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In order to provide more comprehensive and meaningful search results on our site, several reports are available for viewing and download directly. Kindly visit the main sites of the author organisations for more complete and updated information. We acknowledge our gratitude to the many people and sources whose work has been drawn freely upon. We thank them all.
"If I have seen farther it is by standing on the shoulders of giants." - Isaac Newton
Micronutrient malnutrition, or hidden hunger, afflicts billions of people. It is caused by a lack of micronutrients in the diet. Fruits, vegetables, and animal products are rich in micronutrients, but these foods are often not available to the poor. Their daily diet consists mostly of a few inexpensive staple foods, such as rice or cassava, which have few micronutrients. The consequences, in terms of malnutrition and health, are devastating and can result in blindness, stunting, disease, and even death.
HarvestPlus seeks to reduce hidden hunger and provide micronutrients to billions of people directly through the staple foods that they eat. We use a novel process called biofortification to breed higher levels of micronutrients directly into key staple foods.
HarvestPlus focuses on three critical micronutrients that are recognized by the World Health Organization (WHO) as most limiting in diets: iron, zinc, and vitamin A. HarvestPlus envisions that in fifteen years, millions of people suffering from micronutrient malnutrition will be eating new biofortified crop varieties. >> Publications
This course, from the University of Southampton, is designed to cater individualised learning for health professionals who have any responsibility for child care, especially paediatricians, nurses, medical students and nursing students. The course is designed to support interactive and self-directed learning.
Based on the WHO's guidelines, the course provides standardised and interactive learning in 3 modules. In the first module you will learn the definition and classification of malnutrition, the visible and invisible changes caused by malnutrition and why malnourished children need different care from other children. In the second module you will learn how to assess and screen children for malnutrition, and in the third module how to manage children with malnutrition. These will include the ten steps for successful management, how community- and facility-based approaches can be integrated to widen coverage and why common conditions such as gastroenteritis, pneumonia and malaria have to be treated differently when there is coexisting malnutrition.
by David Dawe, Hartwig de Haen, Kostas Stamoulis et al. UN Food and Agriculture Organization (FAO), the International Fund for Agricultural Development (IFAD) and the World Food Programme (WFP), October 2012 - .pdf - 65 pp. 3.8 MB:
The report presents new estimates of undernourishment based on a revised and improved methodology. The new estimates show that progress in reducing hunger during the past 20 years has been better than previously believed, and that, given renewed efforts, it may be possible to reach the MDG hunger target at the global level by 2015. However, the number of people suffering from chronic undernourishment is still unacceptably high, and eradication of hunger remains a major global challenge.
The Challenge of Hunger: Ensuring Sustainable Food Security under Land, Water, and Energy Stresses by Klaus von Grebmer, Claudia Ringler, Mark W. Rosegrant et al. International Food Policy Research Institute (IFPRI), 2010 .pdf - 72 pp. 4.3 MB
In this report, IFPRI describes the evidence on land, water, and energy scarcity in developing countries and offers two visions of a future global food system - an unsustainable scenario in which current trends in resource use continue, and a sustainable scenario in which access to food, modern energy, and clean water improves significantly and ecosystem degradation is halted or reversed.
For the first time UNICEF, WHO and the World Bank report joint estimates of child malnutrition for 2011 and trends since 1990. Estimates of prevalence and numbers for child stunting, underweight, overweight and wasting are presented by United Nations, Millennium Development Goal, UNICEF, WHO regional and World Bank income group classifications. This is the result of the data harmonization effort which started in 2011. More information and reports
Want to understand how high food prices really are? And how they're affecting the world's poor?
Take a look at this infographic from the World Food Programme, which also underlines how hikes in food prices mean the poorest families have to make painful savings in areas such as health and schooling for their children.
Almost one in three of the world's poorest children cannot reach their full potential due to malnutrition. As the Olympics close, Prime Minister David Cameron and Vice President Michel Temer of Brazil will call on the world to take the action needed to transform the life chances of millions of children before the next Olympic Games in 2016.
Malnutrition is a global issue that affects billions. Programs like The Global Alliance for Improved Nutrion (GAIN) are reducing malnutrition through food fortification strategies aimed at improving the health and nutrition of populations at risk.
Watch Video: See how baladi bread is making a difference in Egypt.
Unlike other hunger indices the HRCI uses indicators derived from a combination of primary data, collected from a perception survey of country experts and secondary data drawn from a variety of publicly available sources. The perceptions surveys, piloted in Bangladesh and Zambia, gathered data from government, civil society, academics, the donor community and others.
These indicators are then grouped under three themes: Policies and programmes, Government expenditures and Legal frameworks.
A Life Free from Hunger: Tackling child malnutrition
15 February, 2012 New global research by Save the Children has revealed that, after a year of soaring food prices, nearly half of surveyed families say they have been forced to cut back on food. Nearly a third of parents surveyed said their children complained that they didn't have enough food to eat. Download report pdf
"Every hour of every day, 300 children die because of malnutrition … But it's not recorded on death certificates and, as a result, it's not effectively addressed." - Save the Children
Seven hundred and fifty thousand Somalis may die of starvation this year. That's equivalent to wiping out every single person in Washington [DC], plus 150,000 more.
The scale of the disaster in the Horn of Africa is something difficult to wrap your head around. Consider some of the other numbers:
The rate of malnutrition in Somalia is now 50 percent, meaning half of its people are at risk of malnutrition, starvation or death.
Some 12 million people across the region need food aid, a number equivalent to the entire population of Illinois.
The amount of money needed to stop the disaster in Somalia is $2.4 billion, the same amount of money Warren Buffett made today alone on paper.
The United Nations is $1.1 billion short of that goal, the same cost as the initial estimated cost of the damage of Hurricane Irene.
Interactive Hunger Map This is one way to map hunger – by percentage of undernourished in the total population. Click here to download the FAO Hunger Map.
This map shows startling facts about nutrition and children in our world where one out of four children from developing countries are underweight. [...]
Scaling Up Nutrition: The UK's position paper on undernutrition
On July 18 Alive & Thrive hosted an event in Washington, D.C. to show how nutrition is being be scaled up in Bangladesh and achieving impact through active, engaged, and creative partners.
Diarrhoea: Why children are still dying and what can be done
Diarrhoea is the second leading cause of death among children under five globally. Nearly one in five child deaths – about 1.5 million each year – is due to diarrhoea. It kills more young children than AIDS, malaria and measles combined.
Today, only 39 per cent of children with diarrhoea in developing countries receive the recommended treatment, and limited trend data suggest that there has been little progress since 2000.
Welcome to GROW, Oxfam's new campaign to build a better food system: one that produces enough for a growing population and empowers poor people to earn a living, feed their families, and thrive. It's time to build global food security within this resource-constrained world.
Despite there being enough food to feed everyone, millions of children die every year due to malnutrition-related causes. The good news is that child malnutrition is preventable and treatable, and cost-effective solutions exist.
Watch Action Against Hunger's latest video to learn more about acute malnutrition and how it can be treated.
