Early Childhood Nutritional Status in CARICOM Countries: An Overview with respect to Five Nutrition Related Millennium Development Goals

Previous reviews of nutritional status in children under 5 years describe the Caribbean grouped with Latin America. This paper focuses specifically on the Caribbean and the goals and targets of the Millennium Declaration that have bearing on childhood development. The results indicate that CARICOM countries have made progress in terms of child health as assessed by gross health indicators. Yet, the millennium generation experiences coexistence of undernutrition and overweight in early childhood. The associations of GNI with markers such as poverty indices are somewhat inconsistent with traditional findings and highlight a need to reassess the causes of infant mortality and low birth weight. However, a lack of systematic local data has hampered progress on an individual country basis. Interventions that deal more pointedly with country specific needs are required including those targeting obesity if the MDGs are to be attained by all member states. 1. Introduction CARICOM countries like many other developing nations are in varying stages of an epidemiologic and nutrition transition [1], such that the traditional public health problems of infectious disease have decreased in prevalence, only to be largely replaced by the diseases of “life style” that are associated with Western-type diets and reduced activity [2]. A challenge facing the incoming millennium generation of the region is the easy availability of calories in the face of sometimes monotonous diets and reduced opportunity for exercise. The WHO proclaims that childhood obesity is one of the most serious public health challenges of the 21st century, with close to 35 million overweight children under the age of five in developing countries [3]. Undernutrition in early childhood is associated with developmental deficits of reduced cognitive [5] and psychosocial [6] functioning as well as later physical and work capacity [5]. In addition, many children who experience undernutrition will be at increased risk of developing chronic diseases [7]. Nutritional status in children clearly has implications for the future of the individual as well as for these nation states as a whole. Tracking these patterns over time is important if policy tailored to the unique needs of the different countries is to be devised. The Millennium Declaration [8] signed by 189 countries, including CARICOM in September 2000, set out to create an environment which is conducive to development and the elimination of poverty. The goals and targets are interrelated and several have bearing on childhood nutritional status. The first