A Human Rights Violation: Malnourished Refugee Children in Camps and After US Resettlement 公开

Lutfy, Caitlyn Leigh (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/pv63g044x?locale=zh
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Abstract

Abstract
Background: Identifying and addressing nutrition issues among US-resettling refugee children are a human rights issue. Methods: The target population is children from Burma, Bhutan, Somalia, Liberia, Eritrea, Sudan, Burundi, and the Democratic Republic of Congo 6-59 months of age who live in secondary country camps prior to US-resettlement. Analysis of camp child nutrition data informs pre-arrival nutrition conditions. A survey of Refugee Health Coordinators provides information on nutritional assessment, reporting and referrals in domestic refugee medical screening. Results: Half of the camps had global acute malnutrition prevalence rates over 15% at least once from 2004-2010. Camps collecting anemia data had greater than 40% prevalence. The majority of State-regulated refugee health exams include height and weight measurements but few use National Center for Health Statistics or WHO standards. Recommendations: Improve overseas monitoring and data linkages of nutrition information to US-resettlement services. Domestically, adopt standards for nutrition assessment and referral protocols.
Length: 149 words

Table of Contents

Definitions 10

ACRONYMS. 11

INDICATORS. 11

Chapter I Introduction. 13

Introduction and Rationale. 13

Problem Statement 14

Figure 1. The Journey of the Refugee from fleeing persecution to establishing a new life in the US: Barriers to nutrition and opportunities for surveillance and intervention. 15

Research Objectives 16

Significance. 16

CHAPTER II Background and History. 20

Who are Refugees?. 20

A Brief History of Refugee Protections 22

The United Nations High Commissioner for Refugees 22

Operation and Services 24

Nutrition Services in Refugee Camps Served by UNHCR. 26

Food Assistance Programs Systems and Regulations 28

General and Selective Feeding Programs: 30

Nutritional Assessments and Surveillance in Refugee Settlements 31

Macro and Micro-Nutrient Deficiencies in Refugee Camps 32

Long-Term Consequences of Childhood Malnutrition. 35

The Barker Hypothesis 35

Malnourishment and Obesity. 36

Micronutrient Deficiencies 36

Micronutrient Deficiencies Overseas 38

Domestic Micronutrient Deficiencies 38

Pre- and Post-Resettlement Health Screenings 39

Overseas Medical Examination. 39

Domestic Medical Screenings 40

Nutrition Guidelines 41

CHAPTER III Nutrition in the US: Literature Review.. 42

Acculturation. 43

Economic Barriers and Governmental Assistance. 45

Analyses of US-Refugee Nutrition indicators and Related Chronic Health Conditions 47

Relating Camp and Post-Resettlement Nutrition. 49

Chapter IV Methodology. 51

Introduction. 51

Overseas Nutrition. 51

Population. 51

Data Source. 54

US Nutrition assessments and services 56

Population. 56

Measurement 57

Chapter V Manuscript and Results. 58

Background. 60

Methods 60

Results 61

Results Tables 62

Figures 64

Global Acute Mortality (GAM)*. 64

Global Anemia Prevalence* 68

Discussion. 72

Recommendations 73

Contribution to the Literature. 74

Chapter VI Conclusion and Recommendations. 75

Limitations 77

Recommendations 78

References. 81

Appendix I: Summary of Overseas Medical Exam.. 85

APPENDIX II CDC Recommended Protocol for Domestic Refugee Screenings that is pertinent to nutritional status 88

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