The number of older persons is growing at a shocking rate. In spite of this reality, the South African health care sector does not prioritise older persons, causing their health to be poorly managed. Not only does poor health management affect the health of the older person, but also economic factors. This causes a high burden on the public health sector of South Africa, with specific reference to the Primary Health Care (PHC) clinics. PHC clinics in this country are not only overcrowded due to staff shortages, but also owing to the rapidly ageing population and the large number of younger persons affected by the high unemployment rate of South Africa. The above-mentioned factors keep the professional nurses in the clinic from spending time on proper physical examinations and provision of health education to older persons. This causes older persons to lack knowledge regarding self-care, potentially leading to unintentional self-neglect, which decreases their quality of life. Studies conducted on older persons concluded that the older person wants to be involved in health promotion, but needs the necessary knowledge to take care of him- or herself. Therefore, the researcher's overarching aim with this study was to develop guidelines to facilitate self-care amongst older persons. Such guidelines aim at constituting an indirect approach to promote the health of the older person. Health education on self-care should be conducted in self-care support groups, since community experience teaches that some older persons in the community do not apply self-care skills learned without some form of support. The aim with these guidelines is to decrease unintentional self-neglect by empowering the older person to make autonomous decisions regarding self-care, in order to increase quality of life. RESEARCH AIM AND OBJECTIVES In order to reach the overarching aim of this study, which comprises the development of guidelines to facilitate self-care amongst the older persons in the Potchefstroom district, the study firstly includes a literature review to understand self-care and related constructs from a theoretical perspective. Secondly, the Appraisal of self-care agency scale-A (ASA-A) and Exercise of self-care agency scale (ESCA) were used as questionnaires to assess the self-care of the selected older persons. Lastly, after determining the self-care of the older persons, the study investigates the relationship between these two questionnaires through correlational analysis. RESEARCH DESIGN A quantitative, descriptive, correlational and contextual design was used in this study to .reach the overarching aim and respective objectives. RESEARCH METHOD The researcher firstly conducted a literature review to understand self-care and related constructs. Thereafter the researcher employed two structured questionnaires, the ASA-A and ESCA, were employed to collect data. The questionnaires were developed to measure self-care (self-care is determined by measuring the self-care agency). These questionnaires were based on Dorothea OrenYs self-care deficit theory of nursing, the same theory that this research study is based on. Minor adaptations were made to both the questionnaires prior to administration to the predominantly Setswana-speaking older population. The study formed part of the larger Multinational Prospective Urban and Rural Epidemiological study (PURE-SA study - ethical approval number 04M10). All the older persons identified in the peri-urban population of the PURE-SA study living in the Potchefstroom district and who were willing to participate were included in the sample. Trained fieldworkers assisted the researcher in data collection. Of the 198 older persons, 192 participated, accumulating to a 98% response rate. Lastly the researcher correlated the ASA-A and ESCA to determine their relationship as an added benefit to this research study. RESULTS The findings indicate that although the studied older population was of a lower socio-economic status with a lower literacy level, their overall self-care was relatively good. Seven self-care deficits were identified namely time management skills affecting self-care, energy deficit affecting self-care, sleep deprivation, lack of knowledge and ability to acquire knowledge with regard to health and self-care, lack of a rest, exercise and self-care programme, self-care deficit caused by physical deterioration and, lastly, the lack of performance of activities to prevent/decrease self-care deficits. These identified self-care deficits supported the development of guidelines to facilitate self-care amongst older persons, together with Menon's psychological health empowerment model, as well as an in-depth literature review on self-care and related constructs to understand self-care from a theoretical perspective. Furthermore, the study compared the ASA-A and ESCA questionnaires to determine the relationship between these questionnaires. The two questionnaires had a very good correlation with each other, conclusion that either of these two questionnaires could be used to measure self-care of a population. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010.

