Journal articles: 'Refugee children, Nutrition. Namibia'

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Fabio, Mary. "Nutrition for Refugee Children: Risks, Screening, and Treatment." Current Problems in Pediatric and Adolescent Health Care 44, no. 7 (August 2014): 188–95. http://dx.doi.org/10.1016/j.cppeds.2014.03.003.

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Williams, Christian A. "SWAPO’s Struggle Children and Exile Home-Making: the Refugee Biography of Mawazo Nakadhilu." African Studies Review 63, no. 3 (September 2020): 593–615. http://dx.doi.org/10.1017/asr.2019.89.

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Abstract:Mawazo Nakadhilu is a former refugee born to a Namibian father and a Tanzanian mother near Kongwa, Tanzania, in 1972. Her biography illuminates how people have made homes in Southern African exile and post-exile contexts. Williams traces Mawazo’s story from her Tanzanian childhood through her forced removal to SWAPO’s Nyango camp to her “repatriation” to Namibia. In so doing, he highlights tensions that have not previously been addressed between exiled liberation movements and their members over family situations. Moreover, he stresses the value of biographical work focused on aspects of refugees’ lives that tend to be overlooked in nationalist discourse.

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Dowell, Scott F. "Health and Nutrition in Centers for Unaccompanied Refugee Children." JAMA 273, no. 22 (June 14, 1995): 1802. http://dx.doi.org/10.1001/jama.1995.03520460086048.

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Hassan, Khurram, Kevin M. Sullivan, Ray Yip, and Bradley A. Woodruff. "Factors Associated with Anemia in Refugee Children." Journal of Nutrition 127, no. 11 (November 1, 1997): 2194–98. http://dx.doi.org/10.1093/jn/127.11.2194.

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Dowell, S. F. "Health and nutrition in centers for unaccompanied refugee children. Experience from the 1994 Rwandan refugee crisis." JAMA: The Journal of the American Medical Association 273, no. 22 (June 14, 1995): 1802–6. http://dx.doi.org/10.1001/jama.273.22.1802.

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Lane, Ginny, Christine Nisbet, and Hassan Vatanparast. "Dietary habits of newcomer children in Canada." Public Health Nutrition 22, no. 17 (August 7, 2019): 3151–62. http://dx.doi.org/10.1017/s1368980019001964.

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AbstractObjective:To explore the dietary habits, nutrient adequacies and dietary change experiences of immigrant and refugee children.Design:Mixed-methods cross-sectional design. Children completed three 24 h dietary recalls to determine nutrient inadequacies. Parents and service providers were interviewed to capture dietary practices.Setting:Healthy Immigrant Children study, Saskatchewan, Canada.Participants:Three hundred immigrant and refugee children aged 3–13 years and twenty-two parents who lived in Regina or Saskatoon for less than 5 years; twenty-four newcomer services providers.Results:Immigrant children had higher mean intakes of meat and alternatives, milk and alternatives, and whole grains; and consumed more vitamin B12, folate, Ca, vitamin D, Fe and Zn compared with refugee children. Refugee children were at higher risk of having inadequate intakes of folate (37 %) and Fe (18 %). Both immigrant and refugee children were at high risk of inadequate vitamin D (87 and 93 %, respectively) and Ca intakes (79 and 80 %), and a substantial portion were at risk for inadequate Zn intake (21 and 31 %). Participants mentioned challenges with maintaining a healthy traditional diet in the midst of a busy schedule, while responding to their children’s demands for foods high in fat and sugar.Conclusions:Newcomer children are at risk for inadequate intakes of vitamin D, Ca and Zn, while refugee children are at additional risk for inadequate folate and Fe intakes. Newcomers to Canada may experience subtle or drastic changes in their food environment leading to dietary acculturation that includes increased consumption of foods high in sugar, salt and fat.

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Monzon, Carlos M., Virgil F. Fairbanks, E. Omer Burgert, Peter C. O'Brien, John E. Sutherland, and Stephen C. Elliot. "Height and weight of Southeast Asian refugee children." Nutrition Research 5, no. 7 (July 1985): 685–92. http://dx.doi.org/10.1016/s0271-5317(85)80202-5.

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Kemmer, Teresa M., Maria E. Bovill, Wantanee Kongsomboon, Steven J. Hansch, Karen L. Geisler, Carrie Cheney, Bettina K. Shell-Duncan, and Adam Drewnowski. "Iron Deficiency Is Unacceptably High in Refugee Children from Burma." Journal of Nutrition 133, no. 12 (December 1, 2003): 4143–49. http://dx.doi.org/10.1093/jn/133.12.4143.

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Longhurst, Richard. "Nutrition and Care of Young Children during Emergencies." Food and Nutrition Bulletin 16, no. 4 (December 1995): 1–6. http://dx.doi.org/10.1177/156482659501600414.

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Emergencies are not only sudden events with natural causes that can be ameliorated with resources from outside. The causes and consequences of emergencies with sudden or slow onset, those that are complex and involve conflict, or are permanent emergencies are all deeply rooted in the vulnerability of people to hazards and their incapacity to recover. This will have implications for care behaviours and practices in the feeding, health, hygiene, and psychosocial areas. Families react to slow-onset emergencies by managing a declining resource with inevitable negative impacts on child care. Food intake declines. At the extreme of destitution, families may migrate to refugee camps where children face health crises as large displaced populations congregate around contaminated water sources. Breastfeeding may cease. In war situations, children face extreme psychosocial stresses. The importance of care for young children is given insufficient attention by those providing assistance from outside. Care interventions should improve the effectiveness of health, food, and psychosocial support

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Tappis, Hannah, Shannon Doocy, Christopher Haskew, Caroline Wilkinson, Allison Oman, and Paul Spiegel. "United Nations High Commissioner for Refugees Feeding Program Performance in Kenya and Tanzania: A Retrospective Analysis of Routine Health Information System Data." Food and Nutrition Bulletin 33, no. 2 (June 2012): 150–60. http://dx.doi.org/10.1177/156482651203300209.

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Background The United Nations High Commissioner for Refugees (UNHCR) Health Information System is a primary source of routine nutrition program data and provides a comprehensive assessment of UNHCR selective feeding programs in more than 90 refugee camps in 18 countries worldwide. Objective To evaluate the coverage and effectiveness of UNHCR supplementary and therapeutic feeding programs for malnourished children under 5 years of age in Kenya and Tanzania refugee camps. Methods Analysis of Kenya and Tanzania refugee camp population, growth monitoring, and nutrition program data from the UNHCR Health Information System. Results UNHCR-supported implementing partners in Kenya and Tanzania admitted nearly 45,000 malnourished refugee children in selective feeding programs between January 2006 and May 2009. Average recovery rates of 77.1% and 84.6% in the therapeutic and supplementary programs, respectively, mortality rates of less than 1%, and average readmission below 5% suggest that feeding programs had a beneficial effect on enrolled children. Conclusions Increasing admission and enrollment in supplementary feeding programs was successful in preventing cases of severe malnutrition in some camps. Further attention to these camps would be likely to yield sizeable benefits in terms of absolute reductions in malnutrition prevalence and mortality rates.

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Amirazodi, Elmira, Michelle Turcotte, and Andrea Hunter. "OBESITY TRENDS AND RISK FACTORS AMONG REFUGEE CHILDREN/YOUTH: A SCOPING REVIEW." Paediatrics & Child Health 23, suppl_1 (May 18, 2018): e46-e46. http://dx.doi.org/10.1093/pch/pxy054.118.

