We conducted a randomized controlled trial of the effects of dietary supplements on anemia, weight and height in 136 anemic school children from a low socioeconomic background in Bagamoyo District schools in Tanzania. The aim of the current study was to investigate the impact of dietary supplements on anemia and anthropometric indices of anemic school children. The supplements were vitamin A alone, iron and vitamin A, iron alone or placebo, administered in a double-blinded design for 3 mo. All supplements were provided with local corn meals. Hemoglobin concentration, body weight and height were measured at baseline and at follow-up after supplementation. Vitamin A supplementation increased the mean hemoglobin concentration by 13.5 g/L compared with 3.5 g/L for placebo [P < 0.0001, 95% confidence interval (CI) 6.19-13.57), the mean body weight by 0.6 kg compared with 0.2 kg for placebo (P < 0.0001, 95% CI 0.19-0.65) and the mean height by 0.4 cm compared with 0.1 cm for placebo (P = 0.0009, 95% CI 0.08-0.42). However, the group of children who received combined vitamin A and iron supplementation had the greatest improvements in all indicators compared with placebo (18.5 g/L, P < 0.0001, 95% CI 14.81-22.23; 0.7 kg, P < 0. 0001, 95% CI 0.43-0.88 and 0.4 cm, P < 0.0001, 95% CI 0.22-0.56 for hemoglobin, weight and height, respectively). It is likely that vitamin A supplementation may have a useful role in combating the problems of vitamin A deficiency and anemia, as well as in improving children's growth, in developing countries.

Purpose -The purpose of this paper is to describe the application of empowerment and the role that it plays in fostering community participation, community integration and in enabling a healthy re-settlement of culturally and linguistically diverse migrants who have recently arrived in Australia from Sub Saharan Africa.Design/methodology/approach -The paper's approach is a discussion expressing the views of authors supported by the relevant literature drawn from a wide range of sources on migration, settlement, health, social, environment, cultural and public health issues. The African community and its peak organisation, the African Communities Council of South Australia is presented and various empowerment strategies used by the council are discussed as a healthy model for empowering new settlers in the new environment.Findings -The first part of the paper describes the migration of African migrants in South Australia and sets the scenario describing the current state of these migrants including opportunities and challenges they face in the new environment. The second part describes theories and contexts of community empowerment, relationship between community empowerment and a healthy settlement; and the relevance and implications of community empowerment. The third part draws the above context and the empowerment strategy is specifically related to the African Community in South Australia. The empowerment strategy in this case represents a wide range of interventions aimed to equip new African migrants to a successful and a healthy resettlement and integration in South Australia. By addressing a wide range of settlement challenges and issues, the strategy employs concepts of empowerment that have been used in public health in general, health promotion, health education, communications, community engagement and community development.Originality/value -The paper highlights challenges and opportunities for new migrants in the new environment and argues that community empowerment is an important enabling tool for a healthy settlement, particularly for people with refugee backgrounds. The paper also acknowledges that the community development approach has assisted the target group and has improved their ability to overcome challenges associated with settlement through capacity building, social capital and community connectivity.

Iron deficiency anaemia is highly endemic in rural areas of Tanzania and in many developing countries. Its prevention among school children requires greater dissemination of knowledge of anaemia among children, teachers, parents and the general community. Associated improvements in the hygienic status of domestic and school environments are also often required. One-hundred-and-thirty-one anaemic children, 90 parents and 76 teachers were interviewed to ascertain their understanding of anaemia. Most children and parents had little knowledge of the symptoms, causes and prevention of anaemia. In addition to their iron-deficient diets, more than half of the children went to school without something to eat at breakfast and during school hours. However, parents and teachers were willing to work together to provide meals for the children. Poor sanitation in the children's homes and in schools was a little recognized factor which could pose a serious risk of anaemia. In addition, inadequate sanitation facilities and poor quality of physical environment prevailed both in the children's homes and in schools. The findings suggest the need for the establishment of a health-promoting schools network to provide a comprehensive framework for health promotion in schools as well as in homes in Tanzania and in other developing countries. Schools can be an ideal setting to positively influence a community's health status. Partnerships among teachers, parents and the wider community are required to identify, prioritize and ameliorate health problems.

Childhood undernutrition is highly prevalent in low and middle-income countries resulting in a substantial increase in overall disease burden and mortality. The problem is markedly severe in low-income countries particularly in Africa, and Tanzania is not exceptional. Childhood undernutrition is associated with decreased productivity resulting in a vicious cycle of poverty in affected families, communities and nations. Children who survive after two years of life may develop poor health outcomes including faltering growth and irreversible damage to their cognitive, physical and psychosocial development. In a long term, childhood undernutrition can lead to poor socio-economic development of individuals, families and affected communities. Childhood undernutrition in African countries significantly contributes to poor development and the burden of disease as it complicates the existing problem of infectious diseases. Current strategies addressing this problem largely utilise a medical care model which aims to reduce mortality and may have limited selected preventative aspects confined broadly to vaccinations, food fortifications, and micronutrient supplementations. It is apparent that environmental, cultural and social factors are receiving limited attention. This complex and dire situation demands systematic, effective comprehensive multi-level and multi-sectoral policy drivers that provide effective socioeconomic, environmental, health policies and legislations in the pursuit of effective, equitable and just delivery of social and health services for all groups of its citizens regardless of their socio-economic status. Tanzania as a nation alongside other developing countries need to recognise the magnitude of this scourge and develop comprehensive approaches that will enable development of legislations, policies and long term solution to childhood undernutrition. This paper reviews strategies outside of the health sector with high potential for preventing childhood undernutrition in Tanzania and that can be translated in many developing countries. Comprehensive range of legislations and policies are recommended for implementation of interventions to reduce their occurrence or ameliorate childhood undernutrition consequences.