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You W, Donnelly F. A greater nurse and midwife density protects against infant mortality globally. J Pediatr Nurs 2024; 77:e158-e166. [PMID: 38614819 DOI: 10.1016/j.pedn.2024.04.004] [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: 12/16/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE As the largest profession within the health care workforce, nurses and midwives play a critical role in the health and wellness of families especially children and infants. This study suggests those countries with higher nurse and midwife densities (NMD) had lower infant mortality rates (IMR). DESIGN AND METHODS With affluence, low birthweight and urbanization incorporated as potential confounders, this ecological study analyzed the correlations between NMD and IMR with scatterplots, Pearson r correlation, partial correlation and multiple linear regression models. Countries were also grouped for analysing and comparing their Pearson's coefficients. RESULTS NMD inversely and significantly correlated to IMR worldwide. This relationship remained significant independent of the confounders, economic affluence, low birthweight and urbanization. Explaining 57.19% of IMR variance, high NMD was implicated in significantly reducing the IMR. PRACTICE IMPLICATIONS Countries with high NMD had lower IMRs both worldwide and with special regard to developing countries. This may interest healthcare policymakers, especially those from developing countries, to consider the impacts of global nursing and midwifery staffing shortages. Nurses and midwives are the group of healthcare professionals who spend most with infants and their carers. This may be another alert for the health authorities to extend nurses and midwives' practice scope for promoting infant health.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia; Acute and Urgent Care, Royal Adelaide Hospital, Adelaide, Australia; Adelaide Medical School, the University of Adelaide, Adelaide, Australia; School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Frank Donnelly
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
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Guerrero CH, Cremades R, Sierra-Diaz E, López Flores MDL, Murcia-Baquero LM, Sandoval-Pinto E. Association of Food Security With Breastfeeding Practices: A Scoping Review. Cureus 2024; 16:e61177. [PMID: 38933626 PMCID: PMC11205263 DOI: 10.7759/cureus.61177] [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] [Accepted: 05/23/2024] [Indexed: 06/28/2024] Open
Abstract
Breastfeeding is the fundamental, physiological, and psychosocial process by which the mother feeds the newborn. Early initiation of breastfeeding is recommended within the first hour of life and exclusive breastfeeding up to six months of age due to its optimal contribution of nutrients for the development of the newborn. Despite this, there are factors that affect this process which involve the nutritional, physical, and psychological state of the mother, such as food security or food insecurity, however, it is unknown if it will have a decisive impact on these factors concerning the cessation of breastfeeding or total duration of breastfeeding. This study is an in-depth review of the available information related to food security as a determinant in breastfeeding practices. We did a scoping review between December 2022 - January 2023. The principal inclusion criteria were: the use of the English language, qualitative and quantitative methods, and analytical studies. All the articles were available in full text and the manuscripts ranged from 1997 and 2022. Twelve studies were included: eight quantitative, two qualitative, and two mixed. In the quantitative studies, significant positive and negative associations were found between food insecurity, exclusive breastfeeding, early initiation of breastfeeding, cessation of breastfeeding, and total duration of breastfeeding. For their part, qualitative and mixed studies describe that women with severe food insecurity tend to feel weak and may have a poor perception of their diet and, consequently, their breastfeeding practices are lower. Moreover, there are qualitative studies that mention that the higher the food insecurity, the more frequently breastfeeding occurs. The inconsistency in the results may be due to factors involving the characteristics of each population, the instrument used to measure food security, and the variables by which the models were adjusted. It is necessary to carry out more studies on the subject since it is obvious that the relationship between the variables needs to be clarified.
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Affiliation(s)
- Christian H Guerrero
- Centro Universitario de Ciencias de la Salud, Departamento de Salud Pública, Universidad de Guadalajara, Guadalajara, MEX
| | - Rosa Cremades
- Centro Universitario de Ciencias de la Salud, Departamento de Microbiología y Patología, Universidad de Guadalajara, Guadalajara, MEX
| | - Erick Sierra-Diaz
- Centro Universitario de Ciencias de la Salud, Departamento de Salud Pública, Universidad de Guadalajara, Guadalajara, MEX
| | - María de Lourdes López Flores
- Centro Universitario de Ciencias de la Salud, Departamento de Salud Pública, Universidad de Guadalajara, Guadalajara, MEX
| | - Lina María Murcia-Baquero
- Centro Universitario de Ciencias de la Salud, Departamento de Salud Pública, Universidad de Guadalajara, Guadalajara, MEX
| | - Elena Sandoval-Pinto
- Centro Universitario de Ciencias Biológicas y Agropecuarias, Departamento de Biología Celular y Molecular, Universidad de Guadalajara, Guadalajara, MEX
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Giorgetti A, Nyilima S, Stoffel NU, Moretti D, Mwasi E, Karanja S, Zeder C, Speich C, Netland C, Jin Z, Zimmermann MB, Brittenham GM. Stable iron ( 58Fe) isotopic measurements in Kenyan toddlers during 3 months of iron supplementation demonstrate that half of the iron absorbed is lost. Br J Haematol 2024; 204:2057-2065. [PMID: 38302093 DOI: 10.1111/bjh.19319] [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: 10/31/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
Increased iron loss may reduce the effectiveness of iron supplementation. The objective of this study was to determine if daily oral iron supplementation increases iron loss, measured using a stable isotope of iron (58Fe). We enrolled and dewormed 24 iron-depleted Kenyan children, 24-27 months of age, whose body iron was enriched and equilibrated with 58Fe given at least 1 year earlier. Over 3 months of supplementation (6 mg iron/kg body weight [BW]/day), mean (±SD) iron absorption was 1.10 (±0.28) mg/day. During supplementation, 0.55 (±0.36) mg iron/day was lost, equal to half of the amount of absorbed iron. Supplementation did not increase faecal haem/porphyrin or biomarkers of enterocyte damage and gut or systemic inflammation. Using individual patient data, we examined iron dose, absorption and loss among all available long-term iron isotopic studies of supplementation. Expressed in terms of body weight, daily iron loss was correlated significantly with iron absorption (Pearson's r = 0.66 [95% confidence interval 0.48-0.78]) but not with iron dose (r = 0.16 [95% CI -0.10-0.40]). The results of this study indicate that iron loss is increased with daily oral iron supplementation and may blunt the efficacy of iron supplements in children. This study was registered at ClinicalTrials.gov as NCT04721964.
