Rural areas still have the highest rate of malnourished children.
Yemeni children under one year of age are especially prone to malnutrition, according to a Sana’a University study conducted by a group of researchers at the Faculty of Medicine and Health Science.
The study was conducted on child patients younger than ten years of age from a number of governmental hospitals in Sana’a. “This research was aimed to assess and quantify the magnitude of inequalities in under-ten child malnutrition, particularly those ascribable to socio-economic status and gastroenteritis, to consider the policy implications of these findings,” said Dr. Ubada Jum’a, one of the researchers involved in the study.
About 53 percent of Yemen’s population,with more than 24,000 Yemeni children under the age of five, are estimated to suffer from malnutrition, according to officials of the Country Program, run by the United Nations World Food Programme in cooperation with the Ministry of Public Health and Population and the Ministry of Education. The Country Program is expected to be implemented in Yemen during the next five years.
The World Health Organization defines malnutrition as the cellular imbalance between supply of nutrients and energy and the body’s demand for them to ensure proper growth, maintenance and specific bodily functions.
A child becomes malnourished because of illness in combination with inadequate food intake. Insufficient access to food, poor health services, the lack of safe water and sanitation and inadequate child and maternal care are underlying causes.
More than 1.1 billion people in the world lack access to safe drinking water and some 2.9 billion people lack access to adequate sanitation. This results in the spread of infectious diseases, including childhood diarrhea, which in turn are major causes of malnutrition.
Malnutrition contributes to over 6 million deaths of children each year of the nearly 12 million deaths among children under five in developing countries. Half of all children under five years of age in South Asia and one third of those in sub-Saharan Africa are malnourished.
Poor eating habits or lack of available food may lead to malnutrition. Malnutrition occurs in children who are either undernourished or overnourished. Children who are overnourished may become overweight or obese, which may lead to long-term health problems and social stress. Malnutrition can occur because of the lack of a single vitamin in the diet, or it can be because a person isn’t getting enough food.
Malnutrition also occurs when adequate nutrients are consumed in the diet, but one or more nutrients are not digested or absorbed properly.
The Yemeni study found that most cases of malnourishment, 44 percent are found in children less than six months of age with about 33 percent of children between 7 months and one year old are suffering from malnutrition. Children between one to five years of age suffer less from malnutrition than other age groups, with a rate of 22 percent, the study found.
According to the study, most of the malnourished children, 76 percent, come from various rural areas, while just 25 percent are found to be living in cities. Since the highest rate of malnourished children is found in rural areas, this can be interpreted and being caused by the parents’ lack of education. It was found that 89 percent of the mothers were not educated, while just 3 percent of the fathers were highly educated.
The family’ socioeconomic condition plays an important role in affecting children’s nutrition, as about 33 percent of affected children were living in a low socioeconomic state.
The study noted that about 23 percent of malnourished children suffered from respiratory problems after delivery and 29 percent of them had gastrointestinal tract (GIT) troubles. Moreover, it is important to note that just 45 percent of the children were breast feeding, while 33 percent were fed with artificial milk and 22 percent were fed with both, the study said.
“It’s also interesting to know that more than 40 percent of malnourished children had stopped breast feeding before reaching one year of age. This may be the main cause of malnutrition and inadequate nutrient intake,” said Dr. Jum’a.
Vaccination is very important for protecting children from many diseases. The study also found that 50 percent of the children did not receive regular vaccinations.
Gastroenteritis was found to be the most prevalent cause of malnutrition in Yemen as about 64 percent of cases were found to be due to gastroenteritis and 22 percent were due to abnormal dietary intake. These causes have a correlation with breast feeding and the family’s low education and poor socioeconomic conditions.
Yemen is one of the least developed countries in the world. Its widespread nutritional deficit is likely the result of Yemen’s extremely low national income, as well as the poor state of education in the country. The fact that roughly 50 percent of families’ income goes towards qat is also a factor. In 2005 the United Nations Development Programme (UNDP) ranked Yemen 151st out of 177 in the list of countries on the Human Development Index.
According to the UN World Food Programme, almost half the people in Yemen do not have enough to eat. About 40 percent of Yemen’s population of 22 million lives below the poverty line on less than $2 per day. Moreover, opportunities to receive education and health care are limited, especially in rural areas, where 88 percent of women and 36 percent of men are illiterate, the report shows.
The World Bank has noted that the average annual income was only $450 in 2003, and Yemen’s unemployment rate was close to 40 percent in that same year. “Malnutrition is one of the main challenges in Yemen, where 46 percent - almost half - of the children are underweight,” said Naseem Ur-Rehman, communications coordinator at UNICEF’s Sana’a office. “The magnitude of the problem is huge, as underweight children are particularly vulnerable to diseases, compounding the issue.”
Health indicators also reveal other serious problems. The number of mothers who die during childbirth is increasing faster than in the world’s most underdeveloped countries. In 2005, the infant mortality rate (for babies under 1 year of age) was 76 deaths per 1,000 live births, according to UNICEF. The rate for children under five was 102.
The study’s researchers think that prevention of malnutrition in children starts with an emphasis on prenatal nutrition and good prenatal care. Health care providers should emphasize the importance of breastfeeding in the first year of life.
In addition to the promotion of breastfeeding, health care providers should counsel parents on the appropriate introduction of nutritious supplemental foods, the researchers said.
The study, supervised by Dr. Mohammed al-Naeb who is an assistant professor in the Community Medicine Department, recommended paying more attention to those children who are at risk of nutritional deficiency. According to the study, they should be referred to a registered dietitian or other nutritional professional for a complete nutritional assessment and dietary counseling.
The study was conducted by Ubada Jum’a, Qutaiba Lutfi, and Amer Attia.
