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Sheikh S, Barolia R, Habib A, Azam I, Qureshi R, Iqbal R. "If the food is finished after my brother eats then we (girls) sleep hungry." Food insecurity and dietary diversity among slum-dwelling adolescent girls and boys in Pakistan: A mixed methods study. Appetite 2024; 195:107212. [PMID: 38242362 DOI: 10.1016/j.appet.2024.107212] [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: 09/15/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/21/2024]
Abstract
To explore gender differences in food insecurity (FI) and minimum dietary diversity (MDD) among adolescent girls and boys in a slum community in Karachi, we employed an explanatory sequential mixed methods study that included a survey of 391 girls and boys of 10-19 years of age and followed by semi-structured interviews of eight purposely selected food insecure adolescents. Survey data was analyzed by Cox proportional algorithm and adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were estimated for associated factors of FI and thematic analysis was undertaken for qualitative work. Meta inferences for mixed methods study were drawn by joint display analysis of survey results juxtaposed to qualitative findings. Overall, FI among adolescents was prevalent (46.5%) which was not different between boys (52.7%) and girls (47.3%) (APR 0.8, (95% CI 0.6, 1.2); p-value-0.4). MDD (5/10 food groups consumed) was achieved by only 23.0% and it was also not different between boys (25.1%) and girls (20.9%) (p-value-0.3). The survey found no significant difference in FI and MDD between boys and girls however, qualitative findings provided insight into the cultural practices at mealtimes that prefer boys. Qualitative results contrasted the survey results and revealed the increased vulnerability of girls towards FI and low MDD compared to boys due to gender norms.
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Affiliation(s)
- Sana Sheikh
- Department of Obstetrics and Gyanecology, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Rubina Barolia
- School of Nursing and Midwifery, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Atif Habib
- Department of Peadiatrics and Child Health, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Rahat Qureshi
- Department of Obstetrics and Gyanecology, Aga Khan University, Stadium Road, Karachi, Pakistan.
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, Pakistan.
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Beressa G, Whiting SJ, Belachew T. Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial. Nutr J 2024; 23:3. [PMID: 38166908 PMCID: PMC10763129 DOI: 10.1186/s12937-023-00907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia. METHODS A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect. RESULTS After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity. CONCLUSION The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy. TRIAL REGISTRATION Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).
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Affiliation(s)
- Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia.
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Tefera Belachew
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Gulema H, Demissie M, Worku A, Yadeta TA, Fasil N, Berhane Y. The Association between Intrahousehold Food Allocation Social Norms and Thinness among Young Adolescent Girls: A Community-Based Study. Ethiop J Health Sci 2023; 33:945-954. [PMID: 38784491 PMCID: PMC11111270 DOI: 10.4314/ejhs.v33i6.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 08/31/2023] [Indexed: 05/25/2024] Open
Abstract
Background Inequalities in food allocation related to social norms among household members significantly affect the nutritional status and well-being of the vulnerable members of the household, such as adolescent girls. This study assesses the association between social norms related to intrahousehold food allocation and young adolescent girls' thinness. Materials and Methods The study involved 1,083 pairs of mothers/caregivers and young adolescent girls. Data were collected using a structured and pretested questionnaire. Multilevel mixed-effect logistic regression analysis was employed to examine associations using STATA/SE V.14 statistical software. In addition, a stratified analysis was done to investigate the effect of social norms on thinness in food-secure and food-insecure households. Result The overall prevalence of young adolescent girls' thinness was 15.70% (95% CI 13.52-17.86%). Young adolescent girls' thinness was associated with mothers'/caregivers' conformity to inequitable intrahousehold food allocation social norms in food-secure households [Adjusted odds ratio (AOR): 1.43, 95% CI: 1.14-1.80] but not in food-insecure households. Conclusion Nearly 16% of adolescent girls were thin. Mothers/female caregivers conforming to inequitable intrahousehold food allocation social norms compromise the nutritional status of adolescent girls, particularly in food-secure households. The lack of statistically significant association in food-insecure households hints at the need to address inequality in food-secure households while addressing food shortage to improve the nutritional status of adolescents in low-income countries. We also recommend more studies in different sociocultural contexts to fully gather the evidence for adopting appropriate policies and practices.