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Affiliation(s)
- Ambra Giorgetti
- Laboratory of Human Nutrition, ETH, Zurich, Switzerland
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Suzane Nyilima
- Public and Community Health Department, Jomo Kenyatta University, Nairobi, Kenya
| | - Nicole U Stoffel
- Laboratory of Human Nutrition, ETH, Zurich, Switzerland
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Diego Moretti
- Nutrition Group, Swiss Distance University of Applied Sciences, Regensdorf, Switzerland
| | - Edith Mwasi
- Paediatric Department, Msambweni District Hospital, Msambweni, Kwale County, Kenya
| | - Simon Karanja
- Public and Community Health Department, Jomo Kenyatta University, Nairobi, Kenya
| | | | | | | | - Zhezhen Jin
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Michael B Zimmermann
- Laboratory of Human Nutrition, ETH, Zurich, Switzerland
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Gary M Brittenham
- Department of Paediatrics, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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Vankayalapati A, Wamwere-Njoroge G, Fujita M. Effects of household composition on infant feeding and mother-infant health in northern Kenya. Am J Hum Biol 2024; 36:e23993. [PMID: 37767929 DOI: 10.1002/ajhb.23993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Households with alloparents, individuals other than the mother who care for an infant, can shift members' roles and affect mother-infant health. AIMS To investigate how household composition relates to infant feeding and infectious disease risk in mother-infant dyads, the team utilized data from breastfeeding dyads (n 208) surveyed during a prolonged drought and food scarcity in northern Kenya. METHODS Households were classified by the presence/absence of potential alloparents, distinguishing non-siblings and siblings of the infant. Regression models for breastfeeding frequency, complementary feeding status, and recent infections (n 83) evaluated these outcomes' associations with household type while accounting for food insecurity, adjusted for infant age, infant sex, and maternal age. RESULTS Household type was unassociated with breastfeeding frequency, but the presence of non-sibling alloparents interacted with food insecurity, predicting increasing breastfeeding frequency as food insecurity intensified among dyads living with non-sibling alloparents. Households with non-sibling alloparents were also inversely associated with complementary feeding but had no association with infection. Households with siblings were inversely associated with (protective against) infant and maternal infection. CONCLUSION Further research is needed to understand the interactive influence of household social and food ecologies on mother-infant diet and health under diverse cultural rules and norms for alloparenting.
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Affiliation(s)
- A Vankayalapati
- Lyman Briggs College, Michigan State University, East Lansing, Michigan, USA
- Biomarker Laboratory for Anthropological Research, Michigan State University, East Lansing, Michigan, USA
| | | | - M Fujita
- Biomarker Laboratory for Anthropological Research, Michigan State University, East Lansing, Michigan, USA
- Department of Anthropology, Michigan State University, East Lansing, Michigan, USA
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Rosen F, Settel L, Irvine F, Koselka EPD, Miller JD, Young SL. Associations between food insecurity and child and parental physical, nutritional, psychosocial and economic well-being globally during the first 1000 days: A scoping review. MATERNAL & CHILD NUTRITION 2024; 20:e13574. [PMID: 37828823 PMCID: PMC10750018 DOI: 10.1111/mcn.13574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
Food insecurity affects billions of individuals annually and contributes to myriad poor health outcomes. Experiences of food insecurity may be particularly harmful during the first 1000 days, but literature on the topic has not been synthesized. We therefore aimed to characterize all available studies examining associations between food insecurity and nutritional, psychosocial, physical and economic well-being among parents and children during this period. We implemented a standardized search strategy across 11 databases. Four researchers screened 10,257 articles, 120 of which met the inclusion criteria. Most studies were conducted in Sub-Saharan Africa (43.3%), followed by North America (20.8%). Studies were primarily quantitative (95.8%), cross-sectional (70.0%) and focused on women (pregnant or post-partum, 48.3%) or women and children (15.8%). Physical health outcomes were the most investigated (n = 87 studies), followed by nutritional (n = 69), psychosocial (n = 35) and economic well-being (n = 2). The most studied associations were between food insecurity and stunting (n = 15), maternal depression (n = 12), child dietary diversity (n = 7) and maternal body mass index (n = 6). The strength of evidence for the observed associations varied across populations as well as within and between examined outcomes. We recommend that future studies recruit more diverse study populations, consider temporality of relationships, use instruments that facilitate cross-site comparisons, measure individual-level food insecurity and outcomes most likely to be impacted by food insecurity, evaluate contextual factors that may modify the effects of food insecurity and employ analytic techniques that permit assessment of causal pathways.
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Affiliation(s)
- Francesca Rosen
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | - Lily Settel
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
| | - Faith Irvine
- Department of Global Health StudiesNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Joshua D. Miller
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sera L. Young
- Department of AnthropologyNorthwestern UniversityEvanstonIllinoisUSA
- Institute for Policy ResearchNorthwestern UniversityEvanstonIllinoisUSA
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Elolu S, Agako A, Okello DM. Household food security, child dietary diversity and coping strategies among rural households. The case of Kole District in northern Uganda. DIALOGUES IN HEALTH 2023; 3:100149. [PMID: 38515798 PMCID: PMC10953863 DOI: 10.1016/j.dialog.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 03/23/2024]
Abstract
Household food security, feeding practices, dietary diversity and coping strategies to household food insecurity are largely interconnected. Using a cross sectional study approach involving 162 mothers and care givers of children 0-36 months of age in Kole district of northern Uganda, this study examined the household food security status, child dietary diversity and household coping strategies. The study revealed that a slight majority of the households (55%) were food secure although with a low level of child dietary diversity experienced (68.1% for children 6-23 months age group and 55.3% for 24-36 months age group). We found that starch-based foods derived from cereals, roots and tubers were the most predominantly used food group in child feeding (82%), with limited consumption of other essential food groups, notably fruits, vegetables, meats and dairy products (18% combined). Additionally, only 57% of children 0 to 6 months old were receiving exclusive breastfeeding, and the introduction of complementary foods is often delayed and not well planned for those above 6 months of age. Results also showed that a wide range of coping strategies are employed however the major ones were, reliance on less preferred food (54.9%), limiting portions of meals (35.2%), reducing number of meals taken in a day (29%), and gathering wild fruits and harvesting immature crops (29.6%). It was observed that household food security is a strong determinant of child dietary diversity, may influence feeding practices and the range of coping strategies applicable to households when they experience food insecurity. Furthermore, nutritional education, household size and livelihood diversity play a significant role in determining household food security status, child dietary diversity and coping with food insecurity within rural households. In conclusion, addressing household food security, and coping strategies can play an important role in improving child feeding practices and dietary diversity in rural communities.
