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UNICEF Health Primer Works in Underdeveloped Countries

Newest edition highlights sensitivity to local customs while improving health care

SUNDAY, March 24, 2002 (HealthDayNews) -- A UNICEF health-care book, responsible for increasing the immunization rates in one African country from 6 percent to 75 percent, has just been updated and is now available on the Internet.

Facts for Life was first published in 1989, with the aim of offering basic health-care information to the 200 underdeveloped countries served by UNICEF. It has been translated into 215 languages, and there are now 15 million copies in print.

The book offers 13 essential facts, including: Breast milk alone is the only food and drink a baby needs for its first six months; good nutrition is important for a pregnant mother and young child; every child should be immunized; children with diarrhea need to drink plenty of the right liquids; a child with a cough who has trouble breathing should see a health-care professional immediately, and good hygiene and clean water are essential to good health.

New to this edition are updates about HIV/AIDS, and chapters on avoiding injuries and how to deal with emergencies and disasters.

The book has been a invaluable resource for countries with tremendous health needs and too few resources, say UNICEF representatives.

In Sierra Leone, Facts for Life was key to dramatically increasing the rate of childhood immunizations, says a UNICEF communications officer from that country.

"When the book was first published in 1989, the immunization rate in our country was very low, about 6 percent, but now it is about 75 percent," Mohammad Jalloh says.

He adds that the book, which has been translated into six of the major languages of his country, has also been a great resource in the effort to improve literacy.

When surveys were done on what people most wanted to know about, health and agriculture were the two biggest requests.

"The health messages were already developed in Facts for Life. It came in very handy. We used it in all our classes," he says.

The success of Facts for Life is due to the sensitivity with which it is introduced into local populations, says one of its editors.

"We begin with science," says Patrice Engle, who is a senior advisor for early childhood development at UNICEF. The recommendations work to counter poor health practices in many underdeveloped countries.

"The key is to be respectful of the family's belief system, and to work with them to figure out which of their beliefs will lead to the right kind of outcomes for their children and which of their beliefs can be modified," she says.

For instance, it is known that newborns need to suckle the colostrum at their mother's breast soon after birth. Colostrum, the yellow liquid released by the breast before milk comes in, has a lot of minerals and lines the baby's stomach.

"However, in many cultures, people think colostrum is bad, and women don't begin breastfeeding for two or three days, until their milk comes in," Engle says, thus putting their babies at unnecessary risk for disease.

In these same cultures, many in India and southern Asia, the colostrum of a cow is valued and used for many medicinal purposes. So health workers are able to point to that and suggest the benefits of human colostrum are just as valuable.

"If you take something people understand from their own culture and help them see the sense of it, they will do it," Engle says, adding that in one Indian village where health workers explained this, the number of women who began to breastfeed their babies right after birth went from "one in 10 to 90 percent in a very short period of time."

Another health misconception is that children with diarrhea shouldn't eat or drink anything to "rest their stomachs," when in fact they need liquids so they don't become dehydrated, Engle says.

There are social customs as well.

"In some cultures, there's a belief that someone in the family has to be the first to place the nipple in the child's mouth," Engle says.

However, waiting for that person could unnecessarily delay the start of breast-feeding.

All this means that health-care workers must do more than just hand out the book and expect compliance.

"We have to use a variety of strategies," Engle says. "You have to understand that these cultural beliefs are important, and have to take what's positive about them and use it [to improve health care.]"

What To Do

To read Facts for Life, visit UNICEF.

If you are interested in how different countries have improved the lives of their children, you can read the reports from The United Nations Special Session on Children.

SOURCES: Patrice Engle, Ph.D., senior advisor, early childhood development, UNICEF, New York City; Mohammad Jalloh, communications officer, UNICEF, New York City; Facts for Life
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