Publications by authors named "Richard Kumapley"
The World Health Organization's (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions and health challenges, the nutrition status is often discussed only by using either regional or country-specific estimates. This analytical review studies the nutrition situation of the EMR during the past 20 years by dividing the region into four groups based on their income level-the low-income group (Afghanistan, Somalia, Sudan, Syria, and Yemen), the lower-middle-income group (Djibouti, Egypt, Iran, Morocco, Pakistan, Palestine, and Tunisia), the upper-middle-income group (Iraq, Jordan, Lebanon, and Libya) and the high-income group (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates)-and by comparing and describing the estimates of the most important nutrition indicators, including stunting, wasting, overweight, obesity, anaemia, and early initiation and exclusive breastfeeding.
View Article and Find Full Text PDFIntroduction: Evidence on the rate at which the double burden of malnutrition unfolds is limited. We quantified trends and inequalities in the nutritional status of adolescent girls and adult women in sub-Saharan Africa.
Methods: We analysed 102 Demographic and Health Surveys between 1993 and 2017 from 35 countries.
Article Synopsis
- - Subnational inequalities in health coverage for reproductive, maternal, newborn, and child health (RMNCH) have been largely overlooked in tracking health progress, despite their importance for effective health planning and intervention delivery in countries.
- - The study reveals significant disparities in RMNCH coverage across 39 sub-Saharan African nations, highlighting different inequality patterns based on national coverage levels and regional performance.
- - While some countries have made strides in reducing these inequalities from 2004 to 2015, many still exhibit persistent gaps, often linked to factors like poor governance and conflict, necessitating targeted efforts to ensure essential health interventions reach all populations.
Background: Delivering vaccination services during the second year of life (2YL) provides countries with an opportunity to achieve greater coverage, to provide booster doses and vaccines missed during the first year of life, as well as contribute towards disease control and elimination goals.
Methods: Using data from demographic health surveys (DHSs) conducted during 2010 to 2016, this paper explores the proportion of missed opportunities for vaccinations generally provided during routine immunization among children in their 2YL.
Results: DHS data in 46 countries surveyed 478,737 children, from which 169,259 children were 12-23 months old and had vaccination/health cards viewed by surveyors.
Age-appropriate complementary feeding practices are far from optimal among low- and middle-income countries with available data. The evidence on the association between feeding practices and linear growth is mixed. We sought to systematically examine the association between two indictors of dietary quality-dietary diversity and animal source food (ASF) consumption (WHO, 2008)-and stunting (length-for-age z-score) employing existing data from 39 Demographic and Health Surveys.
View Article and Find Full Text PDFInsufficient quantities and inadequate quality of complementary foods, together with poor feeding practices, pose a threat to children's health and nutrition. Interventions to improve complementary feeding are critical to reduce all forms of malnutrition, and access to data to ascertain the status of complementary feeding practices is essential for efforts to improve feeding behaviours. However, sufficient data to generate estimates for the core indicators covering the complementary feeding period only became available recently.
View Article and Find Full Text PDFBackground: As part of our review of the evidence of the effectiveness of community-based primary health care (CBPHC) in improving maternal, neonatal and child health (MNCH), we summarize here the common delivery strategies of projects, programs and field research studies (collectively referred to as projects) that have demonstrated effectiveness in improving child mortality. Other articles in this series address specifically the effects of CBPHC on improving MNCH, while this paper explores the specific strategies used.
Methods: We screened 12 166 published reports in PubMed of community-based approaches to improving maternal, neonatal and child health in high-mortality, resource-constrained settings from 1950-2015.
Background: The degree to which investments in health programs improve the health of the most disadvantaged segments of the population-where utilization of health services and health status is often the worst-is a growing concern throughout the world. Therefore, questions about the degree to which community-based primary health care (CBPHC) can or actually does improve utilization of health services and the health status of the most disadvantaged children in a population is an important one.
Methods: Using a database containing information about the assessment of 548 interventions, projects or programs (referred to collectively as projects) that used CBPHC to improve child health, we extracted evidence related to equity from a sub-set of 42 projects, identified through a multi-step process, that included an equity analysis.
Background: Global deworming programs aim to reach 75% of at-risk preschool-age children (pre-SAC) by 2020. The 2013 global pre-SAC deworming coverage initially published by the World Health Organization (WHO) was 23.9%, but this estimate inadequately captured deworming delivered through Child Health Day (CHD) platforms.
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