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Abstract BACKGROUND Overweight and obese children are at a heightened risk of adult-onset health complications including hypertension, cardiovascular disease, type 2 diabetes, certain cancers, and psychosocial complications. These disorders can begin in childhood, which increases the likelihood of early morbidity and mortality. In parallel, over the past two decades, the global population of refugees has grown substantially. OBJECTIVES Given the rapid increase of refugee populations in Canada, it is important to understand how obesity and overweight patterns for refugee children and youth differ from those of native-born populations. To date, no review has comprehensively documented weight gain trends and risk factors in paediatric refugee populations. DESIGN/METHODS A scoping review of the literature was conducted using Medline, CINAHL, and EMBASE for publications in English from August 1991 to April 2017. A total of 11 articles were identified relating to prevalence and risk factors for becoming overweight/obese in refugee children and youth aged 0 to 18 years old after arrival in a high-income setting. RESULTS Paediatric refugees were at increased risk of rapid weight gain after migration. After living in a HIC for 1.5 to 9 years, refugee children demonstrated a prevalence of obesity that ranged from 1.4 to 21%. The prevalence of overweight children and youth ranged from 5.7 to 22.8%. Refugee children and youth had a steeper increase in their BMI compared with non-refugees (P < 0.001). Younger children (< 2 years) experienced an increase in BMI at a slower rate (P = 0.002) than older children and youth. A longer length of stay in HICs was associated with an increase in BMI percentile among refugee children. Populations of Eastern European, African, and Middle Eastern ethnic backgrounds demonstrated a higher risk of becoming overweight/obese in comparison to other paediatric refugees or non-refugee children. CONCLUSION This review demonstrates that despite methodological differences between the 11 included studies, 6 of them consistently demonstrate a direct relationship between increased BMI and length of residence in HICs among refugee children. Multiple studies (n=7) emphasize the need for culturally tailored prevention strategies including timely orientation to nutrition in HICs. Preventing the development of obesity among refugee children is crucial for reducing the short and long-term health consequences associated with childhood obesity.

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HJERN, A., T. KOÇTÜRK-RUNEFORS, O. JEPPSON, R. TEGELMAN, B. HÖJER, and H. ADLERCREUTZ. "Health and Nutrition in Newly Resettled Refugee Children from Chile and the Middle East." Acta Paediatrica 80, no. 8-9 (August 1991): 859–67. http://dx.doi.org/10.1111/j.1651-2227.1991.tb11961.x.

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Rana, Ritu, Hatty Barthorp, and Mary T. Murphy. "Leaving no one behind: Community Management of At-risk Mothers and Infants under six months (MAMI) in the context of COVID-19 in Gambella refugee camps, Ethiopia." World Nutrition 11, no. 2 (June 29, 2020): 108–20. http://dx.doi.org/10.26596/wn.2020112108-120.

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Refugees are at an increased risk of contracting Coronavirus disease (COVID-19) due to their suboptimal living environment and inadequate access to healthcare services. As refugee-hosting countries are preparing to prevent and contain the spread of COVID-19 infections by diverting healthcare efforts, it is equally important to prevent the collapse of existing lifesaving services, including those provided during the first 1,000 days (nutrition services from conception to a child’s second birthday). Recently, many international organisations, including United Nations agencies, have published guidance documents for programming in refugee context. Similarly, there is global guidance available for nutrition programs in the context of COVID-19, such as -infant and young child feeding, management of child wasting, and nutrition information management; however, no specific guidance is available for community management of nutritionally at-risk mothers and infants under six months (MAMI). In response to the major refugee influx, mainly women and children, from South Sudan, GOAL, an international humanitarian response organisation, is implementing a MAMI program since 2014. GOAL believes, despite COVID-19 context, it is critical to continue the MAMI program with adaptive measures to prevent and manage malnutrition among at-risk mothers and infants. In this regard, considering available international guidelines, both nutrition and refugee context-specific, GOAL has developed its own guidelines for the refugee population. In this article, we present GOAL Ethiopia’s COVID-19 response within nutrition support services, for the South Sudanese refugees, focused on at-risk mothers with infants under six months, living in two Gambella refugee camps. We believe our guidelines will also be helpful for other organisations implementing MAMI in different contexts.

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Putra, Irwansyah, Endy Paryanto Prawirohartono, and Madarina Julia. "Pola makan, penyakit infeksi, dan status gizi anak balita pengungsi di Kabupaten Pidie Provinsi Nanggroe Aceh Darussalam." Jurnal Gizi Klinik Indonesia 3, no. 3 (March 1, 2007): 115. http://dx.doi.org/10.22146/ijcn.17562.

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Background: The declaration of Martial Law in Aceh Province have been held, they evacuate themselves to save from the risks when bombardment happen. In refugee camp, there were problems, like improperly place to live, lack of food, and lack of water. This condition will make the nutritional and health status become worse. It can be signed by the increasing of under nutrition prevalence.Objective: The objective of this study was to determine the food consumption pattern, breastfeeding pattern, nutritional intake, infection diseases, and nutritional status of infant under five years old in refugee camp.Method: This was an observational study with cross sectional design. This study was conducted in Keunire refugee camp, Pidie District, Nanggroe Aceh Darussalam Province. Subjects of this study were infants under five years old. Data were collected by interview using open questionnaire, while nutritional intake data were collected by recall method and analyzed using computer. The assesment of nutritional intake was using anthropometry method. Data were analyzed using chi square test and t-test.Results: General and specific feeding pattern were given by the team of disaster and refugee tackling of Pidie District for Keunire refugee camp. Specific feeding pattern was given to the infant of under five years old as a food supplement. That food supplement should fulfill 15.4-30.5% energy and 28.5% - 69.1% protein requirements. Breastfeeding pattern changed into more regular when they were ini refugee camp, because their children were thirsty and crying. Mean of energy and protein intake of refugee infant of under five years old were higher than that of non refugee. The under nutrition prevalences of refugee infant of under five years old were 21.7% (WHZ), 32.5% (WAZ), while that prevalences of non refugee infant were 23.8% (WHZ) and 39.7% (WAZ). Statistically, there were no differences in under nutrition prevalences between both of them. Nutritional status had association with energy intake, protein intake, and infection diseas in refugee camp.Conclusions: There was changing in breastfeeding pattern in refugee camp. There were also differences in mean of energy and protein intake between refugee and non refugee infant of under five years old, but there was no difference in nutritional status.

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Lane, Ginny, Marwa Farag, Judy White, Christine Nisbet, and Hassan Vatanparast. "Chronic health disparities among refugee and immigrant children in Canada." Applied Physiology, Nutrition, and Metabolism 43, no. 10 (October 2018): 1043–58. http://dx.doi.org/10.1139/apnm-2017-0407.

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There are knowledge gaps in our understanding of the development of chronic disease risks in children, especially with regard to the risk differentials experienced by immigrants and refugees. The Healthy Immigrant Children study employed a mixed-methods cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3–13 years who had been in Canada for less than 5 years. Quantitative data regarding socioeconomic status, food security, physical activity, diet, and bone and body composition and anthropometric measurements were collected. Qualitative data regarding their experiences with accessing health care and their family lifestyle habits were gathered through in-depth interviews with the parents of newcomer children. Many newcomers spoke about their struggles to attain their desired standard of living. Regarding health outcomes, significantly more refugees (23%) had stunted growth when compared with immigrants (5%). Older children, those with better-educated parents, and those who consumed a poorer-quality diet were at a higher risk of being overweight or obese. Sixty percent of refugees and 42% of immigrants had high blood cholesterol. Significant health concerns for refugee children include stunting and high blood cholesterol levels, and emerging trends indicate that older immigrant children from privileged backgrounds in low-income countries may be more at risk of overweight and obesity. A variety of pathways related to their families’ conceptualization of life in Canada and the social structures that limit progress to meeting their goals likely influence the development of health inequity among refugee and immigrant children. Public health initiatives should address these health inequities among newcomer families.

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Betts, Nancy M., and Ann Weidenbenner. "Dietary intakes, iron status and growth status of southeast Asian refugee children." Nutrition Research 6, no. 5 (May 1986): 509–15. http://dx.doi.org/10.1016/s0271-5317(86)80104-x.

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Kay, Ariel, Eva Leidman, Velma Lopez, Caroline Wilkinson, Melody Tondeur, and Oleg Bilukha. "The burden of anaemia among displaced women and children in refugee settings worldwide, 2013–2016." BMJ Global Health 4, no. 6 (November 2019): e001837. http://dx.doi.org/10.1136/bmjgh-2019-001837.

