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Kim J, Eom YJ, Ko S, Subramanian SV, Kim R. Problems accessing health care and under-5 mortality: a pooled analysis of 50 low- and middle-income countries. J Public Health (Oxf) 2024; 46:315-325. [PMID: 38684342 DOI: 10.1093/pubmed/fdae053] [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: 08/22/2023] [Revised: 02/27/2024] [Accepted: 04/05/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Access to health care remains suboptimal in low- and middle-income countries (LMICs) and continues to hinder survival in early childhood. We systematically assessed the association between problems accessing health care (PAHC) and under-five mortality (U5M). METHODS Child mortality data on 724 335 livebirths came from the latest Demographic and Health Surveys of 50 LMICs (2013-2021). Reasons for PAHC were classified into three domains: 'money needed for treatment' (economic), 'distance to health facility' (physical), 'getting permission' or 'not wanting to go alone' (socio-cultural). Multivariable logistic regression was used to estimate the association between PAHC (any and by each type) and U5M. RESULTS In our pooled sample, 47.3 children per 1000 livebirths died before age of 5, and 57.1% reported having experienced PAHC (ranging from 45.3% in Europe & Central Asia to 72.7% in Latin America & Caribbean). Children with any PAHC had higher odds of U5M (OR: 1.05, 95% CI: 1.02, 1.09), and this association was especially significant in sub-Saharan Africa. Of different domains of PAHC, socio-cultural PAHC was found to be most significant. CONCLUSIONS Access to health care in LMICs needs to be improved by expanding health care coverage, building health facilities, and focusing more on context-specific socio-cultural barriers.
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Affiliation(s)
- Jinseo Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea
| | - Yun-Jung Eom
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea
| | - Soohyeon Ko
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA 02115, USA
- Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Republic of Korea
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea
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Raholiarimanana F, Rakotomanana H, Ishida A. Does Raising Livestock Improve Household Food Security and Child Dietary Diversity in a Rural Region of Madagascar? CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050765. [PMID: 37238313 DOI: 10.3390/children10050765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 05/28/2023]
Abstract
Madagascar is one of the poorest countries and has an alarming prevalence of food insecurity and child undernutrition. Most of the Malagasy population live from agricultural activities making livestock a livelihood asset and a source of animal-source foods, especially for smallholder farmers. This study aimed to examine the association between livestock ownership, household food security, and children's dietary diversity in a rural region of Madagascar. Data from a cross-sectional survey of 344 respondents were used to assess the association between household tropical livestock units (TLU) per capita, Household Food Insecurity Access Scale (HFIAS) scores, and dietary diversity scores (DDSs) among children aged 6-23 months. The estimation results from the ordered probit model showed that household TLU per capita is negatively associated with HFIAS scores and positively associated with DDSs among children. Additionally, households with mothers who received information on childcare and nutrition from health facilities and community nutrition agents were more likely to be food secure and have better dietary diversity. Therefore, promoting livestock ownership and strengthening nutrition-sensitive messages focusing on the benefits of raising livestock to mothers from rural Madagascar will likely be effective in improving household food security and nutrition for children.
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Affiliation(s)
| | - Hasina Rakotomanana
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA
| | - Akira Ishida
- Graduate School of Agricultural Science, Kobe University, Kobe 657-8501, Japan
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Jubayer A, Islam MH, Nayan MM. Malnutrition among under-five children in St. Martin's Island, Bangladesh: A cross-sectional study on prevalence and associated factors. SAGE Open Med 2022; 10:20503121221116246. [PMID: 35983084 PMCID: PMC9379269 DOI: 10.1177/20503121221116246] [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: 02/10/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Early childhood nutrition is critical for physical and mental development, and any hindrance (malnutrition) at this stage adversely affects adulthood which makes them more susceptible to a variety of communicable and non-communicable diseases. St. Martin's Island was the focus of this study, which examined the prevalence and risk factors for malnutrition among under-five children. Methods In this cross-sectional study, 256 children aged under five were assessed for anthropometry, and multiple logistic regression models were fitted to identify potential predictors of malnutrition. For analysis, SPSS and WHO Anthro software were used. Results The prevalence of stunting, wasting, underweight, and overweight were 34.4%, 17.6%, 18.9%, and 6.9% respectively among children under-five years of age in St. Martin's Island. An increase in child's age decreases their risk of being stunted (AOR = 0.97, p = 0.006). Males were more likely than females to be wasted (AOR = 2.03, p = 0.001). Both stunting (AOR = 2.42, p = 0.004) and wasting (AOR = 2.82, p = 0.015) rate were higher among the poorer section as compared to the richest. On the contrary, underweight was low among the poorest section (AOR = 0.37, p = 0.024). Other socio-economic factors, for example, household food insecurity, and parental occupation affect these forms of malnutrition significantly. Conclusion Prevalence of all forms of malnutrition except underweight was higher as compared to the national perspective in St. Martin's Island among the under-five children. Community-based approaches by the local government in collaboration with various non-government organizations should be taken to reduce and prevent malnutrition among children.
