Public health is now in the epidemiological transition of communicable diseases to non-communicable diseases. This shifting in trend of diseases continuously strike almost all parts of the world, particularly the developing countries. Many of these ill health outcomes can be prevented if the policies are effectively implemented in timely manner. As such, states should be aware of these changes and respond in appropriate public health systems and policies.
However, in many countries, the capacity of public health response is poor in making effective decisions, and there is no well established research for this process (Allin et al., 2004). During recent decade, a number of ...view middle of the document...
Public Health Decision Making in Addressing Stunting among Children Under 5 in Yemen
Step 1: Assess the Problem
1.1 Global Situation of Stunting
Stunting, wasting and overweight are the co-existing nutritional problems in many countries, being a double burden of malnutrition. Amongst these, stunting ("low height for age") is a chronic manifestation of under nutrition due to insufficient food intake and triggered by frequent infections. It usually starts before age of two and is irreversible once occurred. Stunting leads to delayed motor development, impaired cognitive function and poor school performance. These impaired educational, health and economic performance later in life (Dewey and Begum, 2011). According to the United Nations Children's Fund (UNICEF), 195 million of children under five (U5) are suffering from stunting all over the world, mainly in developing countries. One in three U5 children are stunted, and Asia and Africa bear 90% of this burden (UNICEF, 2009).
1.2 Country Background of Yemen
The Republic of Yemen is an Arab country in western Asia, with limited resources in terms of land and water. It has the area of 527,970 square kilometers with the total population of 23 million which is still growing rapidly. Approximately 50% of population are below 15 years of age and there are 4 million of children under 5 in Yemen. Gross national income per capita stood at 2,310 US$ in 2012 and remains one of the least developed and poorest countries in Middle-East region. The economy largely depend on oil sector which is now declining oil reserve. The unemployment rate is high at more than 50% while the total adult literacy rate is at 65% (WHO, 2012;Bank, 2008).
Political insecurity has worsened the country's economy and education. Since 2011, the high threat from terrorism remains unstable with continuing unrest and violence. These conflicts have been further deteriorated by increasing poverty, unemployment and highly radicalization. The fights between powerful tribes lead to serious corruption across the country which in turn, affect national level political struggles. Moreover, the number of internally displaced people (IDPs) is constantly growing and stood at over 306,000 in 2013 (UNHCR, 2014). In addition, the difficult terrain and desert in the country make poor access to any services and communication.
In terms of health statistics, Yemen has the highest rates of children under 5 mortality and maternal mortality ratio among the Middle East countries, being 60 per 1,000 live births and 200 per 100,000 live births, respectively. In contrast, total expenditure on health per capita is 152 US$, which is only 5% of gross domestic product. As a result, there is huge disparity in coverage and quality of health care, particularly in rural areas being covered only 25% of services (WHO, 2012).
1.3 Stunting Issue in Yemen
Under nutrition is a serious problem in Yemen: 12% of children under 5 are wasting, 45% are of...