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Dambayi E, Nakua E, Aborigo RA, Chatio ST, Dalaba MA, Sekwo E, Adoctor JK, Ofosu W, Oduro AR, Nonterah EA. Exploring infant and young child-feeding practices among mothers of well-nourished children in northern Ghana: An INPreP substudy. Food Sci Nutr 2024; 12:869-880. [PMID: 38370036 PMCID: PMC10867453 DOI: 10.1002/fsn3.3800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 02/20/2024] Open
Abstract
This study investigated infant and young child-feeding (IYCF) practices among mothers of well-nourished children in northern Ghana. This was a qualitative study where in-depth individual interviews were conducted with participants. The interviews were audio recorded, transcribed, and QSR Nvivo software version 11 was used to organize the data before thematic analysis. It was observed that mothers of well-nourished children were likely to adhere to breastfeeding guidelines and also practice appropriate complementary feeding. Furthermore, these mothers mostly had some form of support from their husbands and mother-in-laws in feeding their infants. While adoption and adherence to appropriate IYCF practices contribute to improved nutrition outcomes in children, social support systems are needed to sustain the practice.
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Affiliation(s)
- Edith Dambayi
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
- Department of Epidemiology and BiostatisticsKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Emmanuel Nakua
- Department of Epidemiology and BiostatisticsKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Raymond A. Aborigo
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
| | - Samuel T. Chatio
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
| | - Maxwell A. Dalaba
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
- Institute of Health ResearchUniversity of Health and Allied SciencesHoGhana
| | - Enos Sekwo
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
| | - James K. Adoctor
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
| | - Winfred Ofosu
- Upper East Regional Health DirectorateGhana Health Service, PMBBolgatangaGhana
| | - Abraham R. Oduro
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
- Research and Development DivisionGhana Health ServiceAccraGhana
| | - Engelbert A. Nonterah
- Navrongo Health Research Centre, Social Science DepartmentGhana Health ServiceNavrongoGhana
- Julius Global Health, Julius Center for Primary Care and Health SciencesUniversity Medical Center Utrecht, Utrecht UniversityUtrechtThe Netherlands
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Iddrisu WA, Gyabaah O. Identifying factors associated with child malnutrition in Ghana: a cross-sectional study using Bayesian multilevel ordinal logistic regression approach. BMJ Open 2023; 13:e075723. [PMID: 38110390 DOI: 10.1136/bmjopen-2023-075723] [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] [Indexed: 12/20/2023] Open
Abstract
OBJECTIVE In developing countries, malnutrition is a noteworthy concern related to the well-being of people, and this study aimed to determine the factors that affect malnutrition among children below 5 years in Ghana. DESIGN The study used a secondary data source, specifically the Ghanaian Multiple Indicator Cluster Survey Six (MICS 6), which was conducted by the Ghana Statistical Service in 2017-2018. The MICS data are hierarchical, as children are categorised within households, and households are further grouped within a higher cluster, violating the independence assumption that must be addressed in the analyses. This study used a Bayesian multilevel ordinal logistic regression to model, identify and analyse the factors linked to child malnutrition in Ghana. SETTING The setting of the study was the household level across the previous 10 administrative regions in Ghana. PARTICIPANTS Data for 8875 children under 5 years were used for the study. The data were gathered from households in all 10 administrative regions of Ghana using a sampling procedure consisting of stratification and random selection to ensure national representation. RESULTS The results showed that the Northern Region of Ghana had the highest occurrence rate of severe and moderate malnutrition, and factors such as the count of children's books or picture books, whether the child experienced fever in the last 2 weeks, age and sex of the child, and the child's household wealth index quintile were strongly linked to malnutrition among Ghanaian children. CONCLUSION These findings underscore the intricate interplay of factors contributing to child nutrition in Ghana and suggest that addressing malnutrition necessitates a comprehensive approach that considers factors such as access to healthcare and reading materials, household wealth, and other social and environmental factors.