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Affiliation(s)
- Ahmed Jubayer
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh.,Bangladesh Institute of Social Research (BISR) Trust, Dhaka, Bangladesh
| | - Md Hafizul Islam
- Institute of Nutrition and Food Science, University of Dhaka, Dhaka, Bangladesh
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Timing and pattern of growth faltering in children up-to 18 months of age and the associated feeding practices in an urban setting of Sri Lanka. BMC Pediatr 2022; 22:190. [PMID: 35410168 PMCID: PMC8996519 DOI: 10.1186/s12887-022-03265-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Growth faltering is commonly encountered in breastfed infants during 4-6 months of age in low socioeconomic communities. The objective of this study was to describe the changes of growth indices with age, timing of growth faltering and its association with the feeding practices in children up-to 18 months of age. METHODS A cross sectional descriptive study was conducted in 254 children aged 12 and 18 months attending an immunization clinic. Data on growth were extracted from the Child Health Development Record. Weight and length were measured using standard methods. Feeding practices were assessed using interviewer-administered questionnaire. A drop of > 0.25 in weight-for-age Standard Deviation Score (SDS) from birth SDS was defined as weight faltering. RESULTS Weight faltering occurred at some point in 64.2% (n = 163) during first 18 months of life, and 78.5% of whom, had the onset ≤ 4 months of age. Majority (76.6%, n = 98) with weight for age faltering by 4 months remained so at 12 months (p = 0.497), while 29.7% (n = 38) had a weight-for-length below-2SD (p < 0.001). Prevalence of weight faltering was 50.4%, 46.1%, 48.4% and 48% at 4, 6, 9 and 12 months respectively. Exclusive breastfeeding was given at least until 4 months in 88% (n = 223) and up to 6 months in 60% (n = 153) while 92.9% (n = 236) were breastfed at 12 months, with 38.2% (n = 97) were breastfed on demand after six months. Complementary feeding (CF) was started before 6 months in 40.6% (n = 52) with early weight faltering, but only 20.3% received it with proper consistency. Breastfeeding throughout the night was significantly associated with current weight-for-length being < -1SD (OR = 1.89, CI, 1.04-3.45; p = 0.037). CONCLUSIONS Early growth faltering was found in this population with high exclusive breastfeeding rates and persisting growth faltering was associated with poor feeding practices. Therefore, timely individualized interventions need to be taken to improve long term growth.
