Using the proximate determinants framework, discuss the relative impacts of one of the following reproductive health issues: contraception, breastfeeding, abortion, sexual activity and infecundity on total fertility rates in Latin America versus Africa from both a family-centered and systems-based perspective. What are the policy implications of these findings? Provide a real-world example of this issue and explain how the policy impacts the low-income population. Similarly, explain why Japan, which has a relatively low contraceptive prevalence rate, has such a low total fertility rate.
The Ministry of Health of a lower-income country has decided to institute a national nutrition surveillance system to monitor the country’s most pressing child and maternal nutrition problems. The surveillance system should incorporate the micronutrient deficiencies that affect the population, and account for people at different life stages, socioeconomic, and geographic groups’ vulnerabilities to individual nutrient deficiencies. As a health professional working for the ministry, provide your professional summary for a selected lower middle income country, of the nutritional problems, target groups, approaches to assessment, options for routine contact in the community, and types of agencies to organize into a surveillance system to guide the ministry. Discuss ways in which single-micronutrient deficiency prevention strategies might be combined, integrated, or coordinated to achieve cost-effective control. Describe the roles of general rations, supplementary feeding programs, and therapeutic feeding programs in maintaining population nutrition.