The first 1,000 days of the health of a child and U.S. development aid programs that address health and nutrition were the focus a congressional hearing on Tuesday before the House global health panel chaired by Congressman Chris Smith (NJ-04).
The hearing, entitled, “The First One Thousand Days: Development Aid Programs to Bolster Health and Nutrition” underscored how the quality of life for mother and child is dependent on the best possible medical care from the earliest stages of pregnancy through age two.
“According to the United Nations Children’s Fund (UNICEF), 6.6 million children died before reaching their fifth birthday in 2012; an average of roughly 18,000 daily deaths among children under five years old,” said Smith. “Among the factors contributing to such a grim tally are malnutrition, obstructed newborn breathing, pneumonia and diarrhea. All these, and other causes, are ones which we are capable of addressing, if we apply resources and political will to the problem.
“There is perhaps no wiser investment that we could make in the human person than to concentrate on ensuring that sufficient nutrition and health assistance is given during the first one thousand days of life,” Smith said. Click here to read Smith’s full statement.
The lead witness testifying before Chairman Smith’s global health subcommittee of the Foreign Affairs Committee was Tjada D'Oyen McKenna, U.S. Acting Assistant to the Administrator, Bureau for Food Security, U.S. Agency for International Development (USAID).
“I want to recognize Congress for the strong leadership it has demonstrated in addressing the challenge of global child and maternal nutrition,” McKenna said. “At least 165 million children worldwide are stunted, or have short stature resulting from chronic under-nutrition. New evidence shows that the effects of stunting are even more far reaching than we realized, with implications on many aspects of the lives of individual survivors and the countries they live in. Stunting leads to irreversible cognitive impairment and poor health over the lifespan. Each year, under-nutrition in all forms is the underlying cause of 3.1 million child deaths or 45% of all child deaths worldwide.” Click here to read McKenna’s opening remarks.
Also testifying wereLisa Bos, Senior Policy Advisor for Health, Education, and Water, Sanitation, and Hygiene at World Vision; Dr. Henry Perry, M.D., Ph.D., Sr. Associate, Dept. of International Health, Bloomberg School of Public Health at Johns Hopkins University; Carolyn Wetzel Chen, Chief Grant Development Officer, Food for the Hungry; Dr. Sophia Aguirre, Ph.D., Chair, Integral Economic Development Management Program at Catholic University of America, and Dr. Mehret Mandefro, M.D., Adjunct Professor of Health Policy, Milken Institute School of Public Health at George Washington University.
“Growth stunting at the age of two is irreversible,” said Aguirre, Director of the Economic Programs at the School of Business and Economics at Catholic University. “Growth stunting in early childhood has been found to be also related to dementia, obesity, hypertension, and diabetes among other illnesses. These illnesses not only affect those who suffer them but it places an economic burden on the family members, communities, and finances of the country to which they belong. These burdens can be avoided through investing in effective preventive initiatives.”
Bos, of World Vision, called for the prioritization of community-based initiatives, such as promoting community involvement of key leaders, such as faith leaders, critical to ensuring changes in behavior that lead to improvements in maternal and child health. She also recommended an approach concentrating from the earliest stages of pregnancy through the first two years of a child’s life, as well as concentrating on interventions in the first 1,000 days in such areas as adequate food and nutrition.
“Good nutrition is an essential foundation for health and development, yet malnutrition continues to be the world's most serious health problem and the single biggest contributor to child mortality,” Bos said, noting that World Vision has made addressing malnutrition a top priority in its approach to improving maternal and child health.
“The period of time from a start of woman’s pregnancy to her child’s second birthday lays the foundation for a child’s lifelong health, cognitive development and future potential,” said Chen. “Investing in the 1,000 day window of opportunity saves lives.” She noted 6.6 million children under five died in 2012, largely from preventable causes.”
“The public health components of our foreign assistance program are the most leveraged investments we can make to advance the wellbeing of communities around the world,” said Mandefro, who cited poverty as a key factor in challenges to child health. “Because we pay insufficient attention to the prenatal and postpartum environment, we miss a huge opportunity to improve the lives of the very people we could help the most.”
Perry said that one of the greatest unheralded advances in global health over the past half century has been the reduction in the number of mothers and children dying around the world even as the number of pregnant women and births has greatly increased.
“In spite of this progress, we must recognize that we have a long ways to go, since we have the scientific knowhow and the proven low-cost program strategies to further accelerate reductions in the number of readily preventable deaths,” Perry said. “The United States Government has been a leader in this process over the past 50 years – by funding research and programs that have contributed to this progress. I am here to urge the Congress to continue and in fact expand its support for research and programs that are geared to reducing readily preventable deaths among women and children, particularly during the first 1,000 days of life.”