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Affiliation(s)
- Wahab Abdul Iddrisu
- Department of Mathematics and Statistics, Ghana Communication Technology University, Accra, Ghana
| | - Opoku Gyabaah
- Department of Mathematics and Statistics, Ghana Communication Technology University, Accra, Ghana
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Mawusi SK, Shrestha P, Xue C, Liu G. A comprehensive review of the production, adoption and sustained use of biomass pellets in Ghana. Heliyon 2023; 9:e16416. [PMID: 37292302 PMCID: PMC10245022 DOI: 10.1016/j.heliyon.2023.e16416] [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: 02/20/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/10/2023] Open
Abstract
Ghana's Renewable Energy Master Plan of 2019 includes the production and use of biomass pellets. However, pellets have neither been developed commercially nor included in Ghana's energy mix. This paper reviewed the prospect of production, adoption and sustained use of pellets in Ghana. Besides having abundant biomass resources, Ghana has high market demand and relevant policies for pellet development. The production of pellets can significantly replace traditional household biomass demand and improve environmental and health quality. However, the production and use of pellets are limited due to technical, financial, social and policy issues. Our estimates show that 3% of the annual national average household income will be spent on pellet demand for cooking, with the highest burden on rural households in Ghana. Practical measures are required since the cost of pellets and gasifier stoves may limit pellet adoption and use in Ghana. Based on study findings, it is recommended that the government of Ghana establishes a robust supply chain and provides infrastructure for pellet production and use. Existing renewable energy policies should be reviewed to remove ambiguities, attract investment, and build capacity in the renewable energy sector. Apart from raising public awareness of the benefits of pellets use, the government of Ghana should ensure that continuous and thorough impact assessments are undertaken to assess the implications of pellet production and use. This review will inform policymaking on achieving sustainable production, adoption and use of pellets and assess Ghana's contribution to achieving the United Nations' sustainable development goals.
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Affiliation(s)
- Sylvester Kosi Mawusi
- Biomass Energy and Environmental Engineering Research Center, College of Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Prabin Shrestha
- Biomass Energy and Environmental Engineering Research Center, College of Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Chunyu Xue
- Biomass Energy and Environmental Engineering Research Center, College of Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
| | - Guangqing Liu
- Biomass Energy and Environmental Engineering Research Center, College of Engineering, Beijing University of Chemical Technology, Beijing 100029, PR China
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Joseph FI, Falade A, Earland J. Time to recovery and its predictors among children 6-59 months with acute malnutrition admitted to community inpatient therapeutic feeding centers in Katsina State, Northwest Nigeria: a retrospective review of health records (2010-2016). JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:10. [PMID: 36800992 PMCID: PMC9936680 DOI: 10.1186/s41043-023-00352-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 02/07/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Severe acute malnutrition (SAM) among children under five years of age remains a huge public health and economic burden in Sub-Saharan Africa. We investigated time to recovery and its predictors among children aged 6 to 59 months admitted into Community-based Management of Acute Malnutrition (CMAM) stabilisation centres for complicated severe acute malnutrition and whether the outcomes met the minimum Sphere standards. METHODS The study was a retrospective cross sectional quantitative review of data recorded in six CMAM stabilization centres registers in four Local Government Areas, Katsina state, Nigeria from September 2010 to November 2016. Records of 6925 children, aged 6-59 months with complicated SAM were reviewed. Descriptive analysis was used to compare performance indicators with Sphere project reference standards. Cox proportional hazard regression analysis was used to estimate the predictors of recovery rate at p < 0.05 and Kaplan-Meier curve to predict the probability of surviving different forms of SAM. RESULTS Marasmus was the most common form of severe acute malnutrition (86%). Overall, the outcomes met the minimum sphere standards for inpatient management of SAM. Children with oedematous SAM (13.9%) had the lowest survival rate on Kaplan-Meier graph. The mortality rate was significantly higher during the 'lean season'-May to August (Adjusted Hazard Ratio (AHR) = 0.491, 95% CI = 0.288-0.838). MUAC at Exit (AHR = 0.521, 95% CI = 0.306-0.890), marasmus (AHR = 2.144, 95% CI = 1.079-4.260), transfers from OTP (AHR = 1.105, 95% CI = 0.558-2.190) and average weight gain (AHR = 0.239, 95% CI = 0.169-0.340) were found to be significant predictors of time-to-recovery with p values < 0.05. CONCLUSION The study showed that, despite a high turnover of complicated SAM cases in the stabilization centres, the community approach to inpatient management of acute malnutrition enabled early detection and reduced delays in access to care of complicated SAM cases. In the face of health workforce shortage in rural communities to provide pediatric specialist care for SAM children, we recommend task shifting to community health care workers through in service training could bridge the gap and save more lives of children dying from the complication of SAM in rural communities in Nigeria.