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Affiliation(s)
- Hanna Gulema
- Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Meaza Demissie
- Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Public Health, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Nebiyou Fasil
- Department of Global Health and Health Policy, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Gebretsadik MT, Adugna DT, Aliyu AD, Belachew T. Optimal complementary feeding practices of children aged 6–23 months in three agro-ecological rural districts of Jimma zones of southwest Ethiopia. J Nutr Sci 2023; 12:e40. [PMID: 37008415 PMCID: PMC10052435 DOI: 10.1017/jns.2023.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/29/2023] Open
Abstract
Abstract
Despite the critical importance of complementary feeding, large proportions of children in developing countries are sub-optimally fed during 6–23 months of age. In Ethiopia, even though the government has been rolling out infant and young child feeding (IYCF) guidelines, the proportion of mothers adhering to the recommended optimal practices and its associated factors have not been assessed in different agro-ecological areas. Hence, the present study aimed to determine optimal complementary feeding practices and associated factors in three agro-ecological rural districts (high, mid and lowland) of southwest Ethiopia. A community-based cross-sectional study was carried out among 845 mothers-index young children 6–23 months Jimma zone. Multistage sampling was employed to select the study participants. Structured and pretested questionnaires were used to collect data and entered into Epi Data V.1.4.4.0. The data were analysed using SPSS version 20. Binary and multivariable logistic regressions were used to identify factors associated with optimal child-feeding practices. The significance of the association was determined at P < 0⋅05. The overall proportion of optimal complementary feeding practice (OCFP) was 9⋅4 % at 95 % CI (7⋅19, 11⋅08). The timely initiation of complementary feeding, minimum meal frequency, minimum dietary diversity and minimum acceptable diet was 52⋅2, 64⋅1, 17⋅2 and 12⋅2 %. Multivariable logistic regression showed that being in the highland districts, having good maternal knowledge, and mothers having primary school education, having a family size of less than six were positively associated with optimal complementary feeding practices. The findings showed that OCFP was low, especially in the midland agro-ecological districts.
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Biadgilign S. Coping Strategies to Mitigate Food Insecurity at Household Level: Evidence From Urban Setting in Addis Ababa, Ethiopia. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231206263. [PMID: 37872773 PMCID: PMC10594962 DOI: 10.1177/00469580231206263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/25/2023]
Abstract
Food insecurity is the limited or uncertain ability of households to acquire nutritionally adequate and safe foods in socially acceptable ways. There is paucity of empirical evidence on household food insecurity, level of expenditure, and coping strategies in urban setting of Ethiopia. The objective of this paper is to examine the coping strategies of food insecure households in an urban area setting of Addis Ababa, Ethiopia. This study is based on data collected from 632 mothers interviewed in 2017. Multi-stage sampling techniques were carried out to identify the study unit from selected sub-cites. From each sub-city, proportion to population sampling was applied to obtain the sample size. Simple random sampling method was used to select districts in each sub-city. Multivariable logistic regression model was used to identify factors associated with food security status. The most common coping strategies households used in response to food insecurity were: rely on less preferred and less expensive foods, borrow food, or borrow money to buy food and purchase of food on credit. Food insecure households were 3 times more likely to rely on help from a relative or friend outside the household [AOR = 2.37; 95% CI: (1.01, 5.53); P < .047] compared to food secure households. Similarly, food insecure households were approximately 4 times more likely to limit portions at mealtimes [AOR = 3.55; 95% CI: (1.36, 9.30); P < .010] compared to food secure households. Furthermore, households with no access to a bank or microfinance savings account were 3 times [AOR = 2.62; 95%: (1.21, 5.66); P < .014] more likely to become food insecure compared to those with access to financial services. Households rely on less preferred cheap foods or lending to cope with food insecurity in urban settings of Ethiopia. Encouraging households to practice urban gardening, social protection through integrated national safety net programs, and improving access to microfinance services would be vital to address food insecurity among urban households of the country to bring successful social and economic development.
