Nutrition for Women and Children - Research Paper Example

?Nutrition for women and children Introduction Public Health, since ages has been a topic of big concern with its related unsolved problems. Human Development Index (HDI) has cited three prime dimensions in its measurement of a country’s well being, listed as Life Expectancy of birth (prolonged and healthy life), proper access to knowledge and a respectable standard of living. So, HDI has also mentioned public health as the main means of measuring a nation’s well being. However, nutrition being more of a global problem than a local one has long been facing several problems with alarming rise in disease trends related positively to nutrition. The problem of public health and nutrition is persistent both in the developing as well as developed nations, the reasons being different. The basic concern of nutrition is that of food supply. The developing countries like most of the African countries are inflicted with the problem of food crisis with under nutrition and lack of essential nutrients, which cause an estimated death of almost 3.5 million young children and pregnant women per year. On the other hand, one can find developed nations of Europe and America suffering from universal epidemic of obesity, mostly in the children. One can also find evidences of increased threat of dietary chronic diseases like cancer, heart problems and diabetes. (Chan, World Health Organization,2011).This project tries to get an overview of some of the significant aspects of public health regarding nutritional status of children and women, the various problems related to this and their probable solutions.  Literature Review American Public Health Association, in a study made by them has come up with the ten essential public health services that usually make up the agenda of National Public Health Performance Standards Program (NPHPSP). The ten essential public health services are mainly based on principles of assessment, policy development and assurance. Assessment consist of monitoring health status to recognize health related problems of the community, diagnosis of health problems in the community, policy developments in the form of providing information and education about health problems to the people and empowering them to fight these diseases, mobilizing population partnerships to recognize and cure health issues, developing plans and programs to sustain individual and societal health efforts and assurance that requires enforcing laws and issues to ensure public health and safety, building linkages among people needed for personalized health services and ensuring supply of health care services that are otherwise unavailable, assurance of a very diligent public and personal health care workforce, evaluating accessibility, validity and quality of personal as well as public health care services and researching newer and innovative solutions to health care service related problems(10 Essential Public Health Services, pp.1).Although theoretically this can sound assuring, yet the problem lies somewhere else that needs to be discussed. First, let us take some examples of malnutrition and its effects in certain developing nations affecting its women and children. Research on malnutrition in sub-Saharan African nations done by Abosede and McGuire (2001) show that in Gambia, seasonal food shortage causing low food intakes by pregnant women in times of agricultural workload being very high resulted in their dramatic weight loss during their pregnancy period resulting in lower birth weight rise from 13% to 35%. Another instance show anemic women in Benin, 55% of whom are pregnant, giving birth to iron- deficient babies. Nigeria shows children below 80% expected weight-for-age having a 33% increase in the duration of diarrhea. In Uganda it has been found that malnourished infants below 3 years of age being able to develop at a standard rate only be shortening physical activities by 20% per kg. body weight. This study also shows that many African countries suffering from vitamin A deficiency affecting 53 million children but only a mere 8million covered by supplementation programs. One hundred million people in Africa are suffering from Iodine Deficiency Disorders (IDD) with almost two-thirds of pregnant women and more than half of infants being anemic due to deficiency of iron in their bodies (Abosede, and McGuire, 2001, pp.1-3). So, in this case, one can see the assessment, policy descriptions and assurance parts of the ten most essential public health services have had no use while considering the public health scenario of Africa. According to Abosede and McGuire (2001), malnutrition in African nations originates from four main sources: not enough intakes of food, excessive disease, malnutrition of mothers and unhealthy food and health behaviors. African people generally feed on roots and tubers, which are not sufficient enough in protein content to help growth in children. Maize diets also lack key amino acids. They also do not get enough access to fruits and vegetables that are rich in micronutrients. Even the quality and quantity of water is very low which results in water borne diseases, primarily seen in women. As a result, health diseases like diarrhea and cholera are very prevalent. Without proper access to health care facilities there is no formal way to fight these diseases. Maternal malnutrition results in low birth rate as well as below par potential to household activities. The children are faced with fears of increased mortality risk. Anemia and underweight syndromes are also factors of higher productivity risks. Food and health behaviors are also undeniable in this context as early or late initiation to non- breast milk foods, not getting enough food during diseases also add to malnutrition causes (Abosede, and McGuire, 2001, pp 4-5). These findings are in sync with that of Measham and Chatterjee (1999), whose study was based on malnutrition