Multi-sectoral interventions for healthy growth.

The risk of stunted growth and development is affected by the context in which a child is born and grows. This includes such interdependent influences as the political economy, health and health care, education, society and culture, agriculture and food systems, water and sanitation, and the environment. Here, we briefly review how factors linked with the key sectors can contribute to healthy growth and reduced childhood stunting. Emphasis is placed on the role of agriculture/food security, especially family farming; education, particularly of girls and women; water, sanitation, and hygiene and their integration in stunting reduction strategies; social protection including cash transfers, bearing in mind that success in this regard is linked to reducing the gap between rich and poor; economic investment in stunting reduction including the work with the for-profit commercial sector balancing risks linked to marketing foods that can displace affordable and more sustainable alternatives; health with emphasis on implementing comprehensive and effective health care interventions and building the capacity of health care providers. We complete the review with examples of national and subnational multi-sectoral interventions that illustrate how critical it is for sectors to work together to reduce stunting.

Obesidad infantil en municipios rurales de altura / Child obesity in rural municipalities at altitude

PREGUNTA DE INVESTIGACIÓN: ¿cuáles son los conocimientos y prácticas de alimentación, nutrición y cuidado de madres y/o cuidadores y su asociación con sobrepeso y obesidad en niños menores de 23 meses que viven en municipios rurales de altura en Bolivia? OBJETIVO GENERAL: determinar las características de cuidado y prácticas alimentarias de niños menores de 23 meses de edad con sobrepeso y obesidad que viven en municipios rurales productores de papa que participan en el proyecto Ios Andes en Bolivia, datos de línea de base, desde septiembre a noviembre de la gestión 2012. MATERIAL Y MÉTODOS: es un estudio descriptivo transversal y analítico. Se estudiaron todos los niños de 0 a 23 meses (290) considerados en la línea de base del Proyecto Ios Andes realizado en Bolivia, también en Ecuador y Perú, cuyo tamaño muestral fue de 450 niños distribuidos en 75 comunidades rurales de la región andina de Bolivia. Se aplicaron encuestas sobre prácticas y conocimientos de alimentación y cuidado infantil a madres y/o cuidadores y se tomaron medidas de peso y talla a sus niños menores de dos años durante los meses de septiembre a noviembre del 2012. En una sub-muestra se realizó un recordatorio de 24 horas con pesada de alimentos para determinar consumo y adecuación de alimentos y nutrientes de los niños menores. Los datos fueron analizados en relación al indicador peso para talla en los puntos de corte que indican sobrepeso y obesidad. RESULTADOS: el porcentaje de sobrepeso y obesidad encontrada fue de 10% más elevado que la media nacional; no se encontraron asociaciones relevantes de conocimientos, practicas alimentarias y adecuación de nutrientes. CONCLUSIONES: se resalta la presencia de obesidad en edades tempranas en zonas rurales con vulnerabilidad a la inseguridad alimentaria, recomendando el desarrollo de investigaciones específicas para identificar determinantes de esta condición.

RESEARCH QUESTION: wich are the understanding and practices of feeding, nutrition and caring mothers and/or nursemaids and their association with overweight and obesity in children under two years of age living in Bolivian rural municipalities ofhigh altitude? OBJECTIVE: To determine knowledge and feeding and child care of mothers or care givers and the association with overweight and obesity in children under two years of age living in Bolivian rural municipalities of high altitude METHODOLOGY: It is a descriptive cross-sectional study. All children under 2 years old (290) of a baseline line survey of the Andes Project were included, the whole survey sample was of 450 children under three years of age living in 75 communities of rural communities in the Bolivian Andean region. Anthropometric measures of children under two years were collected and feeding and care knowledge and practices of their mothers or caregivers. The survey was done during September to November 2012. In a sub sample a 24 hour dietary recall was taken weighing all food mentioned. For the analysis, weight to height Z score with the cut off points related to overweight and obesity was considered. RESULTS: The study found 10% of overweight and obesity, which is above the media in the country. None of knowledge, practices or nutrition adequacy was found relevant for obesity. CONCLUSIONS: Presence of obesity early in life time was found. It is recommendable to develop survey focused on obesity to find out characteristics that could cause this condition.