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Affiliation(s)
- Friday Ilop Joseph
- Department of Paediatrics, Federal Teaching Hospital, Katsina, Katsina State, Nigeria.
| | - Adewale Falade
- Department of Public Health, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
| | - Jane Earland
- Department of Public Health and Policy, School of Medicine, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
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Nahalomo A, Iversen PO, Andreassen BA, Kaaya AN, Rukooko AB, Rukundo PM. Seasonality- and disaster effects on food variety and food insecurity coping strategies among a landslide-prone cohort. Clin Nutr ESPEN 2022; 52:229-239. [PMID: 36513458 DOI: 10.1016/j.clnesp.2022.11.005] [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: 07/20/2022] [Revised: 10/31/2022] [Accepted: 11/06/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND & AIMS Landslides may impact on nutritional health among vulnerable populations. However, there is limited data on the seasonal effects of landslides on diet and food security. Among the 2010 and 2018 households affected by the landslides in Eastern Uganda, we assessed seasonality and disaster effects on food varieties consumed and food insecurity coping strategies. This study is among the first to report on seasonal- and disaster effects on food varieties and food insecurity coping strategies among vulnerable populations in Uganda. METHODS We used a three-stage simple random technique to select a total of 422 households during May-August (food-plenty season) in 2019, of whom 211 had been affected by the landslides and 211 had not (controls). Six months later, in January-March (food-poor season) of 2020, 388 households were re-assessed (191 affected and 197 controls). We analyzed data only from the households that participated in both food seasons to compare results between the two food seasons. Food variety scores (FVS) were obtained by summing the frequency of weekly intakes of 86 food items while a coping index was derived based on the severity weighting of household food insecurity coping strategies. RESULTS After adjusting for covariates, significantly lower mean (SE) FVS were among the affected than controls during the food-plenty season: 9.3 (0.5) vs 11.4 (0.3), and during the food-poor season: 7.6 (0.5) vs 10.1 (0.1) (P < 0.001 for both). The affected households were more likely to use food insecurity coping strategies compared to controls (mean [SE]: 35.2 [2.1] vs. 27.1 [1.8], P < 0.001) during the food-plenty season and the severity further increased during the food-poor season: 42.1 (2.1) vs. 28.2 (2.1) (P < 0.001). Disaster exposure was associated with both household food varieties and food insecurity coping strategies during both food seasons (P < 0.001). The adjusted models, showed that, the affected compared to the controls had a significantly higher likelihood to rely on 5 of the 11 coping strategies during food-plenty season and 9 of the 11 coping strategies during the food-poor season. CONCLUSION Low variety diets and coping strategies among disaster affected individuals cut across seasons and implies needs for strong social protection and targeted safety nets irrespective of season.
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Affiliation(s)
| | - Per Ole Iversen
- Department of Nutrition, University of Oslo, Oslo, Norway; Department of Hematology, Oslo University Hospital, Oslo, Norway; Division of Human Nutrition, Stellenbosch University, Tygerberg, South Africa.
| | | | - Archileo Natigo Kaaya
- School of Food Technology, Nutrition and Bioengineering, Makerere University, Kampala, Uganda.
| | | | - Peter Milton Rukundo
- Department of Nutritional Sciences and Dietetics, Kyambogo University, Kampala, Uganda.