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Ribeli J, Pfister F. An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6-59 months. BMC Nutr 2022; 8:21. [PMID: 35277205 PMCID: PMC8915529 DOI: 10.1186/s40795-022-00509-8] [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: 04/26/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background More than 1.7 million children in Madagascar are stunted, with low dietary diversity being a determinant. Although diverse crops are produced in the Vakinankaratra region, it registers the highest stunting prevalence rate nationally. While children’s diets may be influenced by region-specific cultural factors, little is known about this link so far. The aim of this study was to determine the influence of cultural habits on dietary diversity in children between 6 to 59 months in the Vakinankaratra region. Methods A mixed method design with a qualitative lead approach was used, including three transect walks, six focus group discussions and 51 semi-structured interviews with caregivers. The interviews contained a quantitative part to assess the four feeding indicators: ‘minimum meal frequency’, ‘minimum dietary diversity’, ‘minimum acceptable diet’ and the consumption of iron-rich foods. Participants were selected by convenience sampling. Data was collected in November 2019 in three communities displaying maximal possible variation. Results Subsistence farming with diverse crops and livestock was found to be a common practice. Minimum meal frequency was achieved by 78% of the sixty included children. In total, 45% attained minimum dietary diversity and 40% consumed a minimum acceptable diet. Across the three communities, the range of children attaining a minimum acceptable diet was 25–60%. Older, no longer breastfed children were prone to not achieving a minimum acceptable diet. Although caregivers had a basic idea of important foods for child development, these were often not available to or affordable for them. An effect of cultural events on diet, especially diversity, was found. Whilst for annual events this effect was short-term, the region-specific ceremony of reburying the dead (Famadihana) was found to have a long-term influence on the diet of certain families. Conclusions The dietary diversity of children under five in the Vakinankaratra region is influenced by cultural factors like agricultural practices, caregivers’ knowledge of child nutrition, food taboos and a region-specific cultural event. Cultural determinants, especially important traditions that result in significant expenditures, may thus influence the quality of children’s diet and should therefore be considered in future nutrition programmes and research on child malnutrition and stunting.
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Affiliation(s)
- Jacqueline Ribeli
- School of Agricultural, Forest and Food Sciences HAFL, Bern University of Applied Sciences, Länggasse 85, 3052, Zollikofen, Switzerland
| | - Franziska Pfister
- Health Department - Nutrition and Dietetics, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
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Vonaesch P, Djorie SG, Kandou KJE, Rakotondrainipiana M, Schaeffer L, Andriatsalama PV, Randriamparany R, Gondje BP, Nigatoloum S, Vondo SS, Etienne A, Robinson A, Hunald FA, Raharimalala L, Giles-Vernick T, Tondeur L, Randrianirina F, Bastaraud A, Gody JC, Sansonetti PJ, Randremanana RV. Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic. Matern Child Health J 2021; 25:1626-1637. [PMID: 34383227 PMCID: PMC8448698 DOI: 10.1007/s10995-021-03201-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/29/2022]
Abstract
Objectives With a fourth of all under-five children affected, stunting remains one of the biggest health challenges worldwide. Even though the main underlying factors are known, the exact pathways to stunting varying in affected regions, and interventions thus need to be tailored to the local contexts. This study aimed assessing and comparing factors associated with stunting in two understudied sub-Saharan urban contexts with some of the highest stunting prevalence globally: Bangui, Central African Republic (~ 36%) and Antananarivo, Madagascar (42%). Methods We performed a case–control study on 175 + 194 stunted and 237 + 230 non-stunted control children aged 2–5 years and matched for age, gender and district of residency. Factors associated with stunting were identified using a standardized, paper questionnaire delivered by trained interviewers. Statistical analysis was done using logistic regression modelling. Results In both sites, formal maternal education lowered the risk of being stunted and restricted access to soap, suffering of anaemia and low birth weight were associated with higher risk of stunting. Short maternal stature, household head different from parents, diarrhoea and coughing were associated with an increased risk and continuing breastfeeding was associated with a lower risk of stunting in Antananarivo. Previous severe undernutrition and dermatitis/ fungal skin infections were associated with higher and changes in diet during pregnancy with lower risk of stunting in Bangui. Conclusions Our results suggest maternal education, antenatal care, iron supplementation and simple WASH interventions such as using soap and infection control as general and breastfeeding (Antananarivo) or better nutrition (Bangui) as area-specified interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-021-03201-8.
