Malnutrition improvement for infants under 18 months old of Dai minority in Luxi, China.

BACKGROUND: Child malnutrition and thiamine deficiency remain a matter of public concern in Dai children under 5 years old in Southwest areas of China. The aim of the present study was to understand the status and correlates of malnutrition and thiamine deficiency in Dai children under 18 months old in Yunnan, China, and to explore an effective intervention for improving their nutritional status and decreasing the prevalence of malnutrition and thiamine deficiency in Dai children. METHODS: Well-trained investigators completed a baseline evaluation survey, including questionnaire survey by maternal interviews, child physical measurements, lab examination of thiamine, and group discussions in a cross-sectional study. An intervention plan was constructed by a group consisting of the city governor, government officers, maternal and child health workers, community leaders, and villagers etc. A comprehensive community-based intervention was carried out for 352 children born after July 2001 and their mothers or caregivers in half of the baseline survey villages by the end of 2003. The intervention included participatory intervention, community nutrition education, child growth monitoring and distributing thiamine to new mothers just before or after delivery. RESULTS: The baseline evaluation survey in 2000 indicated that the prevalence of moderate and severe protein-energy malnutrition was 19.5% for underweight, 16.4% for stunting, and 6.7% for wasting, respectively. With increasing age, the prevalence increased, peaking at 12-15 months. The prevalence of underweight in girls was higher than in boys. A total of 10.5% of children suffered from thiamine deficiency, and 5.7% of the children were insufficient in thiamine supply. Low Kaup target (<25%) was significantly associated with lack of guidance by doctors, lack of nutrition knowledge, lack of knowledge of causes of malnutrition and local culture food taboos. The status of child nutrition has been improved significantly since the intervention measure implementation. The change of prevalence of underweight children aged 6-17 months prior to and after the intervention was significant: 20.5% before and 13.7% after the intervention in infants aged 6-11 months, and 39.0% before and 26.4% after the intervention in young children aged 12-17 months. Prevalence of girls was higher than that of boys. Some women began to eat vegetables and pork from the market, which were forbidden by the culture food taboos. There is no case report of child thiamine deficiency in project villages. CONCLUSION: The prevalence of moderate and severe protein-energy malnutrition is high in Dai infants and young children. However, based on the local situation, participatory community-based comprehensive nutrition intervention effectively reduces the prevalence of child malnutrition and thiamine deficiency. It is highlighted that population nutritional intervention can produce better results with participation at a community level.

Situational analysis of maternal and child health services for foreign residents in Japan.

BACKGROUND: Since the 1980s, the number of foreign residents in Japan has continuously been on the rise. In order to improve the foreign resident support services infrastructure and effectiveness, a survey was conducted at a national level from February to August 2002. The survey was done via a mailed questionnaire to all municipalities in Japan. METHODS: For the purpose of the study, municipalities were divided into four groups based on level of urbanization and numbers of foreign residents in the area. The situation of the foreign maternal and child support programs were compared and the municipal administrations were evaluated. In addition, the attribution analysis and evaluation of the foreigner support program was conducted in each municipality group. RESULTS: The evaluation of the current service support program for foreigner was not judged positively in the majority (95%) of the municipalities. In the non-urbanized municipalities with a low composition of foreigners, the foreigner mother and child support program were not functional compared with other regions. Additionally, various factors were highlighted based on attribution analysis among each group. Although most of the municipalities recognized the importance of the foreign resident support program, the evaluations showed a wide gap between intention and reality. CONCLUSION: It is recommended that the barriers as identified in the research results are rectified, and the current situation improved based on municipality characteristics, local demands and the needs of the population. The efficient use of limited fiscal and human resources is also advocated by strengthening of cooperation with other official bodies and also employing foreign residents to work in public offices for facilitating the foreign residents support programs.

Risk factors for low Kaup index among children in rural ethnic minority areas of Yunnan, China.

BACKGROUND: The general living standard and health level have been greatly improved in China. But the result of a significant change in a child's growth level has not been reported in the Yunnan rural minority area. The aim of this study was to identify the risk factors for low Kaup index in the Dai peoples' autonomous region to construct a better health service system in rural minority areas. METHODS: A total of 1173 mother-child pairs were selected in 36 villages of the Dai peoples' autonomous region. Sampled mothers were interviewed using a structured questionnaire. Sampled children were measured for weight and height. RESULTS: In total, 36.1% of the candidate group was under weight, 12.0% was wasting, and 30.8% had stunted growth. A child's gender (odds ratio; OR, 1.42; 95% confidence interval; 95% CI, 1.07-1.88), existence of a weaning food (OR, 0.35; 95% CI, 0.26-0.46), grasp of the cause of the child's malnutrition (OR, 1.82; 95% CI, 1.16-2.89), positiveness to information on better nutrition (OR, 2.97; 95% CI, 1.07-8.18), coincidence of the child-rearing plan between parents (OR, 3.15; 95% CI, 1.12-4.11), and existence of a doctor who can consult about child-rearing (OR, 3.17; 95% CI, 1.22-8.22) indicated significant relationships to the low value of a child's Kaup index. CONCLUSION: The mother's child-rearing behavior and social support were identified as risk factors. An offer of effective and abundant information to mothers, and the existence of professionals with whom mothers can consult immediately, were required to construct a better health system in the target area.