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IntroductionDisplaced persons have a unique risk for developing anaemia due to often limited diets, overcrowding, new infections and inadequate sanitation and hygiene. The lack of anaemia prevalence estimates among the displaced inhibit global planning for anaemia reduction.MethodsWe analysed population representative, cross-sectional nutrition surveys from 2013 to 2016 conducted by the United Nations High Commissioner for Refugees and partner agencies. Included surveys measured haemoglobin concentration among children 6–59 months, non-pregnant women 15–49 years, or both groups. For each survey, we calculated mean haemoglobin and prevalence of total anaemia (<110 g/L in children, <120 g/L in women), and classified public health severity following WHO guidelines. Pearson correlations between indicators from women and children surveys were calculated where both subpopulations were measured.ResultsAnalysis included 196 surveys among children and 184 surveys among women from 121 unique refugee settings in 24 countries. The median prevalence of total anaemia in children and women was 44% and 28%, respectively. Sixty-one per cent of child surveys indicated a problem of severe public health importance compared with 25% of surveys in women. The prevalence of total anaemia in children and women was strongly correlated (ρ=0.80). Median prevalence of total anaemia was approximately 55% greater and mean haemoglobin was 6 g/L lower among children age 6–23 months compared with children 24–59 months. West and Central Africa region had the highest median prevalence of anaemia both in women and children.ConclusionWhile the burden of anaemia is high among the displaced, it mirrors that of the general population. Haemoglobin should continue to be measured in nutrition surveys in refugee settings. Sustained, multisectoral efforts to reduce anaemia are needed, with specific focus on children under 2 years of age and refugee settings in the West and Central Africa region.

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Gozalbo, Mónica, Marisa Guillen, Silvia Taroncher-Ferrer, Susana Cifre, David Carmena, José M. Soriano, and María Trelis. "Assessment of the Nutritional Status, Diet and Intestinal Parasites in Hosted Saharawi Children." Children 7, no. 12 (November 29, 2020): 264. http://dx.doi.org/10.3390/children7120264.

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Since the early 1990s, Spanish humanitarian associations have welcomed Saharawi children from the refugee camps in Tindouf (Argelia). These children are the most affected by the lack of food, water, hygienic measures and health care. The main objective of this study was to analyze the anthropometric, nutritional and parasitological data of 38 Saharawi boys and girls (from 10 to 13 years old) under a holiday host program in the city of Valencia. Our results confirm that malnutrition and multiparasitism are highly frequent, so it is understood that living conditions in refugee camps continue to be precarious with a lack of proper hygiene and nutrition. Furthermore, biochemical alterations, lactose malabsorption and the risk of celiac disease, also detected in our study as a secondary objective, will complicate nutritional management and restoration of health. For this reason, sustainable feeding alternatives and interventions from a hygienic and nutritional point of view are proposed, emphasizing in an improvement in the education of parents and children.

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Fu, Jia-Chen. "Scientising Relief: Nutritional Activism from Shanghai to the Southwest, 1937–1945." European Journal of East Asian Studies 11, no. 2 (2012): 259–82. http://dx.doi.org/10.1163/15700615-20121107.

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The Shanghai Refugee Children Nutritional Aid Committee, formed in 1937, sought to improve refugee children’s nutritional health by making and distributing a scientifically tested soybean milk and soybean cakes. By 1942, the Committee had adopted a national platform and changed its moniker to the Chinese Nutritional Aid Council, with plans to open offices and nutrition clinics in Chongqing, Chengdu, Guiyang and Kunming. This paper argues that in linking biomedical understandings of nutrition with social change, this group of Western-trained physicians and young female social workers enacted a new kind of social activism, one which seized upon the food-as-fuel idea and staked the welfare of the nation upon the nutritional health of its citizenry. In contrast to earlier social relief projects promoted by the imperial state and the local philanthropic initiatives of gentry elites, the Chinese Nutritional Aid Committee articulated an image of professional and specialised expertise in the science of nutrition and care. Theirs was a project of modern refashioning in which science played a key and foundational role in crafting their understanding of both relief and the children they aimed to save.

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Todd, Karen S., and Mary J. Kretsch. "Accuracy of the self-reported dietary recall of new immigrant and refugee children." Nutrition Research 6, no. 9 (September 1986): 1031–43. http://dx.doi.org/10.1016/s0271-5317(86)80046-x.

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Salami, Bukola, Higinio Fernandez-Sanchez, Christa Fouche, Catrin Evans, Lindiwe Sibeko, Mia Tulli, Ashley Bulaong, et al. "A Scoping Review of the Health of African Immigrant and Refugee Children." International Journal of Environmental Research and Public Health 18, no. 7 (March 28, 2021): 3514. http://dx.doi.org/10.3390/ijerph18073514.

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Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social inclusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment.

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Bovill, Maria, Timothy Moore, Panrawee Praditsorn, Piyanit Churak, Mary Kyang Yone, Rachin Thongprakaidown, Patcharamai Parichatkheeree, Suchai Phaiphupha, and Wanphen Wimonpeerapattna. "Nutrition Surveillance in Thailand-Myanmar Border Refugee Camps - Trends in Wasting and Stunting Over 8 Years." Current Developments in Nutrition 5, Supplement_2 (June 2021): 626. http://dx.doi.org/10.1093/cdn/nzab045_008.

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Abstract Objectives Biennial nutrition surveys are conducted in the 9 refugee camps situated along the Thailand-Myanmar border to examine trends in acute and chronic malnutrition; food consumption patterns; and household hunger. Methods TBC and health agency partners conducted nutrition surveys of children 6–59 months (n = 3,780) in these camps May-November 2019. Random sampling was used to select households with children using TBC's Total Population Database. TBC trained and supervised health agencies and ethnic health departments in survey implementation. The WHO Growth Standards were used to analyze anthropometric data which were presented by prevalence. The Food Consumption, Nutritional Quality and Household Hunger Scale were used to determine diet diversity, quality and food deprivation. Results 2.2% of children surveyed were wasted (global acute malnutrition), considered “very low” (WHO). Wasting has remained unchanged since 2011. Although stunting prevalence was “high” (WHO) at 25.8% (range 13.6%-36.6%), there has been significant progress with a 15.0% reduction since 2011. Food Consumption Score was measure with 98.5% of households reporting an acceptable diet. While most households reported daily intake of protein and vitamin-rich foods, iron (heme) food sources were only consumed daily by about 1 in 3 households. Finally, 96.1%, 3.5% and 0.3% reported little to no hunger, moderate, and severe household hunger, respectively, similar to 2017 (97.7%, 2.2% and 0.1% reported little to no hunger, moderate hunger and severe hunger, respectively). Conclusions Stunting negatively impacts not only individuals but entire nations, currently affecting 162 million children under the age of 5 years. While stunting remains a challenge in the 9 Thailand-Myanmar border refugee camps, a continued downward trend indicates significant progress since 2011, with a 15% reduction. Therefore, supporting recommended maternal and infant and young child feeding practices, including emphasis on diet quality, particularly for heme iron-rich foods for women of reproductive age and protein-rich foods for children, in innovative ways remains a priority. Funding Sources The Border Consortium.

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Smock, Laura, Thinh Nguyen, Elizabeth Metallinos-Katsaras, Hema Magge, Jennifer Cochran, and Paul L. Geltman. "Refugee Childrenʼs Participation in the Women, Infants, and Children Supplemental Nutrition (WIC) Program in Massachusetts, 1998-2010." Journal of Public Health Management and Practice 25, no. 1 (2019): 69–77. http://dx.doi.org/10.1097/phh.0000000000000789.

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El Harake, Marwa, Samer Kharroubi, Shadi Hamadeh, and Lamis Jomaa. "Impact of a Pilot School-Based Nutrition Intervention on Dietary Knowledge, Attitudes, Behavior and Nutritional Status of Syrian Refugee Children in the Bekaa, Lebanon." Nutrients 10, no. 7 (July 17, 2018): 913. http://dx.doi.org/10.3390/nu10070913.