in India. Since its independence in1947, India has been making substantial improvement in human development yet more than half of the infants below four years of age are more or less malnourished with almost 30 % of newborn babies being severely underweight and 60% women being prone to anemia. Another interesting finding of this study is that although India produces less than 20% of universal child population it consists of almost 40% of the world’s malnourished children. The reasons cited by them in Indian context are a bit different to that of other underdeveloped and developing countries. The main reason is that state of nutrition is very much correlated to that of poverty and gender inequality, both being serious problems of India. Secondly, malnutrition is not as visible as any other diseases and therefore gets lesser attention compared to those visible in the naked eye. Thirdly, nutritional improvements require complex and co integrated set of actions for which competence, co ordination and proper commitment is of utmost importance (Measham and Chatterjee, 1999, pp.1-6). Dzhorayeva, Khodzhayeva & Tagirova (2000) carried out a study on the nutritional conditions of the children and their mothers in Turkmenistan. They have stressed on the points of breastfeeding and other related feeding patterns to infants and the importance of bottle- feeding, present nutritional status of the infants below five years of age as well as their mothers based on the height and weight data accumulated in the survey and the levels of food consumption rich in Vitamin A supplementation and use of iodized salt in the household. Their findings show that almost 95% of Turkmen offsprings are breast fed for at least some period. As far as introducing complementary foods to children of 6-months as within that period, only mother’s milk is not adequate to provide wholesome nutrition to children, it is found that almost every child is receiving other foods in addition to breast milk. At 8-9 months, one out of six children is being denied of complementary foods along with breast milk. Coming to the case of bottle- feeding, it has been found that excessive indulgence in bottle-feeding can be detrimental to a child’s health since feeding with artificial nipple can raise the risk of illness if the nipple is not properly sterilized and it can also cause lessening of breastfeeding intensity. In Turkmenistan, only about one third of children below 9 months age are being bottle-fed and with increase in age, number of children being bottle-fed gradually decreases. Moreover, about 80% of children under three years of age are seen to be receiving foods rich in Vitamin A like meat, fish, poultry etc and almost 89% of the household are seen to be consuming iodized salt. So herein one can see that the two dimensions of the 10 essential public health services consisting of Assessment and Policy Development have been followed. But the third dimension, the part of Assurance raises some questions. Nutritional status, being a child’s primary determinant of health and well-being shows poor results with inadequate and unbalanced diets and chronic diseases being part of the Turkmenian children. Height-for-age index show that that much of the population of children is abnormally stunted or short according to their age. This is a result of malnutrition in a population for over a very long period of time and can also be result of chronic illnesses. The weight-for- height shows children being excessively thin or severely wasted. This also stems from malnutrition and unhealthy food habits. Weight-for- age index shows maximum children to be underweight according their age. This can be the outcome of children being stunted or wasted or both (Dzhorayeva, Khodzhayeva & Tagirova, 2000, pp.127-140). Clugston and Smith (2002), in their article have discussed another aspect of malnutrition, - obesity and its looming global epidemic, mainly in the industrialized nations, where this chronic illness is affecting more than half of the population. According to this study, in 1995 the number of obese adults worldwide was 200 million with 18 million infants under the age of five. In 2000, the number has increased to 300 million. Developed nations usually contain 50% of obese population worldwide. Junk foods rich in high saturated fats and carbohydrates amplify the threat of CVD, obesity and various types of cancers. An increasing food availability, urbane culture and depletion in physical exercises have all caused a rise in the level of obesity over these years. Consumption of high-saturated fatty foods also stops production of Omega 3 fatty acids, which are useful for hearts thereby increasing the risk of heart ailments. Even diseases like Osteoporosis are seen as a result of complex and prolonged consumption of foods that do not fulfill the necessary nutritional requirements. Ready to use breakfast cereals and machine made fruit juices do not contain desired amount of calcium and women are mostly its prey since their body requires more of calcium than that of men (Clugston and Smith, 2002, pp. S104- S108).  