Marshall Islands' Pre-schoolers Have High Rate of Vitamin Deficiency

Over one-third of Marshallese children below five years of age suffer from vitamin deficiency and malnutrition according to several studies published in American health journals this year.

Children in the Republic of the Marshall Islands, ages 1 to 5 years, are at high risk of anemia, vitamin A deficiency, and iron deficiency, said a study published in the May 2003 issue of Nutrition. Thirty-three percent tested had the co-occurrence of vitamin A and iron deficiencies. The community-based survey tested 919 children of pre-school age. The study reveals that the proportion of children with vitamin A deficiency was at 59.9%, anemia at 36.4%, iron deficiency at 53.5, and iron deficiency anemia at 23.8%.

"Vitamin A Deficiency, Iron Deficiency, and Anemia among Preschool Children in the Republic of the Marshall Islands" was the work of Dr. Neal Palafox, of the John A Burns School of Medicine, at the University of Hawaii, and five others, including Marshall Islands’ Dr. Kennar Briand.

The problems associated with malnutrition in the Marshall Islands have been long noted and have not decreased significantly. A 1994 study quote by an UN Agency said that 62 percent of those under five had severe vitamin A deficiency and that malnourishment accounted for approximately 17 per cent of all deaths in that age group. A 2000 government survey showed that more than half of students in Majuro were malnourished

The World Health Association identifies special risk for nutrient deficiencies in atoll island countries having limited soil capacity and importing a lot of food. The most recent Asian Development Bank country strategy report states that malnutrition in the Marshall Islands is often associated with excessive consumption of junk food.

Parents attracted to the store-bought, packaged foods, rather than the more time and preparation-intensive local foods. According to the April ADB report, "Hardship in the Marshall Islands", child neglect in urban areas was seen as leading to problems of malnourishment.

"In many large extended families, children do not receive the individual care they need, and some teenage and young mothers do not know how to raise children properly,: said the report.

Research published in January of this year, found that over a third of children ages one to five, are stunted, with "stunting associated with worse economic status, less active feeding, increased consumption of imported foods and urban residence."

The paper points out that food decisions are primarily controlled at the national level, through food importation and government programs. Decisions at the personal level are "constrained by macrolevel factors of disempowerment." The study, "Macro- and Microlevel Processes Affect Food Choice and Nutritional status in the Republic of the Marshall Islands," was done by Dr. John Gittelsohn, of the Center for Human Nutrition, at Johns Hopkins University, Baltimore, Maryland, and four others including Palafox.

The RMI health ministry, in concert with the Healthy Store Project and other health initiatives, has made healthful eating a premier focus of community outreach programs. Organizations and schools are sponsoring daily distribution of vitamins to school age children.

The recent studies both concluded that further investigation is needed to identify risk factors and evaluate interventions to address the issues of vitamin deficiency and malnourishment.

by Aenet Rowa, Yokwe Online, July 25, 2003