State of the World's Children 2013 - Unicef

Early childhood stunting, which is measured as
low height for age, is caused by poor nutrition
and diarrhoea. A multi-country study showed
that each episode of diarrhoea in the first two
years of life contributes to stunting, 41 which is
estimated to affect some 28 per cent of children
younger than 5 in low- and middle-income
countries. 42 The consequences of stunting, such
as poor cognitive and educational performance,
begin when children are very young but affect
them through the rest of their lives. However,
community-based efforts to improve basic health
practices have been shown to reduce stunting
among young children. 43
A combination of physical factors and attitudes
may adversely affect child nutrition. In some
societies, mothers may not be encouraged to
breastfeed a disabled child. Stigma and discrimination
may also result in a child with a disability
being fed less, denied food or provided with less
nutritious food than siblings without disabilities.
49 Children with some types of physical or
intellectual disabilities may also have difficulty
in feeding themselves, or need additional time
or assistance to eat. It is probable that in some
cases what is assumed to be disability-associated
ill health and wasting may in fact be connected
with feeding problems. 50
Malnutrition in mothers can lead to a number of
preventable childhood disabilities. Approximately
42 per cent of pregnant women in low- and
middle-income countries are anaemic, and more
than one in two pregnant women in these countries
suffer iron deficiency anaemia. 44 Anaemia
also affects more than half of pre-school aged
children in developing countries. It is one of the
most prevalent causes of disability in the world
– and therefore a serious global public health
problem. 45 Malnutrition in lactating mothers can
also contribute to poorer infant health, 46 increasing
the risk of diseases that can cause disability.
Healthy mothers can help reduce the incidence
of some disabilities and are better prepared to
minister to their children’s needs.
While malnutrition can be a cause of disability,
it can also be a consequence. Indeed, children
with disabilities are at heightened risk of malnutrition.
For example, an infant with cleft palate
may not be able to breastfeed or consume
food effectively. Children with cerebral palsy
may have difficulty chewing or swallowing. 47
Certain conditions, such as cystic fibrosis, may
impede nutrient absorption. Some infants and
children with disabilities may need specific diets
or increased calorie intake in order to maintain a
healthy weight. 48 Yet they may be hidden away
from community screening and feeding initiatives.
Children with disabilities who do not attend
school miss out on school feeding programmes.
Water, sanitation and hygiene
It is a widely acknowledged but little documented
fact that throughout the developing world, persons
with disabilities routinely face particular
difficulties in accessing safe drinking water and
basic sanitation. Children with physical impairments
may be unable to collect water or carry
it for long distances; others may find well walls
and water taps too high. Hardware and washroom
doors can be difficult to manipulate and
there may be nowhere to rest the water container
while filling it, or there may be nothing to hold
on to for balance to avoid falling into a well,
pond or toilet. Long or slippery paths and poor
lighting also limit the use of latrines by children
with disabilities.
Barriers to persons with disabilities extend beyond
physical and design issues. Social barriers vary in
different cultures. Children with disabilities often
face stigma and discrimination when using household
and public facilities. Wholly inaccurate fears
that children with disabilities will contaminate
water sources or soil latrines are frequently reported.
When children or adolescents, and particularly
girls, with disabilities are forced to use different
facilities than other members of their households,
or are compelled to use them at different times,
they are at increased risk of accidents and physical
attack, including rape. Issues preventing disabled
children from accessing water and sanitation in
A STRONG FOUNDATION
25