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Affiliation(s)
- Samuel Elolu
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and Environment, Gulu University, P.O BOX 166, Gulu, Uganda
| | - Alod Agako
- Department of Food Science and Postharvest Technology, Faculty of Agriculture and Environment, Gulu University, P.O BOX 166, Gulu, Uganda
| | - Daniel Micheal Okello
- Department of Rural Development and Agribusiness, Faculty of Agriculture and Environment, Gulu University, P.O BOX 166, Gulu, Uganda
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Tadesse M, Ali Dawed Y, Fentaw Z, Endawike A, Adamu K. Determinants of inappropriate complementary feeding among children 6-23 months of age in Dessie City Northeast Ethiopia: a case-control study. BMC Nutr 2023; 9:124. [PMID: 37924096 PMCID: PMC10625273 DOI: 10.1186/s40795-023-00779-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/11/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Inappropriate complementary feeding is one of the leading causes of malnutrition among children 6-23 months old and delays children's growth milestone. The determinants of inappropriate complementary feeding practice have diverse natures, so that many of the previous studies fail to generate adequate evidence on it. This study aim to address the determinants of in appropriate complementary feedings at community level. METHODS A community-based unmatched case-control study design was carried out among children 6-23 months of age in Dessie City from April 13, 2021 to May 13, 2021. Nine kebeles were selected by simple random sampling method. One month prior to the data collection time survey was conducted and 482 samples were taken from the preliminary survey data; 241 cases and 241 controls by computer generated random numbers. Interviewer administered questionnaire was used to investigate potential determinants of inappropriate complementary feeding practice. Binary logistics regression was used to identify independent determinants. RESULTS Part working situation of mother [AOR = 0.21 CI: 0.08, 0.52] was negatively associated with inappropriate complementary feeding. Having no post-natal care visit [AOR = 4.062 CI:2.35,7.02], poor wealth status [AOR = 2.7 CI:1.09,6.68], food in-security [AOR = 4.49 CI:1.94,10.37], home delivery [AOR = 4.33 CI:1.43,13.15], having poor knowledge on infant and young child feeding [AOR = 5.94 CI:2.8,12.6], having no health education on complementary feeding [AOR = 2.54 CI:1.28,5.06] and father's job [AOR = 2.2 CI:1.17,4.1] were found to be positively associated with inappropriate complementary feeding. CONCLUSION Mothers' work situation, fathers' job, wealth index, food security, mothers' knowledge on infant feeding, post-natal care, health education on infant feeding and place of delivery were independent determinants for inappropriate complementary feeding. Thus, interventions shall effectively address those factors to alleviate the problem.
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Affiliation(s)
- Meron Tadesse
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, 1145, Ethiopia
| | - Yeshimebet Ali Dawed
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, 1145, Ethiopia
| | - Zinabu Fentaw
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abel Endawike
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kidist Adamu
- Department of Health System Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
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Bwalya R, Chama-Chiliba CM, Malinga S, Chirwa T. Association between household food security and infant feeding practices among women with children aged 6-23 months in rural Zambia. PLoS One 2023; 18:e0292052. [PMID: 37782631 PMCID: PMC10545113 DOI: 10.1371/journal.pone.0292052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 09/11/2023] [Indexed: 10/04/2023] Open
Abstract
Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, ultimately impacting their survival. However, ensuring that newborns and young children are fed according to the WHO-recommended practice has proven to be a challenge in many developing nations, especially in households that face food insecurity. This study aims to determine the association between IYCF practices and household food security's availability and access dimensions in rural Zambia. The study uses data from a cross-sectional survey of 2,127 mother-child pairs drawn from 28 rural districts in 8 out of the 10 Zambian provinces. Logistic regression analysis was used to examine the association of minimum dietary diversity, minimum meal frequency, and minimum acceptable diet with measures of household food security such as household dietary diversity score, and food insecurity experience scale, while controlling for confounding variables. The results show that children living in households classified as being food-secure based on the household dietary diversity score were significantly more likely to achieve appropriate feeding practices on all three IYCF measures, even after controlling for confounding factors. Notably, poor IYCF practices exist even in food-secure households, as most children in these households still need to receive a minimum acceptable diet. Although living in a household classified as food secure based on the access dimensions of household dietary diversity score and food insecurity experience scale is significantly associated with improvements in all three IYCF indicators even after controlling for confounding factors, the relationship does not hold for the availability measure of months of adequate household food provisioning. These findings highlight the need for targeting specific dimensions of household food security to solve child malnutrition, especially in rural areas. The focus should go beyond basic food availability, ensuring adequate diversity, and enhancing knowledge of appropriate feeding practices.
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Affiliation(s)
- Richard Bwalya
- Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia
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Nyamasege CK, Kimani-Murage EW, Imungi JK, Kaindi DWM, Wagatsuma Y. Risks of Anaemia Among Pre-School Children Following Maternal Nutrition Education and Counselling in Urban Informal Settlements of Nairobi, Kenya. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 43:265-274. [PMID: 34096381 DOI: 10.1177/0272684x211022584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Slum environment may pose risk to child health and nutrition. This study assessed the risks of anemia among under five-year-old children, five years after implementing a nutrition education and counseling intervention in two urban slums in Nairobi, Kenya. A cross-sectional study was conducted in May 2018 as a follow-up of a randomized controlled study carried out between 2012-2015. A trained nurse measured hemoglobin levels of 438 children from households which participated in the initial study. Multivariate logistic regression was conducted to identify risks of anemia. The mean (+SD) age of the children was 55.9 (5.3) months and mean (+SD) hemoglobin was 10.7 (1.5) g/dL. Anemia prevalence was 59.8%, 33.9% had mild, 24.7% moderate, and 1.2% severe anemia. Absence of home toilet (AOR = 3.31; 95% CI, 1.20-9.09), household which paid to use a toilet facility (AOR = 1.86; 95% CI, 1.12-3.08), child's frequency of eating colored fruits and vegetables (AOR = 0.28; 95% CI, 0.08-0.96), meat and meat products (AOR = 0.31; 95% CI, 0.23-6.01), number of meals a child aged <15years ate a day preceding the study (AOR = 1.49; 95% CI, 1.14-1.98), and a mother who had a history of anemia (AOR = 2.89; 95% CI, 1.22-12.01), were factors significantly associated with child's anemia status. The environment of urban informal settings influences child anemia status. Further studies with interventions are therefore required in order to improve sanitation facilities and access to meats, fruits, and vegetables in urban slums through innovative kitchen gardens and small animal husbandry.