<p style="text-align: justify / " class="Default">In developing economies and specifically Sub-Saharan Africa physical inactivity has been identified as a risk factor along with tobacco use, poor nutrition and poor diet as this has increasingly formed part of today&rsquo / s lifestyle. Physical activity declines with age this decline is more marked during the adolescent period. The aim of this study was to determine the prevalence of physical inactivity and factors associated with it among adolescents in <st1:place><st1:city>Nairobi</st1:city>, <st1:country-region>Kenya</st1:country-region></st1:place>. The overall aim of the study is to determine the factors influencing their levels of physical activity in relation to their socio-economic characteristics. <o:p></o:p></p>

2/2 Abstract: In the present work we deal with a specific class of factors with the assumed potential to determine (refine) the preferred lexical meaning in case of ambiguity. A required feature of these factors is that they don't depend on the nature of any particular communication situation, but should be exclusively related to the person of the speaker or listener and some of his personality, sociolinguistics and other characteristics, i.e. traditional factors such as context, time-space characteristics, are deliberately excluded. The preferred lexical meaning was studied by means of a questionnaire survey in the sample of respondents. The analysed data were the initial immediate associations reported by the respondents in the association test for each of the thirty selected ambiguous words. The respondent was confronted with individual test terms in isolation outside of any context or specific communication situation. Under these assumptions, the ability of selected respondents' characteristics such as gender, age, education, geographical area of their life, profession or hobbies of the respondent can be examined to what extent they can be the explanatory factors of the lexical meaning of the first choice in the test expressions. In addition to the specific findings concerning the factors of lexical...

Background: Stunting is impaired linear growth that occurs within the first 1000 days of life and continues later in life. It is associated with short and long term morbidity. This study aims to examine the association between stunting and maternal biodemographic and socioeconomic characteristics in children 0-59 months in Ghana.  Methodology: The study is an analysis of a nationally representative sample of households, based on the socio-ecological framework. Data was sourced from the Demographic and Health Surveys (DHS) conducted in 2014. Logistic regression was used to analyze 2759 children aged 0-59 months.  Results: The prevalence of stunting was 17.6%. Children 24-35 months had higher odds of stunting (OR=10.6 95% CI 5.18-21.8). Boys had higher odds than girls to be stunted (OR=1.62, 95% CI 1.21-2.17). There was an association between early initiation of breastfeeding, access to proper toilet facility, mothers’ level of education and ethnicity with stunting. Difficult access to healthcare was associated with high risk of stunting (OR=10.3, 95% CI, 1.38-76.8). Households with more than two U-5 children had higher odds of stunting (OR=1.61, 95% CI, 1.10-2.34). Conclusions: Stunting is a public health concern in Ghana. To address stunting, multisectorial interventions needs to be targeted at extending nutrition programmes to above 24 months. Nutrition interventions should prioritize early initiation of breastfeeding. Easy access to quality healthcare by strengthening the National Health Insurance Scheme (NHIS) should be promoted. Results also suggested that it is critical to invest in free education and scale up family planning programs.

Made available in DSpace on 2014-12-17T14:13:25Z (GMT). No. of bitstreams: 1 JairSVJ.pdf: 494758 bytes, checksum: ff6d790cbf26c2b6783c7734bbfc33e1 (MD5) Previous issue date: 2008-09-29 / Funda??o de Amparo a Pesquisa do Estado da Bahia / The identification of the factors that interfere in the decline of functional conditions is useful in the planning of actions addressing the improvement in the conditions of the lives of elderly people. The purpose of this investigation was to analyze the relationship between social demographics and health aspects of the functional condition in elderly women of low income of the Brazilian northeast. This crosssectional study involved a representative sample of 222 women with an average age of 70 years (? 