Maria Mchele is a mother and farmer in Tanzania who relies on farming for food and income. Through a local agricultural program, Maria learned about a new crop of orange-fleshed sweet potatoes, specifically bred to thrive in sub-Saharan Africa. Learn how investments in programs like this have helped farmers increase their incomes by up to 400%.
Millions of Egyptians suffer from poor nutrition, including birth defects and miscarriages. Now, a food fortification program is making an edible difference. One family's newest member is living proof.
Right now, the humanitarian food aid system provides nutritionally inadequate foods to malnourished children under two years of age.
Doctors Without Borders / Médecins Sans Frontières (MSF) and VII Photo present "Starved for Attention," a multimedia campaign exposing the neglected and largely invisible crisis of childhood malnutrition.
Accelerating interventions aimed at improving infant and young child feeding (IYCF) at community level is a key priority in the effort to improve survival, growth, and development of children with equity.
UNICEF recently developed a new set of generic tools for programming and capacity development on community based IYCF counselling.
"Our research shows that a mother's breast milk — one single nutrition intervention — can save a million children's lives each year,... All mothers should have the support they need to choose to breastfeed if they want to. Breastfeeding is good for babies no matter where they live, but in developing countries, especially those without access to clean water, breastfeeding can be a matter of life or death."
Final Report: Our global efforts to prevent malnutrition during the first 1,000 days
The report summarizes the IYCN Project's accomplishments and offers recommendations for building on IYCN's maternal, infant, and young child nutrition programming that spanned 16 countries over five years.
By focusing on prevention of malnutrition during the critical 1,000 days from pregnancy through a child's second birthday, involving communities in improved nutrition, and strengthening health systems, IYCN aimed to improve the nutritional status of mothers and children and to increase children's chances of surviving free of HIV. These activities resulted in the following achievements:
» Built an enabling environment for improved nutrition
» Strengthened social and behavior change communication programming
» Enhanced complementary feeding programs
» Increased HIV-free survival for the next generation
» Brought women's and children's nutrition to the forefront of agriculture
» Strengthened health systems for healthier mothers and children
Translators Without Borders The work of Translators without Borders is of crucial importance for the success of humanitarian projects. Information available in the local language is much more effective than in a foreign language. This is true for engineering and construction projects (such as digging water wells), and agricultural projects (such as how to irrigate the land). But it is particularly important in healthcare. In many areas in the world people do not only die from diseases, but also from the fact that they do not have basic information about how to stay healthy and what to do to prevent disease.
If you are a translator and you are willing to donate your time and professional skills to Translators without Borders, you will directly support humanitarian projects. To join TWB, we ask you to fill in the translator application form.
One billion. That's the number of hungry people worldwide. The effects are heartbreaking. The causes myriad. Solutions are needed now to feed future generations. In this series, the UN 's three food agencies - FAO, WFP and IFAD - take us around the globe in search of answers to some of the most pressing questions we face today.
The HUNGaMA Survey collects data on nutritional status of children, it also captures the voice of mothers and takes a quick look at the Anganwadi Centres in villages across 100 districts in India. Naandi Foundation deployed a trained team of over 1000 surveyors who interviewed 74,020 mothers and measured 109,093 children in 4 months.
Research shows that inadequate maternal and child nutrition is the underlying cause of 3.5 million deaths every year and 35 percent of the disease burden for children under 5 years of age.
However, universal coverage of proven nutrition-related interventions could reduce overall mortality of children under 3 by 25 percent.
Are you familiar with the basic concepts of good nutrition?
How does nutrition affect maternal and child health?
What are common nutritional deficiencies, vulnerable groups, and the causes of undernutrition?
The Nutrition course covers the basic concepts of good nutrition and common nutritional deficiencies, the magnitude of malnutrition in different populations, the causes of undernutrition in vulnerable groups, and key indicators and ways of measuring them. It also outlines the major population-based interventions to improve nutritional status. One-time registration at globalhealthlearning.org gives you free access to this and 49 other courses that cover a variety of global health topics.
1. Introduction - What is Severe Acute Malnutrition?
2. Community Mobilization
3. Screening for Acute Malnutrition
4. Checking for Complications
5. Appetite Testing Techniques
6. Assessment and Classification of a Child with Acute Malnutrition
7. OTP Admission Procedure
8. Management of Severe Acute Malnutrition in OTP and Follow Up
9. Discharge Criteria
Exercise 1 - Assessing for Presence of Severe Acute Malnutrition
Exercise 2 - Assessing, Classifying and Taking Action
Solution Exchange is a Knowledge Management initiative of the United Nations Country Team in India. The brand is recognized by development professionals as a platform for exchange of ideas and dialogue between different stakeholders. SE membership is a talent pool of more than 35,000 subscriptions including practitioners from civil society, grass roots organizations, academics, research institutions and government who come together to share knowledge and best practices, provide solutions and address development challenges. There are 13 Communities of Practice organized around national priorities and MDGs, facilitated by different UN agencies. Solution Exchange (SE) offers a free, impartial space where all partners are welcome members of the community.
Maternal and Child Health Community of Practice of Solution Exchange aids in addressing the Millennium Development Goals (MDGs) relating to improving maternal and child health and to reducing maternal, infant and child mortality. The community has been in existence for last 7 years with a membership of about 4,000 MCH practitioners, has discussed over 190 issues which are available here- Maternal and Child Health Community - For queries and subscription, write to se-mch@solutionexchange.un.in
Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk.
If the vast majority of babies were exclusively fed breastmilk in their first six months of life – meaning only breastmilk and no other liquids or solids, not even water – it is estimated that the lives of at least 1.2 million children would be saved every year. If children continue to be breastfed up to two years and beyond, the health and development of millions of children would be greatly improved. more >>
Eliminating hunger and malnutrition cannot be done by governments alone but must involve coordinated action. The Alliance Against Hunger and Malnutrition (AAHM) is a global voluntary partnership where members share a common commitment to the rapid eradication of hunger and malnutrition in the world.
10 August 2011 | Colombo/Geneva - In a bid to stop millions of people dying and suffering every year from malnutrition, WHO today is launching a new web-powered initiative that clarifies guidance on life-saving nutrition interventions, and assists governments and healthcare providers to better scale up action against all forms of malnutrition.
An e-library for nutrition The WHO e-Library of Evidence for Nutrition Actions (eLENA), launched during today's opening of a three-day Asia regional nutrition meeting in Sri Lanka, helps governments overcome one of the major challenges in fighting malnutrition: the vast, and often conflicting, array of evidence and advice that exists on effective, preventive and therapeutic nutrition interventions.
The online eLENA project does this by prioritizing and presenting the latest advice on tackling the three main forms of malnutrition: undernutrition, vitamin and mineral deficiencies, and overweight and obesity.
Medical Aid Films (MAF - MedicalAidFilms.org) is a cutting edge film-making charity. We produce training films and animations for grassroots health workers in low income countries. Our films provide information and medical techniques on issues surrounding safe childbirth and infant health, with the aim of saving the lives of vulnerable women and children around the world.
Approximately one woman a minute dies in childbirth. We hope that by using film and animation to train health workers, we can overcome literacy and language barriers that so often impede learning.