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Affiliation(s)
- Carolyn Kemunto Nyamasege
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Japan.,Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Japan
| | - Elizabeth W Kimani-Murage
- Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Japan.,Department of Maternal and Child Wellbeing, African Population and Health Research Center, Nairobi, Kenya
| | | | | | - Yukiko Wagatsuma
- Department of Food Science, Nutrition and Technology, University of Nairobi, Kenya
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Koyratty N, Mbuya MNN, Jones AD, Schuster RC, Kordas K, Li CS, Tavengwa NV, Majo FD, Chasekwa B, Ntozini R, Humphrey JH, Smith LE. Implementation and maintenance of infant dietary diversity in Zimbabwe: contribution of food and water insecurity. BMC Nutr 2022; 8:136. [PMCID: PMC9673371 DOI: 10.1186/s40795-022-00622-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 10/19/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
Inadequate food and water resources negatively affect child health and the efficiency of nutrition interventions.
Methods
We used data from the SHINE trial to investigate the associations of food insecurity (FI) and water insecurity (WI) on mothers’ implementation and maintenance of minimum infant dietary diversity (MIDD). We conducted factor analysis to identify and score dimensions of FI (poor access, household shocks, low availability & quality), and WI (poor access, poor quality and low reliability). MIDD implementation (n = 636) was adequate if infants aged 12 months (M12) ate ≥ four food groups. MIDD maintenance (n = 624) was categorized into four mutually exclusive groups: A (unmet MIDD at both M12 and M18), B (unmet MIDD at M12 only), C (unmet MIDD at M18 only), and D (met MIDD at both M12 and M18). We used multivariable-adjusted binary logistic and multinomial regressions to determine likelihood of MIDD implementation, and of belonging to MIDD maintenance groups A-C (poor maintenance groups), compared to group D, respectively.
Results
Low food availability & quality were negatively associated with implementation (OR = 0.81; 0.69, 0.97), and maintenance (ORB = 1.29; 1.07, 1.56). Poor water quality was positively associated with implementation (OR = 1.25; 1.08, 1.44), but inconsistently associated with maintenance, with higher odds of infants being in group C (OR = 1.39; 1.08, 1.79), and lower odds of being in group B (OR = 0.80; 0.66, 0.96).
Conclusion
Food security should be prioritized for adequate implementation and maintenance of infant diets during complementary feeding. The inconsistent findings with water quality indicate the need for further research on WI and infant feeding.
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Mohlala TB, Mathunjwa SN, Legodi HM, Mataboge MS. Exploring the infant feeding experiences of mothers living in selected Tshwane informal settlements: a qualitative study. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2022. [DOI: 10.1080/16070658.2022.2140498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The Household Food Security and Feeding Pattern of Preschool Children in North-Central Nigeria. Nutrients 2022; 14:nu14194112. [PMID: 36235764 PMCID: PMC9572999 DOI: 10.3390/nu14194112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/17/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Children’s feeding patterns and health outcomes are important determinants of any country’s food and nutrition security status. This study assessed the household food security and feeding patterns of preschoolers in Niger State, Nigeria. A cross-sectional descriptive design and a multi-stage sampling technique were employed to analyze 450 preschool children from selected local government areas. Household food security was measured using the HFIAS nine-item questionnaire, and feeding patterns were evaluated using the qualitative food frequency questionnaire (FFQ). The mean age of the preschoolers was 3.71 ± 0.80 years. A majority (61.30%) of the children consumed cereal-based products, while fruits and vegetables were the least consumed (16.40%). More than half (59.80%) of the preschoolers met their minimum dietary diversity. Almost all (98.80%) of the children were from food-insecure households, with 40.3% being severely food insecure. Parity, religion, and having a breadwinner and source of potable water were significantly associated with the adequacy of minimum dietary diversity (MDD) among the preschoolers (F value = 5.528, p ≤ 0.05). The contribution of poor feeding patterns and household food insecurity to the overall health outcome of preschoolers cannot be overlooked. Hence, nations must prioritize improving the availability, accessibility, and utilization of food to better meet the nutritional needs of preschool children.
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Ssewanyana D, Zhang L, Martin MC, Proulx K, Malti T, Abubakar A, Angwenyi V, Kabue M, Marangu J, Odhiambo R, Njoroge E, Ombech E, Mokaya MM, Obulemire EK, Moran G, Marfo K, Lye S. Health seeking behaviors and childcare patterns in an informal settlement of Nairobi, Kenya: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000738. [PMID: 36962422 PMCID: PMC10021912 DOI: 10.1371/journal.pgph.0000738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 06/16/2022] [Indexed: 11/19/2022]
Abstract
Children in urban informal settlements experience high risks for poor health and development. Understanding health seeking behaviors and childcare patterns of caregivers in urban informal settlements is important for devising effective interventions. This study describes household characteristics and aspects of nurturing care among caregivers of children aged 0-2 years in Dagoretti informal settlement, Nairobi-Kenya. In this cross sectional study, data were collected on household socio-demographic characteristics, antenatal care and child delivery practices, infant and young child feeding practices, activities that promote play, learning and school readiness, and on childcare and protection practices. Descriptive statistics of proportions and means were used to summarize the data. The study covers a total of 458 Kenyan and 118 immigrant households. Caregivers from immigrant households, with low education and from the younger age-group (less than 20 years) were vulnerable to sub-optimal caregiving and health seeking practices, including relatively lower rates of age-appropriate breastfeeding and poor dietary diversity. Seventy-five percent of expectant mothers attended less than four antenatal care visits. Households surveyed had limited possession of children's books (2% with three or more books), limited access to play materials (43% had two or more play materials), and low paternal involvement in child stimulation and early learning activities (14%). One-third and half of the children were left with inadequate care and disciplined using both violent and non-violent methods, respectively. Our findings highlight the urgent need for contextually appropriate and integrated interventions anchored in the WHO's nurturing care framework. These interventions can benefit from extensive involvement of caregivers, facility and community-based healthcare workers, policy makers, and other relevant stakeholders.