7.1), belonging to coexisting groups and that were resident in the urban area of the municipal district of Jequi? /Bahia. In order to achieve this objective, a battery of physical tests of functional aptitude was carried out previously tested in pilot study, anthropometric measurements collected with a comparison of the measures referred to the reported weight and height as well as the application of an interview with questions containing subjects related to social demographic variables, clinical conditions and health, physical conditions and behaviors. Descriptive statistics Proceedings (frequency, average, standard deviation and percent distribution) were used for statistic analysis, and the calculation of the respective odds ratio by binary logistics regression, for the analysis of factors hierarchically grouped; p<0.05. The prevalence of 56% (n=122) of women considered with moderated or serious type of functional limitations was found, In which from multi-varied hierarchical analysis, significant association was verified with the age group over 80 years (p=0.02), conditions of widowhood (p=0.04), presence of arterial hypertension (p=0.001), and physical inactivity during leisure time (p=0.03). On the other hand for functional incapacities the prevalence was of 46.8% (n=104) being associated to the increase of the age (p=0.01), hospitalization (p=0.02), absence of physical activities along their lives (p=0.001) and the occurrence of alterations in the cognitive function (p=0.001). The normative table for the parameters of physical fitness generated conducive to health professionals in the diagnosis of health conditions and the prescription of physical exercises. The identified characteristics that are associated with the functional limitations / functional incapacities suggest a complex causal net in the determination of the functional condition in elderly women. However, actions addressed to the incentive of the practice of physical activities in the leisure time and the preservation of the cognitive function can contribute to a life with more quality for these people. This research was multidisciplinary approach to involve elements of psychology, nutrition and Physical Education in the elucidation of the object of study related to the functional condition of elderly women / A identifica??o de fatores que interferem no decl?nio da condi??o funcional ? ?til no planejamento de a??es direcionadas as melhorias nas condi??es de vida das pessoas idosas. O prop?sito dessa investiga??o foi o de analisar a rela??o dos aspectos s?cio-demogr?ficos e referentes a sa?de com a condi??o funcional em mulheres idosas de baixa renda do nordeste brasileiro. Este estudo teve um delineamento transversal, tendo uma amostra representativa de 222 mulheres, com m?dia de 70 anos (? 7,2) pertencentes a grupos de conviv?ncia e que eram residentes na zona urbana do munic?pio de Jequi?, Bahia. Para tanto foi conduzida uma bateria de testes de desempenho f?sico para avalia??o da aptid?o funcional previamente testada em estudo piloto, coletadas medidas antropom?tricas com a compara??o de medidas referidas com as reportadas para o peso e estatura, al?m da aplica??o de uma entrevista contendo quest?es relativas ?s vari?veis s?cio-demogr?ficas, condi??es cl?nicas, sa?de percebida, condi??es f?sicas e comportamentais. Para an?lise estat?stica foram utilizados procedimentos da estat?stica descritiva (freq??ncia, m?dia, desvio padr?o e distribui??o percent?lica) e o c?lculo da respectiva raz?o de chances mediante regress?o log?stica bin?ria, para an?lise de fatores hierarquicamente agrupados; p<0,05. Encontrou-se uma preval?ncia de 56% (n=122) de mulheres consideradas com limita??es funcionais do tipo moderada ou grave, nos quais a partir de an?lise multivariada hierarquizada, verificaram-se associa??o significativa com a faixa et?ria superior a 80 anos (p=0,02), condi??es de viuvez (p=0,04), presen?a de hipertens?o arterial (p=0,001), e inatividade f?sica no lazer (p=0,03). J? para as incapacidades funcionais a preval?ncia foi de 46,8% (n=104) sendo associada ao aumento da idade (p=0,01), hospitaliza??o (p=0,02), aus?ncia de pr?ticas de atividades f?sicas ao longo da vida (p=0,001) e a ocorr?ncia de altera??es na fun??o cognitiva (p=0,001). A tabela normativa para os par?metros de aptid?o f?sica gerada favorece aos profissionais de sa?de no diagn?stico das condi??es de sa?de e na prescri??o de exerc?cios f?sicos. As caracter?sticas identificadas que se associaram ?s limita??es funcionais/incapacidades funcionais sugerem uma complexa rede causal na determina??o da condi??o funcional em mulheres idosas. No entanto, a??es direcionadas ao incentivo da pr?tica de atividades f?sicas no lazer e a preserva??o da fun??o cognitiva podem contribuir para uma vida com mais qualidade a estas pessoas. Esta investiga??o teve a abordagem multidisciplinar ao envolver elementos da psicologia, nutri??o e da Educa??o F?sica na elucida??o do objeto de estudo relacionado ? condi??o funcional de mulheres idosas.

