1.TFIn the poor nations almost everyone is hungry; in the remainder almost everyone gets an adequate...
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1.TFIn the poor nations almost everyone is hungry; in the remainder almost everyone gets an adequate diet 2.TFWorldwide, more people have their lives shortened
1.TFIn the poor nations almost everyone is hungry; in the
remainder almost everyone gets an adequate diet 2.TFWorldwide, more
people have their lives shortened by overeating than by starvation
3.TFWhen poor nations now find a place on the ladder of
development, they develop slower than rich nations did when they
enjoyed their phase of development? 4.TFMost Canadian specialists
in global health understand how the distribution of poverty &
hunger are changing? 5.TF Health & nutrition benefits are
possible only after economic development occurs 6.TFPeople in
regions of extreme hunger & poverty desperately need money
7.TF50% of children in the US are currently so poor that they must
rely on charity for their meals? Quick quiz two of the following
are T
Slide 2
Quick answers 1.FIn some nations hunger is the norm; in the
remainder, an adequate diet is the norm 2.T Worldwide, more people
have their lives shortened by overeating than by starvation 3.F In
the present era, when poor nations find a place on the ladder of
development, they develop slowly compared with the rich nations in
their phase of development? 4.FMost Canadian specialists in global
health understand the how the distribution of poverty and hunger
are changing? 5.F Health & nutrition benefits inevitably occurs
after economic development rather than before 6.FPeople in regions
of extreme hunger & poverty desperately need money 7.T50% of
children in the US are currently so poor that they must rely on
charity for their meals?
Slide 3
Slides & practice questions (see web) 1. The 50% (actually
49.2%) is US children that will require food-aid some time during
childhood 2. Pct % of people hungry is declining over years 3. Plan
to spend 2-3 hours reviewing web info What works & what doesnt?
toward evidence-based solutions http://www.sfu.ca/global-nutrition
This is a problem we can solve at a fraction the cost of ignoring
it (Senator Geo McGovern: US Ambassador to UN Food & Ag
Org)
Slide 4
1 billion hungry (800m); 1 billion overweight Minefield Experts
are living in the past Nothing in texts
Slide 5
Page 5 Nutrition in global health - Overview Inequities in food
distribution global hunger & starvation One billion are too
hungry to live productive lives - an equal number are adversely
affected by overweight! 6 major deficiencies impact health through
the life cycle: water, protein, iron, vitamin A, iodine, folic acid
Childbearing women & their children are hardest hit Meanwhile,
overnutrition & inactivity risk of heart disease, osteoporosis,
cancer, diabetes, strokes, etc.
Slide 6
World GDP $PPP per cap (est) 1500-2100 http://
ers.usda.gov/Data/Macroeconomics / Manifest destiny of world -
wealth China + India 2040? 6
Slide 7
Global Nutrition We have a roadmap to a world without hunger
Where are we headed? The ugly We know what works? It wasnt an
accident How did we get here? Where are we now? Can anything help?
Yes Stuffed & starved The bad We keep doing what we know doesnt
work? The good Most of you will see hunger in museums! We are part
of the problem
Slide 8
Overview of Nutrition in Global Health 1.Malnutrition and MDGs:
cause, effect & cure3 2.Major categories & measures of
nutritional status4 3.Nutrition & crucial periods in the
life-cycle; 4 4.Determinants of nutrition, dietary patterns &
culture2 5.Nutrition and its relationship to disease4 6.Making
hunger history - breaking the poverty-trap 3 7.Trends in nutrition,
food security & globalization3 Page 8
Slide 9
Preface: Nutrition is crucial to global health Among the
immediately modifiable factors that affect individual & public
health nutrition is of prime importance Nutrition at every stage of
life lays a foundation for health in the ensuing stage For all
nations, rich & poor, nutrition determines physical health
& development through the life- cycle, including: Success in
childbearing, cognitive function, socio-economic independence,
education, disease resistance & employability Health &
economic development are contingent on provision of adequate food,
nutritional resources & support Page 9
Slide 10
Page 10 Fundamentals and emphasis As we consider cause and
effect we must ask: How & why have such inequities come to be?
