Dietary changes in African urban households in response to currency devaluation: foreseeable risks for health and nutrition.

OBJECTIVE: To investigate the effects of currency devaluation on dietary change and nutritional vulnerability of poor households in two African capital cities. DESIGN: A qualitative study based on 120 semistructured individual interviews and four focus group discussions in each city. SETTING: Dakar, Senegal (western Africa) and Brazzaville, Congo (central Africa). SUBJECTS: All of the subjects were randomly selected women from modest or poor households, who spoke the local common language and were responsible for household meal preparation. Only those likely to restrict the dynamic of focus group discussions (because of language, age or education) were excluded. RESULTS: Changes were found in meal preparation characteristics (frequency, sharing pattern) and meal composition. There was frequent depletion of fat and vegetable contents in meals, frequent elimination of desserts and even the elimination of one daily meal. These changes specifically affected economically disadvantaged and socially isolated households, and those headed by women. Other changes were the reduction in the size of consumption units and the development of neighbourhood-specific street food - which has been a growing trend in Brazzaville since the outset of the economic crisis but is more recent in Dakar. CONCLUSIONS: If lasting, these changes pose a dual health risk, i.e. reducing dietary diversity and altering the bacteriological quality of prepared meals. In addition, attempts to reduce the consumption units were found to upset community ties that bind these societies.

Early nutritional history and motor performance of Senegalese children, 4-6 years of age.

The effects of undernutrition on motor coordination and performance of 139 4.0-6.5 year-old Senegalese children were studied. The sample was partitioned into three nutritional history groups: 54 children exposed chronically to a mild-to-moderate form of undernutrition (group A), 52 children hospitalized for severe undernutrition during infancy and nutritionally rehabilitated but who had been subsequently exposed to moderate undernutrition (group B); and 33 children from well-off urban households (group C). Tests included six items from the McCarthy (arm coordination) and the Charlop-Atwell (gross motor coordination) scales, and five motor fitness items (endurance run, shuttle run, distance throw, standing long jump, grip strength). Performances improved with age, and boys performed better than girls in all motor fitness tests except the jump, but not in motor coordination items. In general, group C performed better than group A and B in most of the tests. Body dimensions explained a significant part of variance of motor performance, and stature was the main predictor. After removing the effect of age and body size, differences between nutritional groups disappeared in motor performance, but persisted in certain motor coordination items. It is concluded that chronic undernutrition reflected by reduced body size and perhaps muscle mass is an important determinant of the motor performance of preschool Senegalese children.

Anthropometric and motor characteristics of Senegalese children with different nutritional histories.

The effects of Protein Energy Malnutrition (PEM) on the motor performance of 4.5-6.5-year-old Senegalese children were studied. Body dimensions included weight, lengths, circumferences, and four skinfolds. Motor performance tests included a 3-min endurance run, 4 x 10 m shuttle-run, distance throw, standing long jump and grip strength. The sample consisted of 147 children: 52 children who were hospitalized for severe undernutrition (severe UN group) during infancy but who had been nutritionally rehabilitated; 63 children who were never severely malnourished but who were chronically exposed to mild-to-moderate undernutrition up to the time of study (chronic UN group); and 32 well nourished children (well nourished group) from well-off households. After adjusting for sex and age, the well nourished group performed better than the severe UN and chronic UN groups. Principal components analysis resulted in two factors which explained 65% of the variance in anthropometry and motor performance. One was related to body size and the second to body composition. The three nutritional groups differed significantly in principal component scores for the two factors; chronic UN and severe UN children also differed for the second factor. Body composition, especially low fat mass appeared to be an important feature for motor performance in chronically undernourished children.

[Complementary nutrition for the young child following the devaluation of the CFA franc (African Financial Community): 2 case studies in the Congo and Senegal urban environment]. / L'alimentation de complément du jeune enfant après la dévaluation du franc CFA: deux études de cas en milieu urbain, au Congo et au Sénégal.

Developing countries frequently see their currency depreciated to varying degrees. The consequences of such monetary disturbances on the nutrition of young children are not well known, though children are the most vulnerable in nutritional terms. One year after the 50% devaluation of the CFA Franc (communauté financière africaine, "African Financial Community"), which took place on 12 January 1994 simultaneously in fourteen countries, nine of which are on the UNDP list of least developed countries, we wanted to find out the long-term effects of the devaluation, and the strategies that families had adopted to cope with it. In Brazzaville, Congo, in December 1994, an epidemiological survey was conducted on a representative sample of 893 children between the ages of 4 and 12 months in two districts, and indicators of child nutrition were established. A comparable survey had been conducted in December 1993, before the devaluation. In Senegal, in the absence of a previous survey which could be used in comparison, a qualitative survey using RAP methodology, was conducted in January 1995 in two towns near the capital. In three districts in each of these towns, a cluster of ten plots was chosen at random and surveyed, with a combination of semi-structured individual interviews with mothers (n = 60) and group interviews with all the women together (n = 6). The information was put together with interviews of 25 local traders selling food. In the Congo, comparison of the two surveys shows that the practice of breast-feeding had hardly changed, nor had the age at which baby food was introduced (90% of children of 4-5 months take semi-solid and solid foods); on the other hand, more children are being given the ordinary family meal earlier, at 6-9 months. The proportion of baby foods based on commercially imported flour has fallen (from 32% in 1993 to 18% in 1994), and has been replaced with local products based on maize; this change is more marked among poorer families. The low nutritional value of such preparations is in part compensated by the addition of sugar, though less milk is added (28% in 1994 as opposed to 43% in 1993). In Senegal, mothers do not seem to have changed their breast-feeding practices either, the age at which baby foods are introduced, or the number of times they are provided daily. The most important change is the drop in quality of food given to children, and the poorer family food for the older children. The partial switch from imported products to local produce was an expected consequence of devaluation; it is clearly confirmed here for nutrition of young children, with the consequent loss of nutritional quality (a reduction in energy density and in nutrients). The first thing needed is, therefore, an improvement in local manufacture of food supplements of good nutritional quality, for young children. Mothers also complain of the increased difficulty in managing a family diet so as to take account of economic needs, cultural values and nutrition. They therefore criticize a number of nutritional education messages that are clearly no longer appropriate to the new economic context. Finally the fact that young children are getting poorer quality nutrition is worrying for the future: if it lasts, the nutritional status of children will deteriorate; whenever possible, monitoring must be established so that measures can be taken when necessary to forestall any dramatic deterioration that would endanger the health of the children.