clove and Disease

This article discusses the success of the Madagascar Food Security and Nutrition project in decreasing malnutrition and monitoring child health. Success has occurred in the following realms: effective collaboration between government and nongovernmental organizations (NGOs), capacity building through investment in training of community workers, increased quality of services provided by community nutrition workers, community involvement, government commitment, and a flexible program design. NGOs were able to respond to community concerns by adding program inputs without losing the focus on core nutrition interventions. Community workers were selected from a group of mothers. Women were trained to monitor the growth of all children under age 5. Children who were severely malnourished were identified and referred to rehabilitation centers for treatment lasting up to 3 weeks. The program offered support and nutrition education for mothers of sick children. One drawback of the treatment program was the inability of mothers to stay for long periods of time during the duration of treatment. The program offers distribution of iodine capsules as part of a long-term salt iodization program that is supported by UNICEF and the World Bank. The program also offers microcredit. Since 1993, 28,000 children under age 5 have been weighed each month. These children came from two provinces and belonged to 300,000 families. The monitored children were 66% of the total number of children aged under 5 years. Malnutrition rates decreased from 46% to 37%.

Topics: Africa; Africa South of the Sahara; Africa, Eastern; Africa, Northern; Child Nutritional Physiological Phenomena; Child Welfare; Community Health Workers; Conservation of Natural Resources; Deficiency Diseases; Delivery of Health Care; Developing Countries; Disease; Economics; Education; Environment; Food Supply; Health; Health Education; Health Personnel; Health Planning; Health Services; Income; Madagascar; Nutrition Disorders; Nutritional Physiological Phenomena; Organization and Administration; Primary Health Care

1992 Madagascar Demographic and Health Survey (DHS) data indicate that Madagascar has a long way to go in order to realize its 1990 National Population Policy Law goal of reducing fertility from 6.1 to 4.0 by the year 2000. Madagascar DHS data are based upon a nationally representative sample of 6260 women aged 15-49. Only 62% of sampled women in union knew a modern method of contraception and 45% knew where they could obtain one. 56% of rural women and 38% of women with no education were similarly knowledgeable. Injection, the pill, and female sterilization are the best known modern methods. The infrequent airing and limited reach of family planning messages found only 6% of respondents reporting hearing a family planning message on the radio or television in the month preceding the survey. An aggressive and widespread information, education, and communication program is therefore needed to increase the level of knowledge about modern contraceptive methods. There is considerable unmet need for family planning in Madagascar. 40% of married women in 1992 reported that they did not want to have any more children, while another 30% reported wanting to space their next birth. Only 5% of married women, however, were then currently using modern methods, and 12% were using traditional methods, mainly periodic abstinence. As for maternal and child health, 163 children under five years old die per 1000 births, with the level of mortality inversely related to the level of education attained by the mother. The under-five mortality rate is 183/1000 in rural areas and 142/1000 in urban areas. In 1992, 78% of mothers received antenatal care from an health professional, and an health professional was present at delivery for 57% of births. Only 43% of children aged 12-23 months, however, have received all recommended vaccinations, such that childhood illnesses, particularly diarrhea, are common among young children. More than 50% of children under five are stunted, and 40% are underweight.

Topics: Africa; Africa South of the Sahara; Africa, Eastern; Africa, Northern; Contraception; Contraception Behavior; Demography; Developing Countries; Disease; Economics; Educational Status; Family Planning Services; Health Services Needs and Demand; Infant Mortality; Knowledge; Madagascar; Mortality; Nutrition Disorders; Population; Population Dynamics; Research; Social Class; Socioeconomic Factors

The main causes of death in rural areas of the Faritany of Toamasina during 1986 are identified and classified by order of importance for the entire population as well as for vulnerable groups such as preschool children and reproductive-aged women. The 10 leading causes of death of infants and children under age 5 years are coughs and fevers, as well as thoracic pains; vomiting and diarrhea; age factors; high, intermittent fevers and chills; protein-calorie malnutrition; convulsions; other high fevers; cough of long duration; sudden death; and measles. Leading causes of death for women aged 15-49 years include coughs and fevers, as well as thoracic pains; high, intermittent fevers and chills; vomiting and diarrhea; other high fevers; delivery complications; cough of long duration; malnutrition; abortion or miscarriage; sudden death; and postpartum illnesses. Over 60% of deaths reported for children aged 0-5 years could have been prevented through a broader vaccination program, oral rehydration therapy, nutrition education and growth monitoring, and the preventive treatment of malaria. Priority focus should be given to respiratory infections.

Topics: Africa; Africa South of the Sahara; Africa, Eastern; Africa, Northern; Cause of Death; Demography; Developing Countries; Disease; Economics; Health Services Needs and Demand; Infections; Madagascar; Mortality; Population; Population Characteristics; Population Dynamics; Respiratory Tract Infections; Rural Population

Topics: Black People; Disease; Expeditions; Humans; Madagascar; Malaria; Military Personnel