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Affiliation(s)
- Derrick Ssewanyana
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Linlin Zhang
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Marie-Claude Martin
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Kerrie Proulx
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
| | - Tina Malti
- Centre for Child Development, Mental Health, and Policy, University of Toronto, Mississauga, Canada
| | - Amina Abubakar
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
- Neuroassement group, KEMRI/Wellcome Trust Research Programme, Centre for Geographic Medicine Research, Kilifi, Kenya
| | - Vibian Angwenyi
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Margaret Kabue
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Joyce Marangu
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Rachel Odhiambo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Njoroge
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Eunice Ombech
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | | | | | - Greg Moran
- Department of Psychology, Western University, London, ON, Canada
| | - Kofi Marfo
- Institute for Human Development, Aga Khan University, Nairobi, Kenya
| | - Stephen Lye
- Alliance for Human Development, Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada
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Ochola S, Ogada IA, Odera CA. Predictors of the amount of intake of Ready-To-Use-Therapeutic foods among children in outpatient therapeutic programs in Nairobi, Kenya. Food Sci Nutr 2022; 10:1135-1145. [PMID: 35432961 PMCID: PMC9007311 DOI: 10.1002/fsn3.2745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/27/2021] [Accepted: 01/02/2022] [Indexed: 11/12/2022] Open
Abstract
Ready‐to‐use Therapeutic Food (RUTF) therapy is a standard protocol for treating children with severe acute malnutrition (SAM) admitted in Out‐Patient Therapeutic Programmes (OTP). The amount of RUTF to be consumed by a child is based on weight (200 kcal/kg body weight/day) as stipulated in the Kenya Integrated Management of Acute Malnutrition (IMAM) protocol for timely weight gain. There is limited information on the determinants of consumption of the correct amount of RUTF. This study sought to fill this gap by establishing the associations between the caregivers' and the child's characteristics and the amount of RUTF the child ate within a 24‐h recall period. We used a cross‐sectional study design and interviewed 200 caregivers of children 6–23 months of age admitted in four OTP centers in Nairobi Kenya. We used a researcher‐administered questionnaire to collect information from the caregivers. Seventy‐three percent of the children ate the recommended amount of RUTF. A smaller proportion (54.4%) of younger children (6–11 months of age) ate the recommended amount of RUTF compared to older children (12–17 months old and 18–23 months old at 89.1% and 82.8%, respectively). The predictors of consumption of the correct amount of RUTF were child's birth order—firstborn (AOR 29.92; 95% CI: 5.67–157.93) and children's age; 12–17 months old (AOR 5.19; 95% CI: 2.18–12.36) and 18–23 months (AOR 6.19 95% CI: 2.62), indicating that firstborn and older children were more likely to consume the correct amounts of RUTF. Caregivers' knowledge and correct practices in feeding a child with RUTF also predicted the consumption of the correct amount of RUTF. In conclusion, maternal and child characteristics are determinants of the consumption of the correct amount of RUTF by children in OTP.
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Affiliation(s)
- Sophie Ochola
- Department of Food, Nutrition and Dietetics Kenyatta University Nairobi Kenya
| | - Irene A Ogada
- Department of Applied Human Nutrition Mount Saint University Halifax Nova Scotia Canada
| | - Colleta A Odera
- Department of Food, Nutrition and Dietetics Kenyatta University Nairobi Kenya
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15
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Syafiq A, Fikawati S, Gemily SC. Household food security during the COVID-19 pandemic in urban and semi-urban areas in Indonesia. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:4. [PMID: 35189982 PMCID: PMC8860285 DOI: 10.1186/s41043-022-00285-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 02/10/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND One of the impacts of the COVID-19 pandemic was the weakening of the community's economic condition. The weak economy of the community will have an impact on household food security. This study aims to determine food security in the COVID-19 pandemic situation and the impact of the pandemic on food security in urban and semi-urban areas. METHODS A cross-sectional study with a total sample of 517 people who live in urban (Jakarta) and semi-urban (Depok) areas. The research data was collected online and purposively through Posyandu cadres who have access to family/community. Food security was measured using HFIAS (Household Food Insecurity Access Scale) method, while impact of COVID-19 pandemic was categorized into two categories: impacted (reduced income and laid off) and less impacted (not reduced income and laid off). Data analysis used the Chi-square test and multiple logistic regression. RESULTS There were 65.0% of households with various level of food insecurity during the COVID-19 pandemic. The results of the multivariate analysis showed that family income during the COVID-19 pandemic (AOR = 4.2; CI = 2.7-6.7), the type of impact of the COVID-19 pandemic, i.e., reduced income and stopped working (AOR = 2.6; CI = 1.6-4.1), and the age of the respondent (AOR = 1.7; CI = 1.1-2.5) were significantly related to household food security during the pandemic after being controlled by husband's work status. Households with lower income had 4 times higher risk to experience food insecurity compared to those with higher income. Heavily impacted households (through reduced income and stopped working) had 3 times higher risk to experience food insecurity compared to those who did not. Additionally, we found that households with younger respondent (< 31 years old) had 2 times higher risk to experience food insecurity compared to those older counterparts. CONCLUSIONS The COVID-19 pandemic impacted household food security in both urban and semi-urban areas through worsening employment status and income condition.
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Affiliation(s)
- Ahmad Syafiq
- Center for Nutrition and Health Studies, Faculty of Public Health, University of Indonesia, Building F Level 2, Faculty of Public Health University of Indonesia, Depok, West Java, Indonesia.