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Affiliation(s)
- Sibhatu Biadgilign
- University of South Africa, Regional Learning Office Ethiopia, Addis Ababa, Ethiopia
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Kidane R, Eshete T, Sintayehu T, Belachew T. Dietary Patterns and Hypertensive Disorders Among Pregnant Women Attending Antenatal and Delivery Care in Public Hospitals of Jimma Zone, Southwest Ethiopia. J Multidiscip Healthc 2022; 15:1645-1656. [PMID: 35937311 PMCID: PMC9348132 DOI: 10.2147/jmdh.s373749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Rediet Kidane
- Department of Human Nutrition and Dietetics, Institution of Public Health Sciences, Jimma University, Jimma, Ethiopia
| | - Tewodros Eshete
- Department of Public Health, Debre Markos University, Debre Markos, Ethiopia
- Correspondence: Tewodros Eshete, Email
| | - Tsion Sintayehu
- Department of Public Health, Wachemo University, Hosanna, Ethiopia
| | - Tefera Belachew
- Department of Human Nutrition and Dietetics, Institution of Public Health Sciences, Jimma University, Jimma, Ethiopia
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Liang K, Chi X, Chen ST, Clark CCT, Zhang Y, Wang J. Food Insecurity and Bullying Victimization Among 170,618 Adolescents in 59 Countries. Front Psychiatry 2021; 12:766804. [PMID: 34858236 PMCID: PMC8631901 DOI: 10.3389/fpsyt.2021.766804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Bullying victimization can impose long-lasting impacts on adolescent's current and subsequent well-being. Understanding the correlates of bullying victimization and how to prevent its occurrence is an urgent need. Food insecurity, an indicator of low socioeconomic status, may be related to bullying victimization. However, research on the association between food insecurity and bullying victimization is limited. Using a representative global sample, this study aimed to investigate the association between food insecurity and bullying victimization in adolescents and whether the association varied between country income levels, sexes, and age groups. Methods: Using cross-sectional, school-based data by 170,618 adolescents in 59 countries from the Global School-based Student Health Survey, multivariable logistic regression and meta-analysis were conducted to investigate the overall, country-stratified, sex-stratified, and age-stratified associations. Results: The prevalence of bullying victimization was 33.3%. In the total sample, adolescents with food insecurity showed significantly higher odds for bullying victimization than those without no food insecurity with a pooled odds ratio (OR) being 1.37 (1.28, 1.47). Further, the association was stronger in higher-income countries, females, and older adolescents. Conclusions: Bullying victimization is prevalent among global adolescents with food insecurity being a significant correlate. The identification of adolescents with perceptions of food insecurity and remedying this condition may be important to reduce the prevalence of bullying. This highlights the need to design and implement sex- and age-specific interventions focusing on remedying food insecurity and bullying victimization among in-school adolescents by taking country income levels into account.
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Affiliation(s)
- Kaixin Liang
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Xinli Chi
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | | | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, South Korea.,Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, China
| | - Jian Wang
- School of Public Policy and Management, Anhui Jianzhu University, Hefei, China.,Urban Management Research Center, Anhui Jianzhu University, Hefei, China.,Department of Psychology, Anhui Normal University, Wuhu, China
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Himmelgreen D, Romero-Daza N, Heuer J, Lucas W, Salinas-Miranda AA, Stoddard T. Using syndemic theory to understand food insecurity and diet-related chronic diseases. Soc Sci Med 2020; 295:113124. [PMID: 32586635 DOI: 10.1016/j.socscimed.2020.113124] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022]
Abstract
Syndemic Theory (ST) provides a framework to examine mutually enhancing diseases/health issues under conditions of social inequality and inequity. ST has been used in multiple disciplines to address interacting infectious diseases, noncommunicable diseases, and mental health conditions. The theory has been critiqued for its inability to measure disease interactions and their individual and combined health outcomes. This article reviews literature that strongly suggests a syndemic between food insecurity (FI) and diet-related chronic diseases (DRCDs), and proposes a model to measure the extent of such interaction. The article seeks to: (1) examine the potential syndemic between FI and DRCDs; (2) illustrate how the incorporation of Life History Theory (LHT), into a syndemic framework can help to highlight critical lifeperiods when FI-DRCD interactions result in adverse health outcomes; (3) discuss the use of mixed methods to identify and measure syndemics to enhance the precision and predictive power of ST; and (4) propose an analytical model for the examination of the FI-DRCD syndemic through the life course. The proposed model is more relevant now given the significant increase in FI globally as a result of the ongoing COVID-19 pandemic. The differential impact that the pandemic appears to have among various age groups and by other demographic factors (e.g., race, gender, income) offers an opportunity to examine the potential FI-DRCD syndemic under the lens of LHT.
