To obtain baseline pre-intervention prevalence levels of iodine deficiency and parasitic and helminth infections in school-going children in Bie Province, Angola.

A cross-sectional study conducted in randomly selected schools. The target population was children aged 6–10 years.

Bie Province, Angola.

A total of 1029 children sampled, with 791 stool samples and 826 urine samples collected from twenty-four schools.

Widespread severe and moderate deficiencies in iodine. Children in five schools were severely iodine deficient. All sampled schoolchildren were iodine deficient to a greater or lesser extent. In all, 80 % of all children across the twenty-four schools were infected with one or a combination of intestinal helminths and intestinal protozoa.

These findings have serious implications for the cognitive development of Angolan children, as well as for Angola’s development in terms of productivity and economic potential. It is strongly recommended that the provincial and national Ministries of Health, in collaboration with international health agencies, immediately plan and implement a strategy to provide sufficient iodine through iodised oil capsules and iodised salt to the iodine-deficient population. National coalitions need to be strengthened among the government, partners and salt producers. It is also recommended that all the children in schools be de-wormed for multiple helminth species at least twice a year.

The possibility of mother-to-child transmission (MTCT) of HIV through breast-feeding has focused attention on how best to support optimal feeding practices especially in low-resource and high-HIV settings, which characterizes most of sub-Saharan Africa. To identify strategic opportunities to minimize late postnatal HIV transmission, we undertook a review of selected country experiences on HIV and infant feeding, with the aims of documenting progress over the last few years and determining the main challenges and constraints.

Field teams conducted national-level interviews with key informants and visited a total of thirty-six facilities in twenty-one sites across the three countries – eighteen facilities in Malawi, eleven in Kenya and seven in Zambia. During these visits interviews were undertaken with key informants such as the district and facility management teams, programme coordinators and health workers.

A rapid assessment of HIV and infant feeding counselling in Kenya, Malawi and Zambia, undertaken from February to May 2007.

Infant feeding counselling has, until now, been given low priority within programmes aimed at prevention of MTCT (PMTCT) of HIV. This is manifest in the lack of resources – human, financial and time – for infant feeding counselling, leading to widespread misunderstanding of the HIV transmission risks from breast-feeding. It has also resulted in lack of space and time for proper counselling, poor support and supervision, and very weak monitoring and evaluation of infant feeding. Finally, there are very few examples of linkages with community-based infant feeding interventions. However, all three countries have started to revise their feeding policies and strategies and there are signs of increased resources.

In order to sustain this momentum it will be necessary to continue the advocacy with the HIV community and stress the importance of child survival – not just minimization of HIV transmission – and hence the need for integrating MTCT prevention.

To identify the factors associated with childhood undernutrition.

Cross-sectional survey.

Hlabisa health district in KwaZulu/Natal, South Africa.

Eight hundred and sixty-eight children aged 3–59 months.

Questionnaire survey and anthropometric survey of 516 random house-holds with children in the health district. Multivariate analysis took into account the hierarchical relationships between the proposed risk factors. This conceptual model was built up during qualitative studies and with reference to international research in this area.

The mean Z-scores for weight-for-age and height-for-age were −0.52 (95% confidence interval (CI)−0.44 to −0.60) and −1.25 (95% CI −1.15 to −1.35), respectively. Of the children, 26.3% (95% CI 23.3–29.3%) were stunted, 12.0% (95% CI 9.8–4.2%) were underweight-for-age (UWFA) and only 1.3% were wasted. Migrant father, mother's education, literate mother, whether the house was made of traditional materials, the presence of a toilet, whether the last child was breast-fed, duration of breast-feeding and birth weight were found to be significantly related to UWFA, the latter with an odds ratio of more than eight.

While there are individual health and feeding behaviours that need to be addressed, this study has also uncovered the maternal and socio-economic factors which present an array of constraints in the social environment shaping the infant feeding and caring practices employed by women. For the full potential of nutrition promotion activities to be realised, there is a need to address some of these ‘deeper’ constraints.