Who and what factors impede solutions? What current initiatives
will bring the resolution? To help answer these, we must will
emphasize: Immediate causes - scarcity of specific nutrients
Primary and secondary prevention Public health approaches to
solutions
Slide 11
World % undernourished 11 same data 22% 14%
Slide 12
Number fed & under-nourished worldwide 12 14% Prediction
6%11% Target 33% 1212 millions
Slide 13
A vicious cycle for malnutrition poverty, health, economic
deprivation Page 13 Development: Marginalization inability to
provide for self or family Access to the ladder of development
Poverty: Diminished access to agricultural & food resources
malnutrition high birth rate Health: Physical & cognitive
impairment, susceptibility to disease, early death inability to
earn an income nutrition
Slide 14
Routes to famine Discovering resources Externally initiated
armed conflict Uncertain rainfall & drought... Being
landlocked... Bad governance... Israel, Afghanistan So.Africa
Nigeria, Iraq Lesotho Being on a trade or pipeline route...
Zimbabwe [USA] Sudan, Afghanistan Sahel, Palestine Blaming the
bonsai tree... Yunus:
Slide 15
1 Malnutrition & MDGs: cause, effect, cure 3 slides:
1.Trends in nutrition, food security & globalization
2.Agricultural trends 3.Nutritional inequities - Cause &
consequence 4.Food security; Prospects for having enough food Page
15
Slide 16
16 Paying for total strangers to eat? Not us, not if it goes to
corrupt dictators } 16
Slide 17
17 http://www.globalissues.org/articl
e/35/foreign-aid-development- assistance#GovernmentsCutting
BackonPromisedResponsibilities Development aid, not spent on
poverty or development Clawed back by unfair trade Emergency aid
Debt relief Refugee, Tied to benefit rich Phantom aid, the wasted
47% Refers to ODA, not MDGs
Slide 18
The Millennium Development Goals Page 18 At a UN Millennium
(2002) summit, the nations of the world set eight MDGs to be
achieved by 2015 The world's main development challenges were
identified Specific actions and targets (the MDGs) A commitment to
provide the means was made by 189 nations & signed by 147 heads
of state The MDGs break down into 21 quantifiable targets Targets
are measured by 60 time-lined indicators Some nations have kept
their trust. But some of the richest in the world have announced
that they will not meet their commitments
Slide 19
Nutrition & Millennium Development Goals Page 19 Primary
goal is to eradicate extreme poverty & hunger Nutrition direct
prerequisite to goals 1, 3, 4, 5 & 6; indirectly to 7 & 8
see next 2 slides 1 maternal health Child mortality Gender equity
Empower Achieve universal primary education HIV, malaria, other
diseases Environmental sustainability Global partnership for
development
Slide 20
Page 20 1. Eradicate extreme poverty & hunger. Poverty is
the main determinant of hunger. In turn, malnutrition irreversibly
compromises physical & cognitive development & thus
transmits poverty & hunger to future generations. 2. Achieve
universal primary education. Malnutrition diminishes the chance
that a child will go to school, stay in school, or perform well in
school 3. Promote gender equality, empower women. Womens
malnutrition impairs the whole familys health & nutrition
Centrality of nutrition to MDGs 1, 2, & 3
Slide 21
Centrality of nutrition to MDGs 4, 5, & 6 4. Reduce child
mortality. Delivery of a live healthy child is dependent, above
all, on a well nourished mother. Protein & folic acid are
critical here 5. Improve maternal health. Malnutrition accentuates
all major risk factors for maternal mortality, e.g., inadequate
protein, iron, iodine, vitamin A & calcium 6. Combat serious
infectious diseases. Malnutrition aggravates infections, immune
competence, transmission & mortality in HIV, malaria,
tuberculosis Adapted from Gillespie and Haddad (2003)
http://web.worldbank.org/http://web.worldbank.org/ Page 21
Slide 22
2 Categories & measures of nutritional status 4 slides:
Malnutrition, undernutrition, Overnutrition / Overweight, Obesity
Energy requirements: calories, carboh, proteins, fats
macronutrients, micronutrients Page 22
Slide 23
Categories of nutritional status Nutritional status is assessed
as one of four categories 1.Good nutritional status: All nutrients
(right quantities, time & place) allow optimal, growth,
maintenance, & reproduction 2.Overnutrition: An excess of a
nutrients (usually calories) is being consumed, so that health is
negatively impacted 3.Undernutrition: Insufficient food is consumed
to allow for the energy needs of the individual. Inevitably dietary
(& then body) protein is burned for energy. A secondary protein
deficiency ensues thus: "protein-energy-malnutrition"
4.Malnutrition: Energy consumption is adequate, but there is an
imbalance among constituents of the diet and health is impacted
Page 23 Note C
Slide 24
Worldwide distribution of malnutrition Over 20 million children
