User:Csteel3777/Child health and nutrition in Africa

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Child health and nutrition in Africa is concerned with the health care of children through adolescents in the various countries of Africa. The right to health and a nutritious and sufficient diet are internationally recognized fundamental human rights that are protected by international treaties and conventions on the right to life, as well as in charters, strategies and declarations. Millennium Development Goals (MDGs) 1, 4, 5 and 6 highlight, respectively, how poverty, hunger, child mortality, maternal health, the eradication of HIV/AIDS, malaria, tuberculosis and other diseases are of particular significance in the context of child health.

Despite these commitments and ideals, however, the reality is that high mortality among young children, particularly in Africa, continues to be a cause for concern. Children born in developed countries such as Sweden have a less than 1 per cent risk of dying before the age of 1 year, whereas for children born in developing countries, the risk is closer to 10 per cent or higher. Within developing countries, there are significant disparities between rich and poor and urban and rural areas. These large differences are likely the result of initial and continuous colonial control across Africa.

Malnutrition has had, and continues to have, a long and complicated history, most of which has stemmed from the initial imposition of colonial rule. With added European influence, African farmers were instructed about how and what to cultivate on the land. One method of farming that was implemented and promoted throughout much of the continent was monocropping, or utilizing cash crops. Cash crops are the production of crops for commercial use rather than for personal consumption. This practice often consists of mainstream crops that are grown year after year on the same plot of land, leading to a lack of diversity, soil erosion and soil depletion. By requiring that farmers switch to new crops and new farming methods, malnutrition rates skyrocketed.

Deficiency in essential nutrients and micronutrients[edit]

The prevalence of malnutrition and related health conditions among children in Africa leads to a plethora of diseases that impact the child and their development. Given that vitamin A is critical for proper functioning of the visual system and for maintaining immune defences, its deficiency remains a public health issue. An estimated 250,000 to 500,000 children deficient in vitamin A become blind every year, half of them dying within 12 months of losing their sight. This deficiency accounts for 350 million cases of blindness and 670,000 deaths globally (WHO, 2001). In Africa alone, it contributes to 23 per cent of child deaths. In 2009, the prevalence of low serum retinol, associated with vitamin A deficiency, was 37.7 per cent in Ethiopia, 49 per cent in the Congo, and 42 per cent in Madagascar. The immediate causes of this deficiency are the low rates of consumption of animal products, the poor bioavailability of vitamin A in cereal-based diets, the consumption of green leaves with low lipid content, and an increased bodily demand for vitamin A owing to the infections that frequently affect African children (Manga, 2011).

There are equally disturbing levels of zinc deficiencies which has extreme adverse effects on growth, the risk and severity of infections, as well as the level of immune function. Although the actual prevalence is unclear, zinc deficiency is recognized as one of the main risk factors for morbidity and mortality. It contributes to over 450,000 deaths per year among children under 5 years, particularly in sub-Saharan Africa. It affected 57 per cent of children under 5 in Senegal, 72 per cent in Burkina Faso, and 41.5 per cent in Nigeria in 2004. The main causes of this deficiency in children are a lack of zinc-rich easily absorbed foodstuffs (such as meat, poultry, seafood) and the over-consumption of foodstuffs that inhibit zinc absorption, such as cereals, roots and tubers, which are among Africa's staples.

Inadequacies in iodine intake on the other hand impair the synthesis of thyroid hormones, which are critical for normal development and proper functioning of the brain and nervous system as well as the conservation of body heat and energy. Iodine deficiency causes endemic goitre and cretinism as well as stunting of mental and physical development. Globally, 1.6 million people are at risk of iodine deficiency disorders and 50 million children affected by them. About 100,000 children are born each year with mental retardation, most of them in Africa. This is due to the low consumption of iodine-rich foodstuffs (e.g. marine products) and the over-consumption of foodstuffs causing goitre, particularly bitter cassava, which is a staple in Central Africa.

Child undernutrition itself takes three common forms: stunting, wasting, and being underweight. Stunting is low height that results from insufficient nutrient intake, wasting is low weight which indicates body mass and fat deficit, and being underweight is a measure that includes the effects of both stunting and wasting.

Anaemia is quite prevalent in Africa especially among young children due mainly to a diet that is low in animal-based foodstuffs and high in fibre-rich cereals, tannins and phytates which inhibit iron absorption. In 2006, about 67.6 per cent of children under 5, and overall 83.5 million children were anaemic. Through its effects on metabolic processes such as oxygen transport, oxidative metabolism and cell growth, iron deficiency also retards growth and development. It impairs the immune response and increases susceptibility to infection, delays motor development, and diminishes concentration (impairing cognitive and behavioural capacities). It therefore prevents 40-60 per cent of African children from attaining their full mental capacities. Moreover, of the 26 health risks reported by the WHO Global Burden of Disease project, iron deficiency is ranked ninth in terms of years of life lost.

Curative interventions[edit]

Oral rehydration solutions[edit]

Oral rehydration is considered one of the greatest revolutions in improving child health and managing diarrhoea. With new oral rehydration solutions containing zinc, child mortality can be reduced by 15 per cent.

Therapeutic feeds[edit]

F75 and F100 are types of therapeutic milk that is used in inpatient management of severe acute malnutrition. They differ in concentrations of ingredients and amount of energy. Ready to use therapeutic foods (RTUF) are semi-solid foods for outpatient management of malnutrition. Ready to use therapeutic food (RUTF) is made from a variety of macro- and micro-nutrients that help malnourished children effectively gain weight. RUTF is considered a promising new method for managing severe acute malnutrition. Additionally, RUTF is beneficial because it is dehydrated and sealed, allowing it to have a longer shelf life and limiting the spread of bacteria. These RUTFs may be used as part of a community-based food and nutrition program.