The Effect of an International Embargo on Malnutrition and Childhood Mortality in Rural Haiti

Abstract

The study objective was to determine the effect of an international embargo against Haiti, from October 1991 through October 1994, on early childhood protein-energy malnutrition and all-cause mortality in a geographic area where humanitarian aid was continuously available to the children in the study. The authors used longitudinal anthropometric records on 1593 children, 24 months old or younger, living in the rural Grand Anse Department of Haiti from 1989 through 1996. Kaplan-Meier graphs for all-cause mortality accounting for malnutrition status and stratified by calendar period were applied to the database and assessed using logrank tests. Adjusted relative risks were assessed by Cox regression. The results show that despite the continuous availability of preventive services (1989-1996), higher all-cause mortality was more strongly associated with a calendar period coinciding with the international embargo than with periods before and after the embargo. The incidence of childhood mortality and of severe malnutrition were also higher during the period of the embargo than in the periods before and after the embargo. The findings suggest that future international sanctions, even those with humanitarian/medical exceptions, could result in substantial infant death.

The Impact of Nutrition-Based Interventions on Nutritional Status and Metabolic Health in Small Island Developing States: A Systematic Review and Narrative Synthesis

“…This was also consistent with the literature conducted in other settings [82,83], which found that supplement-based interventions, specifically ready-to-use supplementary food, were effective in improving markers of anaemia, and wasting among children under 5 years of age [82,83]. Similar to the interventions discussed above, most authors highlighted that scarce resources were a major limitation within these settings [28,31,32,38,71]. One of the included studies specifically highlighted the success of an intervention that used micronutrient powder distributed by microfinance institutions [25].…”

“…Studies were conducted in seventeen countries. Twenty-four studies were conducted in the Caribbean: nine in Haiti [25][26][27][28][29][30][31][32][33], three in Cuba [34][35][36], three in Dominican Republic [37][38][39], three in Jamaica [24,40,41], three in Trinidad and Tobago [42][43][44], two in Puerto Rico [45,46] and one in Barbados [47]. Eighteen studies were conducted in the Atlantic, Indian Ocean, Mediterranean and South China Sea (AIMS region): fifteen in Singapore [48][49][50][51][52][53][54][55][56][57][58][59][60][61][62], two in Mauritius [63,64] and one in Seychelles [65].…”

“…Of the fifty studies, twenty-eight used randomised designs: fifteen individuallyrandomised parallel group trials [40,41,[43][44][45][46][48][49][50][51]53,55,57,64,65], eight cluster-randomised parallel group trials [25,[29][30][31]33,61,68,72], and five individually-randomised cross over or other matched trials [24,46,52,58,64]. Twenty-two were of non-randomised study design: fifteen uncontrolled before and after studies [32,34,36,37,39,47,52,54,56,57,59,62,63,67,71], six controlled before and after studies [26,38,60,66,69,…”

“…These interventions included using cocoa [42]), n-3 enriched polyunsaturated fatty acid (PUFA) eggs [65], coffee [48], and different forms of guava and papaya [58] to improve blood pressure, triglycerides, and markers of glycaemia, respectively. One intervention included an embargo policy, and targeted childhood malnutrition in communities [32].…”

Effect of early childhood protein‐energy malnutrition on permanent dentition dental caries

“…Around 80 percent of the rural population lives in poverty, and their life expectancy is only 54 years. The poverty level is also reflected in the prevalence of malnutrition; approximately half of children under 5 years of age experience some level of malnutrition .…”