1
|
Negesse A, Girma T, Desalegn BB, Kerac M, Berhane M. The epidemiology and associated factors of non-exclusive breastfeeding: a comparative cross-sectional study of livelihood-secure and insecure areas. Front Nutr 2024; 11:1347780. [PMID: 38826580 PMCID: PMC11141399 DOI: 10.3389/fnut.2024.1347780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/29/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Regardless of national commitment, non-exclusive breastfeeding (NEBF) is a public health problem that worsens over time. It can be associated with sociodemographic, economic, and environmental factors and may vary depending on livelihood security. Hence, this study aimed to determine the magnitude of NEBF and identify its associated factors by considering two areas with varied degrees of livelihood security. Methods This study represented a comparative cross-sectional survey of 1,060 under 6 months (u6m) infant-mother pairs. Both descriptive and analytic statistics were evaluated using STATA version 17 packages. A binary logistic regression was used to identify associated factors of NEBF. The odds ratio (OR) with a 95% confidence interval (CI) was used to measure the significance of the association at a p-value of <0.05. Results The pooled magnitude of 51% of NEBF mothers (95% CI: 48.0, 54.0) was 53.1% (95% CI: 49.2, 57.0) and 48.1% (95% CI: 43.4, 52.8) in livelihood-secure and livelihood-insecure areas, respectively. The lack of recollecting the infant's birth date by mothers (AOR = 2.4; 95% CI = 1.15-4.40) had the highest odds of NEBF while household heads with tertiary education (AOR = 0.14; 95% CI = 0.01-0.54) and the poorest households (AOR = 0.43; 95%CI = 0.20-0.82) had the lowest odds of NEBF in livelihood-secure areas but not in livelihood-insecure areas. Moreover, mothers with male infants (AOR = 1.9; 95% CI = 1.18-2.92) had high odds of NEBF in livelihood-insecure areas but not in livelihood-secure areas. Infants of 2 to less than 4-month-old (AOR = 8.5; 95% CI = 3.47-18.63) and 4 to less than 6-month-old (AOR = 22.2; 95% CI = 8.02-51.97) in livelihood-secure areas and infants of 2 to less than 4-month-old (AOR = 4.3; 95% CI = 1.29-11.67) and 4 to less than 6-month-old (AOR = 8.3; 95% CI = 2.44-22.39) in livelihood-insecure areas had high odds of NEBF. Conclusion Over half of the mothers were practicing NEBF, which represents a failure to meet national and international targets. Area vulnerability to livelihood security modifies factors of NEBF. Male infants in insecure areas, infants of unknown age in secure areas, and infants aged 2 months or older, regardless of setting, were more vulnerable to NEBF. However, households with the lowest wealth and higher household head educational status in livelihood-secure areas were less vulnerable to NEBF. Hence, livelihood-based interventions targeting mothers of 2 to less than 6-month-old infants, with emphasis on these factors, may help address and reduce NEBF.
Collapse
Affiliation(s)
- Ayenew Negesse
- Academic center of Excellence in Human Nutrition, School of Nutrition, Food Science and Technology (SNFST), Hawassa University, Hawassa, Ethiopia
- Department of Human Nutrition, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tsinuel Girma
- Department of Paediatrics and Child Health, Jimma University, Jimma, Ethiopia
- University of British Colombia (UBC), Vancouver, BC, Canada
| | - Beruk Berhanu Desalegn
- Academic center of Excellence in Human Nutrition, School of Nutrition, Food Science and Technology (SNFST), Hawassa University, Hawassa, Ethiopia
| | - Marko Kerac
- London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom
| | - Melkamu Berhane
- Department of Paediatrics and Child Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
2
|
Wubetie BY, Tsunekawa A, Haregeweyn N, Tsubo M, Nigussie Z, Meshesha TM, Abe T. Analysis of Malnutrition among Children under Five Years across Contrasting Agroecosystems of Northwest Ethiopia: Application of Structural Equation Modeling. Nutrients 2024; 16:1208. [PMID: 38674898 PMCID: PMC11054005 DOI: 10.3390/nu16081208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
Child malnutrition remains a public health challenge in developing countries, but a comprehensive understanding of its burden and its determinants in specific local contexts is generally lacking. This study examined the prevalence of malnutrition and its determinants among children aged <5 years across contrasting agroecosystems in northwest Ethiopia. A community-based cross-sectional study involving 400 respondents was employed. Data were collected through semi-structured questionnaires and anthropometric measurements, complemented with focus group discussions and key informant interviews. The direct and indirect effects of the determinants of malnutrition were examined using structural equation modeling (SEM). The overall prevalence of child malnutrition, measured using the Composite Index of Anthropometric Failure, was 49%, with notable variation across agroecosystems (from 36.1% [midland with red soil] to 59% [lowland and valley fragmented]). Disease experience had significant positive direct effects on malnutrition. Dietary intake had negative and significant total (direct and indirect) effects on malnutrition, partially mediated through disease experience. Serial mediation in SEM analysis revealed significant indirect relationships between malnutrition and food security, feeding and care practices, household environment, health services, maternal diet, maternal empowerment, household wealth, and nutrition-sensitive agricultural practices. In conclusion, child malnutrition was highly prevalent and higher among children in the lowland and valley fragmented agroecosystem, characterized by unfavorable agro-climatic conditions, lower wealth status, poor health services access, and higher disease (particularly malaria) exposure. This study demonstrates the dynamics and multifaceted nature of malnutrition, highlighting the importance of considering geographical differences when planning interventions for childhood malnutrition and its determinants.