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This study evaluated the impact of a 6-month school nutrition intervention on changes in dietary knowledge, attitude, behavior (KAB) and nutritional status of Syrian refugee children. A quasi-experimental design was followed; Syrian refuge children in grades 4 to 6 were recruited from three informal primary schools (two intervention and one control) located in the rural Bekaa region of Lebanon. The intervention consisted of two main components: classroom-based education sessions and provision of locally-prepared healthy snacks. Data on household socio-demographic characteristics, KAB, anthropometric measures and dietary intake of children were collected by trained field workers at baseline and post-intervention. Of the 296 school children enrolled, 203 (68.6%) completed post-intervention measures. Significant increases in dietary knowledge (β = 1.22, 95% CI: 0.54, 1.89), attitude (β = 0.69, 95% CI: 0.08, 1.30), and body mass index-for-age-z-scores (β = 0.25, 95% CI = 0.10, 0.41) were observed among intervention vs. control groups, adjusting for covariates (p < 0.05). Compared to the control, the intervention group had, on average, significantly larger increases in daily intakes of total energy, dietary fiber, protein, saturated fat, and several key micronutrients, p < 0.05. Findings suggest a positive impact of this school-based nutrition intervention on dietary knowledge, attitude, and nutritional status of Syrian refugee children. Further studies are needed to test the feasibility and long-term impact of scaling-up such interventions.

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Ghattas, Hala, AnnieBelle J. Sassine, Karin Seyfert, Mark Nord, and Nadine R. Sahyoun. "Food insecurity among Iraqi refugees living in Lebanon, 10 years after the invasion of Iraq: data from a household survey." British Journal of Nutrition 112, no. 1 (April 17, 2014): 70–79. http://dx.doi.org/10.1017/s0007114514000282.

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Iraqi refugees in Lebanon are vulnerable to food insecurity because of their limited rights and fragile livelihoods. The objective of the present study was to assess household food insecurity among Iraqi refugees living in Lebanon, almost 10 years after the invasion of Iraq. A representative survey of 800 UN High Commissioner for Refugees-registered refugee households in Lebanon was conducted using multi-stage cluster random sampling. We measured food insecurity using a modified US Department of Agriculture household food security module. We collected data on household demographic, socio-economic, health, housing and dietary diversity status and analysed these factors by food security status. Hb level was measured in a subset of children below 5 years of age (n 85). Weighted data were used in univariate and multivariate analyses. Among the Iraqi refugee households surveyed (n 630), 20·1 % (95 % CI 17·3, 23·2) were found to be food secure, 35·5 % (95 % CI 32·0, 39·2) moderately food insecure and 44·4 % (95 % CI 40·8, 48·1) severely food insecure. Severe food insecurity was associated with the respondent's good self-reported health (OR 0·3, 95 % CI 0·2, 0·5), length of stay as a refugee (OR 1·1, 95 % CI 1·0, 1·2), very poor housing quality (OR 3·3, 95 % CI 1·6, 6·5) and the number of children in the household (OR 1·2, 95 % CI 1·0, 1·4), and resulted in poor dietary diversity (P< 0·0001). Anaemia was found in 41 % (95 % CI 30·6, 51·9) of children below 5 years of age, but was not associated with food insecurity. High food insecurity, low diet quality and high prevalence of anaemia in Iraqi refugees living in Lebanon call for urgent programmes to address the food and health situation of this population with restricted rights.

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Mulenga, Ester, Hans Amukugo, and Anna Shilunga. "The experiences of mothers and caregivers on feeding practices of children under the age of five years with undernutrition in Oshikoto region, Namibia." International Journal of Healthcare 4, no. 2 (May 30, 2018): 20. http://dx.doi.org/10.5430/ijh.v4n2p20.

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Background: Undernutrition in children under the age of five years is prevalent in the developing countries which increase the risk of morbidity and mortality among such age group. Lack of information related to nutrition and feeding practices as well as other factors such as employment and pressure from family and community members cause mothers and caregivers of children under the age of five years to use inappropriate methods of feeding which contribute to undernutrition.Purpose: The aim of this article is to relate the experiences of mothers and caregivers on feeding practices of children under the age of five years in Oshikoto region, Namibia.Methods: A qualitative study design was utilized to explore and describe the experiences of mothers and caregivers on feeding practices of children under the age of five years. The study population comprised of mothers and caregivers of children diagnosed with undernutrition either severe or moderate, admitted in pediatric units or registered on Nutritional Assessment Counseling and Support programme. A purposive sampling was used to select participants and a total number of fifteen mothers/caregivers were interviewed. The data were transcribed verbatim and analysed using Tesch steps.Results: The study revealed that mothers and caregivers experienced lack of information related to nutrition and feeding practices and other contextual constraints which resulted in the utilization of suboptimal feeding practices of children under the age of five years.Conclusions: Due to challenges experienced by mothers and caregivers, they need to be empowered with knowledge on nutrition and feeding practices of children under the age of five years.

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Othman, Sally, Amanda Trofholz, and Jerica Berge. "How Time in the US and Race/Ethnicity Shape Parents Feeding Practices and Child Diet Quality." Current Developments in Nutrition 5, Supplement_2 (June 2021): 986. http://dx.doi.org/10.1093/cdn/nzab051_030.

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Abstract Objectives Childhood obesity is a critical public health issue with short and long-term health and financial burdens. Studies show that childhood obesity is higher among children of immigrant/refugee households compared to children whose parents were born in the United States. Poor child dietary intake is a critical risk factor for elevated obesity prevalence. Nonetheless, parents feeding practices are known to be associated with child dietary intake. Thus, this study aimed to examine the associations between length of residence time in the US of migrants/refugees, parents feeding practices, and child diet quality while also taking into consideration race/ethnicity. Methods Data are from baseline measures of a longitudinal cohort study called Family Matters. The sample includes 1307 children ages 5–9 and their families from six racial/ethnic backgrounds. Results Results showed that feeding practices of immigrant/refugee parents changed in relation to their length of residency in the US, in particular, with regard to using directive (e.g., restriction), non-directive (e.g., modeling), and emotional feeding practices. Additionally, race/ethnicity was found to influence the relation between time length in the US and parents feeding practices. Moreover, the diet quality score changed in relation to parents' length of time in the US. For example, Hmong children had the poorest diet quality compared to African American, Native American, Hispanic, Somali, and White children. Conclusions Future research should consider studying more in-depth why parent feeding practices may change when parents move to the US and explore whether there is a combination of parent feeding practices that are most useful in promoting healthful child diet quality. It is also important to further examine why child diet quality declines (e.g., Hmong children) with parents' time living in the US as a migrant/refugee. Funding Sources Research is supported by grant number R01HL126171 from the National Heart, Lung, and Blood Institute (PI: Berge). Content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute of the National Institutes of Health.

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Lazzerini, Marzia, Humphrey Wanzira, Peter Lochoro, Amos Ndunguste, Jerry Ictho, Ambrose Katungi, Ilaria Mariani, and Giovanni Putoto. "Quality of healthcare for children with severe acute malnutrition in a refugee setting: cross-sectional study in West Nile Region, Uganda." BMJ Open 10, no. 6 (June 2020): e034738. http://dx.doi.org/10.1136/bmjopen-2019-034738.

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Objectives5.0 million annual deaths in low-income and middle-income countries are due to poor quality of care (QOC). We evaluated the QOC provided to malnourished children in West Nile Region in Uganda.DesignCross-sectional study.SettingWest Nile Region, an area hosting over one million refugees.ParticipantsAmong 148 facilities providing nutritional services, 30 randomly selected facilities (20%) and the records of 1467 children with severe acute malnutrition (100% of those attending the 30 facilities during last year) were assessed.OutcomesThe national Nutrition Service Delivery Assessment (NSDA) tool was used to assess capacity areas related to QOC. Case management, data quality and health outcomes were assessed from official health records. Multivariate analysis was performed to explore factors significantly associated with better cure rates.ResultsOf 305 NSDA scores allocated to 30 participating centres, 201 (65.9%) were ‘good’ or ‘excellent’. However, 20 (66.7%) facilities had ‘poor’ ‘quality improvement mechanisms’ and 13 (43.3%) had ‘poor’ ‘human resources’. Overall data quality in official records was poor, while recorded quality of case management was overall fair. Average cure rate was significantly lower than international Sphere standards (50.4% vs 75% p<0.001) with a higher default rate (23.2% vs 15% p<0.001). Large heterogeneity among facilities was detected for all indicators. Refugee-hosting and non-refugee-hosting facilities had a similar cure rate (47.1% vs 52.1%) though transfer rates were higher for those hosting refugees (21.5% vs 1.9%, p<0.001) despite better ‘equipment and supplies’. ‘Good/excellent’ ‘equipment’ and ‘store management’ were significantly associated with better cure rates in outpatient therapeutic centres (+55.9, p<0.001; +65.4, p=0.041, respectively) in multivariate analysis.ConclusionsThough most NSDA capacity areas were rated good or excellent, health outcomes of malnourished children in West Nile Region, both in refugee-hosting and non-refugee-hosting facilities, are significantly below international standards. Effective and sustainable approaches to improve malnourished child health outcomes are needed.