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Affiliation(s)
- Pascale Vonaesch
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France. .,Human and Animal Health Unit, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland. .,University of Basel, 4051, Basel, Switzerland.
| | - Serge Ghislain Djorie
- Unité D'Epidémiologie, Institut Pasteur de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Kaleb Jephté Estimé Kandou
- Unité D'Epidémiologie, Institut Pasteur de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Maheninasy Rakotondrainipiana
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Laura Schaeffer
- Unité D'Epidémiologie Des Maladies Emergentes, Institut Pasteur, 28 Rue du Dr. Roux, 75015, Paris, France
| | - Prisca Vega Andriatsalama
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Ravaka Randriamparany
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Bolmbaye Privat Gondje
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Synthia Nigatoloum
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Sonia Sandrine Vondo
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Aurélie Etienne
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar
| | - Annick Robinson
- Centre Hospitalier Universitaire Mère Enfant de Tsaralalana, Rue Patrice Lumumba, Rue Mabizo S, 101, Antananarivo, Madagascar
| | - Francis Allen Hunald
- Service de Chirurgie Pédiatrique, Centre Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Ampefiloha, BP 4150, 101, Antananarivo, Madagascar
| | - Lisette Raharimalala
- Centre de Santé Maternelle Et Infantile de Tsaralalana, Lalana Andriantsilavo, 101, Antananarivo, Madagascar
| | - Tamara Giles-Vernick
- Anthropology and Ecology of Disease Emergence Unit, Institut Pasteur, 28 Rue du Dr. Roux, 75015, Paris, France
| | - Laura Tondeur
- Unité D'Epidémiologie Des Maladies Emergentes, Institut Pasteur, 28 Rue du Dr. Roux, 75015, Paris, France
| | - Frédérique Randrianirina
- Centre de Biologie Clinique, Institut Pasteur de Madagascar, BP 1274, 101, Antananarivo, Madagascar
| | - Alexandra Bastaraud
- Laboratoire D'Hygiène Des Aliments Et de L'Environnement (LHAE), Institut Pasteur de Madagascar, BP 1274, 101, Antananarivo, Madagascar
| | - Jean-Chrysostome Gody
- Centre Pédiatrique de Bangui, Avenue de l'Indépendance, Bangui, Central African Republic
| | - Philippe Jean Sansonetti
- Unité de Pathogénie Microbienne Moléculaire, Institut Pasteur, 25-28 Rue du Dr Roux, Paris, France.,The Center for Microbes, Development and Health, Institut Pasteur of Shanghai and Chinese Academy of Sciences, 411 Hefei Rd, Huangpu, Shanghai, China
| | - Rindra Vatosoa Randremanana
- Unité Epidémiologie Et de Recherche Clinique, Institut Pasteur de Madagascar-Ambatofotsikely, BP 1274, 101, Antananarivo, Madagascar.
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Cordier LF, Kalaris K, Rakotonanahary RJL, Rakotonirina L, Haruna J, Mayfield A, Marovavy L, McCarty MG, Tsirinomen'ny Aina A, Ratsimbazafy B, Razafinjato B, Loyd T, Ihantamalala F, Garchitorena A, Bonds MH, Finnegan KE. Networks of Care in Rural Madagascar for Achieving Universal Health Coverage in Ifanadiana District. Health Syst Reform 2020; 6:e1841437. [PMID: 33314984 DOI: 10.1080/23288604.2020.1841437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Health care is most effective when a patient's basic primary care needs are met as close to home as possible, with advanced care accessible when needed. In Ifanadiana District, Madagascar, a collaboration between the Ministry of Public Health (MoPH) and PIVOT, a non-governmental organization (NGO), fosters Networks of Care (NOC) to support high-quality, patient-centered care. The district's health system has three levels of care: community, health center, district hospital; a regional hospital is available for tertiary care services. We explore the MoPH/PIVOT collaboration through a case study which focuses on noteworthy elements of the collaboration across the four NOC domains: (I) agreement and enabling environment, (II) operational standards, (III) quality, efficiency, and responsibility, (IV) learning and adaptation. Under Domain I, we describe formal agreements between the MoPH and PIVOT and the process for engaging communities in creating effective NOC. Domain II discusses patient referral across levels of the health system and improvements to facility readiness and service availability. Under Domain III the collaboration prioritizes communication and supervision to support clinical quality, and social support for patients. Domain IV focuses on evaluation, research, and the use of data to modify programs to better meet community needs. The case study, organized by the domains of the NOC framework, demonstrates that a collaboration between the MoPH and an NGO can create effective NOC in a remote district with limited accessibility and advance the country's agenda to achieve universal health coverage.