| | - Sandra Fikawati
- Center for Nutrition and Health Studies, Faculty of Public Health, University of Indonesia, Building F Level 2, Faculty of Public Health University of Indonesia, Depok, West Java, Indonesia
| | - Syilga Cahya Gemily
- Center for Nutrition and Health Studies, Faculty of Public Health, University of Indonesia, Building F Level 2, Faculty of Public Health University of Indonesia, Depok, West Java, Indonesia
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16
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Berhanu Mamo Z, Wudneh A, Molla W. Determinants of complementary feeding initiation time among 6–23 months children in Gedeo Zone, South Ethiopia: Community-based case-control study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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17
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Feeding practices and factors associated with the provision of iron-rich foods to children aged 6-23 months in Matam area, Senegal. Public Health Nutr 2021; 24:4442-4453. [PMID: 34284842 DOI: 10.1017/s1368980021002718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objectives of this study were to document feeding practices amongst rural Senegalese children aged 6 to 23 months and to investigate psychosocial and environmental factors associated with the provision of iron-rich foods (IRF). DESIGN This was a cross-sectional study conducted from January to July 2018. SETTING The study took place in the region of Matam, northern Senegal. PARTICIPANTS Ninety-eight mothers of children aged 6-23 months. RESULTS Results show that 27·6 % of children were fed according to the minimum acceptable diet, and 55·1 % and 53·1 % had the minimum diet diversity and minimum meal frequency, respectively. About 65·3 % of mothers provided IRF to young children the day before the survey, mostly fish. Mother's intention to provide IRF to their children was not associated with the provision of these foods neither was the perceived behavioural control. Child's age (OR = 1·14, 95 % CI (1·03, 1·26), P = 0·012) and household food insecurity score (OR = 0·80, 95 % CI (0·68, 0·96), P = 0·014) were the predictors of the provision of IRF to children aged 6-23 months. CONCLUSIONS Household food insecurity status and age of the child rather than mothers' psychosocial factors were significant predictors of IRF consumption amongst children aged 6-23 months in the study area. More attention should be given to food environment and child-related factors in order to improve children feeding practices and, in particular, their consumption of IRF in the study setting. For instance, home visits and the 5-month-old vaccine consultation in health centres might be opportunities to reinforce the importance of providing IRF as part of complementary foods from the age of 6 months. Implementation of measures for the improvement of socio-economic conditions and food security of households would also be valuable.
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18
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Kemboi S, Mungiria-Mituki D, Ramkat R, Termote C, Covic N, Cheserek MJ. Variation in the Factors Associated With Diet Quality of Children Aged 6 to 23 Months in Low and High Agroecological Zones of Rongai Subcounty, Kenya. Food Nutr Bull 2021; 41:186-199. [PMID: 32522128 DOI: 10.1177/0379572120912875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adequate quality complementary diets and appropriate feeding practices are important for proper growth and development of young children. OBJECTIVE To assess factors associated with diet diversity, meal frequency, and acceptable diet of children aged 6 to 23 months in two agroecological zones of Rongai subcounty, Kenya. METHODS A cross-sectional study was conducted among 384 mothers/caregivers with children aged 6 to 23 months. A structured questionnaire was used to assess sociodemographic characteristics and child feeding practices. Diet diversity, meal frequency, and acceptable diet were derived from a 24-hour recall of child's food intake. Factors associated with diet quality were determined using binary logistic regression. RESULTS Mean child diet diversity score was 3.54 ± 1.0 of 7 food groups, with 56.8% of the children achieving minimum dietary diversity. A majority of the children (81.8%) received minimum meal frequency (MMF), with significant (P < .05) difference between low (91.1%) and high (75.2%) agricultural potential areas. Children who received minimum acceptable diet (MAD) were only 34.1%. Mother/caregiver education level positively (P < .05) associated with minimum diet diversity in low potential area (adjusted odds ratio [AOR] = 3.79, 95% CI: 1.47-9.75) and with MAD in high potential area (AOR = 1.87, 95% CI: 1.01-3.46). Other factors associated with MDD, MMF, and MAD included household income and slow feeding in low potential area, and child gender and active feeding in high potential area. CONCLUSION There is a variation in factors associated with diet quality and child feeding practices in different agroecological zones. Therefore, nutrition education and behavior change communication interventions aimed at improving child nutrition should be context-specific.
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Affiliation(s)
| | | | | | | | - Namukolo Covic
- International Food Policy Research Institute, Addis Ababa, Ethiopia
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19
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Woldetensay YK, Belachew T, Ghosh S, Kantelhardt EJ, Biesalski HK, Scherbaum V. The effect of maternal depressive symptoms on infant feeding practices in rural Ethiopia: community based birth cohort study. Int Breastfeed J 2021; 16:27. [PMID: 33743775 PMCID: PMC7980325 DOI: 10.1186/s13006-021-00375-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/12/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Maternal depression and other psychosocial factors have been shown to have adverse consequences on infant feeding practices. This study explored the longitudinal relationship of maternal depressive symptoms and other selected psychosocial factors with infant feeding practices (IFPs) in rural Ethiopia using summary IFP index. METHODS This study uses existing data from the ENGINE birth cohort study, conducted from March 2014 to March 2016 in three districts in the southwest of Ethiopia. A total of 4680 pregnant women were recruited and data were collected once during pregnancy (twice for those in the first trimester), at birth, and then every 3 months until the child was 12 months old. A standardized questionnaire was used to collect data on IFPs, maternal depressive symptoms, household food insecurity, intimate partner violence (IPV), maternal social support, active social participation, and other sociodemographic variables. A composite measure of IFP index was computed using 14 WHO recommended infant and young child feeding (IYCF) practice indicators. High IFP index indicated best practice. Prenatal and postnatal maternal depressive symptoms were assessed using the patient health questionnaire (PHQ-9). Linear multilevel mixed effects model was fitted to assess longitudinal relationship of IFPs with maternal depression and other psychosocial factors. RESULTS Reports of higher postnatal depressive symptoms (ß = - 1.03, P = 0.001) and IPV (ß = - 0.21, P = 0.001) were associated with lower scores on the IFP index. Whereas, reports of better maternal social support (ß = 0.11, P = 0.002) and active social participation (ß = 0.55, P < 0.001) were associated with higher scores on the IFP index. Contrary to expectations, moderate household food insecurity (ß = 0.84, P = 0.003), severe household food insecurity (ß = 1.03, P = 0.01) and infant morbidity episodes (ß = 0.63, P = 0.013) were associated with higher scores on the IFP index. CONCLUSIONS Overall, a multitude of factors are related to IFPs and hence coordinated, multi-sectoral and multi-stakeholder interventions including maternal depressive symptoms screening and management are needed to improve infant feeding practices.