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Shah, Shailja, Zahra Ali Padhani, Daina Als, Mariella Munyuzangabo, Michelle F. Gaffey, Wardah Ahmed, Fahad J. Siddiqui, et al. "Delivering nutrition interventions to women and children in conflict settings: a systematic review." BMJ Global Health 6, no. 4 (April 2021): e004897. http://dx.doi.org/10.1136/bmjgh-2020-004897.

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BackgroundLow/middle-income countries (LMICs) face triple burden of malnutrition associated with infectious diseases, and non-communicable diseases. This review aims to synthesise the available data on the delivery, coverage, and effectiveness of the nutrition programmes for conflict affected women and children living in LMICs.MethodsWe searched MEDLINE, Embase, CINAHL, and PsycINFO databases and grey literature using terms related to conflict, population, and nutrition. We searched studies on women and children receiving nutrition-specific interventions during or within five years of a conflict in LMICs. We extracted information on population, intervention, and delivery characteristics, as well as delivery barriers and facilitators. Data on intervention coverage and effectiveness were tabulated, but no meta-analysis was conducted.ResultsNinety-one pubblications met our inclusion criteria. Nearly half of the publications (n=43) included population of sub-Saharan Africa (n=31) followed by Middle East and North African region. Most publications (n=58) reported on interventions targeting children under 5 years of age, and pregnant and lactating women (n=27). General food distribution (n=34), micronutrient supplementation (n=27) and nutrition assessment (n=26) were the most frequently reported interventions, with most reporting on intervention delivery to refugee populations in camp settings (n=63) and using community-based approaches. Only eight studies reported on coverage and effectiveness of intervention. Key delivery facilitators included community advocacy and social mobilisation, effective monitoring and the integration of nutrition, and other sectoral interventions and services, and barriers included insufficient resources, nutritional commodity shortages, security concerns, poor reporting, limited cooperation, and difficulty accessing and following-up of beneficiaries.DiscussionDespite the focus on nutrition in conflict settings, our review highlights important information gaps. Moreover, there is very little information on coverage or effectiveness of nutrition interventions; more rigorous evaluation of effectiveness and delivery approaches is needed, including outside of camps and for preventive as well as curative nutrition interventions.PROSPERO registration numberCRD42019125221.

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Tepa, Arnaud, Idrissa Abame, Viviane Makamta, Balotin Fongang, Josiane Donkeu, Lawrence Ayong, and Constant Anatole Pieme. "Nutritional Status and Humoral Immune Response to Plasmodium falciparum in Children Aged 6–59 Months." Journal of Tropical Medicine 2020 (May 20, 2020): 1–7. http://dx.doi.org/10.1155/2020/1843780.

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Malaria is a leading cause of morbidity and mortality in Africa. Children are mostly exposed to this disease; numerous studies have investigated the relationship between child malnutrition and either malaria morbidity or infection. Few studies demonstrated the interaction between child malnutrition and specific anti-Plasmodium falciparum immune responses. The purpose of this study was to investigate the impact of nutritional status and iron on total anti-Plasmodium falciparum IgG levels in children living in the Gado-Badzéré refugee camp. We carried out a cross-sectional study during August–November 2017 in the Gado-Badzéré refugee camp in the East region of Cameroon. Children aged from 6 to 59 months with fever were recruited from the medical center. The data were recorded using a standardized data collection sheet and were analyzed using SPSS and WHO Anthro software. The total anti-Pf 3D7 total IgG level was determined using an ELISA technique while a colorimetric method was used to measure the total iron level. A total of 83 patients aged 6–59 months were enrolled in this study. The prevalence of malaria and malnutrition was 47% and 31%, respectively. Acute malnutrition was statistically less recurrent in noninfected children compared with that in the infected children. The infection tended to have significant influence on the level of anti-Plasmodium falciparum antibodies in children. In addition, nutritional status and serum iron levels had no significant influence on children’s anti-Pf IgG T levels. Malaria and malnutrition remain real public health problems in the Gado-badzéré refugee camp. Knowledge of the nutritional profile of the population would be of great benefit in setting up an appropriate health program. We therefore suggest that more standardized studies be conducted to highlight the effect of nutrition and micronutrients on immunological status.

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Smock, Laura, MaryKate Martelon, Elizabeth Metallinos-Katsaras, Thinh Nguyen, Jennifer Cochran, and Paul L. Geltman. "Recovery From Malnutrition Among Refugee Children Following Participation in the Special Supplemental Nutrition for Women, Infants, and Children (WIC) Program in Massachusetts, 1998-2010." Journal of Public Health Management and Practice 26, no. 1 (2020): 71–79. http://dx.doi.org/10.1097/phh.0000000000000995.

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Horino, Masako, Lina Bahar, Ghada Al-Jadba, Rami Habash, Seita Akihiro, and Keith P. West. "Dietary Inadequacy, Micronutrient Deficiencies, and Approaches to Preventing Poor Nutrition in the Gaza Strip." Food and Nutrition Bulletin 41, no. 4 (November 2, 2020): 503–11. http://dx.doi.org/10.1177/0379572120967819.

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Palestine refugees comprise the largest refugee population in the world, most of whom are encamped in Middle Eastern countries. In the Gaza Strip, where ∼1.4 million Palestinians reside, there are high prevalences of anemia and multiple micronutrient deficiencies (MNDs), including those of iron, zinc, vitamins A, B12, D, and E, ranging from 11.4% to 84.7% among pregnant women and 2.9% to 70.9% among preschool children. Dietary diversification and adequate food fortification are framed in policies but remain aspirational goals. Alternative, effective, targeted preventive approaches include, for women, replacement of antenatal iron-folic acid with multiple micronutrient supplementation, and for young children, point-of-use multiple micronutrient powder fortification to prevent anemia, both of which can reduce other MNDs and may bring additional health benefits. These interventions coupled with monitoring of dietary intakes, periodic assessment of MNDs, and implementation research to improve existing nutrition interventions are warranted to protect the health of the Middle East Palestinian diaspora.

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Abou-Rizk, Joana, Theresa Jeremias, Lara Nasreddine, Lamis Jomaa, Nahla Hwalla, Hani Tamim, Jan Frank, and Veronika Scherbaum. "Anemia and Nutritional Status of Syrian Refugee Mothers and Their Children under Five Years in Greater Beirut, Lebanon." International Journal of Environmental Research and Public Health 18, no. 13 (June 27, 2021): 6894. http://dx.doi.org/10.3390/ijerph18136894.

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The objective was to assess the prevalence of anemia and nutritional status of mothers and children under five years among Syrian refugees in Lebanon and to identify nutritional deficiencies among pregnant, lactating, and non-pregnant non-lactating (NPNLM) mothers. A cross-sectional study was conducted among Syrian refugee mothers with children under five years in Greater Beirut, Lebanon (n = 433). Data on socio-economic status, maternal health, lifestyle characteristics, dietary intake, anthropometric measurements, and hemoglobin concentrations were collected. The prevalence of anemia was 21.7% among mothers and 30.5% among children. NPNLM with overweight/obesity and an at-risk waist circumference (WC) had 14.7-times and 10.9-times higher odds of anemia than mothers with normal WC and weight. Children of anemic mothers had 2.7-times and 4.4-times higher odds of total and mild anemia than those of non-anemic. Higher odds of mild anemia were found among children of lactating mothers than of NPNLM. A high percent energy intake of total fat and sugar was found among all mothers. Nutritional inadequacy was identified in higher proportions of lactating and pregnant mothers than NPNLM. Our findings highlighted the co-existence of overnutrition and anemia among Syrian refugee mothers and undernutrition among children from the same household. Culture-specific interventions are needed to support maternal nutrition, to ensure the health and wellbeing of their offspring.

