify commonly used products or foods, including salt, sugar, milk, infant formula and flour or bread.

What is SUN?

Scaling Up Nutrition

What is the odd ratio for severe stunting?

Severely stunted child was 4.1 times more likely to die than the non-stunted child

What is the odds ratio for severe wasting?

Severely wasted child was 9.4 times more likely to die than the non-wasted child.

Discuss 'intergenerational cycle of growth'

Small adult women gives birth to LBW babies -> child growth failure -> low weight and height in teens ->> early pregnancies -> small adult women, repeat

Importance of Vitamin A?

Strengthens Immune system, Prevents: Blindness, Diarrhoea, Measles, Premature babies, Deaths

What is chronic malnutrition?

Stunting: Low height for age, result of long periods of inadequate nutrition intake.

What is the 'vicious cycle'?

The malnutrition-infection cycle: Inadequate dietary intake leads to reduced immunity this causes disease which leads to loss of appetite, malabsorption of nutrients, altered metabolism, increased nutrient needs which leads to inadequate dietary intake.

What are the effects of wasting?

Thinness, immediate risk of morbidity or mortality, typically under 5% prevalence in healthy population (Africa)

What is acute malnutrition?

Wasting: Low weight for height, result of recent rapid weight loss or failure to gain weight.