The United Nations has ignored the role of inter-generational influences on health while setting ambitious targets for its millennium development goals to reduce hunger and child mortality, according to a study by an Indian-origin researcher and his colleague at the Harvard School of Public Health in Boston.
S. V. Subramanian and co-researcher Emre Özaltin urge in the study that the UN needs to 'rethink the strategy and time frame for achieving these health-related millennium development goals'.
The first and fourth Millennium Development Goals (MDG) are aiming to halve the number of people suffering from hunger and to reduce the mortality among under-5 children by two-thirds by 2015. While important reductions in child mortality and undernutrition have been achieved, stunting and underweight continue to affect 195 million and 129 million children, respectively, with many countries behind target in achieving these goals.
The researcher duo evaluated the comparative importance of inter-generational and current factors to achieve these targets. They compiled a database of over seven lakh children from 109 demographic and health surveys conducted between 1991 and 2008 in 54 countries1.
Using statistical models, they estimated associations between child mortality/under-nutrition and maternal education, wealth and height. "The social conditions during the mother's childhood impact on her height through net nutrition (the balance between her nutritional intake and the demands on it). We find that socioeconomic conditions, lagged by one generation, are very powerfully associated with child mortality and growth failure," Subramanian says.
They found that contemporary interventions will achieve the MDG targets more readily in populations with better health.
"Our findings indicate that early life factors are important, not only for the subsequent health of a woman (as reflected in her physical stature), but also for her offspring's health, and highlight the long-term effects of mother's poor health stock," he says.
The researchers, however, also point out that failure to reach MDG targets by 2015 may not necessarily reflect a failure of efforts or programmes. "It may be that, due to inter-generational persistence of poor health, it will take considerably longer to eliminate avoidable under-nutrition and deaths among children," they add.
They also suggest a holistic approach to health and development in the form of inter-generational investments and equity to achieve MDG targets. Their findings also provide empirical support for such an approach to reducing under-nutrition and mortality among children in developing countries.