suffer from acute malnutrition WHO. Page 24 Scientific American,
Sept 2007
Slide 25
Worldwide, nutritional inequities follow poverty (as do health
inequities & life expectancy) Globally, there is plenty of food
for everyone but those who have more than they need find reasons
not to share The result in the time you spend on this module over
1000 children will have died of hunger Each day 1500 children go
forever blind from lack of vitamin A The poorest are 50-200x more
likely to die in pregnancy (more than half these deaths are
attributable to iron deficiency). About 2 billion people (56% of
pregnant women) have iron deficiency. Their babies have low birth-
weight, & mortality Page 25 Note D
Slide 26
The bottom billion (title of a book by Paul Collier ) The
poorest of the poor, Public health nutritionists identify a
subclass of the hungry - those who try to survive on resources
worth less than $1 per day We define this subclass as people who
don't get enough to meet the ordinary demands of life They lack the
resources to earn a living, or obtain whats needed for normal,
growth, maintenance & reproduction It goes without saying that
they are unable to provide the necessities for those who depend on
them Page 26
Slide 27
The bottom billion (title of a book by Paul Collier ) Their
lack of access to resources is such that a significant fraction
will be unable to stay alive They live mostly in isolated rural
areas and most are subsistence farmers This means that what they
eat this month is what they can take out of the ground from last
month's planting Page 27
30 http://www.unicef.org/media/files/Tracking_Progress_on_
Child_and_Maternal_Nutrition_EN_110309.pdf
http://ije.oxfordjournals.org/content/32/4/518.full.pdf Percentage
stunted 60% 40% 20% Africa Asia Latin Am Last 2 or 3 points are
projections 1980 & every 5 years
Slide 31
3 Critical periods: nutrition in the life-cycle 4 slides:
1.Perinatal nutrition: 0-6 mo: Breast vs. formula 1 st 5 y Weaning
& infancy intellectual develop 2.School years; ability to learn
3.Work performance 4.Elderly Page 31
Slide 32
Maternal mortality (Demonstration index slide for a note)
Maternal health refers to the health of women during pregnancy,
childbirth and the postpartum period. While motherhood is often a
positive and fulfilling experience, for too many women it is
associated with suffering, ill-health and even death. The major
direct causes of maternal morbidity and mortality include
hemorrhage, infection, high blood pressure, unsafe abortion, and
obstructed labor. Page 32 Note button A click on the note button
takes viewer to the note
Slide 33
Nutrition through the life-cycle Page 33
Slide 34
Factors in perinatal nutrition ( see also Acute malnutrition
module) Nutritional health begins in the womb a healthy outcome to
a pregnancy requires that mother be well nourished; good feeding
must initiated early The most common birth defects result from a
deficiency of folic acid in the diet of the pregnant mother, Best
outcomes require folic acid supplementation before conception! Page
34
Slide 35
Factors in perinatal nutrition ( see also Module on Acute
malnutrition) Delaying clamping the umbilical cord until it stops
pulsing iron stores see:
www.naturalchildbirth.org/natural/resources/labor/labor04.htm
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/jcco
m/en/index.html
www.naturalchildbirth.org/natural/resources/labor/labor04.htm
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/jcco
m/en/index.html Ideally, babies should receive vitamins E & K
injections at birth A baby whos healthy at birth may experience
"failure to thrive" (or "growth faltering") in the first year of
life. So .. Good infant feeding behaviors must start early. Most
importantly, breast- feeding should be initiated within an hour of
birth & maintained exclusively for 6 months. Breastfeeding
could prevent 1.3 million deaths each year
http://www2.unicef.org/nutrition/index_22657.html
http://www2.unicef.org/nutrition/index_22657.html Page 35
Slide 36
Perinatal nutrition requires attention 1 Malnutrition in
pregnancy birth defects & low birth-weight Failure to thrive is
an early danger sign, requiring investigation Nutrition in infancy
to early life impacts physical & cognitive development. It
determines immediate & future risks of blindness, thyroid
function, bone development, & more Under-nutrition or
deficiencies of many micronutrients can cause failure to thrive
Iron, vitamins K and E are of particular importance. Refer to: 1
http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/index.html
http://www.who.int/nutrition/topics/infantfeeding_recommendation/en/index.html
Page 36
Slide 37
Malnutrition in early childhood Children are at special need
because they are at the fastest-growing stage of life. Problems an
adult could survive can be lethal to a child This is the most
vulnerable period a child is developing physically & mentally.