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Linger Endalifer M, Diress G, Linger Endalifer B, Wagaye B, Almaw H. Does birth season correlate with childhood stunting? An input for astrological nutrition. BMC Pediatr 2022; 22:306. [PMID: 35610626 PMCID: PMC9128290 DOI: 10.1186/s12887-022-03343-w] [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: 05/21/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Chronic malnutrition is highly prevalent in Sub-Saharan Africa and a severe public health problem in Ethiopia.At country level in the past three decades,the prevalence of stunting is above 40%.Different researchs and intervention were implemented in the past;but the progresss is non-remarkable.Despite; the effect of birth season on childhood chronic malnutrition was not studied yet in Ethiopia. METHODS This research was extracted from the 2016 demographic health survey of Ethiopia. The data was collected based on national and international scientific protocols. A total of 645 enumeration areas were selected for the national survey.The surevey uses two stage stratified sampling technique to gather data from the sampling unit. After excluding non eligible children a total of 8855 participants were included for final analysis.Height and weight were measured based on the standards nutritional assessment procedure.SPSS version 20 was used to analyze the data.Descriptive statistics were used to present the data. Binary and multivariable logistic regression models were regressed to identify the potential predictors.A p-value of less than 0.05 with 95% CI were used to declare an association. RESULT The prevalence of stunting in Ethiopia was 38.7% (95% CI: 36.8, 40.6). Season of birth had a significant association with stunting. The odds of being stunted among children born in the spring season were decreased by 16% as compared to children born in the winter season. CONCLUSION Children born in the spring season were less likely to be stunted (the so called October effect). The clear scientific relation between the season of birth and child anthropometric indicator is not well understood. Nutritional interventions and policies are better to consider the birth season of the child.
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Affiliation(s)
- Melese Linger Endalifer
- Department of Human Nutrition, College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
| | - Gedefaw Diress
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bedilu Linger Endalifer
- Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Birhanu Wagaye
- Department of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Hunegnaw Almaw
- Department of Public Health Nutrition and Dietetics, College of Medcine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Nonterah EA, Welaga P, Chatio ST, Kehoe SH, Ofosu W, Ward KA, Godfrey KM, Oduro AR, Newell M. Children born during the hunger season are at a higher risk of severe acute malnutrition: Findings from a Guinea Sahelian ecological zone in Northern Ghana. MATERNAL & CHILD NUTRITION 2022; 18:e13313. [PMID: 35008126 PMCID: PMC8932825 DOI: 10.1111/mcn.13313] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/28/2021] [Accepted: 12/10/2021] [Indexed: 12/13/2022]
Abstract
Heightened food insecurity in the hunger season increases the risk of severe acute malnutrition (SAM) in childhood. This study examined the association of season of birth with SAM in a Guinean Sahelian ecological zone. We analyzed routine health and sociodemographic surveillance data from the Navrongo Health and Socio-demographic Surveillance System collected between 2011 and 2018. January-June, the period of highest food insecurity, was defined as the hunger season. We defined moderate acute malnutrition as child mid-upper arm circumference (MUAC) between 115 mm and 135 mm and SAM as MAUC ≤ 115 mm. We used adjusted logistic regression to quantify the association between the season of birth and SAM in children aged 6-35 months. From the 29,452 children studied, 24% had moderate acute malnutrition. Overall, 1.4% had SAM, with a higher prevalence (1.8%) in the hunger season of birth. Compared with those born October-December, adjusted odds ratios (aOR) and 95% confidence interval (95% CI) for SAM were increased for children born in the hunger season: January-March (1.77 [1.31-2.39]) and April-June (1.92 [1.44-2.56]). Low birth weight, age at an assessment of nutritional status, and ethno-linguistic group were also significantly associated with SAM in adjusted analyses. Our study established that being born in the hunger season is associated with a higher risk of severe acute malnutrition. The result implies improvement in the food supply to pregnant and lactating mothers through sustainable agriculture or food system change targeting the hunger season may reduce the burden of severe acute malnutrition.
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Affiliation(s)
- Engelbert A. Nonterah
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Paul Welaga
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
- School of Medicine and DentistryC K Tedam University of Technology and Applied SciencesNavrongoUpper East RegionGhana
| | - Samuel T. Chatio
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
| | - Sarah H. Kehoe
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustUniversity of SouthamptonSouthamptonUK
| | - Winfred Ofosu
- Upper East Regional Health Directorate, PMBBolgatangaGhana
| | - Kate A. Ward
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustUniversity of SouthamptonSouthamptonUK
- Global Health Research Institute, School of Health and Human DevelopmentUniversity of SouthamptonSouthamptonUK
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation TrustUniversity of SouthamptonSouthamptonUK
| | - Abraham R. Oduro
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
| | - Marie‐Louise Newell
- Department of Human DevelopmentUniversity of SouthamptonSouthamptonUK
- School of Public Health, Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
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