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Affiliation(s)
- Yitbarek Kidane Woldetensay
- Institute of Nutrition Science (140a), University of Hohenheim, Stuttgart, Germany
- Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Tefera Belachew
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Shibani Ghosh
- Tufts University, Friedman School of Nutrition Science and Policy, Boston, USA
| | - Eva Johanna Kantelhardt
- Department of Gynecology, Faculty of Medicine, Martin-Luther University, Halle, Germany
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther University, Halle, Germany
| | - Hans Konrad Biesalski
- Institute of Nutrition Science (140a), University of Hohenheim, Stuttgart, Germany
- Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Veronika Scherbaum
- Institute of Nutrition Science (140a), University of Hohenheim, Stuttgart, Germany
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20
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Widyaningrum R, Safitri RA, Ramadhani K, Suryani D, Syarief F. Complementary Feeding Practices During COVID-19 Outbreak in Daerah Istimewa Yogyakarta, Indonesia, and Its Related Factor. Asia Pac J Public Health 2020; 33:150-153. [PMID: 33246381 DOI: 10.1177/1010539520976518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Dyah Suryani
- Universitas Ahmad Dahlan, Daerah Istimewa Yogyakarta, Indonesia
| | - Firman Syarief
- Universitas Ahmad Dahlan, Daerah Istimewa Yogyakarta, Indonesia
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21
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Mutisya M, Markey O, Rousham EK, Chintsanya JMN, Pradeilles R, Kimani-Murage EW, Madise NJ, Munthali AC, Kalimbira A, Holdsworth M, Griffiths PL, Haycraft E. Improving nutritional status among urban poor children in sub-Saharan Africa: An evidence-informed Delphi-based consultation. MATERNAL AND CHILD NUTRITION 2020; 17:e13099. [PMID: 33145974 PMCID: PMC7988854 DOI: 10.1111/mcn.13099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 01/26/2023]
Abstract
In sub‐Saharan Africa (SSA), rapid urbanisation coupled with the high prevalence of infant and young child (IYC) undernutrition in low‐income settings means that interventions to support IYC nutrition are a priority. Little is known about how urbanisation influences IYC feeding (IYCF) practices, and evidence‐based interventions to improve IYC health/nutrition in the urban poor are lacking. Therefore, this research aimed to (a) systematically review evidence on interventions for improving the nutritional status of IYC aged 6–23 months living in urban poor areas (PROSPERO CRD42018091265) and (b) engage stakeholders to identify the highest ranking evidence gaps for improving IYCF programmes/policies. First, a rapid systematic review was conducted. This focused on the literature published regarding nutrition‐specific and nutrition‐sensitive complementary feeding interventions in urban poor areas, specifically low‐income informal settlements, in low‐ and middle‐income countries (LMICs). Six intervention studies met the review inclusion criteria. Intervention adherence was generally high, and indicators of maternal knowledge and IYC nutritional intake typically increased because of the interventions, but the impact on anthropometric status was small. Second, stakeholders working across SSA were engaged via a Delphi‐based approach to identify priority areas for future intervention. Stakeholders reported that a situational analysis was required to better understand IYCF in urban poor areas, particularly the causes of IYC undernutrition, and highlighted the need to involve local communities in defining how future work should proceed. Together, these findings indicate a need for more evidence regarding IYCF and the factors that drive it in urban poor areas across LMIC settings, but particularly in SSA.
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Affiliation(s)
- Maurice Mutisya
- African Population and Health Research Center, Nairobi, Kenya
| | - Oonagh Markey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jesman M N Chintsanya
- Department of Population Studies, Chancellor College, University of Malawi, Zomba, Malawi
| | - Rebecca Pradeilles
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | | | - Alister C Munthali
- Centre for Social Research, Chancellor College, University of Malawi, Zomba, Malawi
| | | | - Michelle Holdsworth
- School of Health and Related Research, University of Sheffield, Sheffield, UK.,UMR NUTRIPASS, Research Institute for Development, Montpellier, France
| | - Paula L Griffiths
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Emma Haycraft
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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22
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The Nairobi Urban Health and Demographic Surveillance of slum dwellers, 2002–2019: Value, processes, and challenges. GLOBAL EPIDEMIOLOGY 2020. [DOI: 10.1016/j.gloepi.2020.100024] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Effect of maternal nutritional education and counselling on children's stunting prevalence in urban informal settlements in Nairobi, Kenya. Public Health Nutr 2020; 24:3740-3752. [PMID: 32693855 DOI: 10.1017/s1368980020001962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine whether the prevalence of stunting differed between an intervention group and a control group and to identify factors associated with the children's linear growth. DESIGN This was a follow-up study of mother-child pairs who participated in a 2012-2015 cluster randomised controlled trial. Linear mixed effects models were performed to model the children's linear growth and identify the determinants of child linear growth. SETTING The study was conducted in two slums in Nairobi. The intervention group received monthly nutrition education and counselling (NEC) during pregnancy and infancy period. PARTICIPANTS A birth cohort of 1004 was followed up every 3 months after delivery to the 13th month. However, as a result of dropouts, a total of 438 mother-child pairs participated during the 55-month follow-up. The loss to follow-up baseline characteristics did not differ from those included for analysis. RESULTS Length-for-age z-scores decreased from birth to the 13th month, mean -1·42 (sd 2·04), with the control group (33·5 %) reporting a significantly higher prevalence of stunting than the intervention group (28·6 %). Conversely, the scores increased in the 55th month, mean -0·89 (sd 1·04), with significantly more males (16·5 %) stunted in the control group than in the intervention group (8·3 %). Being in the control group, being a male child, often vomiting/regurgitating food, mother's stature of <154 cm and early weaning were negatively associated with children's linear growth. CONCLUSIONS Home-based maternal NEC reduced stunting among under five years; however, the long-term benefits of this intervention on children's health need to be elucidated.