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Hulland, Erin N., Eva Leidman, Caroline Wilkinson, Mélody Tondeur, and Oleg Bilukha. "Anemia design effects in cluster surveys of women and young children in refugee settings." PLOS ONE 16, no. 7 (July 15, 2021): e0254031. http://dx.doi.org/10.1371/journal.pone.0254031.

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Background Nutrition surveys in many refugee settings routinely estimate anemia prevalence in high-risk population groups. Given the lack of information on anemia design effects (DEFF) observed in surveys in these settings, the goal of this paper is to better understand the magnitude and distribution of DEFFs and intracluster correlation coefficients (ICCs) in order to inform future survey design. Methods Two-stage cluster surveys conducted during 2013–2016 were included if they measured hemoglobin in refugee children aged 6–59 months and/or non-pregnant women aged 15–49 years. Prevalence of anemia, anemia DEFFs and ICCs, mean cluster size, number of clusters, and total sample size were calculated per-survey for non-pregnant women and children. Non-parametric tests were used to assess differences and correlations of ICC and DEFF between women and children and inter-regional differences. Results Eighty-seven unique cluster surveys from nine countries were included in this analysis. More than 90% of all surveys had ICC values for anemia below 0.10. Median ICC for children was 0.032 (IQR: 0.015–0.048), not significantly different from that observed for non-pregnant women for whom the median was 0.024 (IQR: -0.002–0.055). DEFFs were significantly higher for children [1.54 (IQR: 1.21–1.82)] versus women [1.20 (IQR: 0.99–1.46)]. Regional differences in DEFFs and ICCs were observed. Conclusions Both ICCs and DEFF were relatively small for both non-pregnant women and preschool children and fall in a narrow range. Differences in ICCs between women and children were non-significant, suggesting similar inter-cluster distributions of anemia; significant differences in DEFF were likely attributable to differing cluster sizes. Given regional differences in both ICCs and DEFFs, location-specific values are preferred. However, in the absence of other context-specific information, we suggest using DEFFs of 1.4–1.8 if mean cluster size is around 20, and DEFFs of 1.2–1.4 if mean cluster size is around 10.

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Sellen, Daniel W., Alison E. Tedstone, and Jacqueline Frize. "Food insecurity among refugee families in East London: results of a pilot assessment." Public Health Nutrition 5, no. 5 (December 2002): 637–44. http://dx.doi.org/10.1079/phn2002340.

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AbstractObjective:To identify child hunger and examine its association with family factors, receipt of benefits, housing conditions and social support among recently arrived refugee families with young children.Design:Structured and semi-structured questionnaire administered to a service-based, purposive sample of caregivers.Setting:East London, United Kingdom.Subjects:Thirty households with children <5 years old, resident in the UK for <2 years.Results:All households sampled were food-insecure, and 60% of index children were experiencing hunger as defined on the Radimer/Cornell scale. Child hunger was significantly associated with recent arrival, marginally significantly associated with receipt of fewer benefits and younger parenthood, and not associated with maternal education or self-efficacy score, household size or composition, or measures of social support.Conclusions:A community-based, participatory approach for rapid assessment of the prevalence, extent and causes of child hunger among newly arrived asylum seekers recently arrived in Britain is feasible, and preliminary results suggest a programmatic need for a broader, population-based assessment of food insecurity in this rapidly growing population group.

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Lane, Ginny, Christine Nisbet, Susan J. Whiting, and Hassan Vatanparast. "Canadian newcomer children’s bone health and vitamin D status." Applied Physiology, Nutrition, and Metabolism 44, no. 7 (July 2019): 796–803. http://dx.doi.org/10.1139/apnm-2018-0705.

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Adequate calcium intake and supply of vitamin D during childhood play important roles in ensuring adequate bone mass gain to achieve optimal peak bone mass. The Healthy Immigrant Children study employed a mixed-method cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3–13 years who had been in Canada for less than 5 years. This paper presents bone mineral content and vitamin D status data along with qualitative data that deepen the understanding of newcomer bone health status. A significantly higher percentage of refugee children (72.3%) had insufficient (<50 nmol/L) or deficient (<30 nmol/L) serum vitamin D compared with immigrants (53.2%). Vitamin D deficiency was most common among ethnic minority girls. Newcomer children with higher intakes of vitamin D, younger newcomer children, and those from western Europe or the United States had higher serum vitamin D levels. Immigrants had significantly higher mean total body bone mineral content compared with refugees. Total body fat, serum vitamin D, calcium intake, height, height by calcium intake, total body fat by calcium intake, and total body fat by height predicted total body bone mineral content levels. Vitamin D deficiency among newcomer children may be related to lack of knowledge regarding children’s vitamin D requirements in the Canadian environment, dietary habits established in country of origin, low income that limits healthy dietary choices, and lifestyle habits that limit exposure to sunlight. Results suggest a need to screen newcomer children and pregnant women for vitamin D deficiency and support early intervention.

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Lopriore, Cristina, Yamina Guidoum, André Briend, and Francesco Branca. "Spread fortified with vitamins and minerals induces catch-up growth and eradicates severe anemia in stunted refugee children aged 3–6 y." American Journal of Clinical Nutrition 80, no. 4 (October 1, 2004): 973–81. http://dx.doi.org/10.1093/ajcn/80.4.973.

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Abdeen, Ziad, P. Gregg Greenough, Aruna Chandran, and Radwan Qasrawi. "Assessment of the Nutritional Status of Preschool-Age Children during the Second Intifada in Palestine." Food and Nutrition Bulletin 28, no. 3 (September 2007): 274–82. http://dx.doi.org/10.1177/156482650702800303.

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Background The Palestinian economy has dramatically deteriorated at all levels since the Al-Aqsa Intifada (uprising) began in 2000, resulting in an unprecedented catastrophe to the livelihoods of the Palestinians residing in the West Bank and Gaza. It was also marked by lack of household physical and financial access to food and health care, which placed children at increased risk of malnutrition and poor health. This prompted a significant increase in food aid from 2002 until the summer of 2003. Objectives To assess the nutritional status of children 6 to 59 months of age after 1 year of food assistance. Methods In the West Bank and Gaza, a nationally representative sample of children 6 to 59 months of age was randomly selected with a validated multistage clustered design, with the Health Survey 1999 sample used as the sampling frame. The sample was stratified according to governorate, place of residence (urban, nonurban, or refugee camp), locality, and size of locality (number of households). A cross-sectional survey of nutritional status was carried out. Data were collected by interviews with the primary caregivers of the children. Measurements were made of children's weight and height or length. Food-intake data were collected by the 24-hour food-recall method with the use of a booklet of photographs of foods commonly eaten in Palestine. Results A total of 3,089 children were assessed, of whom 3.1% in the West Bank and 3.9% in the Gaza Strip were suffering from acute malnutrition; the prevalence of chronic malnutrition was 9.2% in the West Bank and 12.7% in the Gaza Strip ( p = .02). Sex, refugee status, locality, and maternal education were not significantly associated with acute malnutrition by logistic regression analysis, whereas infants 6 to 23 months of age were significantly at risk. Calorie and protein intakes were generally lower than recommended dietary allowances. Conclusions The prevalence rates of both acute and chronic malnutrition among children in the West Bank and Gaza are significantly higher than the national Palestinian averages. There is a need to establish nutritional surveillance systems to monitor the nutritional status of children in conflict areas.

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Ghattas, Hala, Jowel Choufani, Zeina Jamaluddine, Amelia Reese Masterson, and Nadine R. Sahyoun. "Linking women-led community kitchens to school food programmes: lessons learned from the Healthy Kitchens, Healthy Children intervention in Palestinian refugees in Lebanon." Public Health Nutrition 23, no. 5 (November 22, 2019): 914–23. http://dx.doi.org/10.1017/s1368980019003161.