Submitted by Marco Antonio Oliveira da Silva (maosilva@ipen.br) on 2016-08-25T18:15:44Z No. of bitstreams: 0 / Made available in DSpace on 2016-08-25T18:15:44Z (GMT). No. of bitstreams: 0 / Com o escopo de fornecer subsídios para compreender como o processo de colaboração científica ocorre e se desenvolve em uma instituição de pesquisas, particularmente o IPEN, o trabalho utilizou duas abordagens metodológicas. A primeira utilizou a técnica de análise de redes sociais (ARS) para mapear as redes de colaboração científica em P&D do IPEN. Os dados utilizados na ARS foram extraídos da base de dados digitais de publicações técnico-científicas do IPEN, com o auxílio de um programa computacional, e basearam-se em coautoria compreendendo o período de 2001 a 2010. Esses dados foram agrupados em intervalos consecutivos de dois anos gerando cinco redes bienais. Essa primeira abordagem revelou várias características estruturais relacionadas às redes de colaboração, destacando-se os autores mais proeminentes, distribuição dos componentes, densidade, boundary spanners e aspectos relacionados à distância e agrupamento para definir um estado de redes mundo pequeno (small world). A segunda utilizou o método dos mínimos quadrados parciais, uma variante da técnica de modelagem por equações estruturais, para avaliar e testar um modelo conceitual, apoiado em fatores pessoais, sociais, culturais e circunstanciais, para identificar aqueles que melhor explicam a propensão de um autor do IPEN em estabelecer vínculos de colaboração em ambientes de P&D. A partir do modelo consolidado, avaliou-se o quanto ele explica a posição estrutural que um autor ocupa na rede com base em indicadores de ARS. Nesta segunda parte, os dados foram coletados por meio de uma pesquisa de levantamento com a utilização de um questionário. Os resultados mostraram que o modelo explica aproximadamente 41% da propensão de um autor do IPEN em colaborar com outros autores e em relação à posição estrutural de um autor na rede o poder de explicação variou entre 3% e 3,6%. Outros resultados mostraram que a colaboração entre autores do IPEN tem uma correlação positiva com intensidade moderada com a produtividade, da mesma forma que, os autores mais centrais na rede tendem a ampliar a sua visibilidade. Por fim, vários outros indicadores estatísticos bibliométricos referentes à rede de colaboração em P&D do IPEN foram determinados e revelados, como, a média de autores por publicação, média de publicações por autores do IPEN, total de publicações, total de autores e não autores do IPEN, entre outros. Com isso, esse trabalho fornece uma contribuição teórica e empírica aos estudos relacionados à colaboração científica e ao processo de transferência e preservação de conhecimento, assim como, vários subsídios que contribuem para o contexto de tomada de decisão em ambientes de P&D. / Tese (Doutorado em Tecnologia Nuclear) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2016-11-11T11:09:07Z No. of bitstreams: 0 / Made available in DSpace on 2016-11-11T11:09:07Z (GMT). No. of bitstreams: 0 / Este trabalho apresenta uma análise da viabilidade econômica e ambiental do processo de reciclagem de Resíduos de Construção Civil em um município. Utilizou-se como base o Município de Guarulhos onde foi efetuado um levantamento das quantidades de resíduos de construção civil produzidos, seu gerenciamento e o processo de reciclagem e reutilização dos agregados reciclados produzidos. O Município de Guarulhos implantou o primeiro Ponto de Entrega Voluntária (PEV) de resíduos em 2003 e, de forma ininterrupta, vem aumentando a disponibilidade desses pontos a população, possuindo 17 pontos em 2014. Inicialmente planejados para receber apenas resíduos provenientes de construção civil, tornaram-se pontos onde a população destina inúmeros resíduos sólidos não orgânicos. A empresa de pública responsável por obras na cidade, PROGUARU, possuiu uma Usina de Reciclagem de Resíduos de Construção Civil (URE) que produz agregados reciclados para uso em manutenções e pavimentação, além de fornecer material para utilização na Fábrica de Pré-Moldados da Prefeitura, fechando um ciclo de captação, processamento e reutilização dos Resíduos de Construção Civil no município. Foram desenvolvidos dois modelos que incluem no cálculo econômico do processo de reciclagem de Resíduos de Construção Civil de um município, a economia obtida com a diminuição do descarte irregular e com a substituição de agregados naturais pelos agregados reciclados produzidos pela PROGUARU. No período de 2003 a 2014, os Pontos de Entrega Voluntária receberam 296.210,11 . 