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Affiliation(s)
- David Himmelgreen
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA.
| | - Nancy Romero-Daza
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
| | - Jacquelyn Heuer
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA; USF Center for the Advancement of Food Security & Healthy Communities, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
| | - William Lucas
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
| | - Abraham A Salinas-Miranda
- USF Center of Excellence in MCH Education, Science & Practice, University of South Florida, 13201 Bruce B. Downs Blvd, UPC 523, Tampa, FL, 33612, USA
| | - Theresa Stoddard
- Department of Anthropology, University of South Florida, 4202 E. Fowler Avenue, SOC 107, Tampa, FL, USA
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Isabirye N, Bukenya JN, Nakafeero M, Ssekamatte T, Guwatudde D, Fawzi W. Dietary diversity and associated factors among adolescents in eastern Uganda: a cross-sectional study. BMC Public Health 2020; 20:534. [PMID: 32306947 PMCID: PMC7169017 DOI: 10.1186/s12889-020-08669-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 04/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally adolescents constitute over 16% but in SSA, they make up 23% of the population. While little is known about diets of these adolescents, rapid changes in physiological and social processes undergone require adequate diets. This study aimed to determine dietary diversity and associated factors among adolescents residing in the Iganga -Mayuge HDSS. METHODS As part of the African Research, Implementation Science, and Education (ARISE) Network, we analysed collected data among 598 adolescents to assess the health status and adolescents' behaviour. Dietary diversity was scored using the 9 food group categories as per the Food and Agriculture Organization -WDDS. Crude and adjusted prevalence rate ratios were estimated using the modified Poisson regression model to identify associated factors. RESULTS Among the participants, 45.3% had a low dietary diversity score. Proportions of adolescents who consumed from the different food categories over a 24-h period were; cereals/roots/tubers (99.7%), fats & oils (87.0%), spices & beverages (84.1%), sweets (77.1%), legumes (66.2%), other non-vitamin A-rich vegetables (53.8%), dark green leafy vegetables (42.3%), meat/poultry/fish (33.1%), dairy products (32.9%), eggs (11.2%), vitamin A-rich fruits and vegetables (33.4%) and other fruits (8.2%). Staying with a single parent or guardian, low socio-economic class, and dependency on home meals was associated with low dietary diversity. CONCLUSIONS Adolescents diets were low in diversity and characterised with low micronutrients source foods, but plenty of fats and oils. Interventions to address contributing factors to the burden ought to target the parenting contexts of the adolescents residing in rural eastern Uganda.
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Affiliation(s)
- Nathan Isabirye
- School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | | | - Mary Nakafeero
- School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Tonny Ssekamatte
- School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - David Guwatudde
- School of Public Health, Makerere University, P.O. Box 7072, Kampala, Uganda
| | - Wafaie Fawzi
- Department of Global Health and Population, Harvard University, Boston, USA
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Aurino E, Wolf S, Tsinigo E. Household food insecurity and early childhood development: Longitudinal evidence from Ghana. PLoS One 2020; 15:e0230965. [PMID: 32243485 PMCID: PMC7122750 DOI: 10.1371/journal.pone.0230965] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/12/2020] [Indexed: 11/19/2022] Open
Abstract
The burden of food insecurity is large in Sub-Saharan Africa, yet the evidence-base on the relation between household food insecurity and early child development is extremely limited. Furthermore, available research mostly relies on cross-sectional data, limiting the quality of existing evidence. We use longitudinal data on preschool-aged children and their households in Ghana to investigate how being in a food insecure household was associated with early child development outcomes across three years. Household food insecurity was measured over three years using the Household Hunger Score. Households were first classified as "ever food insecure" if they were food insecure at any round. We also assessed persistence of household food insecurity by classifying households into three categories: (i) never food insecure; (ii) transitory food insecurity, if the household was food insecure only in one wave; and (iii) persistent food insecurity, if the household was food insecure in two or all waves. Child development was assessed across literacy, numeracy, social-emotional, short-term memory, and self-regulation domains. Controlling for baseline values of each respective outcome and child and household characteristics, children from ever food insecure households had lower literacy, numeracy and short-term memory. When we distinguished between transitory and persistent food insecurity, transitory spells of food insecurity predicted decreased numeracy (β = -0.176, 95% CI: -0.317; -0.035), short-term memory (β = -0.237, 95% CI: -0.382; -0.092), and self-regulation (β = -0.154, 95% CI: -0.326; 0.017) compared with children from never food insecure households. By contrast, children residing in persistently food insecure households had lower literacy scores (β = -0.243, 95% CI: -0.496; 0.009). No gender differences were detected. Results were broadly robust to the inclusion of additional controls. This novel evidence from a Sub-Saharan African country highlights the need for multi-sectoral approaches including social protection and nutrition to support early child development.
