Women's Education Level, Maternal Health Facilities, Abortion Legislation and Maternal Deaths: A Natural Experiment in Chile from 1957 to 2007

The aim of this study was to assess the main factors related to maternal mortality reduction in large time series available in Chile in context of the United Nations' Millennium Development Goals (MDGs).Time series of maternal mortality ratio (MMR) from official data (National Institute of Statistics, 1957-2007) along with parallel time series of education years, income per capita, fertility rate (TFR), birth order, clean water, sanitary sewer, and delivery by skilled attendants were analysed using autoregressive models (ARIMA). Historical changes on the mortality trend including the effect of different educational and maternal health policies implemented in 1965, and legislation that prohibited abortion in 1989 were assessed utilizing segmented regression techniques.During the 50-year study period, the MMR decreased from 293.7 to 18.2/100,000 live births, a decrease of 93.8%. Women's education level modulated the effects of TFR, birth order, delivery by skilled attendants, clean water, and sanitary sewer access. In the fully adjusted model, for every additional year of maternal education there was a corresponding decrease in the MMR of 29.3/100,000 live births. A rapid phase of decline between 1965 and 1981 (-13.29/100,000 live births each year) and a slow phase between 1981 and 2007 (-1.59/100,000 live births each year) were identified. After abortion was prohibited, the MMR decreased from 41.3 to 12.7 per 100,000 live births (-69.2%). The slope of the MMR did not appear to be altered by the change in abortion law.Increasing education level appears to favourably impact the downward trend in the MMR, modulating other key factors such as access and utilization of maternal health facilities, changes in women's reproductive behaviour and improvements of the sanitary system. Consequently, different MDGs can act synergistically to improve maternal health. The reduction in the MMR is not related to the legal status of abortion

Chilean experience with fortified children\u27s formulas.

In this paper we have described all the steps needed to develop an efficient program for distributing children\u27s fortified formulas. The easiest steps are to develop the formulas on an experimental and laboratory basis. The real obstacles lie in implementation at the national level. All that has been described applies to experience in Chile, which we consider very successful because of the acceptance of the program as well as spectacular advances in preventing malnutrition. The figures for 1977 show that combining all degrees of malnutrition in the under six age group, the prevalence is now 12.2% compared to nearly 60% found 10 years ago. This progress is due, not only to the specific program, but also to the many others that constitute the national food and nutrition policy (CONPAN, 1976). This success is due to the persistent, skilled effort of many professional and technical staff members. It is impractical to acknowledge all individual contributions here. The National Food and Nutrition Council, the National Health Service, Universities, Research Bodies, and private enterprizes have all contributed to this joint effort. The purpose of this presentation is that this experience may benefit other countries with similar problems

Nutritional pathology in Latin America and the Caribbean

The Latin American and Caribbean Region has different general characteristics as compared to other regions of the world. These peculiarities have determined certain food and nutritional problems which require specific programs and policies. Even though the universal coverage of basic needs is desirable, this is not the situation in the Region, and it is possible to identify integral vulnerable groups in every population. The study of problems related to food and nutrition requires a global and multidisciplinary approach considering ecological, economical, social and cultural factors affecting communities, especially marginal urban and rural populations. Nutritional diseases represent the last stages of the natural development of malnutrition, and although they are used as indicators of the nutritional situation, their magnitude always underestimate their real impact. It is in the large cities of Latin America that we can really understand the concept of malnutrition, which includes diseases related with both deficient and excessive food consumption. In fact, the development of sub-urban poor communities in large cities, short lactation period, low wages, low maternal schooling, soon lead to the development of under-nutrition in young urban populations. On the other hand, the interaction of urbanization, sedentary jobs, deficient food knowledge and excessive consumption of cheap foods, sometimes produces on the "survivors of under-nutrition" over-nutrition diseases, a problem which is acquiring more prevalence, especially in adults (obesity, diabetes and atherosclerosis). The real nutritional diseases in Latin America do not depend on the deficit or excess of a specific nutrient. The true causes are to be properly identified in order to state recommendations which benefit population groups, and not only reach academic purposes

Nutritive Value of an Extrusion‐Texturized Peanut Protein

Defatted peanut flour was texturized in a Wenger X‐25 extruder at 25.1% moisture content and 140°C product temperature. Texturization did not have any significant effect on the amino acid pattern nor on the PER of defatted flour. For example, the PER of the flour was 1.57 as compared to 1.54 for the textured product. Supplementation of both products with 0.3% DL‐threonine, 0.2% L‐lysine and 0.2% DI ‐methionine resulted in a 39 and 41% increase in PER, respectively (PER = 2.18). Copyright © 1981, Wiley Blackwell. All rights reserve

Comparative nitrogen balance study between young and aged adults using three levels of protein intake from a combination wheat-soy-milk mixture

The protein requirement and the efficiency of protein use were studied in young and old adult human subjects. Protein intake levels (Nx6.25) of 0.4, 0.8, and 1.6 g/kg body weight per day from a combination wheat-soy-milk mixture were fed. Caloric intake was held constant at 40 kcal/kg body weight per day throughout the 11-day study of each dietary period. No significant differences were observed in their protein requirement, efficiency of protein use or the ability to adapt to changes of protein intake levels. Protein digestibility was not impaired in the aged. It is concluded that the protein requirement and the efficiency of protein use are not affected by the aging process