The advent of ready-to-use therapeutic food (RUTF) products has greatly improved the coverage and effectiveness treatment for severe acute malnutrition (SAM). The excitement surrounding this development has led to rapid expansion of SAM treatment activities, often without regard to the prevalence of SAM, the capacity of local health systems to absorb expansion, or the contribution of SAM to overall child mortality. In the context of limited health budgets, on epidemiological and ethical grounds treatment approaches are in most situations a less rational public health investment than approaches that prevent SAM and other types of malnutrition.
Management of Severe Acute Malnutrition and Out Patient Therapeutic Programme Training Material
Intended for Health Extension Workers (HEW) on how to do screening for malnutrition, how to identify Severe Acute Malnutrition (SAM) cases; and how to conduct Out-Patient therapeutic Program for Severe Acute Malnutrition in order to maximize the coverage and improve the quality of services provided to SAM cases at the community level.
Outpatient Therapeutic Feeding Training Videos Federal Ministry of Health and UNICEF, Ethiopia, 2009 Oromifa and Tigrinian versions presently under development
If you have any problems with watching the videos, please ensure you have the latest Adobe Flash Player. Click here to download
1. Introduction - What is Severe Acute Malnutrition? English
> high definition YouTube
| Amharic
> high definition YouTube
Exercise 1 - Assessing for Presence of Severe Acute Malnutrition English
> high definition YouTube
| Amharic
> high definition YouTube
Exercise 2 - Assessing, Classifying and Taking Action English
> high definition YouTube
| Amharic
> high definition YouTube
Management of Severe Acute Malnutrition at Health Post level, Quick Reference for Health Extension Workers Federal Ministry of Health and UNICEF, Ethiopia, 2009 English26 pages 5 mb Afar26 pages 4.2 mb Amharic27 pages 5.3 mb Oromifa26 pages 4.4 mb Somali26 pages 4.8 mb Tigrigna27 pages 5.2 mb
A significant gap remains between need and capacity for management of severe acute malnutrition (SAM) in children. This is despite clear advances in the development and implementation of international and national protocols for the management of SAM, as well as guidelines and training for inpatient care of severely acutely malnourished children. The Training Guide for Community-Based Management of Acute Malnutrition (CMAM) aims to address this gap by increasing knowledge of and building practical skills to implement CMAM in both emergency and non-emergency contexts.
This work was supported by UNICEF, USAID and AED. The guide is available for free download. More information
Copies of the CD-ROM are available by emailing your request to fanta2@aed.org.
The Infant and Young Child Nutrition (IYCN) Project maintains a collection of useful resources on maternal nutrition, infant and young child feeding, prevention of mother-to-child transmission of HIV (PMTCT), and more. Our collection offers a variety of high-quality training materials, publications, web links, and other helpful resources.
Featured resource: Review of breastfeeding literature
Our latest literature review examines evidence on community interventions to promote optimal breastfeeding. We are grateful to our colleague Dr. Miriam Labbok, Director of the Carolina Global Breastfeeding Institute at the University of North Carolina at Chapel Hill, for expertly composing this publication. Dr. Labbok shared her thoughts on the findings of the review in a recent Q&A. See the Q&A with Dr. Labbok.
World Health Statistics 2009 contains WHO's annual compilation of data from its 193 Member States, and includes a summary of progress
towards the health-related Millennium Development Goals and targets. This edition also contains a new section on reported cases of selected infectious diseases.
This statement presents the recommended cut-offs, summarizes the rationale for their adoption and advocates for their harmonized application in the identification of 6–60 month old infants and children for the management of severe acute malnutrition (SAM). It also reviews the implications on patient load, on discharge criteria and on programme planning and monitoring.
This review provides useful programmatic recommendations based on lessons learned from large-scale programmes to improve breastfeeding practices in 10 countries: in Africa (Benin, Ethiopia, Ghana, Madagascar, and Mali), in Asia (Cambodia, India, and Nepal), and in Latin America (Bolivia and Honduras).
A large body of evidence demonstrates the benefits of breastfeeding for child survival, growth, and development. An estimated 1.30-1.45 million child deaths could be prevented each year with improved breastfeeding practices. Community-based breastfeeding promotion and support is one of the key components of a comprehensive programme to improve breastfeeding practices, as outlined in the WHO/UNICEF Global Strategy for Infant and Young Child Feeding (IYCF).
A list of acceptable medical reasons for supplementation was originally developed by WHO and UNICEF as an annex to the Baby-friendly Hospital Initiative (BFHI) package of tools in 1992. WHO and UNICEF agreed to update the list of medical reasons given that new scientific evidence had emerged since 1992, and that the BFHI package of tools was also being updated. The process was led by the departments of Child and Adolescent Health and Development (CAH) and Nutrition for Health and Development (NHD).
The mission of The Countdown to 2015 is to track progress made towards the achievement of the United Nations Millennium Development Goals 1, 4 and 5 and promote evidence-based information for better health investments and decisions by policy-makers regarding health needs at the country level.
Countdown to 2015 111 pages 4.2 mb Tracking Progress in Maternal, Newborn & Child Survival - The 2008 Report
This article is excerpted from the Population Bulletin, "World Population Highlights: Key Findings From PRB's 2007 World Population Data Sheet." (PDF: 945KB) 16 pages - 972 kb - download pdf document
This issue of SCN News focuses on the Landscape Analysis on Readiness to Accelerate Nutrition Action with Chizuru Nishida of WHO as the Special Guest Editor. It describes the country assessments undertaken in five countries that are part of the 36 high-burden countries identified by the Lancet Nutrition Series. The Landscape Analysis country assessment is led by the countries and facilitated by the partner agencies of the SCN constituencies, including WHO, UNICEF, FAO, WFP, IFAD, Helen Keller International, GAIN, and the Medical Research Council of South Africa, supported by the Bill and Melinda Gates Foundation. The Landscape Analysis is an important follow-up to the Lancet Nutrition Series in order to understand how existing commitment and capacity at the country level can be utilized to scale-up the evidence-based nutrition interventions and to further strengthen weak areas.
The outcome of the Landscape Analysis will help the development or the update of country action plans and will facilitate the mobilization of resources for implementation. We hope that the agencies participating in the SCN will look at the process of the Landscape Analysis to be inspired in their approach to programme development, and to draw on the specific results achieved in this first group of countries in setting their action priorities.
The paper presents a new composite indicator – the Poverty and Hunger Index (PHI) – to measure countries' performance towards achieving MDG1 on halving poverty and hunger by 2015. The PHI combines all five official MDG1 indicators, including a) the proportion of population living on less than US$ 1/day, b) poverty gap ratio, c) share of the poorest quintile in national income or consumption, d) prevalence of underweight in children under five years of age, and d) the proportion of population undernourished.
Data for the five MDG1 indicators are compiled for the 81 countries which together account for 90 percent of the world poverty and 85 percent of global undernourishment. The analysis shows a weak correlation between undernourishment and child underweight; this is in line with a growing body of evidence documenting that reducing income poverty or improving the food supply without changing the way young children are fed and cared for does little to reduce levels of undernutrition among children.
