nutritional impact of the school feeding program in the Mafraq area, Jordan

The nutritional and educational impact of the school feeding program in the Mafraq area was assessed and compared with that of Madaba, which was not included in the school feeding program and was used as a control. A total of 2,554 male and female students from eight primary and preparatory schools [four urban and four rural] were studied in both areas. Weight and midarm circumference values were significantly and generally higher in Mafraq area, especially among females and younger age groups, the latter being the most sensitive period to nutritional changes. In most age groups, height retardation was significantly more in Mafraq than in Madaba, suggesting a greater presence of past or chronic malnutriton. This difference agrees with the known fact that in general the people of Mafraq are of a lower economic status than those of Madaba. The personality characteristics of the students were more favorable and the attendance record better in Madaba than in Mafraq, suggesting that other factors such as socioeconomic status are more influential on these characteristics than a school lunch. In order to truly test the positive impact of school feeding on the measured characteristics, especially the anthropometric ones, it is advisable to allow a longer period of school feeding before following up with a longitudinal study. In addition, a comparison of the feeding group with a control group would be more revealing if the two groups are more similar except for the presence of school feeding. The World Food Program [WFP] assisted project in Jordan began in March, 1978. Its objective was to raise the standard of education by helping the school children of the poorest districts through the provision of supplementary diet to [a] improve the level of nutrition and consequently their health, and [b] encourage their school attendance and improve their learning capacity. The WFP assisted project was implemented by the Nutrition and School Health Section of the Ministry of Education. The total number of beneficiaries in the 1979-1980 school year averaged almost 47,000 students. Almost 90% of beneficiaries were children enrolled in primary and preparatory schools and only about 10% in secondary schools. The WFP daily ration per child [provided over 210 days during the school year] consisted of 120 g wheat flour, 20 g dried skim milk, 25 g canned beef meat, 25 g canned cheese, and 10 g sugar. This ration provided approximately 690 calories, 31 g protein and 10 g fat. Since there was a problem with the acceptability of the milk, 10 g sugar were added to the original daily ration to sweeten the milk. The daily snack is normally served around 10 a.m. Children brought homemade bread [WFP donated flour] and received a cup of milk [sweetened] and alternatively each day, a slice of meat or cheese weighing 50 g or two days' ration [i.e. 25 g h 25 g] Nutrition education in the schools is taught as part of the science subjects and is also part of the newly "life-oriented curriculum" of the compulsory cycle. The School Health Section undertakes periodical medical check-up of all students enrolled in the first year primary and first year preparatory schools. In addition, all students receive the necessary vaccinations. After the program had been in operation for less than one year, we were asked by the project authorities to evaluate the impact of the school feeding program on the nutritional status of school children during the months of March, April, and May, 1978

Sclerema neonatorum

This is an epidemiologic review of 44 cases of sclerema neonatorum admitted to the Special Care Baby Unit [SCBU] at the Jordan University Hospital [JUH] between October 1975 and July 1980. The diagnosis was based on the clinical criteria laid down by Hughes in 1948. These cases constituted 7.2% of total admissions to the SCBU. The male to female ratio was 1.75:1.0; 75% weighed under 2.5 kg; and 25% were members of twins. Those admitted during the colder months of December, January, and February were 56.8%. All patients, except one, were either referred from small private hospitals or home deliveries. Most patients were of low socioeconomic status. The average age on admission was five days; and 6.3 days for home deliveries versus 2.4 days for those referred from hospitals. The overall death rate was 50%; 65,6% died on the first day of admission. The mortality rate for boys was 39.3% as compared to 68.7% for girls. The chance of survival was more than double in babies weighing 2.5 kg and over, compared to those between 1.5 and 2.49 kg. Mortality rate was much less in early admission and early life compared to those who were admitted late. The social implications of this latter fact is discussed. Improvement in social conditions as well as more awareness of the disease and earlier referral may decrease the mortality in this condition. Sclerema neonatorum is a condition of the newborn characterized by subcutaneous adipose derangement. Since the scholarly description by Hughes in 1948[1] its clinical picture remains basically unchanged. This condition appears to be more prevalent in developing societies[2]. With proper management, its course may become safer and markedly reduce deaths. The purpose of this paper is to review, from an epidemiological point of view, cases of sclerema neonatorum admitted to the JUH. Clinical findings shall be reported elsewhere