Analysis of findings Health problems related to malnutrition are concentrated mainly in the underdeveloped and developing nations. Almost 99% of under nutrition related deaths can be seen in lower and middle income countries. Nutrition is also responsible for the survival of people suffering from HIV and AIDS, malaria and diarrhea. Proper nutrition also helps to prevent disabilities in older people and prolonging their lives (McDonald, 2010, pp.153-154). Health economists are of view that proper nutrition should be provided right from young age to reap its multiple gains throughout the lifespan. Proper nutrition will allow a child to be well nourished having good physical and mental development with good education and economic productivity in order to realize their proper human potential and canalize it for economic development. Women, primarily in the developing nations often suffer from anemia and post pregnancy stress and therefore needs to be provided with more of foods rich in nutritional content. They should be encouraged to have foods with more protein and calcium since after pregnancy, proteins help to generate the creation of breast milk that is very important for the newborn child and sustained consumption of calcium will strengthen their bones so as to prevent diseases like osteoporosis. Poverty is also one of the prime reasons for malnutrition. Poor people cannot afford foods with high nutritional levels, like fruits, vegetables, milk etc since quality and price of foods are positively correlated. In urban areas, people often consume foods filled with fats and carbohydrates while in rural areas families rely on nutrient-deficient staple foods. This nutrition crisis needs to be eradicated as early as possible. For this a central plan should be adopted with fund raising activities (Working for health: An introduction to the World Health Organization, 2007).  Recommendations and Conclusion The 10 essential public services are quite costly to implement. For implementation of the 10 essential public services to ensure proper nutrition to children and women, there is immediate need of a leadership to provide interventions foe nutritional deficiencies to those who need it the most. The intervention should be pocket friendly and innovative in ensuring successful delivery mechanisms. The leadership is also expected to ensure government policies regarding agriculture and food production should be such as to ensure human nutritional demands.  There are a few areas where the leadership can be useful in accelerating progress. Primary health care services is the prime sector where intervention should be operational, that is, proper counseling of mothers will help reduce infant deaths due to sub optimal breast feeding, supply of ready-to- use therapeutic foods which will allow malnourished infants to be treated in home etc (Chan, 2011). Another sector where intervention can be useful is that of the existing delivery systems, for instance, more arrangement of childhood immunization programs to provide Vitamin A supplements to increase awareness among people of its relevance in the child’s life, especially in those areas where it is difficult to reach. The third strategy can be by directing the food industry to manufacture foods with increased levels of nutrition. For example, U.S Department of Agriculture (USDA) has banned junk food and “mystery meat” from the diet of the school children. They have called for “competitive” foods that children will be able to buy from vendors like fruits and vegetables. USDA has called for decreasing level of sodium from diets, increasing the amount of fruits and vegetables for the consumption of kids, using food materials free of trans-fats, increasing the amount of whole grain consumption in schools, providing, one cup of skimmed milk to children (Thompson, 2011). The topical time is a genetic age. In certain ways it is more of a natural development of biotechnology and genetic engineering; on the other hand, it is a revolutionary era in which there have been various views regarding diet and nutritional needs of human body. Genomic information is now being utilized to evaluate the reasons for individual variations in correspondence to specific nutritional requirements and dietary plans. This has opened a new door towards defining particular sub populations thereby identifying dietary interventions to be more target specific, and allowing it to help building dietary habits and health outcomes. Dietary recommendations are now being redefined. Diseases regarding malnutrition are now being clinically distinguished and this fragmentation will further allow treatments with more efficiency and prevention strategies. However, there are a few questions that need to be answered. Firstly, where is the insight when it comes to answering questions and addressing consequences of food crisis? Secondly, how much is it going to cost the future to address human unprecedented crises caused by storms, floods, food crisis and hunger? References: 1. 10 Essential Public Health Services, Public Health Museum in Massachusetts. Retrieved on May 16,2011 from: http://www.publichealthmuseum.org/10%20Essential%20Public%20Health%20Services.pdf 2. Abosede, O. and McGuire, J.S(2001), Improving Women’s and Children’s Nutrition in Sub-Saharan Africa, Population and Human Resources Department The World Bank Retrieved on May 16, 2011 from: http://books.google.co.in/books?id=0krKuusjq1QC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false 3. Chan, M. (2011), The global nutrition challenge: getting a healthy start, World Health Organization. Retrieved on May 16, 2011 from: http://www.who.int/dg/speeches/2008/20080618/en/index.html 4. Clugston, G.A and T.E Smith (2002) “Global nutrition problems and novel foods”, Nutrition for Health and Development, World Health Organization 11(S6): S 100-S111. Retrieved on May 16, 2011 from: http://apjcn.nhri.org.tw/server/apjcn/Volume11/vol11sup2/S100.pdf 5. Dzhorayeva, G.R., Khodzhayeva, G.Y & Tagirova,T.R.(2000)”Nutrition of Women and Children”, 127-140. Retrieved on May 16, 2011 from: http://rochr.qrc.com/bitstream/123456789/2013/12/11Chapter11.pdf 6. Measham A.R. and Chatterjee M.(1999) Wasting away: the crisis of malnutrition in India, Washington D.C: World Bank Publications 7. McDonald, B.L, (2010),  Food Security, Cambridge: Polity Press 8. Thompson, D.,(2011) U.S pushes school cafetarias toward healthier offerings, HealthDay. Retrieved on May 16, 2011 from: http://health.usnews.com/health-news/managing-your-healthcare/policy/articles/2011/05/13/us-pushes-school-cafeterias-toward-healthier-offerings 9. Working for health: An introduction to the World Health Organization, (2007), World health Organization. Retrieved on May 16, 2011 from: http://www.who.int/about/brochure_en.pdf Read More