Damage can be permanent Most importantly, they are unable to fend
for themselves & depend on others (parents, others) for health
& survival They are the planets future. We owe it to them &
to ourselves to ensure that they grow well, with a sense that they
have reason to invest in the future, in a caring world Page 37
Slide 38
Parenthetically a personal perspective How easily we see the
moral failings of the past. Slavery, the holocausts &
genocides, conquests motivated by greed When future generations
look amazed at the moral blindness of this generation, what will
stand out? Clearly child hunger Where life expectancy is short,
toddlers are orphans. In war or famine a region may lack
necessities. You cant blame a child Yet in rich countries, yes, the
US & Canada, we turn our empty eyes and hands away from those
outside our borders A napalmed child turned a nations mind to
peace. What will it take to open our eyes to children dying of
hunger? Page 38
Slide 39
Nutrition through the life cycle - adolescence Adolescence
carries risks for both poor & affluent Adolescent & adult
patterns of food consumption & activity massively impact
immediate & future health risks Adolescents are notoriously
careless about health. Their eating patterns can lead quickly to
obesity or anorexia. Page 39
Slide 40
Nutrition through the life cycle - adolescence Adolescence
carries risks for both poor & affluent Dieting can lead to
deficiencies of vit. C, protein, folic acid in a sedentary person.
Even if a good mix of foods is consumed, total food intake may be
insufficient. A pattern of healthy eating in adolescence sets a
pattern that can promote lifelong health A foundation for healthy
bones is set by exercise, calcium, & vitamin D. After early
adult life, bones go slowly downhill Page 40
Slide 41
Nutrition through the life cycle adult life Nutrition &
acute & infectious diseases Malnutrition depletes immunity
leading to increased risk & severity of infections &
parasites: AIDS, malaria, etc. Flagrant deficiencies of specific
micronutrients can put at risk the life & health of the mother
in pregnancy & lactation Nutritional anaemias, pellagra,
blindness, skin disorders beriberi, scurvy, etc, can range in
severity from mild to fatal Page 41
Slide 42
Adult life - degenerative diseases In late life, risk of
breast, prostatic, & most other cancers are predicted by diet,
obesity, inactivity or smoking in adult life Also heart disease,
strokes, osteoporosis, diabetes Cancers and diabetes are now
leading causes of death & disability in low- and middle-income
countries (see Lancet August 13, 2009) Nearly two-thirds of the
worlds 7.6 million cancer- related deaths now occur in developing
nations. Page 42
Slide 43
Differential nutritional vulnerability of females Women are
much more prone to nutritional anaemias since they need to replace
red cells lost in menstruation Women are the majority of elders,
increasingly so in Asia and Africa. Osteoporosis is more common in
the elderly Osteoporosis is a major cause of illness, disability
and death. The annual number of hip fractures worldwide will rise
from 1.7 million in 1990 to around 6.3 million by 2050. Page
43
Slide 44
Differential nutritional vulnerability of females Women suffer
80% of hip fractures; lifetime risk 30 - 40% compared with 13% for
men. Osteoporosis prevention (exercise, calcium, & vitamin D)
must start well before age 30 when bones still respond. Negative
calcium balance in later life is not very responsive to nutritional
measures. Page 44
Slide 45
Under- & over-nutrition occur in all cultures Disparities
in income, nutrition & health care are increasing between
countries & within groups in the same country In addition, in
low and middle income countries diseases of overnutrition are
increasingly common Obesity related disorders, including diabetes,
are now as important in some lower to middle income countries as in
North America and the European Union Page 45
Slide 46
Also, under-nutrition occurs in many rich nations In rich
nations, enormous wealth for some has left others ravaged by health
costs, unemployment, foreclosures Developed countries have
marginalized cultural groups. Hunger is common in N & S
America, China & E Europe For example, ~49% of US children (and
over 80% of black children) require food-aid at some time during