10³ kg de resíduos totais, e enviou 214.910, 57 . 10³ kg de Resíduos de Construção Civil para a URE. O lucro anual do sistema incluindo o custo dos terrenos (PEV e URE) foi de R$ 3,50 por habitante, e desprezando o valor dos terrenos foi de R$ 5,02 por habitante. O trabalho de pesquisa comprova a viabilidade econômica da reciclagem, além dos ganhos ambientais pela diminuição dos descartes irregulares e economia de recursos naturais. / Tese (Doutorado em Tecnologia Nuclear) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2016-11-11T17:02:12Z No. of bitstreams: 0 / Made available in DSpace on 2016-11-11T17:02:12Z (GMT). No. of bitstreams: 0 / O Estudo de Dieta Total (EDT) tem sido recomendado pela Organização Mundial da Saúde como o método mais adequado para estimar as ingestões dietéticas de contaminantes e nutrientes para um país ou grandes grupos populacionais. O presente estudo é o segundo realizado no Brasil, atualizado com dados da Pesquisa de Orçamento Familiar-POF 2008-2009 do IBGE, para avaliação de ingestão dietética dos elementos essenciais e tóxicos referente à região Sudeste do Brasil. Os alimentos que compõe a lista de alimentos foram coletados em mercados, preparados como prontos para consumo, liofilizados e homogeneizados para a análise pelos Métodos de Análise por Ativação com Nêutrons Instrumental (INAA) e Absorção Atômica com Forno de Grafite (GF-AAS). Foram determinados os elementos As, Br, Ca, Cd, Cl, Co, Cr, Cs, Cu, Fe, K, Mg, Mn, Na, Rb, Sc, Se e Zn. Os valores de ingestão dietética diária dos elementos foram calculados e mostraram-se satisfatórios para os elementos Cl, Cu, Fe, Mg, Mn, Se e Zn. Para Ca, Cr e K as ingestões dietéticas calculadas encontraram-se abaixo das recomendações nutricionais. Já para os elementos cujos valores de ingestão diária média superaram as recomendações nutricionais (Cu, Fe, Mg e Mn), as ingestões foram comparadas com os valores de Limite tolerável de ingestão (UL). Concluiu-se que nenhum elemento se encontrava em quantidade acima desses limites, exceto o Na que apresentou valor ligeiramente mais alto que o UL. Em relação aos elementos tóxicos, os valores de concentração estiveram muito abaixo dos valores limites estabelecidos pela legislação brasileira, exceto para o As no grupo de peixes. Porém a ingestão de peixe é baixa, o que contribuiu para que a ingestão dietética de As nesse estudo estivesse bem abaixo do limite máximo tolerável preconizado pela JECFA (Joint FAO/WHO Expert Committee on Food Additives), assim como o valor de ingestão dietética mensal de Cd, que esteve bem abaixo limite tolerável mensal (PTMI). / Dissertação (Mestrado em Tecnologia Nuclear) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Introdução: A hanseníase, doença infecciosa crônica, causada pelo bacilo Mycobacterium leprae, tem seu mecanismo de transmissão não totalmente esclarecido. A transmissão ativa pode estar associada a movimentos migratórios, condições sociais ou outras fontes de infecção (como a manutenção do bacilo no ambiente). Objetivos: Descrever o padrão espacial do risco relativo da hanseníase em menores de 15 anos no estado da Bahia; identificar possíveis agrupamentos espaciais e investigar a possível associação entre o risco relativo da hanseníase e fatores socioeconômicos e ambientais. Metodologia: Este estudo ecológico utilizou dados do Sistema de Informação de Agravos de Notificação (SINAN) de 2005 a 2011, do Censo Demográfico do Instituto Brasileiro de Geografia e Estatística de 2010, da Federação das Indústrias do Estado do Rio de Janeiro, Informações Demográficas e Socioeconômicas do Departamento de Informática do SUS, bases cartográficas digitais de dados ambientais do IBGE e bases cartográficas digitais do estado da Bahia e estados vizinhos. Os riscos relativos por município foram padronizados pela covariável gênero. A análise de varredura espacial com o programa SaTScan permitiu verificar a existência de agrupamentos espaciais do tipo alto e/ou baixo. O segundo estágio da análise consistiu em verificar a possível associação entre risco relativo da hanseníase como variável dependente e variáveis