Collapse
Affiliation(s)
- Biruk Yazie Wubetie
- The United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori 680-8553, Japan
- College of Agriculture and Environmental Sciences, Bahir Dar University, Bahir Dar P.O. Box 5501, Ethiopia
| | - Atsushi Tsunekawa
- Arid Land Research Center, Tottori University, 1390 Hamasaka, Tottori 680-0001, Japan
| | - Nigussie Haregeweyn
- International Platform for Dryland Research and Education, Tottori University, 1390 Hamasaka, Tottori 680-0001, Japan
| | - Mitsuru Tsubo
- Arid Land Research Center, Tottori University, 1390 Hamasaka, Tottori 680-0001, Japan
| | - Zerihun Nigussie
- College of Agriculture and Environmental Sciences, Bahir Dar University, Bahir Dar P.O. Box 5501, Ethiopia
| | - Taye Minichil Meshesha
- The United Graduate School of Agricultural Sciences, Tottori University, 4-101 Koyama-Minami, Tottori 680-8553, Japan
- School of Civil and Water Resources Engineering, Debre Markos Institute of Technology, Debre Markos University, Debre Markos P.O. Box 269, Ethiopia
| | - Takeshi Abe
- International Platform for Dryland Research and Education, Tottori University, 1390 Hamasaka, Tottori 680-0001, Japan
| |
Collapse
|
3
|
Lusambili A, Kovats S, Nakstad B, Filippi V, Khaemba P, Roos N, Part C, Luchters S, Chersich M, Hess J, Kadio K, Scorgie F. Too hot to thrive: a qualitative inquiry of community perspectives on the effect of high ambient temperature on postpartum women and neonates in Kilifi, Kenya. BMC Pediatr 2024; 24:36. [PMID: 38216969 PMCID: PMC10787431 DOI: 10.1186/s12887-023-04517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/29/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi. DESIGN Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16). SETTINGS We conducted our research in Kilifi County in Kenya's Coast Province. The area is largely rural and during summer, air temperatures can reach 37˚C and rarely go below 23˚C. DATA ANALYSIS Data were analyzed in NVivo 12, using both inductive and deductive approaches. RESULTS High ambient temperature is perceived by community members to have direct and indirect health pathways in pregnancy and postpartum periods, including on the neonates. The direct impacts include injuries on the neonate's skin and in the mouth, leading to discomfort and affecting breastfeeding and sleeping. Participants described babies as "having no peace". Heat effects were perceived to be amplified by indoor air pollution and heat from indoor cooking fires. Community members believed that exclusive breastfeeding was not practical in conditions of extreme heat because it lowered breast milk production, which was, in turn, linked to a low scarcity of food and time spend by mothers away from their neonates performing household chores. Kangaroo Mother Care (KMC) was also negatively affected. Participants reported that postpartum women took longer to heal in the heat, were exhausted most of the time and tended not to attend postnatal care. CONCLUSIONS High ambient temperatures affect postpartum women and their neonates through direct and indirect pathways. Discomfort makes it difficult for the mother to care for the baby. Multi-sectoral policies and programs are required to mitigate the negative impacts of high ambient temperatures on maternal and neonatal health in rural Kilifi and similar settings.
