A Review of Vitamin A Supplementation in South Sudan: Successes, Challenges, and Opportunities for the Way Forward.

Aim: To identify vitamin A supplementation (VAS) trends in South Sudan and provide insights to refocus VAS programming vis a vis polio eradication campaigns recently phased out while access to health care, land, food, and markets remain challenging.

Method: Review of data from survey and coverage reports; review of policy and program documents; key informant responses; general literature search.

Results: Vitamin A deficiency (VAD) is likely a severe public health problem among preschool-aged children in South Sudan based on a high under-5 mortality rate (96.

Childhood Stunting and Wasting Following Independence in South Sudan.

Background: South Sudan has experienced ongoing civil and environmental problems since gaining independence in 2011 that may influence childhood nutritional status.

Objective: To estimate the prevalence of undernutrition among children in South Sudan in 2018 and 2019 compared to the prevalence in 2010.

Methods: Data on height and weight were collected using a 2-stage stratified sample framework in which households were randomly selected at the county level and nutritional status was calculated for all children under 5 years of age to determine height-for-age, weight-for-height, and weight-for-age Z-scores (HAZ, WHZ, and WAZ) and the prevalence of stunting, wasting, and underweight.

Can we predict the burden of acute malnutrition in crisis-affected countries? Findings from Somalia and South Sudan.

Background: Sample surveys are the mainstay of surveillance for acute malnutrition in settings affected by crises but are burdensome and have limited geographical coverage due to insecurity and other access issues. As a possible complement to surveys, we explored a statistical approach to predict the prevalent burden of acute malnutrition for small population strata in two crisis-affected countries, Somalia (2014-2018) and South Sudan (2015-2018).

Methods: For each country, we sourced datasets generated by humanitarian actors or other entities on insecurity, displacement, food insecurity, access to services, epidemic occurrence and other factors on the causal pathway to malnutrition.

Assessing the Impact of Integrated Community-Based Management of Severe Wasting Programs in Conflict-Stricken South Sudan: A Multi-Dimensional Approach to Scalability of Nutrition Emergency Response Programs.

Community-based management of severe wasting (CMSW) programs have solely focused on exit outcome indicators, often omitting data on nutrition emergency preparedness and scalability. This study aimed to document good practices and generate evidence on the effectiveness and scalability of CMSW programs to guide future nutrition interventions in South Sudan. A total of 69 CMSW program implementation documents and policies were authenticated and retained for analysis, complemented with the analyses of aggregated secondary data obtained over five (2016-2020 for CMSW program performance) to six (wasting prevention) years (2014-2019).

Correction: Implications of the Ebola virus disease outbreak in Guinea: Qualitative findings to inform future health and nutrition-related responses.

[This corrects the article DOI: 10.1371/journal.pone.

Implications of the Ebola virus disease outbreak in Guinea: Qualitative findings to inform future health and nutrition-related responses.

Introduction: Due to the close relationship between EVD and nutrition, the humanitarian community implemented various nutrition-specific and -sensitive interventions to stem the Ebola Virus Disease (EVD) outbreak in West Africa. Little, however, is known about stakeholder and community members' perspectives toward this response in Guinea. Therefore, we aimed to firstly understand how EVD may have influenced the nutrition situation; and secondly to assess the perceived acceptability and effectiveness of the nutrition response.

Determinants of Stunting, Wasting, and Anemia in Guinean Preschool-Age Children: An Analysis of DHS Data From 1999, 2005, and 2012.

Wasting, stunting, and anemia are persistent and important forms of malnutrition in preschool-age children in the less developed world, in particular the Republic of Guinea, which was the site of a large outbreak of Ebola virus disease in 2014 to 2015. We analyzed data from 3 Demographic and Health Surveys done in Guinea in 1999, 2005, and 2012 to identify possible determinants of wasting, stunting, and anemia. All analyses, both bivariate and multivariate, were carried out separately for each of 3 age groups: less than 6 months, 6 to 23 months, and 24 to 59 months.