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Affiliation(s)
| | - Katherine Kalaris
- Maternal Newborn and Reproductive Health, Clinton Health Access Initiative , Boston, Massachusetts, USA
| | | | | | | | - Alishya Mayfield
- NGO PIVOT , Ranomafana, Madagascar.,Department of Global Health Equity, Brigham and Women's Hospital , Boston, Massachusetts, USA.,Department of Global Health and Social Medicine, Harvard Medical School , Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | - Andres Garchitorena
- NGO PIVOT , Ranomafana, Madagascar.,MIVEGEC Laboratory, University of Montpellier, Centre National de la Recherche Scientifique, Institut de Recherche pour le Développement , Antananarivo, Madagascar
| | - Matthew H Bonds
- NGO PIVOT , Ranomafana, Madagascar.,Department of Global Health and Social Medicine, Harvard Medical School , Boston, Massachusetts, USA
| | - Karen E Finnegan
- NGO PIVOT , Ranomafana, Madagascar.,Department of Global Health and Social Medicine, Harvard Medical School , Boston, Massachusetts, USA
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Rakotomanana H, Hildebrand D, Gates GE, Thomas DG, Fawbush F, Stoecker BJ. Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study. Curr Dev Nutr 2020; 4:nzaa162. [PMID: 33274306 PMCID: PMC7695809 DOI: 10.1093/cdn/nzaa162] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar. OBJECTIVES This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6-23 mo in the Vakinankaratra region of Madagascar. METHODS Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than -2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach. RESULTS Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers' workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding. CONCLUSIONS Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.
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Affiliation(s)
- Hasina Rakotomanana
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Deana Hildebrand
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Gail E Gates
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - David G Thomas
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | - Fanjaniaina Fawbush
- Department of Agricultural and Food Science and Technology, University of Antananarivo, Antananarivo, Madagascar
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Chowdhury TR, Chakrabarty S, Rakib M, Afrin S, Saltmarsh S, Winn S. Factors associated with stunting and wasting in children under 2 years in Bangladesh. Heliyon 2020; 6:e04849. [PMID: 32984587 PMCID: PMC7492816 DOI: 10.1016/j.heliyon.2020.e04849] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 12/11/2019] [Accepted: 09/02/2020] [Indexed: 10/31/2022] Open
Abstract
Child undernutrition has been a major concern for Bangladesh as it is amongst the highest stunting and wasting prevalent countries in the world. The objective of our study was to explore the socioeconomic determinants of stunting and wasting in children under two years. This study explored nationally representative sample of 7,230 children ranging in age from 0 to <24 months using two separate binary logistic regression models to determine the risk factors associated with child stunting and wasting. Our study estimated approximately 33 percent children to be stunted and 11 percent to be wasted. Our analysis found that, 12 to <24 months old children's height-for-age-z-score and weight-for-height-z-score deteriorated in comparison to those of below 6 months. Female children had significantly lower odds of stunting and wasting compared with male children. Study revealed that children from wealthier families were at lower risk of being stunted and wasted compared to children from poorer households. Parental education was determined as a significant predictor of stunting. Children who lived in Sylhet division were 1.26 times more likely to be stunted than the children of Dhaka division [OR = 1.26; 95% CI: 1.02-1.55]. Our study revealed age, gender, geographic distribution, and household's position in wealth index as common determinants of child stunting and wasting in Bangladesh. While parental education was significant predictor for child stunting, type of toilet facility was found as statistically significant determinant of child wasting in children of less than two years age.