Collapse
Affiliation(s)
- Adelaide Lusambili
- Environmental Health and Governance Center, Leadership and Governance Hub, School of Business, Africa International University, Nairobi, Kenya.
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Britt Nakstad
- Division of Pediatric and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter Khaemba
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Cherie Part
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Stanley Luchters
- Department of International Public Health, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jeremy Hess
- Emergency Medicine, Env & Occ Health Sciences, and Global Health, University of Washington, Washington, USA
| | - Kadidiatou Kadio
- Institute de Recherche en Siences de la Santé, Bobo-Dioulasso, Burkina Faso
| | - Fiona Scorgie
- Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
4
|
Boyd CM. Rainfall, mothers' time use, and child nutrition: evidence from rural Uganda. POPULATION AND ENVIRONMENT 2023; 45:17. [PMID: 38646023 PMCID: PMC11031269 DOI: 10.1007/s11111-023-00428-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 04/23/2024]
Abstract
Care provision is a key component of women's time use with implications for the health and wellbeing of children. Shifting labor demands resulting from weather shocks may imply that women in developing countries have less time for care provision, potentially affecting their children's nutrition. Nonetheless, a broad literature focusing on the indirect impacts of climate change on child nutrition has yet to explore the mechanisms whereby this occurs, and whether mothers' time use is one of these mechanisms. Using the Uganda National Panel Survey, a unique data set that gathers data on farming activities, time use, and anthropometric measures, I analyze how rainfall variability affects mother's time use and whether time use is a mechanism whereby rainfall variability affects child nutrition in the short run (measured as weight-for-age and weight-for-height Z-scores). My results show that increased rainfall variability in the last month decreases mothers' time share in other household-related activities (e.g., fetching water), while it increases the probability of child wasting. Moreover, using mediation analysis, I find that none of the mothers' time-use variables appears to be a mediating factor between rainfall variability and child nutrition. These results suggest that mothers adjust their time use due to rainfall variability without jeopardizing their children's nutritional levels.
Collapse
Affiliation(s)
- Chris M. Boyd
- Department of Economics, Towson University, Towson, MD, USA
| |
Collapse
|
5
|
Allen CK, Assaf S, Namaste S, Benedict RK. Estimates and trends of zero vegetable or fruit consumption among children aged 6-23 months in 64 countries. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001662. [PMID: 37368873 DOI: 10.1371/journal.pgph.0001662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
Children require a diverse diet, that includes vegetables and fruits, to support growth and development and prevent non-communicable diseases. The WHO-UNICEF established a new infant and young child feeding (IYCF) indicator: zero vegetable or fruit (ZVF) consumption among children aged 6-23 months. We estimated the prevalence, trends, and factors associated with ZVF consumption using nationally representative, cross-sectional data on child health and nutrition in low-and-middle-income countries. We examined 125 Demographic and Health Surveys in 64 countries conducted between 2006-2020 with data on whether a child ate vegetables or fruits the previous day. Prevalence of ZVF consumption was calculated by country, region, and globally. Country trends were estimated and tested for statistical significance (p<0.05). Logistic regression analysis was used to examine the relationship between ZVF and child, mother, household, and survey cluster characteristics by world region and globally. Using a pooled estimate of the most recent survey available in each country, we estimate the global prevalence of ZVF consumption as 45.7%, with the highest prevalence in West and Central Africa (56.1%) and the lowest in Latin America and the Caribbean (34.5%). Recent trends in ZVF consumption varied by country (16 decreasing, eight increasing, 14 no change). Country trends in ZVF consumption represented diverse patterns of food consumption over time and may be affected by the timing of surveys. Children from wealthier households and children of mothers who are employed, more educated, and have access to media were less likely to consume ZVF. We find the prevalence of children aged 6-23 months who do not consume any vegetables or fruits is high and is associated with wealth and characteristics of the mother. Areas for future research include generating evidence from low-and-middle-income countries on effective interventions and translating strategies from other contexts to improve vegetable and fruit consumption among young children.