Childhood anemia in Rural Haiti: the potential role of community health workers.

Background: Childhood iron deficiency anemia (IDA) is an important contributor to under-five mortality in the developing world. There is evidence that Community Health Worker (CHW) delivered programs to increase maternal knowledge of child health practices may decrease childhood IDA. This study reports findings on the association between a long standing CHW intervention and childhood anemia status in rural Haiti.

Infant and young child feeding in four departments in Haiti: mixed-method study on prevalence of recommended practices and related attitudes, beliefs, and other determinants.

Objective: To determine and describe the prevalence and patterns of three recommended practices for infant and young child feeding-exclusive breastfeeding (EB), continued breastfeeding (CB), and achievement of minimum dietary diversity-in four regions in Haiti, and to identify the attitudes and beliefs that inform these practices and any other factors that may facilitate or impede their implementation.

Methods: This study utilized a mixed-methods approach consisting of 1) a cross-sectional survey (n = 310) and 2) 12 focus group discussions among women ≥18 years old with children ≤ 2 years old. Multivariable logistic regression analyses were conducted to identify factors associated with 1) EB during the first six months of life, 2) CB for children ≥ 2 years old, and 3) receipt of a diverse variety of complementary foods.

Determinants of institutional delivery among women of childbearing age in rural Haiti.

Institutional delivery is an important factor associated with reduced maternal mortality rate (MMR). MMR in Haiti is high (350 per 100,000) and institutional delivery is low-just over 25 % of women delivered at a health facility in 2010. There also exists substantial rural-urban disparity in delivery with more hospital deliveries in urban than in rural areas.

Child malnutrition in Haiti: progress despite disasters.

Undernutrition, a chief child killer in developing countries, has been a major public health problem in Haiti. Following the 2010 disasters (earthquake and cholera) and the intensive relief efforts to address them, we sought to determine the trends of child undernutrition in Haiti using data from the 2005-06 Haiti Demographic and Health Survey (HDHS) and from a Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey in 2012. Growth data analyses included 2,463 (HDHS) and 4,727 (SMART) children ages 0-59 months.

Predictors of anemia among haitian children aged 6 to 59 months and women of childbearing age and their implications for programming.

Background: The Haitian National Nutrition Policy prioritizes prevention and treatment of anemia among mothers and young children, but there are few available data to support planning for scale-up of anemia interventions.

Objective: To describe the prevalence and predictors of anemia among Haitian women (15 to 49 years) and children (6 to 59 months) and to draw implications for national nutrition programming.

Methods: Descriptive and univariate analyses and multivariate logistic regression models were performed using data from the nationally representative Haitian Demographic Health Survey 2005/06.

Précis of nutrition of children and women in Haiti: analyses of data from 1995 to 2012.

Between 1995 and 2012, many surveys including child and maternal nutrition indicators were conducted in Haiti. While many questions emerged from the results of those surveys, they have remained unanswered, in particular as they pertain to the determinants of poor children's and women's nutrition in Haiti. The purpose of this paper is to fill that gap and provide policymakers, program managers, and readers interested in nutrition issues in Haiti with information on (1) the trends and determinants of infant and young child feeding and food practices; (2) micronutrient deficiencies among children and women; (3) the status of severe acute malnutrition in children; (4) associations among women's empowerment, access to health care, water, and sanitation and child nutrition; (5) the current community-based early child care and nutrition initiatives; and (6) the status of nutrition governance in the country.

Complementary feeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys.

The Haitian National Nutrition Policy identifies the promotion of optimal complementary feeding (CF) practices as a priority action to prevent childhood malnutrition. We analysed data from the nationally representative 2005-2006 Haiti Demographic Health Survey using the World Health Organization 2008 infant and young child feeding indicators to describe feeding practices among children aged 6-23 months and thus inform policy and programme planning. Multivariate regression analyses were used to identify the determinants of CF practices and to examine their association with child growth outcomes.

Breastfeeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys.

