Anaemia is made worse by some illnesses, particularly hookworm infection. Malaria is also a major cause of anaemia, although this is not directly related to iron losses. In several countries, deworming of schoolchil dren has been shown to reduce the prevalence and severity of anaemia. The nutritional well-being of children around the world has benefited greatly from the enormous achievements since 1990 in improving children's access to basic health services, both curative and preventive. The success of child immunization programmes has been a major boost to child health.
Immunization also protects vitamin A levels, which plum met during acute measles infections.
Programmes to improve hygiene and sanitation are also likely to be of crucial importance almost everywhere there is malnutrition in impoverished communities. Improved water supplies or support to food production may also be very critical, depending on local circumstances. Analyses in several countries have found that the strongest predicting factors for malnutrition are lack of safe water, inade quate sanitation and high fertility rates. Continued progress is needed in diarrhoea prevention, treatment, nutritional management and cure to ensure that growth lost during diarrhoea episodes is rapidly caught up, but the achievements so far have been of great nutritional benefit to millions of children. Similarly, the gains already achieved in access to safe water and sanitation facilities have translated into nutritional benefits around the world.