Collapse
Affiliation(s)
- Courtney K Allen
- Sociology Department, University of Washington, Seattle, Washington, United States of America
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Shireen Assaf
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Sorrel Namaste
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| | - Rukundo K Benedict
- The Demographic and Health Surveys Program, ICF, Rockville, MD, United States of America
| |
Collapse
|
6
|
Brown ME, Carcedo AJP, Eggen M, Grace KL, Neff J, Ciampitti IA. Integrated modeling framework for sustainable agricultural intensification. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2023. [DOI: 10.3389/fsufs.2022.1039962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Agricultural scientists are pursuing sustainable intensification strategies to increase global food availability, but integration from research to impact at the local-level requires knowledge of demographic and human-environment to enhance the adaptive capacity of farmers cultivating <10 ha. Enhancing close collaboration among transdisciplinary teams and these smallholders is critical to co-elaborate policy solutions to ongoing food security crises that are likely to be attuned with local conditions. Human and socio-cultural aspects need to be considered to facilitate both adoption and dissemination of adapted management practices. Despite this well-known need to co-produce knowledge in human systems, we demonstrate the inequality of current agricultural research in smallholder farming systems with heavy focus on a few domains of the sustainable intensification agricultural framework (SIAF), ultimately reducing the overall impact of interventions due to the lack compatibility with prevailing social contexts. Here we propose to integrate agriculture and agronomic models with social and demographic modeling approaches to increase agricultural productivity and food system resilience, while addressing persistent issues in food security. Researchers should consider the scale of interventions, ensure attention is paid to equality and political processes, explore local change interactions, and improve connection of agriculture with nutrition and health outcomes, via nutrition-sensitive agricultural investments.
Collapse
|
7
|
Part C, Filippi V, Cresswell JA, Ganaba R, Hajat S, Nakstad B, Roos N, Kadio K, Chersich M, Lusambili A, Kouanda S, Kovats S. How do high ambient temperatures affect infant feeding practices? A prospective cohort study of postpartum women in Bobo-Dioulasso, Burkina Faso. BMJ Open 2022; 12:e061297. [PMID: 36198451 PMCID: PMC9535177 DOI: 10.1136/bmjopen-2022-061297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To examine the effects of high ambient temperature on infant feeding practices and childcare. DESIGN Secondary analysis of quantitative data from a prospective cohort study. SETTING Community-based interviews in the commune of Bobo-Dioulasso, Burkina Faso. Exclusive breastfeeding is not widely practised in Burkina Faso. PARTICIPANTS 866 women (1:1 urban:rural) were interviewed over 12 months. Participants were interviewed at three time points: cohort entry (when between 20 weeks' gestation and 22 weeks' postpartum), three and nine months thereafter. Retention at nine-month follow-up was 90%. Our secondary analysis focused on postpartum women (n=857). EXPOSURE Daily mean temperature (°C) measured at one weather station in Bobo-Dioulasso. Meteorological data were obtained from publicly available archives (TuTiempo.net). PRIMARY OUTCOME MEASURES Self-reported time spent breastfeeding (minutes/day), exclusive breastfeeding of infants under 6 months (no fluids other than breast milk provided in past 24 hours), supplementary feeding of infants aged 6-12 months (any fluid other than breast milk provided in past 24 hours), time spent caring for children (minutes/day). RESULTS The population experienced year-round high temperatures (daily mean temperature range=22.6°C-33.7°C). Breastfeeding decreased by 2.3 minutes/day (95% CI -4.6 to 0.04, p=0.05), and childcare increased by 0.6 minutes/day (0.06 to 1.2, p=0.03), per 1°C increase in same-day mean temperature. Temperature interacted with infant age to affect breastfeeding duration (p=0.02), with a stronger (negative) association between temperature and breastfeeding as infants aged (0-57 weeks). Odds of exclusive breastfeeding very young infants (0-3 months) tended to decrease as temperature increased (OR=0.88, 0.75 to 1.02, p=0.09). There was no association between temperature and exclusive breastfeeding at 3-6 months or supplementary feeding (6-12 months). CONCLUSIONS Women spent considerably less time breastfeeding (~25 minutes/day) during the hottest, compared with coolest, times of the year. Climate change adaptation plans for health should include advice to breastfeeding mothers during periods of high temperature.