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Affiliation(s)
- Elisabetta Aurino
- Department of Economics and Public Policy, Imperial College London, London, England, United Kingdom
| | - Sharon Wolf
- Graduate School of Education, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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Sheikh S, Iqbal R, Qureshi R, Azam I, Barolia R. Adolescent food insecurity in rural Sindh, Pakistan: a cross-sectional survey. BMC Nutr 2020; 6:17. [PMID: 32226631 PMCID: PMC7098077 DOI: 10.1186/s40795-020-00343-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/11/2020] [Indexed: 11/13/2022] Open
Abstract
Background Food insecurity (FI) is alarmingly high in developing countries including Pakistan. A quarter of Pakistan’s population consists of adolescents yet there is no information on their experience of FI. FI at adolescent age have long term effect on mental and physical health hence we aimed to determine the prevalence of food insecurity (FI) among adolescents and compare it with household FI, and assess social determinants of adolescent FI. Methods A cross-sectional survey on 799 households with unmarried adolescents was conducted from September 2015 to June 2016 in three union councils of Hyderabad, Pakistan. Unmarried 10–19 years old girls and boys were interviewed regarding their FI status using Household Food Insecurity Assessment Scale (HFIAS). Household-level FI was also assessed by interviewing mothers of adolescents, and it was compared with adolescent’s FI. Association of adolescent’s FI with socio-demographic determinants was explored through Cox regression using STATA version 14.0. and prevalence ratios were estimated. Results FI was found among 52.4% of the adolescents compared to 39% of the households. Thirty percent of the adolescents were food insecure within the food secure households. Female adolescents were found to be less food insecure (Adjusted Prevalence Ratio (APR) 0.4 95% CI [0.3, 0.5]) compared to males. Social determinants like socioeconomic status (SES), crowding index or education of parents were not associated with adolescents’ FI. Conclusion Half of the adolescents were found to be food insecure which raises concerns regarding their health in the long run. Gender is an important social determinant of FI among adolescents which suggests an in-depth exploration of social dynamics of adolescent FI. We recommend the mixed-methods study to develop contextually relevant interventions to reduce FI among this group and improve their health status.
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Affiliation(s)
- Sana Sheikh
- 1Department of Obstetrics and Gynecology, Private wing 2nd floor, Aga Khan University, Stadium road, Karachi, 74800 Pakistan
| | - Romaina Iqbal
- 2Department of Community Health Sciences, Ibn-e-Ridwan building, Aga Khan University, Stadium road, Karachi, 74800 Pakistan
| | - Rahat Qureshi
- 2Department of Community Health Sciences, Ibn-e-Ridwan building, Aga Khan University, Stadium road, Karachi, 74800 Pakistan
| | - Iqbal Azam
- 2Department of Community Health Sciences, Ibn-e-Ridwan building, Aga Khan University, Stadium road, Karachi, 74800 Pakistan
| | - Rubina Barolia
- 3School of Nursing and Midwifery, Aga Khan University, Stadium road, Karachi, 74800 Pakistan
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Janmohammadi P, Daneshzad E, Alipour T, Heshmati J, Eshaghi H, Mirzaei K. Is there any association between dietary patterns, food security status and psychiatric disorders among Iranian earthquake victims? BMJ Mil Health 2020; 167:153-157. [PMID: 32086271 DOI: 10.1136/jramc-2019-001301] [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] [Received: 08/02/2019] [Revised: 10/31/2019] [Accepted: 11/03/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Diet changes through disasters may affect psychological health as well as general health. The present study aimed to find food security status-that is defined by having enough food for an active, healthy life-dietary patterns and their relationship with probable psychiatric disorders in earthquake survivors. METHODS This cross-sectional study conducted on 350 women who survived in East Azarbaijan earthquake (At 4:53 am on 11 August 2012). Food frequency questionnaire, Depression, Anxiety and Stress Scale and food security questionnaire of the US Department of Agriculture were used to assess dietary patterns, psychological and food security status, respectively. P values were considered significant at <0.05. RESULTS Four major dietary patterns were defined based on factor analysis. These four dietary patterns explained of 37.09% variation of food intakes. Ten per cent of the population was food secure. There was no significant association between tertiles of major dietary patterns and risk of all psychological disorders (p values>0.05). CONCLUSION There was no statistically significant association between major dietary patterns and psychiatric disorders. Further well-designed studies need to find any significant association.
