The problems of The problems of malnutrition in Armeniamalnutrition in Armenia

Luiza Gharibyan, Luiza Gharibyan, PhDPhD Associate professor Associate professor

Yerevan State Medical University, Yerevan State Medical University, Department of Hygiene and Ecology, Department of Hygiene and Ecology,

ArmeniaArmenia

The transition to the new social-economic conditions creates deep changes in living standards in Republic and that’s why the most part of population is appeared under the threshold of poorness, which reflects on the health index level.

The situation is threatening for the social health. One of the most important indexes of social health is children’s physical development.

In literature there is a lot of information about the decrease of anthropometrics indexes during the wars and economic crashes.

In poor countries the number of short and thin children (according to the standards) is bigger, because of malnutrition.

Over 200 million children in developing countries under the age of five are malnourished.

Malnutrition contributes to more than half of the nearly 12 million under-five deaths in developing countries each year.

Malnourished children often suffer the loss of precious mental capacities.

They fall ill more often. If they survive, they may grow up with lasting mental or physical disabilities.

Using data from 53 developing countries, researchers from Cornell University have concluded that over half of those 13 million child deaths each year are associated with malnutrition.

Further, they show that more than three quarters of all these malnutrition-assisted deaths are linked not to severe malnutrition but to mild and moderate forms.

The major nutrition problems in the world are: 1.Protein–energy malnutrition (PEM) 2.Iodine deficiency disorders (IDD)3.Iron deficiency 4.Vitamin A deficiency or hypovitaminosis A(VAD)5. Nutrition-related chronic diseases

In the public imagination, the home of the malnourished child is sub-Saharan Africa. But the league tables clearly show that the worst-affected region is not Africa but South Asia.

Just over 30% of Africa's children are underweight, but the corresponding figure for South Asia is over 50%.

And in Bangladesh and India, the proportion of children malnutrished is very significantly higher than in even the poorest countries of the sub-Sahara.

Measured by absolute numbers, it is to be expected that problems of poverty will be concentrated in South Asia, simply because of the sheer size of its populations (India alone has 50% more people than 47 countries of sub-Saharan Africa put together).

But when the proportion affected is also far higher, as is the case with child malnutrition, then the centre of gravity of the problem shifts still further.

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That is why half of the world's malnourished children are to be found in just three countries - Bangladesh, India, and Pakistan.

Over 8 million of the 13 million under-five deaths in the world each year can be put down to diarrhea, pneumonia and malaria.

Malnutrition around the world

Birth weight is an obvious place to begin the search. In all countries and cultures, low birth weight is the best single predictor of malnutrition.

Birth weights below 2,500

grams have been found to be very closely associated with poor growth not just in infancy but throughout childhood.

The purpose of this work is to find out the health deviation of children in Armenia, because of malnutrition malnutrition and organize corresponding social-medical help.

We assessed children in Yerevan in 4 secondary schools (No. 32, No. 38. No. 19, No. 8) of children’s anthropometrics indexes (about 4000 children) and data of 2000 newborns.

We found each child’s family social economic status, parents’ health condition and possible harmful factors possible negative influence on a child.

Obtained data’s analysis shows that the physical development indexes are lower than the standards, in the families where the malnutrition is organized badly or it’s connected with the low standards of living.

We want to present you the following dates obtained in 2 different regions in Yerevan about seven-year-olds schoolchildren height and weight.

We compared the schoolchildren of No. 38 (Shengavit region), No. 8 (Central region) in 1986-1988 period Shengavit region children’s height and weight was higher than now.

Analyze dates show, that first form boys’ average height decreased 2.64cm (dignity index t=3.6), girls’ is 2.21cm (dignity index t=3.07).

Yerevan deferent regions’ seven-years-old children’s height and weight in 80s.

Low height boys’ number increased in 7.8% and girls’ - in 10.9%.

Besides it there is a decrease in number of children with good physical development correspondingly mothers’ with high education in 15.23%, mothers’ with secondary education in 7.16%.

The boys’ body mass decreased in 1.22cm (t=3.2). In the same school among 140 examined children’s hemoglobin average level is m=112.3+0.37, which is certainly lower than the norms.

Despite the No. 38 school children’s indexes, No. 8 Pushkin school 1994-1996 first form schoolchildren’s physical development indexes average level is higher. It’s known, that the people attend this school are from well-provided families. The parents mostly have high education and have jobs.

So the presented material first gives us right to speak about children’s malnutrition. In Armenia during the last 10 years many families’ rations contains mostly cheap hydrocarbon origin food. While protein containing food such as meat, dairy, egg is necessary for the drawing body of young children.

Thus 79gr protein from which 47gr must have animal origin, fats – 79gr (16gr animal origin), hydrocarbon – 315gr, calcium – 1100mg, phosphor – 1650mg, iron – 18mg, vitamin B1 – 1.4mg, vitamin B2 – 1.6mg, vitamin C – 60mg, vitamin A – 0.7mg is one day food physiological standard and the food total calorie is 2300kcal.

So it is necessary 47gr animal origin protein for the normal growth of body. It’s necessary to mention, that 1 egg contains 6.25gr complete protein, 100gr meat contains 16-20gr proteins and 100ml milk contains 3.3ml.Schoolchild’s breakfast must contain 1/3-1/4 of the ration.

The most part of the families, which have been studied by us, are in bad financial condition and the expenses of each family per day is less than 1 USD.

The main part of ration in these families contains hydrocarbon – potato, pasta, bread and the usage of food providing protein (egg, meat, dairy) is very low.

Bronchitis in Yerevan(primary morbidity of children)1988-1998

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The number of newborn with low weight per %

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The number of sick newborn per % in Charentsavan (R.Armenia)

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Within the transition period to the new social relations, and correspondingly to the new public health care system the efforts are to be done in public health management sphere.

CONCLUSION

First of all, we must revise the worn out approaches in order to put the health care activities in correspondence with the new realities. Meanwhile we must give due attention to the existing experience in this sphere in the countries with the developed health care system.