childhood Scandinavia & few western European countries are
almost the only exceptions Page 46
Slide 47
Overnutrition is no longer limited to rich countries Obesity is
a growing problem worldwide, particularly among those who lack
resources for a wide range of food choices. All too often, the
cheapest foods are high calorie, poor in nutrients, rich in sugar,
salt, fat, & trans-fats The predominant cause of obesity is
under- exercising rather than overeating. On average, overweight
people eat slightly fewer calories than lean people, but are much
less active Obesity increases risk of many disorders, most notably
cardiovascular disease, cancer, adult-onset diabetes. Prevention is
much better than cure. Page 47
Slide 48
Overnutrition is no longer limited to rich countries
Previously, the poorest were almost immune to diabetes,
hypertension, gout, & atherosclerosis & heart disease No
longer. These are growing problems, impacting health worldwide. In
the next few slides well consider prevention. Diabetes has reached
epidemic proportions threatening, vision, kidney function,
mobility, heart-health & life itself. A cluster of symptoms,
hypertension, hyperlipidemia, and hyperglycemia is sometimes called
metabolic syndrome Each of them increases risk of heart disease,
and together the risk is greatly amplified. Read on.. Page 48
Slide 49
Prevention of heart attacks and strokes Risk factors :
hypertension, hyperlipidemias (LDL / bad cholesterol), inactivity
& diabetes. All correlated with obesity Smoking is the most
life-shortening risk factor of all These risks can be changed
earlier or later, by modification of diet & other life-style
changes or medication In the past 5 years research has established
that exercise & a lean body are the most powerful predictors of
a long healthy life, and also of clear thinking into old age Page
49
Slide 50
Prevention of heart attacks and strokes There is no easy
solution to obesity. In a typical study: 1 day walk More immediate
than money (1) to SURVIVE We dont need studies to learn whats
needed Page 100 The poorest - dont give them money Jeffrey
Sachs
Slide 101
What do they need? The greatest nutritional problems are well
known: Protein energy malnutrition Vitamin A Iron Iodine
Slide 102
What do they need? Short term Give a man a fish... Emergency
rations, safe water, first aid, antibiotics, public health
vaccinations, drugs, etc In conflict zones, shelter, safety to
live, plant, harvest In drought safe-water straws Page 102 oral
rehydration solution ready to use foods Millions saved
Slide 103
Phantom aid: 47% is wasted Evaporating aid - promises broken as
soon as cameras turn elsewhere $ flow benefits the rich nations
tilted trade Aid with strings attached, contingent on UN votes, WB
loans, unfair trade Dumped food surplus local farm economy Money
given by corrupt rich people to corrupt dictators 103 UK banks in
Nigerian corruption Paul Collier: The bottom billion 103 Emergency
aid isnt intended for development
http://www.globalissues.org/article/35/foreign-aid-development-assistance#GovernmentsCuttingBackonPromisedResponsibilities
Slide 104
Slide 105
To become self-sufficient - obviously: good seeds, fertilizer,
drinkable water, sanitation, low technology agricultural info &
resources, drip-irrigation, ARVs mosquito nets, dispensaries,
hospitals Emergency aid beyond Survival at the same time (2)
Sustainablity Long term (3) To thrive Scaling up production -
factories ... teach a man to fish development ladder
Slide 106
To become self-sufficient - obviously: good seeds, fertilizer,
drinkable water, sanitation, low technology agricultural info &
resources, drip-irrigation, ARVs mosquito nets, dispensaries,
hospitals Emergency aid beyond Survival at the same time (2)
Sustainablity Long term (3) To thrive Scaling up production -
factories ... teach a man to fish development ladder
Slide 107
7 Malnutrition & MDGs: cause, effect, cure 3 slides:
1.Trends in nutrition, food security & globalization
2.Agricultural trends 3.Nutritional inequities - Cause &
consequence 4.Food security; Prospects for having enough food Page
107
Slide 108
We know what works Transparent & accountable, open bids
Partnerships not paternalism Goals, objectives, timed milestones
Strategies revised annually by both partners Externally monitored.
