Childhood Nutrition Vital to Achieving Mdg 1, 2, 4, 5

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In developing and implementing nutrition programmes, efforts should be made to incorporate the communities’ own assessment of their nutritional challenges and addressing household food security challenges such as improvement in agriculture, diversification and introduction of crops to increase the variety of foods, home gardens, dietary diversification/modification etc. The government needs to address economic decline and scale-up access to social protection (example, child support grant) which is vital to combating childhood malnutrition.

Adoption of Comprehensive Primary Health Care Approach

To achieve MDG 1, 2, 4, 5, there should be a paradigm shift from the Selective Primary Health Care approach which involves only activities in the health sector by focusing on only preventive, curative and rehabilitative interventions to disease reduction and prevention and adopt the Comprehensive Primary Health Care (CPHC) approach. The CPHC approach entails Primary Health Care services involving five principles namely universal accessibility and coverage on the basis of need (equity), comprehensive care with emphasis on disease prevention and health promotion, community and individual involvement and self-reliance, inter-sectoral action for health and cost-effective interventions. CPHC encompasses an additional intervention being promotive intervention in addition to preventive, curative and rehabilitative interventions. CPHC therefore addresses social injustices such as underlying social, economic and political causes of poor health. CPHC also combines clinical, Public Health and health promotion undertaken in conjunction with other sectors (Education, Works and Housing, Sanitation etc) apart from the health sector. CPHC increases inter-sectoral collaborations at households/ communities, at international and national level through advocacy and lobbying of government and policymakers.

CPHC seeks to increase equity in access to health care and other services essential to health for the whole population at risk. CPHC results in improved community participation, opportunities and political capabilities of marginalized population groups thereby reducing vulnerabilities through improvement in community empowerment. Elements of Comprehensive Primary Health Care approach to address child malnutrition includes the promotion of proper nutrition and adequate supply of safe water, basic sanitation, maternal and childcare, immunisation, prevention and control of locally endemic disease, health education, and methods of prevention and treatment for common diseases. Ghana needs to adopt a holistic approach by using CPHC since it addresses presents curative, preventive, rehabilitative and promotive intervention for addressing child malnutrition. Curative interventions are health care approach emphasising treatment of biological and psychological causes and symptoms of disease through medicine and other therapies. Curative interventions should espouse the correct management of common childhood through provision of protocols, training of healthcare workers and strengthening of supportive supervision. Moreover, availability of supplies and drugs must be ensured.

Preventive interventions emphasises preventing sickness in individuals and populations. Preventive interventions entails promotion of post-natal visit within six days which includes newborn care, supporting mothers to practice exclusive breastfeeding for six months and thereafter give appropriate complementary foods, and continue breastfeeding up to two years and beyond. Also, preventive interventions include provision of services through community-based campaigns such as immunization, growth monitoring and promotion, Vitamin A, mass deworming campaigns. These should be strengthening of Maternal, Newborn, Child and Women’s Health and Nutrition communication strategy to improve practices promoting child nutrition especially amongst mothers and caregivers and to enhance community involvement and participation in child survival activities. Rehabilitative interventions emphasises on restoring people to a state of improved health and functioning. Rehabilitative interventions include care for Low Birth Weight infants and the management of malnourished children in health facilities using WHO’s recommended strategy for management of severe malnutrition.

Promotive intervention addresses basic social, economic and political causes of ill-health that is Social Determinants of Health. Promotive interventions should include mobilizing and empowering women, children and men to participate in efforts to improve their health at individual, household and community levels. Also, there should be strengthening of school health services through provision of comprehensive and integrated school health programme. Promotive interventions should fosters partnerships with other role-players through establishing stakeholder forums for coordination of nutrition interventions, strengthening multi-sectoral collaboration to reduce poverty and inequity - in particular programmes and interventions that improve access to clean water, sanitation and promotes comprehensive health education and promotion in schools.

Improvement in nutritional status of children can only be achieved through improvements in Social Determinants of Health. Thus poverty alleviation is an important intervention essential in the fight against childhood malnutrition which can only be achieved through collaboration amongst government, civil society and local communities, business, and international agencies. In addition, long-term investments through female education, economic, social, and political empowerment will result in sustainable reduction of childhood malnutrition. Also, investment in physical infrastructure, creating healthy environments (sanitation, water supply), job creation, quality health services, etc are key to addressing childhood malnutrition.