Health and Nutrition Modules The Sphere Project: Humanitarian Charter and Minimum Standards in Disaster Response: Nutrition Training Modules 2004
This is a short technical training course in the Sphere Minimum Standards and Key Indicators for health and nutrition. Practicing health and nutrition specialists have written this course, which is designed to build technical capacity in mid-level technical specialists.
Following broadly the structure of the Sphere Training Modules, these highly engaging materials contain numerous examples and case studies from actual field situations. The nutrition training would take approx. two full days (depending on the audience), and the health training would take 1.5 days (again depending on the level of the audience). They can be run independently, however Sphere Training Module 1 should be given first, as they assume a working knowledge with the handbook in the participants before the training starts. A case study, based on South Sudan in 1988, synthesises information given in both the health and nutrition sections, and can be used over an additional ½ day to consolidate the learning.
This course consists of two modules, each broken down into session plans that are 1-2.5 hours in length. Each session plan emphasises a priority Minimum Standard or Key Indicator from the Sphere handbook. The group of specialists who produced the modules have agreed that the material covered is priority knowledge for the target audience. All together, including the Sphere Project Training Module 1 and the case study, this course would last 4.5 days. It is a worthwhile investment for field staff.
You can download these course materials (trainers notes, exercises and readings) by clicking on the tabulated links below. You will also find a link to the full list of documents provided.
The basic right to adequate food and nutrition is implicit in any emergency response and is reflected in humanitarian law. The purpose of this toolkit is to provide an easy reference tool for nutritional response during and after an emergency situation. Too often, in the high-pressure context of emergencies, key aspects of nutritional health and well-being are not adequately addressed. Poor decisions are made in the short-term, which have long-term negative impacts on the nutritional stability of the affected populations. Failure to meet the nutritional needs of populations in emergencies jeopardizes the ability to resist and fight infectious diseases. Growth and development, particularly of children and women, is disrupted resulting in increased childhood malnutrition, poor reproductive health and worsening pregnancy outcomes.
The Interventions
1. Infant and Young Child Feeding in Emergencies
2. Treatment of diarrhoea with ORT/Zinc
3. Prevention and Treatment of Vitamin A Deficiency
4. Prevention and Treatment of Micronutrient Deficiencies
5. Management of Moderate Acute Malnutrition
6. Management of Severe Acute Malnutrition
7. Nutrition, HIV and AIDS
8. The Psychosocial Components of Nutrition
9. Nutritional care for Groups with Special Needs
10. The Use and Role of Food Assistance
11. Food Handling, Storage and Preparation
12. Household Food Security and Livelihoods
The high world food prices that we are currently experiencing provide a chilling reminder of the vulnerability of large parts of sub-Saharan Africa and South Asia to hunger and undernutrition. Many children in these regions are vulnerable to poor growth, poor development and death.
Perhaps the most far-reaching of SIGHT AND LIFE's knowledge-based initiatives is the publication of the SIGHT AND LIFE Magazine, which carries news, features, letters and editorials on nutrition and health-related projects and research activities – supported by SIGHT AND LIFE or otherwise – from on-the-ground practioners as well as leading experts and policymakers in public health and nutrition. Through the Magazine, SIGHT AND LIFE seeks to provide faster access to new and reusable knowledge and insight to people at all levels of practice from people at all levels of engagement in the fight against Hidden Hunger.
This issue: Folic Acid and Arsenic; Combating Vitamin A Deficiency; in Eight Countries; National Family Health Survey of India; Night Blindness in India; Vitamin A Deficiency in Ethiopia; KAP on Iron Deficiency; NIH Vitamin D Conference; A Day in the Life; Critical Review on Vitamin D; News; Letters to the Editor; Publications
Infant and Young Child Feeding and Nutrition
Feeding is a critical aspect of caring for infants and young children. Appropriate feeding practices stimulate bonding with the caregiver and psycho-social development. They lead to improved nutrition and physical growth, reduced susceptibility to common childhood infections and better resistance to cope with them. Improved health outcomes in young children have long-lasting health effects throughout the life-span, including increased performance and productivity, and reduced risk of certain non-communicable diseases.
Malnutrition contributes to more than half of all childhood deaths, although it is rarely listed as the direct cause. For most children, lack of access to food is not the only cause of malnutrition. Poor feeding practices and infection, or a combination of the two, are both major factors of malnutrition. Infection - particularly frequent or persistent diarrhoea, pneumonia, measles and malaria - undermines nutritional status. Poor feeding practices, such as inadequate breastfeeding, offering the wrong foods, giving insufficient quantities, and not ensuring that the child gets enough food, contribute to malnutrition.
Malnourished children are, in turn, more vulnerable to disease and the vicious circle is established.
Improved feeding practices to prevent or treat malnutrition could save 800,000 lives per year.
Counselling for mothers and caretakers
Micronutrient supplements
Management of severe malnutrition
Adolescent Nutrition
Adolescence represents a window of opportunity to prepare for a healthy adult life. During adolescence, nutritional problems originating earlier in life can potentially be corrected, in addition to addressing current ones. It is also a timely period to shape and consolidate healthy eating and lifestyle behaviours, thereby preventing or postponing the onset of nutrition-related chronic diseases in adulthood.
As adolescents have a low prevalence of infections such as pneumonia and gastroenteritis compared with younger children, and of chronic disease compared with ageing people, they have generally been given little health and nutrition attention, except for reproductive health concerns. However, there are nutritional issues, which are adolescent-specific, and which call for specific strategies and approaches.
The main issues in adolescent nutrition are:
Micronutrient deficiencies (iron deficiency and anaemia)
Malnutrition and stunting
Obesity and other nutrition-related chronic diseases
The Joint Statement on Continued Breastfeeding was produced following the WABA GBPM in October 2008 in response to shared concerns that breastfeeding after 6 months has slipped off the policy and programme agenda. Action and investment in improving complementary feeding or providing foods supplements seems to be taking place with little consideration for supporting or improving breastfeeding amongst 6 < 24+ month old children, despite estimates that 20% of deaths in 12 < 24 month age group in developing countries are due to lack of breastfeeding. The statement calls upon everyone involved in improving the health and development of infants and young children to take steps to ensure that continued breastfeeding 6-24+ months is protected, promoted and supported as the precondition for, and foundation of, appropriate complementary feeding. Steps for action encompassing communication, education and promotion; practical support; breastfeeding as part of complementary feeding; definitions and monitoring; addressing misinformation through marketing and special circumstances are described.
This manual reflects the experience gained over five years of implementing and developing Community-based Therapeutic Care (CTC). It is a practical guide that aims to help health and nutrition managers to design, implement and evaluate CTC programmes. It will also be relevant to a variety of others working in relief and development:
Field practitioners who want a better understanding of CTC programmes.
Project managers with Non-governmental Organisations (NGOs) and United Nations (UN) agencies addressing problems of acute malnutrition.
Government officials within Ministries of Health and other government and middle-level agencies who want to learn about CTC and where it might be an appropriate response.
Technical specialists with the UN, donor agencies and non governmental organisation (NGO) headquarters who want to understand what CTC programmes involve and deliver.
