Undernutrition. Malnutrition due to deficiencies in diet include protein-energy malnutrition, i.e. stunting, wasting, and underweight, as well as micronutrient malnutrition due to deficiencies in vitamins and minerals. In 2015, almost 200,000 child under five deaths were attributed to nutritional deficiencies[21]. Stunting, defined as low height for age, is usually the result of persistent or recurrent undernutrition in the early stages of child development. Evidence suggests that the first 1000 days, from conception to two years old, is the critical window to ensure adequate growth and development[29,30]. However, there is evidence that children from low- and middle-income countries are born at a disadvantage, with length at birth below the international WHO growth standards[31]. After birth, height-for-age z scores drop rapidly during the first 24 months, with patterns of growth faltering seeming to differ between populations. In India, children are below even the average for low- and middle-income countries by their first month, and on average rapidly drop below -2.0 HAZ by 24 months[31]. Although worldwide prevalence of stunting has decreased in the past two decades, 23% of children under five are still stunted[29]. Stunting predominately affects children in low resource settings, with over 61 million children under five in South Asia stunted. Stunting results in not only severe physical and neurocognitive development, but also has long-term negative effects on human, social and economic capital[32,33]. Wasting, defined as low weight for height, is an acute condition often due to a rapid decrease in diet quantity or quality, or in the child’s ability to adequately absorb dietary nutrients[34]. Worldwide, over 50 million children under five were wasted in 2015, with more than two thirds of wasted children living in Asia[34,35]. Unlike with stunting, the prevalence of wasting has remained relatively stable over the past decade. Although wasting is treatable, moderate and severe wasting substantially increases the risk of death. Underweight, defined as low weight for age, is due to a combination of chronic and acute undernutrition, and provides a less specific indicator of the likely causes of undernutrition than stunting or wasting[36]. Worldwide, over 16% of children under five were underweight in 2015, with over 69 million underweight children living in Asia[29]. Preventative measures There is a cyclical relationship between undernutrition and infection—especially rec...
Undernutrition. Undernutrition is a global issue, but Sierra Leone has been especially vulnerable. As of 2012, Sierra Leone was ranked 177 out of 187 countries on the Human Development Index, which measures development by combining indicators of life expectancy, education, and income(United Nations Development Programme 2012). The life expectancy is 48 years, and Sierra Leone is ranked first in under five mortality rates(UNICEF. 2008). Since 1990, the under-five mortality rate has decreased by 10%, but this is not enough and it is behind many similar countries. Nutrition wise, 36% of children under the age of five are stunted, 21% are underweight, and 10% are wasted. A qualitative and quantitative formative study that explored the current knowledge and practices was done to inform the topics that are included in this curriculum. Grandmothers, Women with children <24 months, and Men with children <24 months FACILITATOR INTRODUCTION were surveyed and gaps in practice and knowledge were identified. As a result, we focused our sessions on the pertinent information that was needed by the community. Why Grandmothers? Grandmothers are an important part of the family structure & community and they have many years of knowledge and experience to share. Grandmothers are the keepers of traditions and care for the children while the younger women are working outside the home. When it comes to maternal and child health and nutrition issues, men have little knowledge and involvement, often deferring to the elder women. Studies have shown that grandmothers have a strong influence on maternal and child health practices within a family, which means that the previous practice of focusing on the mother-child pairing may not invoke lasting change within a community. The GMP focuses on involving grandmothers in the change process through five steps(The Grandmother Project 2014):
Undernutrition. Nutrition influences acquisition of and susceptibility to infection. It operates bi-directionally, meaning nutritional status can make hosts more susceptible to disease and disease can compromise nutritional status. Nutritional status and disease may also act synergistically to generate adverse health outcomes. It has been suggested that good nutrition provides protection to hosts from small infectious loads so that disease may not develop. Undernutrition has further implications for recovery from infection after treatment with MDA. Although MDA has the potential to kill infectious agents, impaired nutritional status renders hosts more susceptible to re- infection (Hall et al., 2012).
