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Eye Care 2018 & Public Health Congress 2018
Archives of General Internal Medicine
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ISSN: 2591-7951
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Volume 2
S e p t e m b e r 0 3 - 0 4 , 2 0 1 8 | L i s b o n , P o r t u g a l
allied
academies
Joint Event on
PUBLIC HEALTH, EPIDEMIOLOGY AND NUTRITION
OCULAR PHARMACOLOGY AND EYE CARE
&
World Congress on
19
th
International Conference on
Rebecca Nerima, Arch Gen Intern Med 2018, Volume 2 | DOI: 10.4066/2591-7951-C4-011
THE DOUBLE BURDEN OF MALNUTRITION
IN REFUGE SETTLEMENTS
Rebecca Nerima
Vitamin Angels, Uganda
Objective:
The main objective of this study is to explore the existence of a
double burden of malnutrition in Refugee settlements in Uganda.
Background: A growing number of refugee camps in Uganda because of war
in Southern Sudan are facing a double burden of malnutrition, that is, the
persistence of under-nutrition, along with a rapid rise of over-nutrition and
non-communicable diseases such as diabetes, hypertension and coronary
heart disease. This double burden of malnutrition has resulted from various
factors including: a marked transition in dietary patterns over recent years
(e.g. shifts to energy dense diets high in saturated fat, sugar, and refined foods,
and away fromplant-based diets); inadequate access to healthy food choices;
declining levels of physical activity; and inadequate access to health care
services because of displacement and broader social determinants. In refuge
settlements and host communities in Uganda, in addition to the high levels
of under-nutrition, substantial levels of overweight/obesity have also been
observed. At the national level, 35% of children are stunted. The prevalence is
even higher in host communities where 40% of children screened are stunted.
Many low- and refuge settlements and host communities are undergoing a
nutrition transition associated with rapid social and economic transitions. We
explore the coexistence of over and under- nutrition at the neighborhood and
household level, in a refuge settlement setting in Uganda.
Methods:
Data collection and review: datawas collected in 2016 on a cohort of
children aged under five years born between 2010 and 2015. Anthropometric
measurements of the children and their mothers were taken. Additionally,
dietary intake, physical activity, and anthropometric measurements were
collected from a stratified random sample of adults aged 18 years and older
through a separate cross-sectional study conducted between 2012 and
2015 in the same setting. Proportions of stunting, underweight, wasting
and overweight/obesity were determined in children, while proportions of
underweight and overweight/obesity were determined in adults.
Results:
Of the 2335 children included in the analyses with a total of 4750
visits, 46% (51% boys, 40% girls) were stunted, 11% (13% boys, 9% girls) were
underweight, 2.5% (3% boys, 2% girls) were wasted, while 9% of boys and
girls were overweight/obese respectively. Among their mothers, 7.5% were
underweight while 32% were overweight/obese. A large proportion (43% and
37%) of overweight and obese mothers respectively had stunted children.
Among the 3190 adults included in the analyses, 9% (6% female, 11% male)
were underweight, and 22% (35% female, 13% male) were overweight/obese.
Rebecca Nerima is working as Country Program
Manager-Consultant at ‘Vitamin Angels’, a non-profit,
non-governmental organization focused on combat-
ing childhood malnutrition around the world through
vitamin supplementation. She was responsible for
managing ‘Well Share’ programmatic, administrative,
and financial operations. Overseeing a team of pro-
grammatic and operations staff to ensure successful
program implementation and ultimately responsible
for district-level project success in reaching intermedi-
ary and end-of-project goals, within set timelines and
budgets. She worked on Maternal, New born and Child
Health (MNCH) programs fosters from March 2011 –
February 2012 forming collaboration between mem-
ber organizations and associates, while also mobiliz-
ing practitioners, scholars, advocates and donors to
support the health of underserved mothers, children
and communities around the world through commu-
nity health approaches. As a Project officer she was
responsible for overall strategic direction, project lead-
ership, monitoring, and oversight responsibilities for a
multi-year, training and technical assistance, working
in partnership with the Ministry of Health, local gov-
ernment, communities and a nationwide network of
subject matter experts from 2006-2011. Rebecca
accomplished her BA. Degree in Social Sciences from
Makerere University Kampala, in the field of Study So-
ciology & Social Administration during the year 2000
– 2003.
becky.nerima@gmail.comBIOGRAPHY
Conclusion:
The findings confirm an existing
double burden of malnutrition in this setting,
characterized by a high prevalence of under
nutrition particularly stunting early in life, with
high levels of overweight/obesity in adulthood,
particularly among women. In the context of a
rapid increase in refuge population, particularly
in poor settings, this calls for urgent action.
Multispectral action may work best given the
complex nature of prevailing circumstances in
refuge settings. Further research is needed to
understand the pathways to this coexistence,
and to test feasibility and effectiveness
of context-specific interventions to curb
associated health.