Collapse
Affiliation(s)
- Chérie Part
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Véronique Filippi
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Jenny A Cresswell
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Rasmané Ganaba
- Agence de Formation de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté), Bobo-Dioulasso, Burkina Faso
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Britt Nakstad
- Division of Child and Adolescent Health, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Nathalie Roos
- Department of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
| | - Kadidiatou Kadio
- Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Adelaide Lusambili
- Department of Population Health, Medical College, Aga Khan University, Nairobi, Kenya
| | - Seni Kouanda
- Departement Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Sari Kovats
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
8
|
Grace K, Verdin A, Brown M, Bakhtsiyarava M, Backer D, Billing T. Conflict and Climate Factors and the Risk of Child Acute Malnutrition Among Children Aged 24-59 Months: A Comparative Analysis of Kenya, Nigeria, and Uganda. SPATIAL DEMOGRAPHY 2022; 10:329-358. [PMID: 37600470 PMCID: PMC10438900 DOI: 10.1007/s40980-021-00102-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 10/19/2022]
Abstract
Acute malnutrition affects a sizeable number of young children around the world, with serious repercussions for mortality and morbidity. Among the top priorities in addressing this problem are to anticipate which children tend to be susceptible and where and when crises of high prevalence rates would be likely to arise. In this article, we highlight the potential role of conflict and climate conditions as risk factors for acute malnutrition, while also assessing other vulnerabilities at the individual- and household-levels. Existing research reflects these features selectively, whereas we incorporate all the features into the same study. The empirical analysis relies on integration of health, conflict, and environmental data at multiple scales of observation to focuses on how local conflict and climate factors relate to an individual child's health. The centerpiece of the analysis is data from the Demographic and Health Surveys conducted in several different cross-sectional waves covering 2003-2016 in Kenya, Nigeria, and Uganda. The results obtained from multi-level statistical models indicate that in Kenya and Nigeria, conflict is associated with lower weight-for-height scores among children, even after accounting for individual-level and climate factors. In Nigeria and Kenya, conflict lagged 1-3 months and occurring within the growing season tends to reduce WHZ scores. In Uganda, however, weight-for-height scores are primarily associated with individual-level and household-level conditions and demonstrate little association with conflict or climate factors. The findings are valuable to guide humanitarian policymakers and practitioners in effective and efficient targeting of attention, interventions, and resources that lessen burdens of acute malnutrition in countries prone to conflict and climate shocks.
Collapse
|
9
|
Irenso AA, Letta S, Chemeda AS, Asfaw A, Egata G, Assefa N, Campbell KJ, Laws R. Maternal Time Use Drives Suboptimal Complementary Feeding Practices in the El Niño-Affected Eastern Ethiopia Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073937. [PMID: 35409616 PMCID: PMC8997821 DOI: 10.3390/ijerph19073937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
Ethiopia is affected by recurrent drought and food-insecurity crises, including El Niño. El Niño started in mid-2014, worsened in 2015, and continued in 2016, leading to a widespread food-insecurity emergency resulting in a surge in the rate of acute malnutrition in infants due to suboptimal feeding practices. This study explored how El Niño influenced complementary feeding practices in the eastern Ethiopia community from March to September 2016. It was an exploratory qualitative study with a basic interpretative qualitative approach. A general inductive approach was used for the analysis. The study involved 11 focus group discussions (FGD) with a total of 76 people, including three with mothers, three with Health Development Army (HDA) leaders, two with fathers, two with traditional birth attendants, and one with religious leaders. El Niño resulted in failed crops and loss of livestock, resulting in reduced dietary diversity and meal frequency. El Niño resulted in suboptimal complementary feeding practices by reducing food access and altering livelihood and coping strategies, reducing the time mothers allocated to child feeding, keeping them away from home, and stressing community health services. The maternal suboptimal time allocation is central to the poor complementary feeding practices. Thus, the women should be supported with climate-resilient livelihood options in their villages, allowing them to feed their children and attend education sessions with HDA leaders.
Collapse
Affiliation(s)
- Asnake Ararsa Irenso
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (K.J.C.); (R.L.)
- School of Public Health, Haramaya University, Harar P.O. Box 235, Ethiopia
- Correspondence: ; Tel.: +61-420-974-834
| | - Shiferaw Letta
- School of Nursing, Haramaya University, Harar P.O. Box 235, Ethiopia; (S.L.); (A.A.); (N.A.)
| | - Addisu S. Chemeda
- Department of Food Process Engineering and Postharvest Technology, Ambo University, Ambo P.O. Box 19, Ethiopia;
| | - Abiyot Asfaw
- School of Nursing, Haramaya University, Harar P.O. Box 235, Ethiopia; (S.L.); (A.A.); (N.A.)
| | - Gudina Egata
- School of Public Health, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia;
| | - Nega Assefa
- School of Nursing, Haramaya University, Harar P.O. Box 235, Ethiopia; (S.L.); (A.A.); (N.A.)
| | - Karen J. Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (K.J.C.); (R.L.)