Evaluators who want to know the issues relevant to CTC.
There are about 40 different nutrients that are essential for health. If any one of these is deficient in the diet the person will not be fully healthy and able to resist the agents of disease.
The nutrients are divided into two classes. Type I nutrients are the functional nutrients that are required for the hormonal, immunological, biochemical and other processes of the body to function normally. Most of the micronutrients fall into this category. Individuals can be very deficient in these nutrients and not have any anthropometric abnormalities (i.e. they can have grown normally and have a normal body weight). Anthropometric surveys do not give us information about the prevalence of type I nutrient deficiencies. Their deficiency does cause major illness and increased likelihood of death (e.g. iron, iodine and vitamin A deficiency). Deficiency of several of these nutrients, particularly the anti-oxidant nutrients, is the probable cause of oedematous malnutrition (kwashiorkor).
Putting the management of severe malnutrition back on the international health agenda
Severe malnutrition, defined by severe wasting (weight-for-height < –3 z-scores or < 70% of the median National Center for Health Statistics/World Health Organization [NCHS/WHO] reference) and/or the presence of nutritional oedema, is a life-threatening condition requiring urgent treatment. How many lives would better treatment of severe child malnutrition save?
Community-Based Management of Severe Acute Malnutrition 8 pages 393kb A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund
Severe acute malnutrition remains a major killer of children under five years of age. Until recently, treatment has been restricted to facility-based approaches, greatly limiting its coverage and impact. New evidence suggests, however, that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre.
The community-based approach involves timely detection of severe acute malnutrition in the community and provision of treatment for those without medical complications with ready-to-use therapeutic foods or other nutrient-dense foods at home. If properly combined with a facility-based approach for those malnourished children with medical complications and implemented on a large scale, community-based management of severe acute malnutrition could prevent the deaths of hundreds of thousands of children.
The IMTF is an inter-agency advisory and advocacy group on malnutrition. This website provides a forum for governments, organisations and individuals to share ideas, experiences and resources on the management of acute malnutrition.
Context Severe malnutrition has a high mortality rate among hospitalized children in sub-Saharan Africa. However, reports suggest that malnutrition is often poorly assessed. The World Health Organization recommends using weight for height, but this method is problematic and often not undertaken in practice. Mid upper arm circumference (MUAC) and the clinical sign "visible severe wasting" are simple and inexpensive methods but have not been evaluated in this setting.
Objectives To evaluate MUAC and visible severe wasting as predictors of inpatient mortality at a district hospital in sub-Saharan Africa and to compare these with weightfor- height z score (WHZ).
South Africa is one of the few developing countries with a national confi dential inquiry into maternal deaths. 164 health facilities obtain audit data for stillbirths and neonatal deaths, and a new audit network does so for child deaths. Three separate reports have been published, providing valuable information about avoidable causes of death for mothers, babies, and children. These reports make health-system recommendations, many of which overlap and are intertwined with the scarcity of progress in addressing HIV/AIDS. The leaders of these three reports have united to prioritise actions to save the lives of South Africa's mothers, babies, and children. The country is off -track for the health-related Millennium Development Goals. Mortality in children younger than 5 years has increased, whereas maternal and neonatal mortality remain constant. This situation indicates the challenge of strengthening the health system because of high inequity and HIV/AIDS. Coverage of services is fairly high, but addressing the gaps in quality and equity is essential to increasing the number of lives saved. Consistent leadership and accountability to address crosscutting health system and equity issues, and to prevent mother-to-child transmission of HIV, would save tens of thousands of lives every year. Audit is powerful, but only if the data lead to action.
UNICEF, WHO and WABA along with the scientific community strongly recommend initiating breastfeeding within an hour of birth.
Evidence shows that early initiation can prevent 22% of all deaths among babies below one month in developing countries.
Every newborn, when placed on the mother's abdomen, soon after birth, has the ability to find its mother's breast all on its own and to decide when to take the first breastfeed. This is called the "Breast Crawl".
This method is evidence based and has been field tested by us. A documentary on the "Breast Crawl" has been prepared for training, advocacy and for wider dissemination. The video has created a very high level of sensitivity among all the levels of functionaries and was officially endorsed by senior policy makers as the right approach for initiating breastfeeding. This dossier provides the background and a scientific overview to the documentary.
We are sure that this documentary and dossier will greatly help similar initiatives worldwide. It is our strong desire that this information helps every mother and baby to experience the miracle of Breast Crawl. If we all could achieve early initiation of breastfeeding, we will be able to prevent 22% of all deaths among babies below 1 month.
This can be achieved by training all health care providers to initiate breastfeeding, by Breast Crawl, to give infants the best start in life.
Community-based management of severe acute malnutrition
A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund
Severe acute malnutrition remains a major killer of children under five years of age. Until recently, treatment has been restricted to facility-based approaches, greatly limiting its coverage and impact. New evidence suggests, however, that large numbers of children with severe acute malnutrition can be treated in their communities without being admitted to a health facility or a therapeutic feeding centre.
The community-based approach involves timely detection of severe acute malnutrition in the community and provision of treatment for those without medical complications with ready-to-use therapeutic foods or other nutrient-dense foods at home. If properly combined with a facility-based approach for those malnourished children with medical complications and implemented on a large scale, community-based management of severe acute malnutrition could prevent the deaths of hundreds of thousands of children.
The WHO web site presents complete information on the WHO Child Growth Standards.
These standards were developed using data collected in the WHO Multicentre Growth Reference Study. The site presents documentation on how the physical growth curves and motor milestone windows of achievement were developed as well as application tools to support implementation of the standards.
Documentation The following documents describe the sample and methods used to construct the standards and present the final charts.
WHO Child Growth Standards - Methods and development Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age pdf 26.6 mb - 336 pages
In 1993 the World Health Organization (WHO) undertook a comprehensive review of the uses and interpretation of anthropometric references. The review concluded that the NCHS/WHO growth reference, which had been recommended for international use since the late 1970s, did not adequately represent early childhood growth and that new growth curves were necessary. The World Health Assembly endorsed this recommendation in 1994. In response WHO undertook the Multicentre Growth Reference Study (MGRS) between 1997 and 2003 to generate new curves for assessing the growth and development of children the world over.
The MGRS combined a longitudinal follow-up from birth to 24 months and a cross-sectional survey of children aged 18 to 71 months. Primary growth data and related information were gathered from 8440 healthy breastfed infants and young children from widely diverse ethnic backgrounds and cultural settings (Brazil, Ghana, India, Norway, Oman and USA). The MGRS is unique in that it was purposely designed to produce a standard by selecting healthy children living under conditions likely to favour the achievement of their full genetic growth potential. Furthermore, the mothers of the children selected for the construction of the standards engaged in fundamental health-promoting practices, namely breastfeeding and not smoking.
Global Strategy for Infant and Young Child Feeding WHO - UNICEF pdf 440 kb - 37 pages
WHO and UNICEF jointly developed the Global Strategy for Infant and Young Child Feeding to revitalize world attention to the impact that feeding practices have on the nutritional status, growth and development, health, and thus the very survival of infants and young children.