socioeconômicas e ambientais como explicativas, através de análises de regressão hierárquica multivariada não espacial e espacial, de acordo com quadro conceitual definido previamente. Resultados: Durante o período de estudo foram notificados 1.674 casos, que representam 7,87% dos casos totais. As taxas em menores de 15 anos, padronizadas por gênero, diminuiu de 0,89/10.000 em 2005 para 0,57 em 2011. A estatística de varredura espacial identificou 4 agrupamentos de risco alto e 6 de risco baixo. No modelo de regressão hierárquica, o risco relativo foi associado positivamente com porcentagem de corpos dágua, Índice de Gini, porcentagem de população urbana, número médio de moradores em domicílios particulares permanentes, e negativamente com o número de residentes nascidos na Bahia. Conclusão: Este estudo mostrou que a hanseníase ainda está ativa no Nordeste do Brasil, principalmente em ambientes urbanos. Embora o risco relativo da hanseníase tenha diminuído, ele ainda permanece muito alto. Migrações de assentamentos rurais para as cidades, bem como mais pessoas vivendo em domicílios e desigualdades sociais são resultados de um processo histórico no nordeste do Brasil, que dão suporte para a continuidade do processo de transmissão da doença. A associação entre o risco relativo da hanseníase e corpos dágua na escala geográfica proposta, indica que a hipótese que associa a M. leprae e ambientes úmidos ainda não pode ser descartada. / Background: Leprosy is a chronic infectious disease caused by the bacillus Mycobacterium leprae. Its mechanism of transmission has not been completely understood. The active transmission may be associated with people migration, social conditions or other sources of infection (such as maintenance of bacilli in the environment). Objectives: To describe the spatial pattern of the relative risk of leprosy in children under 15 years old in the State of Bahia; to identify possible spatial clusters and to investigate the possible association between the relative risk of leprosy with socioeconomic and environmental factors. Methods: This ecological study used data from the Brazilian Disease Notification System (Sistema Nacional de Informação de Agravos de Notificação SINAN) for the studied period of 2005 to 2011; Instituto Brasileiro de Geografia e Estatstica (IBGE 2011), Department of Data and Information Technology (Informações Demográficas e Socioeconômicas do Departamento de Informática do SUS DATASUS, 2010) and the Federation of Industries of the State of Rio de Janeiro FIRJAN (2010), Cartographic base of municipalities in Bahia and surrounding States corresponded to the shape files from the Brazilian Demographic Census. Relative risks were calculated accounting for the respective covariate gender. The spatial scan analysis with SaTScan program allowed to verify the existence of high and/or low spatial clusters. The second stage of the analysis consisted of verifying possible associations between the relative risks of leprosy as a dependent variable, and socio-economic and environmental variables as independent. This was performed using a multivariate regression analysis according to a previously defined conceptual framework. Results: During the study period, 1,674 cases were reported, representing 7.87% of the total cases. Overall rates have decreased from 0.88/10 000 in 2005 to 0.52 in 2011. Spatial scan statistics identified 4 high-risk and 6 low-risk clusters. In the regression model, after allowing for spatial dependence, relative risks were associated with higher percentage of water bodies, higher Gini index, higher percentage of urban population, larger average number of dwellers by permanent residence and smaller percentage of residents born in Bahia. Conclusions: This study showed that leprosy is still active in the Northeast of Brazil, especially in urban environments. Although relative risks of leprosy in Bahia have been decreasing, they remain very high. Migration of rural settlements to the cities, more people living in households and social inequalities are the result of a historical process in northeastern Brazil, that support the continuity of the disease transmission process. The association between relative risks of leprosy and water bodies in the proposed geographic scale indicates that hypothesis linking M. leprae and humid environments cannot be discarded.