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AbstractObjective:Decades of marginalization have led Palestinian refugees living in Lebanon to experience multigenerational poverty and food insecurity. The Healthy Kitchens, Healthy Children programme implemented and examined the impact of a two-pronged intervention that employed women through community kitchens to deliver a subsidized healthy daily school snack to elementary-school children in Palestinian refugee camps in Lebanon. We describe the rationale, study design, theorized impact pathways, and discuss lessons learned.Design:The programme was quasi-experimental. We conducted formative and process evaluation of both components of the intervention to elucidate the pathways to programme impact.Setting:Palestinian refugee camps in Lebanon.Participants:Thirty-three women participated in the kitchens and provided subsidized snacks to 714 children.Results:Snacks were healthy, traditional Palestinian recipes designed by women and a nutritionist. Participation fluctuated but eventually increased after modifying the meals to ensure acceptability by children. The main challenges to sustainability related to the need for subsidization of the meals and the lack of school policies around the regulation of sales of school food, which together led to fluctuations in programme participation.Conclusions:The study provides lessons learned on the potential of this model to improve the human capital of two generations of protracted refugees. The availability of schools as a constant market for these social enterprises offers an opportunity for sustainable livelihood generation and food security gains. Challenges to sustainability remain and could be addressed through social (subsidies to support the programme) and structural (policies to restrict unhealthy food sales) measures.

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Seal, Andrew, Emmanuel Kafwembe, Ismail AR Kassim, Mei Hong, Annie Wesley, John Wood, Fathia Abdalla, and Tina van den Briel. "Maize meal fortification is associated with improved vitamin A and iron status in adolescents and reduced childhood anaemia in a food aid-dependent refugee population." Public Health Nutrition 11, no. 7 (July 2008): 720–28. http://dx.doi.org/10.1017/s1368980007001486.

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AbstractObjectiveTo assess changes in the Fe and vitamin A status of the population of Nangweshi refugee camp associated with the introduction of maize meal fortification.DesignPre- and post-intervention study using a longitudinal cohort.SettingNangweshi refugee camp, Zambia.SubjectsTwo hundred and twelve adolescents (10–19 years), 157 children (6–59 months) and 118 women (20–49 years) were selected at random by household survey in July 2003 and followed up after 12 months.ResultsMaize grain was milled and fortified in two custom-designed mills installed at a central location in the camp and a daily ration of 400 g per person was distributed twice monthly to households as part of the routine food aid ration. During the intervention period mean Hb increased in children (0·87 g/dl;P< 0·001) and adolescents (0·24 g/dl;P= 0·043) but did not increase in women. Anaemia decreased in children by 23·4 % (P< 0·001) but there was no significant change in adolescents or women. Serum transferrin receptor (log10-transformed) decreased by −0·082 μg/ml (P= 0·036) indicating an improvement in the Fe status of adolescents but there was no significant decrease in the prevalence of deficiency (−8·5 %;P= 0·079). In adolescents, serum retinol increased by 0·16 μmol/l (P< 0·001) and vitamin A deficiency decreased by 26·1 % (P< 0·001).ConclusionsThe introduction of fortified maize meal led to a decrease in anaemia in children and a decrease in vitamin A deficiency in adolescents. Centralised, camp-level milling and fortification of maize meal is a feasible and pertinent intervention in food aid operations.

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Cumber, SN, KN Nchanji, and CH Ngwa. "Meeting the food needs of refugee children in the northern and eastern regions of Cameroon: current challenges faced and strategies to overcome them." South African Journal of Clinical Nutrition 32, no. 4 (July 26, 2018): 91–92. http://dx.doi.org/10.1080/16070658.2018.1480883.

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Talley, Leisel, Bradley A. Woodruff, Andrew Seal, Kathryn Tripp, Laurent Sadikiel Mselle, Fathia Abdalla, Rita Bhatia, and Zhara Mirghani. "Evaluation of the effectiveness of stainless steel cooking pots in reducing iron-deficiency anaemia in food aid-dependent populations." Public Health Nutrition 13, no. 1 (April 1, 2009): 107–15. http://dx.doi.org/10.1017/s1368980009005254.

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AbstractObjectiveTo evaluate the effectiveness of stainless steel (Fe alloy) cooking pots in reducing Fe-deficiency anaemia in food aid-dependent populations.DesignRepeated cross-sectional surveys. Between December 2001 and January 2003, three surveys among children aged 6–59 months and their mothers were conducted in 110 households randomly selected from each camp. The primary outcomes were changes in Hb concentration and Fe status.SettingTwo long-term refugee camps in western Tanzania.SubjectsChildren (6–59 months) and their mothers were surveyed at 0, 6 and 12 months post-intervention. Stainless steel pots were distributed to all households in Nduta camp (intervention); households in Mtendeli camp (control) continued to cook with aluminium or clay pots.ResultsAmong children, there was no change in Hb concentration at 1 year; however, Fe status was lower in the intervention camp than the control camp (serum transferrin receptor (sTfR) concentration: 6·8v. 5·9 μg/ml;P< 0·001). There was no change in Hb concentration among non-pregnant mothers at 1 year. Subjects in the intervention camp had lower Fe status than those in the control camp (sTfR concentration: 5·8v. 4·7 μg/ml;P= 0·003).ConclusionsDistribution of stainless steel pots did not increase Hb concentration or improve Fe status in children or their mothers. The use of stainless steel prevents rusting but may not provide sufficient amounts of Fe and strong educational campaigns may be required to maximize use. The distribution of stainless steel pots in refugee contexts is not recommended as a strategy to control Fe deficiency.

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Walters, Christine, Hasina Rakotomanana, Joel Komakech, and Barbara Stoecker. "Facilitators and Barriers of Breastfeeding in Post-emergency Settlements: Qualitative Findings From Uganda." Current Developments in Nutrition 5, Supplement_2 (June 2021): 696. http://dx.doi.org/10.1093/cdn/nzab045_078.

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Abstract Objectives Suboptimal breastfeeding practices have been reported among vulnerable populations including those living in post-emergency refugee settlements. This study investigated the barriers and facilitators of breastfeeding in post-emergency settlements in Adjumani district, in the West Nile region in Uganda. Methods Participants included mothers and fathers of children less than 23 months of age who lived in post-emergency refugee settlements of Agojo, Ayilo, and Nyumanzi. Participants formed a total of five focus group discussions (FGDs); four FGDs for mothers and two FGDs for fathers. The FGDs were conducted in native languages, Dinka and Madi, and were audio-recorded. Data were transcribed verbatim and back-translated into English. Thematic analysis was used and data were analyzed using NVivo v. 12. Results The mean age (years) for mothers was 27.1 and 39.7 for fathers. Over half (61.9%) of mothers and many fathers (74.9%) received some formal education. Over a quarter (28.5%) of mothers attended less than 4 antenatal visits during their last pregnancy. Facilitators of breastfeeding included knowledge of breastfeeding benefits, support from husband/father, support from the community, and support from non-governmental organizations. Mothers and fathers reported that breastfeeding protected children from diseases and breasted children grow well. Four themes were identified as barriers of breastfeeding: physical, socioeconomic, knowledge, and psychosocial barriers. Mothers and fathers reported physical barriers such as mothers stop breastfeeding when they are sick or they feel they are not producing enough breastmilk. Mothers described socioeconomic barriers including working outside the home and educated mothers chose to use other milk. Fathers reported psychosocial barriers such as mothers’ fear of pain during breastfeeding and maternal mental health issues. Conclusions Policies and interventions that aim to improve breastfeeding in post-emergency settlements should consider addressing the barriers to breastfeeding at each level: physical, socioeconomic, knowledge, and psychosocial. Involving and encouraging support from husbands/fathers, relatives, and the community may increase adherence to breastfeeding recommendations. Funding Sources Thoma Chair, Oklahoma State University.

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Theurich, Melissa Ann, and Veit Grote. "Are Commercial Complementary Food Distributions to Refugees and Migrants in Europe Conforming to International Policies and Guidelines on Infant and Young Child Feeding in Emergencies?" Journal of Human Lactation 33, no. 3 (June 21, 2017): 573–77. http://dx.doi.org/10.1177/0890334417707717.