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (K.J.C.); (R.L.)
| |
Collapse
|
10
|
Edney JM, Kovats S, Filippi V, Nakstad B. A systematic review of hot weather impacts on infant feeding practices in low-and middle-income countries. Front Pediatr 2022; 10:930348. [PMID: 36147803 PMCID: PMC9485728 DOI: 10.3389/fped.2022.930348] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increased rates of exclusive breastfeeding could significantly improve infant survival in low- and middle-income countries. There is a concern that increased hot weather due to climate change may increase rates of supplemental feeding due to infants requiring fluids, or the perception that infants are dehydrated. OBJECTIVE To understand how hot weather conditions may impact infant feeding practices by identifying and appraising evidence that exclusively breastfed infants can maintain hydration levels under hot weather conditions, and by examining available literature on infant feeding practices in hot weather. METHODS Systematic review of published studies that met inclusion criteria in MEDLINE, EMBASE, Global Health and Web of Science databases. The quality of included studies was appraised against predetermined criteria and relevant data extracted to produce a narrative synthesis of results. RESULTS Eighteen studies were identified. There is no evidence among studies of infant hydration that infants under the age of 6months require supplementary food or fluids in hot weather conditions. In some settings, healthcare providers and relatives continue to advise water supplementation in hot weather or during the warm seasons. Cultural practices, socio-economic status, and other locally specific factors also affect infant feeding practices and may be affected by weather and seasonal changes themselves. CONCLUSION Interventions to discourage water/other fluid supplementation in breastfeeding infants below 6 months are needed, especially in low-middle income countries. Families and healthcare providers should be advised that exclusive breastfeeding (EBF) is recommended even in hot conditions.
Collapse
Affiliation(s)
- Jessica M Edney
- Centre on Climate Change and Planetary Health, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Veronique Filippi
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Britt Nakstad
- Division of Paediatrics and Adolescence Medicine, Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Paediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| |
Collapse
|
11
|
Abstract
AbstractThis study investigates how two aspects of agricultural production diversity – farm production diversity and composition of production – relate to child height-for-age and weight-for-height in Ethiopia. We use longitudinal data on child anthropometric measurements, household farm production diversity and farm production composition from the Ethiopia Socioeconomic Survey for 2011, 2013, and 2015 available through the World Bank. Using longitudinal fixed effects models, we show that an increase in farm production diversity reduces the risk of chronic food insecurity (child height-for-age) but has no impact on acute measures of food insecurity (child weight-for-height). Results also suggest that, in a context of poor rainfall, more diversity in farm production can adversely impact child height-for-age, although livestock sales might mitigate that detrimental effect. These findings highlight the importance of considering the relationship between farm-level food production and child nutrition in a context of climate change.
Collapse
|
12
|
Entwisle B. Population Responses to Environmental Change: Looking Back, Looking Forward. POPULATION AND ENVIRONMENT 2021; 42:431-444. [PMID: 34149137 PMCID: PMC8211034 DOI: 10.1007/s11111-021-00382-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
Over the past two decades, population researchers have engaged in a far-reaching and productive program of research on demographic responses to changes in the natural environment. This essay "looks back" to the origins of these developments, identifying pivotal agenda-setting moments in the 1990s and tracing the impact on contemporary research. The essay also "looks forward" to identify critical gaps and challenges that remain to be addressed and to set an agenda for future research on population responses to environmental change. It recommends that the multidimensionality of environmental contexts and change be fully embraced, long run as well as short term effects be investigated, variability in the effects of environmental change in relation to social institutions, policy implementation, and environmental context be examined, movement between contexts as well as change in situ as sources of environmental change be considered, and interconnections among demographic processes in response to environmental change be explored. Taking these steps will position demographers to contribute significantly to a larger and deeper understanding of environmental change and its consequences, locally, regionally, and globally.
Collapse
Affiliation(s)
- Barbara Entwisle
- Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3210
| |
Collapse
|