The Global Strategy is based on the evidence of nutrition's significance in the early months and years of life, and of the crucial role that appropriate feeding practices play in achieving optimal health outcomes. Lack of breastfeeding - and especially lack of exclusive breastfeeding during the first half-year of life - are important risk factors for infant and childhood morbidity and mortality that are only compounded by inappropriate complementary feeding. The life-long impact includes poor school performance, reduced productivity, and impaired intellectual and social development.
Management of Severe Malnutrition: A Manual for Physicians and Other Senior Health Workers pdf 1.2 mb - 68 pages
Malnutrition remains one of the most common causes of morbidity and mortality among children throughout the world. Approximately 9% of children below 5 years of age suffer from wasting (weight-for-height below 22 standard deviations (,22 SD) of the National Center for Health Statistics (NCHS)/WHO reference values) and are at risk of death or severe impairment of growth and psychological development.
This manual is based on The treatment and management of severe protein-energy malnutrition, which was published by WHO in 1981. Since then, many advances have been made in the treatment of severe malnutrition. An improved oral rehydration salts (ORS)
solution has been developed for the treatment of dehydration. Advances in knowledge of the physiological roles of micronutrients have led to improved dietary management during the initial phase of treatment. It has been shown that physical and psychological stimulation, as well as care and affection, are necessary during the rehabilitation phase in order to prevent retardation of growth and psychological development.
This manual provides guidelines for the treatment of severely malnourished children (below 5 years of age) in hospitals and health centres. The treatment of severely malnourished adolescents and adults is also briefly considered. The manual is intended for health personnel working at central and district level, including physicians, nurses, midwives and auxiliaries.
Repositioning Nutrition as Central to Development A Strategy for Large-Scale Action - 2006 pdf 1.6 mb - 272 pages - original at
World Bank site
Persistent malnutrition contributes not only to widespread failure to meet the first Millennium Development Goal—to halve poverty and hunger—but also to meet other goals related to maternal and child health, HIV/AIDS, education, and gender equity. Underweight prevalence among children is the key indicator for measuring progress on nonincome poverty, and malnutrition remains the world's most serious health problem—as well as the single largest contributor to child mortality. Nearly one-third of children in the developing world are underweight or stunted, and more than 30 percent of the developing world's population suffers from micronutrient deficiencies. Moreover, new malnutrition problems are emerging: the epidemic of obesity and diet-related noncommunicable diseases is spreading to the developing world, and malnutrition is linked to the HIV/AIDS pandemic.
Repositioning Nutrition as Central to Development: A Strategy for Large-Scale Action makes the case that development partners and developing countries must increase investment in nutrition programs. This case is based on evidence that the scale of the problem is very large and that nutrition interventions are essential for speeding poverty reduction, have high benefit-cost ratios, and can improve nutrition much faster than reliance on economic growth alone. Moreover, improved nutrition can drive economic growth. The report proposes to the international development community and national governments a global strategy for accelerated action in nutrition.
Counting on Communication: The Uganda Nutrition and Early Childhood Development Project - 2005 - World Bank Working Paper No. 59 pdf 3.2 mb - 56 pages - original at
World Bank site
Counting on Communication is part of the World Bank Working Paper series. These papers are published to communicate the results of the Bank's ongoing research and to stimulate public discussion. This publication is the first in a series of Working Papers sponsored by the Development Communication Division (DevComm) of the World Bank's External Affairs Vice-Presidency. This series is designed to share innovations and lessons learned in the application of strategic communication in development projects. Together with other donors, NGOs, and private sector partners, DevComm seeks to mainstream the discipline of development communication in development practice.
The Uganda Nutrition and Early Childhood Development Project was one of DevComm's first projects to demonstrate the valueadded of strategic communication. The strategic communication component developed for this project included the use of formative research about values and attitudes with respect to child rearing, in order to develop and test effective messages. The communication strategy was developed in a highly participatory manner and included nurturing a team of champions for the project among policymakers, district officials, community leaders, and grassroots organizations to advocate for the project. It also included two-way communication activities developed to address the practices and behaviours that would need to be changed in order for the project to be successful, rather than merely disseminating messages based on assumptions of project benefits.
World Bank Working Papers are available individually or by subscription, both in print and online.
Wiesmann, Doris. 2006. 2006 Global Hunger Index: A Basis for Cross-Country Comparisons. Washington, DC: International Food Policy Research Institute. - October 13, 2006
The International Food Policy Research Institute has released its new Global Hunger Index, an innovative and enhanced approach for measuring hunger in developing and transitional countries. The index reveals hunger hotspots, shows which countries and regions have improved over time, and demonstrates the links between hunger and violent conflict.
Severe Malnutrition
List of publications
Management of severe malnutrition: a manual for physicians and other senior health workers Geneva, World Health Organization, 1999
Chinese version under preparation. Farsi and Indonesian versions available in-country.
This manual provides expert practical guidelines for the management of severely malnourished children. Addressed to doctors and other senior health workers, the manual explains exactly what must be done to save lives, achieve successful management and rehabilitation, prevent relapse, and thus give these children the greatest chance of full recovery. Throughout, the importance of treating severe malnutrition as both a medical and a social disorder is repeatedly emphasized. As successful management does not require sophisticated facilities and equipment or highly qualified personnel, the manual also performs a persuasive function, encouraging health professionals to do all they can to save these children and meet their great need for care and affection.
Recommended procedures draw on extensive practical experience as well as several recent therapeutic advances. These include improved solutions of oral rehydration salts for the treatment of dehydration, better understanding of the role of micronutrients in dietary management, and growing evidence that physical and psychological stimulation can help prevent long-term consequences of impaired growth and psychological development. Noting that the physiology of malnourished children is seriously abnormal, the manual gives particular attention to aspects of management - whether involving the interpretation of symptoms or the use of specific interventions - that differ considerably from standard procedures for well-nourished children. Details range from the reasons why IV infusion easily causes overhydration and heart failure, through a list of treatments that have no value and should never be used, to the simple reminder that underarm temperature is not a reliable guide to body temperature in a malnourished child during rewarming.
Further practical guidance is provided in eight appendices, which use numerous tables, charts, sample recording forms, instructions for preparing feeds, and examples of easily constructed toys to help ensure that management is thorough, safe, and in line with the latest knowledge.
Recent World Health Organization (WHO)/United Nations Children's Fund estimates suggest that the number of children with iron-deficiency anaemia (IDA) is greater than 750 million. Iron deficiency is the most common preventable nutritional problem despite continued global goals for its control. Historically, the problem of IDA in children largely disappeared in North America when foods fortified with iron and other micronutrients became available for children. In this group, the prevalence of IDA has fallen from 21% in 1974 to 13% in 1994. Although pockets of infants and children remain at risk, generally, the eradication of iron deficiency in developed countries is recognized as a successful public health accomplishment. This solution has not worked in developing countries where commercially purchased fortified foods are not available or are not used.