La situation d’insécurité alimentaire et nutritionnelle récurrente dont souffrent environ 155 millions d’enfants dans le monde dont 59 millions en Afrique et particulièrement ceux du Sahel et de la Corne de l’Afrique, constitue un problème majeur de santé publique, de développement et de conscience collective mondiale dans ce nouveau contexte de globalisation de la prospérité, des droits de survie, d’éducation et de protection des enfants.La malnutrition des enfants de moins de cinq ans caractérisée par le rachitisme, l’insuffisance pondérale ou l’émaciation, augmente leurs risques de décès, handicape le développement psycho moteur de même que leurs réussites scolaires et professionnelles et impacte négativement le développement économique des pays entrainant un cercle vicieux de pauvreté familiale et sociétale et d’émigrations.Parmi les pays les plus touchés par la malnutrition des enfants, les cinq pays ayant fait l’objet de cette thèse (le Burkina Faso, le Niger, le Sénégal, l’Ethiopie et le Ghana), sont fragilisés à des degrés variés, par un environnement climatique et géo-écologique austère, une instabilité du régime politique, un faible développement économique et social ainsi qu’une gouvernance nutritionnelle déficiente causée par le déficit d’engagements politiques, législatifs et financiers réels et les faiblesses des capacités institutionnelles.En plus de l’insécurité alimentaire, les enfants et leurs familles sont confrontées au manque de disponibilité et d’infrastructures sociales et de santé communautaires, à la pauvreté du ménage, au statut social précaire, au fardeau démographique, aux inégalités de genre entre hommes et femmes, aux contraintes de normes sociales, culturelles et de croyances traditionnelles, à l’ignorance qui entretiennent des pratiques comportementales inappropriées d’alimentation et de nutrition des enfants ainsi que l’environnement insalubre vecteur de maladies.Le réveil politique, l’investissement multi sectoriel et l’éducation de masse en faveur de la nutrition des enfants sont requis pour l’atteinte des engagements mondiaux pour 2030 visant le développement, la prospérité pour tous, l’élimination de la faim et de la malnutrition. / Continuous food and nutrition insecurity that affect lives of 155 millions of children in the world including about 59 million in African countries mostly in the Sahel and horn of Africa represent a critical public health and underdevelopment problem which creates a deep worldwide collective moral issue within the new global transformative agenda for the universal prosperity (no one is left behind) and child rights for survival, development and protection.Under five child malnutrition characterized by stunting, underweight or wasting increase the risk of child morbidity and mortality, handicap readiness of learning and professional skills and impact on economic development of the country resulting to a vicious circle of poverty and fragility of the family and causing international migrations.Four countries mostly affected by child malnutrition in the Sahel and horn of Africa that we have selected for this study (Burkina Faso, Niger, Senegal and Ethiopia) in comparison to Ghana are facing the severity of climatic and geo-ecologic environment, political instability, weak economic and social development and the gap of nutritional governance undermined by the lack of political, legal and financial commitments of Government and the limited institutional capacities to combat strongly undernutrition.In addition to food insecurity, malnourished children and their families are confronted to bottlenecks of supply and demand of access and use of community based basic social services, to the household poverty, the poor family social status, to demographic burden, gender based inequality, heavy social norms, traditional cultural and believes and ignorance of malnutrition which cause inadequate behavioral practices of child feeding and nutrition, child health care including unsafety water & sanitation conditions that facilitate diseases & malnutrition.Strengthening effective political engagement, accountable governance and massive financial investment for multi sector integrated interventions, promoting social protections systems and massive community based social and behavior changes in favor of child and mother nutrition are required for achieving SDG of “no one left behind prosperity, ending hunger, malnutrition… by 2030” and achieving child rights.