Support for UNRWA's survival

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides life-saving humanitarian aid for 5·4 million Palestine refugees now entering their eighth decade of statelessness and conflict. About a third of Palestine refugees still live in 58 recognised camps. UNRWA operates 702 schools and 144 health centres, some of which are affected by the ongoing humanitarian disasters in Syria and the Gaza Strip. It has dramatically reduced the prevalence of infectious diseases, mortality, and illiteracy. Its social services include rebuilding infrastructure and homes that have been destroyed by conflict and providing cash assistance and micro-finance loans for Palestinians whose rights are curtailed and who are denied the right of return to their homeland

Anemia and Iron Deficiency in Rural Nepali Pregnant Women: Risk Factors, Effect of Vitamin A Supplementation and Their Association with Birth Outcomes

The objectives of the present study in rural Nepali pregnant women living in the terai were: 1) to identify the risk factors of severe anemia and investigate whether risk factors for anemia without iron deficiency, iron deficiency without anemia and iron deficiency anemia (IDA) were different; 2) to examine the effect of vitamin A supplementation, alone or combined with iron, on hemoglobin (Hb) and soluble transferrin receptor (sTfR); and 3) to identify the risk factors of low birth weight (LBW) and preterm delivery, focusing on maternal Hb concentrations. The prevalence of severe anemia (Hb < 8.0 g/dl) in this population (n = 3531) was 4.2% and that of iron deficiency was 31%. Logistic regression analyses indicated that risk factors of severe anemia included hookworm infestation, impaired dark adaptation, lack of iron supplement intake, a diet low in heme iron and malnutrition manifested by thinness and short stature. These same factors differed among non-iron-deficient anemic, iron deficient non-anemic, and iron-deficient anemic pregnant women. We found a significant positive correlation between Hb and retinol concentrations (Pearson r = 0.212, P < 0.0001) and one fourth of our anemic subjects were also vitamin A deficient. There was no evidence that vitamin A alone significantly increased Hb and decreased the prevalence of anemia (n = 498). However, vitamin A, when given together with iron, had an added beneficial effect on Hb but not sTfR. In addition, women with initially compromised iron status benefited more from iron and vitamin A supplementation. The prevalence of LBW and preterm delivery was 22% and 20%, respectively (n = 915). There was an increased risk of LBW associated with short stature, thinness and impaired dark adaptation. The association between Hb measured during the second trimester and risk of LBW had a U-shaped distribution, with risk increasing significantly with Hb < 8.0 g/dl. Based on our findings, we recommend that Hb is evaluated during the second trimester as an indicator of increased LBW risk. While vitamin A supplementation to all pregnant women is recommended, routine supplementation of iron and deworming during pregnancy are essential

Household Dietary Diversity among Households with and without Children with Disabilities in Three Low-Income Communities in Lusaka, Zambia

The purpose of this manuscript is to describe household dietary diversity (HDDS) in Lusaka, Zambia between households with and without a child with a disability living in the same communities. Cross-sectional data were collected in three low-income compounds in September 2021. Participants included households with a child with a disability enrolled in Kusamala+, a community-based program, (n = 444) and a convenience sample of adults living in the same area without a child with a disability (n = 1027). The HDDS tool asked about food groups consumed in the past 24 h by people in the household. The responses were summed (yes = 1, no = 0), range 0&ndash;12. Individual dietary diversity scores (IDDSs) were calculated for children (0&ndash;8 items). Analysis included descriptive statistics and linear regression. Mean HDDS for the households with a child with a disability was 4.8 (SD 2.1) vs. 6.1 (SD = 2.2) among households without a child with a disability (p &lt; 0.001). The individual score for children (IDDS) for households with children with disabilities was 2.6 (SD = 1.4) vs. 3.7 (SD = 1.6) for households without a child with a disability. Households with a child with a disability had a significantly lower HDDS and IDDS in unadjusted and adjusted models (p &lt; 0.001). National policy must assure the most vulnerable populations, and often hidden, receive focused financial and food support

Rapid health impact assessment of COVID-19 on families with children with disabilities living in low-income communities in Lusaka, Zambia.

IntroductionWorldwide, children with disabilities are a vulnerable population and at high risk for COVID-19 morbidity and mortality. There is little information on the impact that COVID-19 had on children with disabilities and their families, particularly in low-income settings. This assessment describes the extent to which the pandemic impacted seven indicators of well-being in three low-income communities in Lusaka, Zambia.MethodsInterviews were conducted with a random selection of families participating in an existing program (n = 39), community health workers (n = 6), healthcare workers (n = 7) and government officials (n = 2). Descriptive data was summarized and qualitative responses reviewed for themes.ResultsMost families reported a major loss of income resulting in food insecurity (79%), housing instability (67%), stress (36%), and increased risk of child separation and neglect (18%). Most families did not report receiving governmental financial assistance and reported loss of access to health services for their child such as physiotherapy (33%). Stakeholders interviewed reported that COVID-19 information was widely available although few specific interventions for children. Families were seen to have greater food insecurity, more poverty, more crowding, less healthcare services and children left alone or on the streets to beg.DiscussionCOVID-19 and related containment measures have impacted the lives of children with disabilities and their families to a great extent. There is an urgent need for disability-inclusive responses that deliberately address the needs of children with disabilities and their families, notably uninterrupted access to adequate food, inclusive education, rehabilitation therapy, and income-generating activities