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In 2015, more than one million migrants and refugees arrived in Europe. Commercial complementary foods, processed foods marketed for infants and young children 6-23 months of age, were distributed by various humanitarian actors along migrant routes and in European refugee camps. Unsolicited donations and distributions of commercial complementary food products were problematic and divergent from international policies on infant and young child feeding during humanitarian emergencies. Interim guidance regarding commercial complementary foods was published during the peak of the emergency but implemented differently by various humanitarian actors. Clearer and more technical specifications on commercial complementary foods are needed in order to objectively determine their suitability for operational contexts in Europe and emergency nutrition assistance in the future.

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Fenn, Bridget, Mark Myatt, Emily Mates, Robert E. Black, Caroline Wilkinson, and Tanya Khara. "Effects on child growth of a reduction in the general food distribution ration and provision of small-quantity lipid-based nutrient supplements in refugee camps in eastern Chad." BMJ Nutrition, Prevention & Health 4, no. 1 (May 14, 2021): 235–42. http://dx.doi.org/10.1136/bmjnph-2021-000292.

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BackgroundWe used the United Nations High Commissioner for Refugees Standardised Expanded Nutrition Survey data to evaluate the effect of a change in food ration on child growth in refugee camps in eastern Chad.MethodsWe compared trends of wasting and stunting prevalence over time and the association between the coexistence of being both stunted and wasted using Pearson’s χ2 test. We analysed the effect of an approximate 50% reduction in the general food distribution, with the introduction of a 20 g daily ration of small quantity lipid-based nutrient supplements given to all children aged 6–23 months, on child growth. This was done using interrupted time-series analysis to observe differences in levels and trends in mean height-for-age z-score (HAZ) and weight-for-height z-score (WHZ) over time and by age group (6–24 months and 24–59 months).ResultsOverall the prevalence of stunting and wasting decreased significantly over time. The odds of being both stunted and wasted was 1.38 higher than having one or the other condition separately (p<0.001, 95% CI=1.29 to 1.47). Trends in mean HAZ and WHZ before and after a ration change in 2014 indicate that growth had either slowed down or worsened. In the period following the ration change, children 24–59 months saw a significant decrease in mean HAZ of 0.04 per year (p=0.02, 95% CI=−0.07 to –0.01) and for the younger age group, there was a significant decrease in mean WHZ of 0.06 per year (p=0.03, 95% CI=−0.12 to –0.01).ConclusionsThe dual burden of stunting and wasting is a considerable challenge in refugee camp settings. Changes to the food distribution had adverse effects on child growth for both age groups. Broadening the scope of interventions aimed at children in camps is essential when tackling malnutrition with increased efforts essential during periods of wider food assistance shortages.

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Ndemwa, Philip, Christine L. Klotz, David Mwaniki, Kai Sun, Erastus Muniu, Pauline Andango, Joyce Owigar, et al. "Relationship of the Availability of Micronutrient Powder with Iron Status and Hemoglobin among Women and Children in the Kakuma Refugee Camp, Kenya." Food and Nutrition Bulletin 32, no. 3 (September 2011): 286–91. http://dx.doi.org/10.1177/156482651103200314.

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Lapping, Karin, Dirk Schroeder, David Marsh, Rachel Albalak, and Mohammad Zahir Jabarkhil. "Comparison of a Positive Deviant Inquiry with a Case-Control Study to Identify Factors Associated with Nutritional Status among Afghan Refugee Children in Pakistan." Food and Nutrition Bulletin 23, no. 4_suppl2 (December 2002): 26–33. http://dx.doi.org/10.1177/15648265020234s205.

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We compared the positive deviance (PD) approach in Save the Children's field guide with a case-control study (CCS) to identify behaviors associated with good nutritional status in Afghan refugee children 6 to 24 months of age in the Northwest Frontier Province (NWFP), Pakistan. The positive deviance inquiry (PDI), utilizing observations and interviews with mothers, fathers, and secondary caregivers in eight households, identified 12 feeding, caring, and health-seeking behaviors that were not widely practiced. The CCS, using the same selection criteria and content as the PDI with 50 mother-child pairs not in the PDI, yielded six significant associations with good nutritional status. Both the PDI and CCS detected feeding behaviors. The PDI alone identified complex phenomena (active feeding and maternal affect). The CCS alone confirmed the beneficial use of health services. The PD approach was an affordable, participatory, and valid method to identify feeding behaviors and other factors associated with good nutrition in this context.

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Lapping, Karin, Dirk Schroeder, David Marsh, Rachel Albalak, and Mohammad Zahir Jabarkhil. "Comparison of a Positive Deviant Inquiry with a Case-Control Study to Identify Factors Associated with Nutritional Status among Afghan Refugee Children in Pakistan." Food and Nutrition Bulletin 23, no. 4_suppl_1 (January 2002): 26–33. http://dx.doi.org/10.1177/15648265020234s105.

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Tondeur, Melody C., U. Núria Salse, Caroline Wilkinson, Paul Spiegel, and Andrew J. Seal. "Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria." Public Health Nutrition 19, no. 10 (March 4, 2016): 1852–61. http://dx.doi.org/10.1017/s136898001600029x.

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AbstractObjectiveTo assess the acceptability and adherence to daily doses of lipid-based nutrient supplement (LNS) among children and micronutrient powder (MNP) among children and pregnant and lactating women.DesignHousehold interviews and sachet counting were conducted to measure acceptability and adherence, 15 and 30 d after product distribution. Qualitative information on product acceptability was collected using focus group discussions.SettingSaharawi refugee camps, Algeria, August–October 2009.SubjectsLNS was distributed to 123 children aged 6–35 months (LNS-C), and MNP to 112 children aged 36–59 months (MNP-C) and 119 pregnant or lactating women (MNP-W).ResultsAt the end of the test 98·4 % of LNS-C, 90·4 % of MNP-C and 75·5 % of MNP-W participants reported that they liked the product (P<0·05). Other measures of acceptability did not differ. Median consumption of sachets was highest in the LNS-C group (P<0·001). ‘Good’ adherence to the daily regimen (consumption of 75–125 % of recommended dose) was 89·1 % in the LNS-C, compared with 57·0 % in the MNP-C and 65·8 % in the MNP-W groups (P<0·001). Qualitative findings supported the quantitative measures and guided selection of local product names, packaging designs, distribution mechanisms, and the design of the information campaign in the subsequent programme scale-up.ConclusionsAcceptability, consumption and adherence were higher in participants receiving LNS compared with MNP. However, both products were found to be suitable when compared with predefined acceptability criteria. Acceptability studies are feasible and important in emergency nutrition programmes when the use of novel special nutritional products is considered.

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Tripp, Katherine, Nancy MacKeith, Bradley A. Woodruff, Leisel Talley, Laurent Mselle, Zahra Mirghani, Fathia Abdalla, Rita Bhatia, and Andrew J. Seal. "Acceptability and use of iron and iron-alloy cooking pots: implications for anaemia control programmes." Public Health Nutrition 13, no. 1 (May 28, 2009): 123–30. http://dx.doi.org/10.1017/s1368980009005928.

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AbstractObjectiveTo evaluate the acceptability of iron and iron-alloy cooking pots prior to an intervention trial and to investigate factors affecting retention and use.DesignPre-trial research was conducted on five types of iron and iron-alloy pots using focus group discussions and a laboratory evaluation of Fe transfer during cooking was undertaken. Usage and retention during the subsequent intervention trial were investigated using focus group discussions and market monitoring.SettingThree refugee camps in western Tanzania.SubjectsRefugee health workers were selected for pre-trial research. Mothers of children aged 6–59 months participated in the investigation of retention and use.ResultsPre-trial research indicated that the stainless steel pot would be the only acceptable type for use in this population due to excessive rusting and/or the high weight of other types. Cooking three typical refugee dishes in stainless steel pots led to an increase in Fe content of 3·2 to 17·1 mg/100 g food (P < 0·001). During the trial, the acceptability of the stainless steel pots was lower than expected owing to difficulties with using, cleaning and their utility for other purposes. Households also continued to use their pre-existing pots, and stainless steel pots were sold to increase household income.ConclusionsPre-trial research led to the selection of a stainless steel pot that met basic acceptability criteria. The relatively low usage reported during the trial highlights the limitations of using high-value iron-alloy cooking pots as an intervention in populations where poverty and the availability of other pots may lead to selling.

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Journal articles on the topic 'Refugee children, Nutrition. Namibia'

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