No political pressure Sustainable emphasis on poverty, agriculture
Serves recipient needs, not donor / ideology Firm long-term
commitments: MV, Grameen Unrealistic? Lets see... 108
Slide 109
Grameen Family of social enterprises Billionaire
philanthropists & foundations The Millennium Village project
Passionate & influential voices for change Scientists &
students bring energy to future Instant spread of innovations:
agric, educ, &c Beyond MDGs: amazing changes109
www.sfu.ca/global-nutrition
Slide 110
Microfinancing successes Donkey carts ($200) repay in 2.5 mos 4
Factories for treadle pumps. 2y later there are 75 Drip irrigation
allows winter cukes @ 3x price. 1A farm profit $100 $550 / yr
Business Week
Slide 111
Grameen Impact http://www.grameenfoundation.org/our-impact 9.4
million poor have been helped 1,000,000 microloans have been
generated http://www.youtube.com/watch?v=kW-4gJmXy5M
http://www.youtube.com/watch?v=1UugpcDjjJU Grameen village phone
10M subscribers 300k cell-phone ladies
Slide 112
Innovations that make a difference Barefoot agriculturistsSoil
conservation, dont burn contour farming, irrigation, crop rotation
Drip irrigation Pump installation Burkina Faso: planting-pits &
stone furrows land food for 500,000 Phillipines: Tilapia in protein
for 30,000,000 China: Hybrid rice in enough for 60,000,000
Bangladesh: Market liberalization in rice yield 3x Millions
fed
Slide 113
Appropriate technology Innovations that make a difference $25
pump irrigates acre $100/y net Watering can irrigation rainwater
collection pits valve sub-surface drip irrigation
Slide 114
Zero-tillage wheat-seeder drill - $100? Labour goes further.
Earlier planting yield Doubled yield govt subsidy Farmer buys &
rents to pay off 2 factories 100 in Haryana & Punjab
Slide 115
Millennium Village Project Farm production Gender equity
Nutritional services Energy & environment Health services Water
Prevent malaria & TB Environment $3m x 5yrs funded in
advance
Slide 116
Initiatives making a difference Grameen Family of social
enterprises The Kings of Philanthropy & 100s of foundations The
Millennium Village project Influential voices for change Scientists
& students are making a difference The Millennium Development
Goals for the poorest You!... amplify with others @ SFU &? Vote
Speak, write, telephone International internship Donate Live
against 99.7% of tax on ourselves Oxfam, IDRF (Can Revenue
charities) to leave enough for everyone consider study abroad
Slide 117
Page 117 Supplementary note to the preceding slide Every day,
1500 women die from pregnancy- or childbirth- related
complications. In 2005, there were an estimated 536 000 maternal
deaths worldwide. Most of these deaths occurred in developing
countries, and most were avoidable. (1) Improving maternal health
is one of the eight Millennium Development Goals adopted by the
international community at the United Nations Millennium Summit in
2000. In Millennium Development Goal 5 (MDG5), countries have
committed to reducing the maternal mortality ratio by three
quarters between 1990 and 2015. However, between 1990 and 2005 the
maternal mortality ratio declined by only 5%. Achieving Millennium
Development Goal 5 requires accelerating progress. Maternal
mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and
the World Bank. Geneva, World Health Organization, 2007
(http://www. who.int/reproductive-
health/publications/maternal_mortality_2005/index.html, accessed 14
August 2008). Source:
http://www.who.int/making_pregnancy_safer/topics/maternal_mortality/en/index.html
Photo credits
Slide 118
Page 118 Supplementary note to the preceding slide Source:
http://www.who.int/making_pregnancy_safer/topics/maternal_mortality/en/index.html
Slide 119
Page 119 Supplementary note to a preceding slide Why do mothers
die? Women die from a wide range of complications in pregnancy,
childbirth or the postpartum period. Most of these complications
develop because of their pregnant status and some because pregnancy
aggravated an existing disease. The four major killers are: severe
bleeding (mostly bleeding postpartum), infections (also mostly soon
after delivery), hypertensive disorders in pregnancy (eclampsia)
and obstructed labour. Complications after unsafe abortion cause
13% of maternal deaths. Globally, about 80% of maternal deaths are
due to these causes. Among the indirect causes (20%) of maternal
death are diseases that complicate pregnancy or are aggravated by
pregnancy, such as malaria, anaemia and HIV.(2) Women also die
because of poor health at conception and a lack of adequate care
needed for the healthy outcome of the pregnancy for themselves and
their babies.
Slide 120
120 Passionate renegades120
Slide 121
Take home message Catastrophic inequities in distribution of
foods Kinds of nutritional status & health impact Weve faced
causes, know there are cures As we face the future we are... water,
protein, iron, vitamin A, iodine Not by accident? Whos responsible?
Whats needed perinatal - women and children not just across nations
increasingly within Impatient Optimistic
http://www.sfu.ca/global-nutrition