Objective: 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 servicebased, 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.
Acute malnutrition is associated with increased morbidity and mortality risk. When episodes are prolonged or frequent, acute malnutrition is also associated with poor growth and development, which contributes to stunting Nutrition-specific and nutrition-sensitive strategies to prevent undernutrition during the first 1,000 days from conception to 24 months of age can reduce the risks of wasting, stunting, and micronutrient deficiencies. Under circumstances that exacerbate the underlying causes of undernutrition and increase the incidence of wasting, such as food insecurity related to lean seasons or emergencies, or increased incidence of illness, such as diarrhea or measles, additional efforts are required to prevent and treat wasting. Special nutritious foods directly meet the increased nutrient requirements of children at risk for wasting; assistance to vulnerable households, in the form of cash or food, enables households to better meet the food, health, and other needs of household members and may increase resilience; water, sanitation, and hygiene (WASH) and health interventions help prevent and address illness and hence reduce wasting risk. The contributions of specific interventions to reducing the incidence of wasting are difficult to assess under emergency conditions, due to ethical constraints and to the fact that multiple strategies are implemented at the same time. However, pragmatic studies under real-life circumstances, using different designs, e.g., including a group receiving "best possible" treatment, can provide evidence about what works, to what extent, at what cost, and under which circumstances. Programs should address the most important causes in given contexts, be feasible to implement at scale, and assess implementation, coverage, and outcomes.
Background: There are many challenges during emergencies to ensure that optimal infant and young child feeding is protected, promoted and supported, but there is a dearth of evidence on strategies and programmes to improve Infant and Young Child Feeding in Emergencies (IYCF-E) and a need to determine research priorities. Methods: Based on interviews with key informants who are experts in the subject, we developed a list of 48 research questions on IYCF-E. A framework, following the Child Health and Nutrition Research Initiative method to set priorities in child health research, was developed to rank the research questions. Four criteria were applied to create a ranking based on answerability, operational relevance, disease burden reduction and prevention, and originality. Using an on-line survey, prioritisation of research questions was done by 27 people from 14 NGOs, universities and research institutions, and UN organisations. Results: The top-ten research questions identified focused on the following:• Use of cash-transfer to buy breast-milk substitutes;• Effectiveness of complementary feeding strategies;• Long-term effect of IYCF-E interventions;• Design of IYCF-E programmes in a context where breastfeeding rates are low and breast milk substitutes use is high;• Design of effective re-lactation interventions;• Provision of psychological support to young children's care-takers;• Determination of number of beneficiaries and coverage of IYCF-E programmes;• Pros and cons of distributing ready-to-use infant formula compared with distributing powdered infant formula plus kit for safer use of BMS, when use of infant formula is necessary;• Assessment of the impact of specific IYCF-E programmes on nutritional status, morbidity and mortality;• Linking and mainstreaming IYCF-E interventions with other sectors such as health, WASH, food security and child protection. Conclusion: The questions found by this study could form the basis of future research on IYCF-E and could be integrated into the agenda of relevant stakeholders. Results of studies based on these questions will be fundamental to fill the evidence gap in IYCF-E, improve IYCF-E programming and ultimately contribute to the reduction in morbidity and mortality among infants and young children in humanitarian emergencies.
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