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Affiliation(s)
- Tuhinur Rahman Chowdhury
- Department of Economics, Shahjalal University of Science & Technology, Sylhet Kumargaon, Sylhet 3114, Bangladesh
| | | | - Muntaha Rakib
- Department of Economics, Shahjalal University of Science & Technology, Sylhet Kumargaon, Sylhet 3114, Bangladesh
| | - Sabiha Afrin
- Department of Economics, Shahjalal University of Science & Technology, Sylhet Kumargaon, Sylhet 3114, Bangladesh.,University of Southern Queensland, Springfield, QLD 4300, Australia
| | - Sue Saltmarsh
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po Campus, New Territories, Hong Kong
| | - Stephen Winn
- School of Education, Edith Cowan University, Australia
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Barik AL, Purwaningtyas RA, Astuti D. The Effectiveness of Traditional Media (Leaflet and Poster) to Promote Health in a Community Setting in the Digital Era: A Systematic Review. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i3.16988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: The use of health promotion media in the digital era, such as e-health and m-health, is increasing. However, traditional health promotion media, such as posters and leaflets, are still used. This review aimed to identify the effectiveness of the use of traditional health promotion media (leaflets and posters) in a community setting in the digital era.Methods: The data was gathered using the following steps: (1) determining the topic, (2) determining the keyword chain, (3) looking for the relevant literature in the database and (4) analyzing the article. The search using a predetermined keyword chain in Scopus, Science Direct and Sage Journals produced 208 publications.Results: After applying the inclusion and exclusion criteria, 16 publications were selected for review.Conclusion: Traditional health promotion media such as leaflets and posters are still useful in the current digital era, especially for adult respondents. This form of media will be more effective when combined with other media such as videos, telephone interactions, games and others.
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Miller AC, Garchitorena A, Rabeza V, Randriamanambintsoa M, Rahaniraka Razanadrakato HT, Cordier L, Ouenzar MA, Murray MB, Thomson DR, Bonds MH. Cohort Profile: Ifanadiana Health Outcomes and Prosperity longitudinal Evaluation (IHOPE). Int J Epidemiol 2019; 47:1394-1395e. [PMID: 29939260 DOI: 10.1093/ije/dyy099] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 05/14/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ann C Miller
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Andres Garchitorena
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,PIVOT, Boston, MA, USA.,UMR 224 MIVEGEC, Institut de Recherche pour le Développement, Montpellier, France
| | - Victor Rabeza
- Institut National de la Statistique, Direction de la Demographie et des Statistiques Sociales, Antananarivo, Madagascar
| | - Marius Randriamanambintsoa
- Institut National de la Statistique, Direction de la Demographie et des Statistiques Sociales, Antananarivo, Madagascar
| | | | | | | | - Megan B Murray
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Dana R Thomson
- Social Statistics Department, University of Southampton, Southampton, UK
| | - Matthew H Bonds
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.,PIVOT, Boston, MA, USA
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Stunting and Overweight among 12-24-Month-Old Children Receiving Vaccination in Ho Chi Minh City, Vietnam. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1547626. [PMID: 30911539 PMCID: PMC6399549 DOI: 10.1155/2019/1547626] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/01/2019] [Accepted: 01/29/2019] [Indexed: 02/06/2023]
Abstract
Introduction Malnutrition and obesity are a double burden on children in developing countries and could induce higher risks of noncommunicable diseases in the long term. In the big cities of Vietnam, both issues are present and share the issue of nutrition problems; the prevalence of malnutrition in children is gradually decreasing while the prevalence of obesity is increasing rapidly. The paper aims to identify the prevalence of stunting and overweight/obesity in apparently healthy young children in Ho Chi Minh City (HCMC). Methods A prospective cross-sectional study recruited 12-24-month-old children receiving national vaccination in community health centers in HCMC from February 2016 to July 2017. Sixteen healthcare centers were randomly selected among 8 districts of HCMC. Stunting and overweight were defined by height-for-age z-score <-2 SD and BMI z-score ≥+2 SD. Results A total of 768 children had mean age of 16.8±4.2 months old, 51.7% boys. The prevalence of stunting and overweight/obesity was 8.2% and 10.7%, respectively. Stunting was associated with older age, boys, and low birth weight of children and occupation of mothers (P <0.05). No associated risk factor was observed for overweight/ obesity status. Conclusion The prevalence of overweight/obesity was higher than the prevalence of stunting in 12-24-month-old children in HCMC. Overweight/obesity would be a public health problem for children in big cities.
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