Decreasing the Burden of Childhood Disease - Western Cape ...

Recommendations
Since the major causes of young child mortality are highly interlinked,
most interventions would be expected to result in improved outcomes for
more than one disease. These recommendations broadly follow the logic
of the conceptual frameworks for malnutrition, addressing proximal risk
factors before going on to more distal upstream determinants.
Maternal education is an effective intervention to address all causes, but
since levels of female education in the Western Cape are generally high
the potential for further intervention in this area would be limited unless
such an intervention is explicitly targeted to areas where average
educational status is low.
A range of interventions aimed at improving immunity on the one hand,
and reducing exposure to harmful pathogens and unsafe environmental
conditions on the other, would substantially reduce the burden of
diarrhoea and respiratory infections. The most important interventions
common to both diarrhoea and ARI as well as to undernutrition are thus
dealt with under these two broad headings. Following these, specific
interventions targeting low birth weight and paediatric HIV infection are
covered, as well as the more basic interventions addressing poverty and
other upstream determinants of all the major causes of childhood diseases
and death.
This summary of interventions concludes with a review of key components
of successful broad based multifaceted programmes.
Interventions to improve immunity
Promote and support breast-feeding
PROMOTE BREAST FEEDING. Promotion of exclusive breast-feeding up to six
months at least, with support of continued breast feeding up to at least 12
months. This would be expected to have far-reaching benefits in
addressing the burden of childhood disease.
Advocate for legislated maternity leave and breast-feeding time for
working women, especially those working in the domestic and agricultural
sectors. Advocate for preferential deployment of pregnant women to do
less physically demanding work.
Promotion of breast-feeding will involve media and education, and support
and incentives for mothers who choose to breastfeed that are equivalent
in value to those provided to formula feeding mothers. There is
accumulating evidence of the effectiveness of breastfeeding
counsellors/supporters: the W Cape Government should consider training
and employing such cadres.