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Addis Ababa, Ethiopia

Nisar Y.B.,United Nations Office for Project Services UNOPS | Dibley M.J.,University of Sydney | Aguayo V.M.,United Nations Childrens Fund UNICEF

The aim of the study was to investigate the effect of antenatal iron-folic acid (IFA) supplementation on child stunting in Nepalese children age <2 years. A retrospective cohort study design was used, in which a pooled cohort of 5235 most recent live births 2 years prior to interview from three Nepal Demographic and Health Surveys (2001, 2006 and 2011) was analysed. The primary outcome was stunting in children age <2 years. The main exposure variable was antenatal IFA supplementation. Multivariate Poisson regression analysis was performed. In our sample, 31% and 10% of Nepalese children age <2 years were stunted and severely stunted, respectively. The adjusted relative risk of being stunted was 14% lower in children whose mothers used IFA supplements compared to those whose mothers did not use (aRR = 0.86, 95% CI = 0.77–0.97). Additionally, the adjusted relative risk of being stunted was significantly reduced by 23% when antenatal IFA supplementation was started ≤6 months with ≥90 IFA supplements used during pregnancy (aRR = 0.77, 95% CI = 0.64–0.92). Antenatal IFA supplementation significantly reduced the risk of stunting in Nepalese children age <2 years. The greatest impact on the risk reduction of child stunting was when IFA supplements were started ≤6 months with ≥90 supplements were used. © 2016 by the authors; licensee MDPI, Basel, Switzerland. Source

Aguayo V.M.,United Nations Childrens Fund UNICEF | Menon P.,International Food Policy Research Institute
Maternal and Child Nutrition

The latest available data indicate that 38% of South Asia's children aged 0-59months are stunted. Such high prevalence combined with the region's large child population explain why South Asia bears about 40% of the global burden of stunting. Recent analyses indicate that the poor diets of children in the first years of life, the poor nutrition of women before and during pregnancy and the prevailing poor sanitation practices in households and communities are important drivers of stunting, most likely because of underlying conditions of women's status, food insecurity, poverty, and social inequalities. With this evidence in mind, UNICEF Regional Office for South Asia convened the Regional Conference: Stop Stunting: Improving Child Feeding, Women's Nutrition, and Household Sanitation in South Asia (New Delhi, November 10-12, 2014). The Conference provided a knowledge-for-action platform with three objectives: (1) share state-of-the-art research findings on the causes of child stunting and its consequences for child growth and development and the sustainable growth and development of nations; (2) discuss better practices and the cost and benefits of scaling up programmes to improve child feeding, women's nutrition, and household sanitation in South Asia; and (3) identify implications for sectoral and cross-sectoral policy, programme, advocacy and research to accelerate progress in reducing child stunting in South Asia. This overview paper summarizes the rationale for the focus on improving child feeding, women's nutrition, and household sanitation as priority areas for investment to prevent child stunting in South Asia. It builds on the invited papers presented at or developed as a follow on to the Stop Stunting Conference. © 2016 John Wiley & Sons Ltd. Source

Ejigui J.,United Nations Childrens Fund UNICEF | Desrosiers T.,Laval University
International Journal of Food Sciences and Nutrition

The objective of the present study was to use lemon and selected foods to improve the nutritional characteristics, quality and the nutrient content of a traditional complementary porridge made of lactic acid fermented yellow maize. Boiled egg yolk, roasted peanut paste, dry crayfish flour, roasted soybean flour and lemon juice were used as food additions. Amounts of food added were calculated on the basis of World Health Organization estimated energy needs from complementary foods of well-nourished children in developing countries, aged 911 months, at four servings per day and a low amount of breast milk energy. The pH and viscosity increased in porridges with food addition, but lemon juice contributed to lowering them. Energy and nutrient densities/100 Â g porridge improved with food addition regardless of the use of lemon juice. An increase in iron, zinc and calcium in vitro availability was observed (P < 0.05) with the addition of lemon juice. © 2011 Informa UK, Ltd. Source

Admasu K.,Federal Ministry of Health | Haile-Mariam A.,United Nations Childrens Fund UNICEF | Bailey P.,Family Health International FHI 360
International Journal of Gynecology and Obstetrics

Objective: To report on the availability and quality of emergency obstetric and newborn care (EmONC) in Ethiopia. Methods: All licensed hospitals and health centers were visited and standard questionnaires were administered. In addition, a nonrandom systematic sample was taken of recent cesarean deliveries, partographs, and maternal deaths-and these cases were systematically reviewed. Health facilities were geocoded using geographic positioning system devices. Results: Too few facilities provided EmONC to meet the UN standards of 5 per 500 000 population, both nationally and in all but 2 regions. Only 7% of deliveries took place in institutions of any type, and only 3% in facilities that routinely provided all the signal functions. Only 6% of women with obstetric complications were treated in any health facility, half of whom were treated in fully functional EmONC facilities. Nationwide, 0.6% of expected deliveries were by cesarean. The mortality rate for women with serious obstetric complications (case fatality rate) was 2%. The cause of death was unknown in 10% of cases, and 21% were due to indirect causes (primarily malaria, anemia, and HIV-related). Conclusion: None of the indicators met UN standards. Ethiopia faces many challenges-not least geography-with regard to improving EmONC. Nevertheless, the government places high priority on improvement and has taken (and will continue to take) action to achieve Millennium Development Goals 4 and 5. This comprehensive survey serves both as a road map for planning strategies for improvement and as a baseline for measuring the impact of interventions. © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. Source

Gandhi G.,United Nations Childrens Fund UNICEF | Lydon P.,World Health Organization | Cornejo S.,GAVI Alliance Secretariat | Brenzel L.,Bill and Melinda Gates Foundation | And 2 more authors.

The Decade of Vaccines Global Vaccine Action Plan has outlined a set of ambitious goals to broaden the impact and reach of immunization across the globe. A projections exercise has been undertaken to assess the costs, financing availability, and additional resource requirements to achieve these goals through the delivery of vaccines against 19 diseases across 94 low- and middle-income countries for the period 2011-2020. The exercise draws upon data from existing published and unpublished global forecasts, country immunization plans, and costing studies. A combination of an ingredients-based approach and use of approximations based on past spending has been used to generate vaccine and non-vaccine delivery costs for routine programs, as well as supplementary immunization activities (SIAs). Financing projections focused primarily on support from governments and the GAVI Alliance. Cost and financing projections are presented in constant 2010 US dollars (US$;). Cumulative total costs for the decade are projected to be US$;57.5 billion, with 85% for routine programs and the remaining 15% for SIAs. Delivery costs account for 54% of total cumulative costs, and vaccine costs make up the remainder. A conservative estimate of total financing for immunization programs is projected to be $;34.3 billion over the decade, with country governments financing 65%. These projections imply a cumulative funding gap of $;23.2 billion. About 57% of the total resources required to close the funding gap are needed just to maintain existing programs and scale up other currently available vaccines (i.e., before adding in the additional costs of vaccines still in development). Efforts to mobilize additional resources, manage program costs, and establish mutual accountability between countries and development partners will all be necessary to ensure the goals of the Decade of Vaccines are achieved. Establishing or building on existing mechanisms to more comprehensively track resources and commitments for immunization will help facilitate these efforts. © 2013 Elsevier Ltd. Source

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