Haiti's national nutrition policy prioritises breastfeeding, but limited data are available to inform strategy. We examined national trends in early initiation of breastfeeding (ErIBF) and exclusive breastfeeding (EBF) over a 10-year period using data from three Haitian Demographic and Health Surveys (1994-1995, 2000 and 2005-2006). We used multivariate regression methods to identify determinants of ErIBF and EBF in the 2005-2006 data set and to examine relationships to growth.

Protecting and improving breastfeeding practices during a major emergency: lessons learnt from the baby tents in Haiti.

Problem: The 2010 earthquake in Haiti displaced about 1.5 million people, many of them into camps for internally displaced persons. It was expected that disruption of breastfeeding practices would lead to increased infant morbidity, malnutrition and mortality.

Age-appropriate infant and young child feeding practices are associated with child nutrition in India: insights from nationally representative data.

Age-appropriate infant and young child feeding (IYCF) practices are critical to child nutrition. The objective of this paper was to examine the associations between age-appropriate IYCF practices and child nutrition outcomes in India using data from ∼18 463 children of 0-23.9 months old from India's National Family Health Survey, 2005-06-3.

Prevalence and Risk Factors of Anemia among Children 6-59 Months Old in Haiti.

Anemia has serious consequences on child growth, development, and survival. This study was conducted in Fond des Blancs and Villa, Haiti, to assess the prevalence of childhood anemia and its risk factors in order to inform program design. Children 6-59 months old (n = 557) were selected using a cross-sectional multistage sampling methodology.

Effect on school attendance and performance of iron and multiple micronutrients as adjunct to drug treatment of Schistosoma-infected anemic schoolchildren.

Background: Relationships among Schistosoma haematobium, anemia, and iron deficiency have been documented, and all have been found to be associated with a decline in school attendance and lower performance.

Objective: To assess the effect of single or combined iron and multiple micronutrients and/or praziquantel on school attendance and achievement in randomly selected 7- to 12-year-old anemic children with documented S. haematobium infection (n = 406) in Mali over a 3-month period.

Maternal anaemia in West and Central Africa: time for urgent action.

Objective: To review the prevalence, severity and determinants of anaemia among women in West and Central Africa (WCA) and raise awareness among policy makers and programme planners in the region.

Design: Systematic descriptive review of data in the public domain of the ORC Macro MEASURE Demographic and Health Surveys, national nutrition surveys, oral and technical communications at regional meetings, studies published in scientific journals, and WHO and UNICEF databases.

Setting: West and Central Africa region.

Nutritional value of locally produced foods and potential for developing age-appropriate complementary foods for children under 2 years of age in Mali.

Background: Promotion of dietary diversity using locally available nutritious foods is an effective approach in low-income areas to improve the quality of young children's diet and, hence, their growth and development.

Objective: To identify the nutritional values of locally acceptable, feasible, affordable, and sustainable foods and develop a number of recipes that could be used to complement effectively nutrient intakes provided through breastfeeding to children 6 to 23 months of age in Bandiagara, Mali.

Methods: Structured questionnaires were used to obtain lists of all locally available foods during village assembly meetings and identify the food basket of households and child feeding practices during interviews with mothers and fathers.

Alpha 1-acid glycoprotein, hepcidin, C-reactive protein, and serum ferritin are correlated in anemic schoolchildren with Schistosoma haematobium.

Background: The World Health Organization and Centers for Disease Control and Prevention recommend the inclusion of indicators of iron status and inflammation in surveys assessing iron deficiency and/or anemia.

Objective: We examined the associations between serum alpha(1)-acid glycoprotein (AGP), serum C-reactive protein (CRP), and urinary hepcidin and their relations with serum ferritin (SF), serum transferrin receptor (sTfR), and hemoglobin.

Design: At enrollment, the measurements were made in randomly selected 7-12-y-old anemic children with documented Schistosoma haematobium infection (n = 224 for AGP, CRP, SF, sTfR, and hemoglobin; n = 61 for urinary hepcidin).