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24
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Abebe Z, Tariku A, Bikes GA, Wassie MM, Gonete KA, Awoke T, Gebeye E, Gete AA, Yesuf ME, Kebede Y, Alemu K, Addis A, Muhammad EA, Abebe SM, Kasahun Belew A, Hunegnaw MT, Fentie M, Kebede A, Muchie KF. Poor child complementary Feeding Practices in northwest Ethiopia: Finding from the Baseline Survey of Nutrition Project, 2016. Ital J Pediatr 2019; 45:154. [PMID: 31791372 PMCID: PMC6889572 DOI: 10.1186/s13052-019-0747-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 11/19/2019] [Indexed: 12/04/2022] Open
Abstract
Background Improving infant and young child feeding practices is critical to improved nutrition, health, and development of children. Ethiopia adopted the WHO recommendations of child feeding practices and developed the national guideline. In spite of this fact, only few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Health and Demographic Surveillance System site (HDSS), northwest Ethiopia. Methods A cross-sectional community based study was carried out from February to June 2016. All children aged 6–59 months old who lived in HDSS site were included in the survey. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, variables with a P-value of < 0.05 were considered statistically significant.. Results In this study, a total of 3433 children were included. About 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR = 6.51; 95%CI: 4.95, 8.56), had antenatal care (AOR = 1.90; 95%CI: 1.60, 2.26) and postnatal care visits (AOR = 1.31; 95%CI: 1.00, 1, 72), and children who feed with their family (AOR = 1.39; 95%CI: 1.17, 1.65). However, a lower dietary diversity score was observed among younger children; 6–11 months old (AOR = 0.59; 95%CI: 0.41, 0.85), and children from food insecure household (AOR = 0.76; 95%CI: 0.63, 0.92). Conclusions Diversified diet feeding practice is low in Dabat HDSS site. Age of the child, maternal education, antenatal and postnatal care visits, and household food insecurity were significantly associated with dietary diversity of children. Hence, ensuring household food security and enhancing the coverage of maternal health care utilization are recommended to increase dietary diversity of children.
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Affiliation(s)
- Zegeye Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Bikes
- Department of Health Services Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Mesele Wassie
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kedir Abdela Gonete
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ejigu Gebeye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azeb Atnafu Gete
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkie Edris Yesuf
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebaw Addis
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Esmael Ali Muhammad
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Mekonnen Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aysheshim Kasahun Belew
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tamir Hunegnaw
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkitu Fentie
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adane Kebede
- Department of Health Services Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindie Fentahun Muchie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fiorella KJ, Gavenus ER, Milner EM, Moore M, Wilson‐Anumudu F, Adhiambo F, Mattah B, Bukusi E, Fernald LCH. Evaluation of a social network intervention on child feeding practices and caregiver knowledge. MATERNAL & CHILD NUTRITION 2019; 15:e12782. [PMID: 30676696 PMCID: PMC7199033 DOI: 10.1111/mcn.12782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/30/2018] [Accepted: 01/09/2019] [Indexed: 01/04/2023]
Abstract
Food insecurity and poor infant and young child feeding (IYCF) practices contribute to undernutrition. The Kanyakla Nutrition Program was developed in rural Kenya to provide knowledge alongside social support for recommended IYCF practices. Utilizing a social network approach, the Kanyakla Nutrition Program trained community health workers (CHWs) to engage mothers, fathers, and grandparents in nutrition education and discussions about strategies to provide instrumental, emotional, and information support within their community. The 12-week programme included six sessions and was implemented on Mfangano Island, Kenya, in 2014-2015. We analysed intervention effects on (a) nutrition knowledge among community members or CHWs and (2) IYCF practices among children 1-3 years. Nutrition knowledge was assessed using a postintervention comparison among intervention (community, n = 43; CHW, n = 22) and comparison groups (community, n = 149; CHW, n = 64). We used a quasi-experimental design and difference-in-difference to assess IYCF indicators using dietary recall data from an ongoing cohort study among intervention participants (n = 48) with individuals living on Mfangano Island where the intervention was not implemented (n = 178) before the intervention, within 1 month postintervention, and 6 months postintervention. Findings showed no effect of the intervention on IYCF indicators (e.g., dietary diversity and meal frequency), and less than 15% of children met minimum acceptable diet criteria at any time point. However, knowledge and confidence among community members and CHWs were significantly higher 2 years postintervention. Thus, a social network approach had an enduring effect on nutrition knowledge, but no effects on improved IYCF practices.
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Affiliation(s)
- Kathryn J. Fiorella
- Department of Population Medicine and Diagnostic SciencesCornell UniversityIthacaNew YorkUSA
- Master of Public Health ProgramCornell UniversityIthacaNew YorkUSA
| | - Erika R. Gavenus
- Institute for Resources, Environment and SustainabilityUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Megan Moore
- Global Health SciencesUCSFSan FranciscoCaliforniaUSA
| | | | | | - Brian Mattah
- Research DepartmentOrganic Health ResponseMbitaKenya
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Machiyama K, Mumah JN, Mutua M, Cleland J. Childbearing desires and behaviour: a prospective assessment in Nairobi slums. BMC Pregnancy Childbirth 2019; 19:100. [PMID: 30922262 PMCID: PMC6437922 DOI: 10.1186/s12884-019-2245-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Advancing an understanding of childbearing desires is an important precursor to achievement of the policy goal of reducing unintended pregnancies. It has been long debated that concepts of fertility desires and planning may be particularly problematic in sub-Saharan Africa. However, examination of the utility of fertility preference measures and their link to reproductive behaviour is still rare in the region. The aim of this study is to assess the predictive validity of future childbearing desires on subsequent reproduction among women living in the highly unpredictable circumstances of Nairobi slums. METHODS We used data from a longitudinal study (2007-2010) nested in the Nairobi Urban Health Demographic Surveillance System that is located in two slums in Nairobi, Kenya. We analysed baseline fertility desires among 4577 postpartum women. Cox proportional hazard model was employed to examine the effect of fertility desires on subsequent reproduction. RESULTS One-third of the women wanted no more children and 37% wanted to wait for at least five years at baseline. While two-thirds of the women who wanted to have a child soon became pregnant within three years, less than one-third of those wanting no more children became pregnant. The multivariable analysis shows that the probability of becoming pregnant among women who expressed desires to stop or delay childbearing at least for five years was 50% less than among women who wanted to have a child in two to four years. In addition to prospective fertility desires, level of woman's education, residence and ethnicity exerted important influences on implementation of baseline preferences. CONCLUSIONS Our study finds a strong link between baseline fertility desires and subsequent reproduction. A large difference in pregnancy risk was observed between those who wanted no more children and those who wanted another child. The link between a woman's stated desire to stop childbearing and subsequent childbearing is just as strong in the Nairobi slums as elsewhere. In addition, the findings revealed a pronounced gradient in pregnancy risk according to preferred spacing length, which support other evidence on the important contribution of long-term spacing or postponement to fertility decline in sub-Saharan Africa.
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Affiliation(s)
- Kazuyo Machiyama
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Joyce N Mumah
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya
| | - Michael Mutua
- African Population and Health Research Center, APHRC Campus, 2nd Floor, Manga Close, Off Kirawa Road, P.O. Box 10787-00100, Nairobi, Kenya
| | - John Cleland
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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