Severe
malnutrition: report of a consultation to review current literature Geneva, World Health Organization, 6-7 September 2004
Management of the child with a serious infection or severe malnutrition: Guidelines for care at first referral level in developing countries Geneva, World Health Organization, 2000
Community-based management of severe malnutrition in children
In preparation for the joint WHO/SCN/UNICEF Meeting on Community-based Management of Severe Malnutrition in Children conducted in November 2005, four background papers were commissioned by the Department of Child and Adolescent Health and Development and by the Department of Nutrition for Health and Development of WHO. A fifth paper was written by an NGO. These papers can be downloaded from this web page. The meeting report and the background paper are presented by a short introduction paper.
Introduction Briend A, Prudhon C, Weise Prinzo Z, Daelmans B, Mason J. Putting back the management of severe malnutrition on the international health agenda
Myatt M, Khara T, Collins S. A review of methods to detect cases of severely malnourished children in the community for their admission into community-based therapeutic care programs -
Full text [pdf 297kb]
Ashworth A. Efficacy and effectiveness of community-based treatment of severe malnutrition -
Full text [pdf 936kb]
Collins S, Sadler K, Dent N, Khara T, GuerreroS, Myatt M, Saboya M, Walsh A. Key issues in the success of community-based management of severe malnutrition -
Full text [pdf 444kb]
Manary M. Local production and provision of ready-to-use therapeutic food for the treatment of severe childhood malnutrition -
Full text [pdf 142kb]
Gatchell V, Forsythe V, Thomas PR. The sustainability of Community-based Therapeutic Care (CTC) in non-acute emergency contexts -
Full text [pdf 96kb]
Thanks to an appropriate management scheme, from being severely malnourished (weight 4.75 kg), this 2-year old girl not only gained 32% more weight in 3 weeks (weight 6.28), but she also gained an appetite for living.
1. Inpatient treatment of severe malnutrition
Severe malnutrition is defined by a very low weight for height (below -3z scores of the median WHO growth standards), by visible severe wasting, or by the presence of nutritional oedema. Decreasing child mortality and improving maternal health depend heavily on reducing malnutrition, which is responsible, directly or indirectly, for 54% of the 10.8 million deaths per year in children under five.
Although the median under-five case-fatality rate for severe malnutrition typically ranges from 30% to 50%, it can be reduced substantially when physiological and metabolic changes are taken into account. Rates have dropped below 5% in treatment centres applying a WHO-recommended scheme for managing severely malnourished children in hospital settings. In order to train health workers in applying this scheme WHO has created a course which, with the aid of institutional partners in Bangladesh, Chile, Gambia, Malawi and the UK, has been conducted in 25 countries in the African, South-East Asia and Western Pacific Regions.
2. Community-based management of severe malnutrition in children
Severe malnutrition is a life threatening condition requiring urgent treatment. Until recently, the recommendation was to refer these children to hospital to receive therapeutic diets along with medical care. The situation changed recently with the advent of ready to use therapeutic foods (RUTF) which allows the management in the community of large numbers of children who are severely malnourished without medical complications.
A short training video on the RUTF appetite test (following the WHO guidelines) is also available here.
A meeting of experts was organized by the Department of Child and Adolescent Health and Development and the Department of Nutrition for Health and Development of the WHO, by UNICEF and the UN Standing committee on Nutrition in Geneva on 21-23rd November 2005 to review these recent developments and formulate recommendations. The report of this meeting is available on this web page. It is expected that implementation of these community-based interventions on a large scale along with a strengthening of referral facilities for severely malnourished children with complications could transform the lives of millions of these children.
Introduction, Meeting report and Background papers
Joint Statement
Community-based management of severe acute malnutrition
A Joint Statement by the World Health Organization, the World Food Programme, the United Nations System Standing Committee on Nutrition and the United Nations Children's Fund
Training Course on the Management of Severe Malnutrition in Hospitals Kabul, Afghanistan, 8 - 19 June 2002 Full text [pdf 128kb]
Training Course on the Management of Severe Malnutrition Banjul, The Gambia, 25 June - 5 July 2002 Full text [pdf 78kb]
Inter-Country Training Workshop on Management of Severe Malnutrition, ICDDR'B Hospital Dhaka, Bangladesh, 11 - 22 December 2002. Full text [pdf 95kb]
Training Course on the Management of Severe Malnutrition Blantyre, Malawi, 24 April to 3 May 2003 Full text [pdf 36kb]
Facilitators' Training on the Management of Severe Childhood Malnutrition in Hospitals Lusaka, Zambia, 3 - 8 August 2003. Full text [pdf 19kb]
National Training Course on the Management of Severe Malnutrition Livingstone, Zambia, 10-17 November 2003 Full text [pdf 54kb]
National Training Course for Improving management of Severe Malnutrition Maseru, Lesotho, 20 November - 6 December 2003 Full text [pdf 28kb]
Inter-country Training Workshop on Management of Severe Childhood Malnutrition National Pediatric Hospital, Phnom Penh, Cambodia, 26 November - 6 December, 2003. Full text [pdf 212kb]
Training Course on the Management Severe Malnutrition La Paz, Bolivia, 2-12 February 2004 Full text [pdf 215kb]
National Training Course on the Management of Severe Malnutrition Mbabane, Swaziland, 9-21 February 2004 Full text [pdf 18kb]
Facilitator Training in the Management of Severely Malnourish Children in Hospitals Lahore, Pakistan, 7-10 March 2005 Full text [pdf 63kb]
World Food Programme Presentations
ending child hunger and undernutrition initiative - Copenhagen, 19 June 2006 overview of issues and moving forward World Health Organization Presentation: flash 785 kb |
powerpoint 2.6 mb
Providing an 'essential package' for child survival: WFP and UNICEF in Ethiopia Government of Ethiopia - World Food Programme - UNICEF World Health Organization Presentation: flash 100 kb | powerpoint 666 kb
End Child Hunger and Undernutrition Initiative in Latin America and the Caribbean United in the Battle to End Child Hunger - WFP Global Meeting Copenhagen - June 2006 World Food Programme - UNICEF World Health Organization Presentation: flash 187 kb | powerpoint 424 kb
Each year, around 9 million children die from preventable and treatable illnesses before reaching their fifth birthday. Many die during their first year of life. Countless more children live in precarious situations and face diminished futures. The handbook, Facts for Life, provides vital messages and information for mothers, fathers, other family members and caregivers and communities to use in changing behaviours and practices that can save and protect the lives of children and help them grow and develop to their full potential.
This version of Facts for Life builds on the three previous editions, which have been helping families and communities around the world since 1989. Newborn Health has been added to the Safe Motherhood chapter, giving attention to child survival from the first stage of life. A new chapter, Child Protection, has been included, focusing attention on the actions needed to ensure children grow up in protective environments.
Facts for Life is a trusted resource that is written in easy-to-understand language. It has been translated into 215 languages, with over 15 million copies of the previous editions in circulation worldwide. Users are encouraged to be innovative in finding ways to extend the reach of the Facts for Life messages to help families and communities realize the rights of children and women everywhere!
This guide is for pregnant mothers and parents of infants, young children, and teenagers. A definitive guide to the parent on pregnancy and childrearing from infancy to the teenage years. Authored by one of India's foremost paediatricians and an internationally renowned authority on breastfeeding, the book combines a knowledge of traditional childrearing practices with the latest medical developments in child care.
