Rare Prism

by Juan L. Mercado

Who of the  kids will die?  Who will get a more-than-even chance to achieve full lives?  “Seventy is the sum of our years, eighty if we are strong,” the Psalmist writes. More important,  how do we ensure that, in the future,  youngsters need no longer slump into premature graves?

Today’s headlines and evening news bulletins swirl around Erap getting fed up with Senator ‘Koko’ Pimentel’s reluctance to play ball with opposition, Manila Mayor Alfredo Lim’s word brawl with  Vice Mayor Francisco Damagoso to Abu Sayyaf kidnapping of a Jordinian journalist.

In contrast, a barely-noticed conference in Cebu City mid-June analyzed “Early Life Determinants of Health and Well Being’. Organized by the Consortium of Health Orientated Research in Transitioning Societies, the meeting examined child-health issues with a rare international prism: studies that tracked children across generations.

“Longitudinal analysis ” is rare.  Countries assembled, under the Consortium’s umbrella, are from the Philippines, Brazil, India, South Africa and Guatemala. These five have  on-going birth cohort studies that  cover close to 11,000 individuals. All had “at least 15 years or more of follow up.”

Brazil failed to track 17 percent of infants, studied by Universidad Federal de Pelotas, into adulthood. In contrast, the Cebu Longitudinal Health and Nutrition Survey (CLHNS),  at University of San Carlos, lost contact with only one percent of 3080 mothers and infants, from 243 barangays, it first examined in 1983.

“Cebu study findings shaped the first World Bank health financing strategy,” University of North Carolina Barry Popkin wrote. Cebu research was “instrumental” in Unicef policy on breast-milk substitutes and Asian Development programs on early child development.  A Harvard University team used CLHNS for analysis of two long-term vaccination programs.

Over the last 28  years, USC’s Office of Population Studies (OPS) conducted seven follow-up surveys. CLNHS data anchor 125 international and national research projects. They range  from pre-birth malnutrition’s effect on blood pressure and early onset of menstruation to  parental and peer pressure on young adult  sexual behavior.

Yesterday’s Cebu infants are today’s adults. Some are parents and hold down jobs. There are school dropouts. A number have died and 136 moved out. One is an OFW worker in Iceland.

These life-changes are mirrored in the analysis. In CLHNS’ early years, focus was on infant feeding, birth spacing to nutritional status. In the 1990s, attention shifted to childhood stunting and entry-into-school development. As kids emerged into young adults. the spotlight turned to “early life factors that predict schooling and academic achievement.”

CLHNS mothers were followed to  learn about their long term patterns of health, birth spacing to diet and work patterns, noted the  “International Journal of  Epidemology”. CLHNS  is “one of the few sources for long analysis of intimate partner violence…and consequences for women and young  adults”.

In 2011, San Carlos completed it’s  examination  of  new pregnancies and birth outcomes among  those who  were once 1983  infants.  This “makes CLHNS a three generation study.”

Linda Adair of North Carolina University  and Judith Borja of  San Carlos OPS  presented findings on breastfeeding in 17 urban barangays and 16 rural villages. Breastfeeding had declined As an alternative, mothers fed their babies milk formulas. Others  used diluted condensed milk. Diarrhea was related to babies who were fed substitute milk, they found. Four in ten of babies who  were not breastfed, and lived in poor conditions, proved vulnerable to diseases.

Cesar Victoria of Brazil cobbled  the Consortium into it’s present structure.  “The bottom line” for decisive intervention in form is in the first 24 months of the child’s life. “Act here,” he urged. Dividends in the child’s health dwindle in the later months.“  “Maternal and child under nutrition have adverse consequences for adult and health capital.”

Some of the fallout  emerge from comparison of data. Malnourished pregnant mothers result in “stunting, lower attained schooling, reduced adult income” and wizened “underweight offspring.”

“Children who are undernourished in early life, and then gain weight rapidly after infancy, are at high risk of chronic disease, “Linda Richter from South Africa.University of Witwatersand reported. “Prevention of maternal and child under nutrition is a long term investment. (It) benefits both the current generation and their children…”

Members differed in patterns of child growth,  in both length and height. “Guatemala and Cebu showed marked growth failure in early childhood. Brazil growth hewed to international standards. South Africa and India showed intermediate patterns.

Data from the five participating countries underscore that children from low and middle income countries, who’re assisted in the “first and possibly in the second year of life show improved human capitral indicators as adults”. They are also less prone to the “increased risk of chronic diseases in later life.”

Present Consortium findings “ in a format that policymakers can understand,” urged Florentino Solon of Nutrition Center of the Philippines who conceptualized CLHNS with the late SVD Father Wilhelm Fleiger.  “Policy-making is in the hands of politicians.   How do you convince these politicians (or implement these them?”

For a start, slam them with  the American psychiatrist  Karl Menninger’s  warning in his book :”The “Human Mind” : “What’s done to children, they will do to society.”

(Email: juan_mercado77@yahoo.com)

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