Background HEALTH AND NUTRITION

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8. HEALTH AND NUTRITION

8.1 Background

In addressing health and nutrition interventions within the context of OVC programming, this section focuses on the complementary integrating role OVC programs can play in combination with other health investments. The comparative advantages of OVC programs for health and nutrition include: A massive community presence A focus on the underlying socioeconomic factors that determine uptake of health care services and behavior The potential to bridge clinic-based health care with community and home care Because of these advantages, OVC programs are uniquely poised to expand and extend health care knowledge and services to reach women, infants, and children who are less likely to present in clinics. The wide and deep community presence of OVC programs also has strong potential to support tracing of mothers and infants lost to follow-up; help in treatment adherence and retention efforts; significantly strengthen malnutrition prevention through early identification of malnutrition risks and referrals to comprehensive clinical care; and strengthen the impact of lifesaving interventions prioritized under child su i al, the P eside t s Mala ia I itiati e PMI , PMTCT, pediat i t eat e t, a d HIV p e e tio a d reproductive health for youth and adolescents. Determining child health status in specific epidemic settings always requires a situation analysis. At the same time, programs should note the following general considerations relating to child health at different points in the age span: Maternalneonatal health, nutrition, a d h gie e i te e tio s du i g the fi st , da s a e critically important to reducing i fa t o talit a d uildi g a st o g fou datio fo a hild s lifelong health and developmental outcomes. 139 Holisti ea l hildhood de elop e t is ke fo lifelo g health out o es. A scientific consensus is emerging that the origins of adult disease are often found among developmental and biological dis uptio s o u i g du i g the ea l ea s of life. 140 The p ese e of elia le u tu i g relationships with adults [that] buffer children from the adverse effects of toxic stre ss a affe t lifelo g out o es i i u e s ste o pete e a d the ea l esta lish e t of health- elated eha io s 141 see Psychosocial section. Nut itio al i take du i g a hild s fi st five years is critical to survival and healthy development. In general, differences in nutritional status between boys and girls are negligible from ages 0 to 4 years. As children become adolescents, the risk of nutritional issues, notably anemia, is significantly higher for girls. 142 Adolescent girls are at far greater risk of contracting HIV than their male counterparts. This risk is a result of a number of factors, including physiological susceptibility and greater exposure to sexual violence both inside and outside marriage. 143 139 Victora C, Adair L, et al. 2008. Maternal and child undernutrition: Consequences for adult health and human capital. The Lancet, 371. 140 Shonkoff JP, Boyce T, McEwan B. 2009. Neuroscience, Molecular Biology, and the Childhood Roots of Health Disparities: Building a New Framework for Health Promotion and Disease Prevention. JAMA. 301 21, 2252-2259. 141 Center on the Developing Child. 2010. Harvard University. 142 UNICEF. 2011. The “tate of the World s Childre : Adoles e e: A Age of Opportu it . New York: UNICEF. 143 UNICEF. 2010. Children and AIDS: Fifth Stocktaking Report. New York: UNICEF. 49

8.2 Evidence-based Implementation Recommendations