Dr. Anand's Guide to Child Care answers questions such as:
Is there a right age to have a baby?
What can I do when my baby cries?
Can a working mother successfully breastfeed?
How helpful is a joint family in bringing up children?
How should we handle our fussy eater?
Is my child ready for toilet-training?
Are vaccines safe?
When is the right age for sex education?
How can I raise a happy child?
Are drugs overprescribed for childhood illnesses?
How should we handle our teenager?
What should I do in a medical emergency?
The Management of Diarrhoea and Use of Oral Rehydration Therapy - Second Edition - A Joint WHO/UNICEF Statement
Preventing and Controlling Iron Deficiency Anaemia Through Primary Health Care
Audience: A Guide for Health Administrators and Programme Managers
E. M. DeMaeyer Formerly Medical Officer, Nutrition, World Health Organization, Geneva, Switzerland with the collaboration of P. Dallman, J. M. Gurney, L. Hallberg, S. K. Sood & S. G. Srikantia 1989
Pathfinder International is pleased to announce the publication of Early Infant Diagnosis of HIV through Dried Blood Spot Testing: Pathfinder International/Kenya's Prevention of Mother-to-Child Transmission Project. Pathfinder/Kenya integrated dried blood spot testing for early infant diagnosis of HIV into its prevention of mother-to-child transmission project in August 2006. This paper describes the process of dried blood spot testing and provides results from the project's first year of implementation.
Please pass this message on to interested colleagues. If you're interested in receiving emails about other Pathfinder International projects, you may sign up for email updates here: http://www.pathfind.org/Register
Pathfinder/Kenya integrated dried blood spot testing for early infant diagnosis of HIV into its prevention of mother-to-child transmission project in August 2006. This paper describes the process of dried blood spot testing and provides results from the project's first year of implementation.
This document provides basic information and practical guidance on antiretroviral therapy and wider care and treatment issues for program implementers and health care managers. It includes information on vigorous prevention and treatment of opportunistic infections, nutrition support, and spiritual, psychosocial, and economic support, and discusses community participation and services necessary for use of facility-based services.
These two-page fact sheets highlight Pathfinder's prevention, care, and support projects in 13 countries, as well as Pathfinder's expertise in key HIV/AIDS program areas, such as home-based care and prevention of mother-to-child transmission.
The study documents the concerns of people living with HIV/AIDS, community health workers, primary care providers, and other stakeholders to inform Pathfinder's support to national efforts to scale-up community home-based care. The proposed project aims to replicate Pathfinder's successful community home-based care model in other areas and improve access to home-based care for more Tanzanians.
This publication documents Pathfinder's collaboration with public, private, and faith-based partners in Kenya in developing new and effective programs to prevent transmission of HIV from mother to child.
This paper examines how integrating reproductive health and family planning services with HIV/AIDS services is an essential step in effectively maximizing impact and resources to confront the raging AIDS epidemic, elevated maternal and infant mortality rates, and the unmet need for contraception worldwide.
This publication from the Nigeria AIDS Response Fund acts as a comprehensive guide for using a gender and human rights strategy to achieve results in curbing the HIV/AIDS epidemic.
Hesperian has made a commitment to publish online versions of all of our books and to keep those online editions up-to-date, incorporating all corrections and revisions as they are made.
Presently we have materials from the following publications:
We will be posting online versions of all of our publications in the coming months, so please visit our site [
Downloads ] again soon to see what new resources are available. The entire books are now available for download in pdf format
We are happy to have other organizations link to our online publications, but in order to prevent out-of-date or altered editions of our publications from being accessed online, we do not allow Hesperian publications to be posted on other sites without our explicit permission.
Where There Is No Doctor
Where There Is No Doctor A village health care handbook by David Werner with Carol Thuman and Jane Maxwell Updated 2003 - 512 pages, illustrated - English ed. ISBN: 0-942364-15-5
Hesperian's classic manual, Where There Is No Doctor, is perhaps the most widely used health care manual for health workers, clinicians, and others involved in primary health care delivery and health promotion programs around the world. With millions of copies in print in more than 70 languages, the book is an irreplaceable health resource in communities worldwide.
As with all Hesperian books, the manual provides practical, easily understood information on how to diagnose, treat, and prevent common diseases. Special attention is focused on nutrition, infection and disease prevention, as well as the use of diagnostic techniques as primary ways to prevent and treat health problems.
The entire book is now available for download in pdf format
Where Women Have No Doctor A health guide for women by A. August Burns, Ronnie Lovich, Jane Maxwell, and Katharine Shapiro paperback - 596 pages, illustrated - English ed. ISBN: 0-942364-25-2
Where Women Have No Doctor combines self-help medical information with the tools for organizing against the poverty and discrimination that impacts women's health and access to medical care. The first community-based health book for women, Where Women Have No Doctor serves as an essential resource for any woman or girl wanting to improve her health. Developed with the help of community-based groups, village health workers, and women's health experts in more than 30 countries, the manual gives treatment information for many health problems that affect only women or affect women differently from men. Topics covered include: ways to stay healthy; understanding the reproductive parts of women's bodies; mental health; politics of women's health; nutrition; pregnancy, birth, and breastfeeding; HIV/AIDS and other STI's; rape and violence against women; health concerns of girls, women with disabilities, refugee women, and older women; how to use medicines safely. Click here to see the complete table of contents.
The entire book is now available for download in pdf format
WHO, UNICEF, the International Committee of the Red Cross and the International Federation of Red Cross and Red Crescent Societies call for support for appropriate infant and young child feeding in the current Asian emergency, and caution about unnecessary use of milk products HTML, 12 KB,pdf, 256 kb
Want to understand how high food prices really are? And how they're affecting the world's poor?
Infographic: Famine in the Horn of Africa
This map shows startling facts about nutrition and children in our world where one out of four children from developing countries are underweight. 
Download .pdf
Translators Without Borders
Babies who are breastfed are generally healthier and achieve optimal growth and development compared to those who are fed formula milk.
Warning Signs in Pregnancy
Neonatal Resuscitation - Skilled Health Worker Version
Understanding your body: How to plan a pregnancy
Understanding your body: How babies are made
How to use the ultrasound probe
Cervical cancer screening: visual inspection of the cervix using acetic acid (VIA)
Ten steps to safe delivery
Management of PPH - Low resource setting
Management of PPH - No resource setting
Food for Life: What Pregnant Women Need to Eat
Food for life: What and when to feed you child?
Food for life: Breastfeeding
The Story of MAF
Our latest literature review examines evidence on community interventions to promote optimal breastfeeding. We are grateful to our colleague Dr. Miriam Labbok, Director of the Carolina Global Breastfeeding Institute at the University of North Carolina at Chapel Hill, for expertly composing this publication. Dr. Labbok shared her thoughts on the findings of the review in a recent Q&A.
Severe
malnutrition: report of a consultation to review current literature 
Guidelines
for the inpatient treatment of severely malnourished children
Training
course on the management of severe malnutrition
