A M E R I C A N U N I V E R S I T Y O F A R M E N I A - CHSR

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Many aspects of child health are determined by maternal health, age, and educational level, duration of breastfeeding as well as the quality of the social and physical environments in early years of life [10]. A study on main predictors of the maternal competence by first time mothers revealed that the more a mother is isolated from the society, the less her competence; and, conversely, the more balanced the mother's state of mind, the better she felt about succeeding in child care, and the more easy going the child [11]. Infant and childhood mortality and morbidity are the most sensitive indicators of inequity and poverty [2]. Over the past decade, despite considerable investment and effort by many partners to assure children the best start to life, indicators of health and nutritional status in the poorest countries have remained stagnant. At primary health care facilities in low-income countries, diagnostic supports such as radiology and laboratory services and pharmaceuticals are minimal or non-existent [2]. Due to scarcity of resources, most of developing countries and countries in transition do not include funding such widely accepted programs as periodic health check-ups for organized groups of children (pre-schools, schools, orphanages) in their national health policy. Most deaths among children after 2 years of age are due to diseases that can be prevented, and also can be treated very easily at home if they are recognized early. These early periodic detection programs are valuable sources of information about the population and one of the options to decrease the burden of childhood illness. Most are funded from external sources [6]. According to the new economic context of health care, each intervention should be clearly calculated in terms of its cost-effectiveness and cost-benefit [12]. From this point of view, a health screening program is a typical example of transforming outputs into years of life saved or into money saved [12]. The UNICEF promoted approach, called “triple-A approach” addresses the same issue and stands for assessment, analysis and actions [9]. Therefore, one of the 7
important parts of decision-making and problem solving is initial assessment. In order to achieve this goal UNICEF and other international organization in developing countries conducted several health and nutritional surveys. By analyzing the data, it was possible to determine the main causes of undernutrition and poor health status for developing intervention strategies that decrease morbidity and mortality. Specifically, the purposes of these health and nutritional assessment are to: Screen for any health emergency or risk from any emergency Identify the main causes of emergency, estimate its severity and geographical extent Assess their likely evolution and impact on health and nutritional state Identify the areas and the socioeconomic groups most affected or at risk Assess existing response capacity and identify the most effective measures to prevent or minimize the nutritional emergency; and Establish or expand existing surveillance, thus, the effectiveness of measures taken can be monitored over time [8]. The Kuwait National Survey and cross-sectional study on morbidity and morbidity-associated factors in Cameroon noted that such factors as birth order, family income and mother's education and employment status, and, in general, the poverty were found to affect the prevalence of undernutrition and morbidity in children [3, 13]. Among several factors affecting the prevalence of obesity among preschool children, birth order was found the main predictor. The result of the Kuwait survey suggests that the “first child received more care from the young mothers which may be reflected in overfeeding and hence obesity” [3]. It is also postulated that many mothers in the Middle East prefer to have an overweight or obese infant than an infant with normal body 8
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Page 3 and 4: Table 10. Results of multiple logis
Page 5 and 6: Abstract Rationale and main goal: T
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Page 11 and 12: the situation was even more devasta
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Page 19 and 20: circumference, which is used for es
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Page 41 and 42: Appendix 3 CONSENT FORM Children’
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A M E R I C A N U N I V E R S I T Y O F A R M E N I A - CHSR

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