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Affiliation(s)
- Parisa Janmohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Elnaz Daneshzad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Tanaz Alipour
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.,Department of clinical Psychology, Psychology & Educational Sciences Faculty, Kharazmi University, Tehran, Iran
| | - Javad Heshmati
- Department of Nutritional Science, School of Nutritional Science and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hesam Eshaghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Fafard St-Germain AA, Siddiqi A. The Relation Between Household Food Insecurity and Children's Height in Canada and the United States: A Scoping Review. Adv Nutr 2019; 10:1126-1137. [PMID: 31075160 PMCID: PMC6855965 DOI: 10.1093/advances/nmz034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/08/2018] [Accepted: 03/18/2019] [Indexed: 01/14/2023] Open
Abstract
Household food insecurity is a determinant of health and marker of material deprivation. Although research has shown that food insecurity is associated with numerous adverse health, developmental and nutritional outcomes among children in high-income countries, little is known about its impact on children's height, an important marker of nutritional status and physical development. We reviewed evidence on the relation between experience-based measures of food insecurity and the height of children aged 0-18 y in Canada and the United States. The search, conducted in Embase, Medline, CINAHL, ProQuest, Web of Science, and EconLit from the inception of the databases to October 2017, identified 811 records that were screened for relevance. A total of 8 peer-reviewed studies, 2 from Canada and 6 from the United States, met the inclusion criteria and were summarized. Five studies found no association between food insecurity and children's height. One study found that having taller children in the household predicted more severe food insecurity, whereas 2 studies found that more severe experiences of food insecurity were associated with shorter height among children from ethnic minority populations. These results suggest that household food insecurity may not be associated with height inequalities among children in Canada and the United States, except perhaps in certain high-risk populations. However, the few studies identified for review provide insufficient evidence to determine whether food insecurity is or is not associated with children's height in these countries. Given the importance of optimal linear growth for current and future well-being, it is critical to understand how different modifiable environmental circumstances relate to children's height to help establish priorities for intervention. Families with children are disproportionately affected by food insecurity, and more research explicitly designed to examine the association between household food insecurity and children's height in high-income countries is needed.
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Affiliation(s)
| | - Arjumand Siddiqi
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Asesefa Kisi M, Tamiru D, Teshome MS, Tamiru M, Feyissa GT. Household food insecurity and coping strategies among pensioners in Jimma Town, South West Ethiopia. BMC Public Health 2018; 18:1373. [PMID: 30547789 PMCID: PMC6295006 DOI: 10.1186/s12889-018-6291-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/03/2018] [Indexed: 11/25/2022] Open
Abstract
Background Ethiopia is currently facing new challenges related to food insecurity among the urban poor. Pensioners are segments of the population with reduced income and working capacity because of advancement of age and other related problems. There is no empirical evidence on Jimma Town pensioner’s household food insecurity and coping strategies. Methods A cross-sectional study was conducted among households in Jimma Town living on an income obtained from a pension from March 01–28, 2017. Data were collected from 399 randomly selected participants. Data were entered into EPi-Data version 3.1 and analyzed using SPSS Version 20.0. Variables with p ≤ 0.25 in the bivariate analyses were entered into a multivariable regression model to control for confounding variables. Results Nearly, 83.5% of households were food insecure. The odds of food insecurity among households with heads attending secondary school and above was 78% lower when compared to that of households with uneducated household heads (AOR = 0.22, 95% CI: 0.97 to 0.49). The odds of food insecurity among households headed by merchants was 91% lower when compared to that of households headed by guards (AOR = 0.09, 95% CI: 0.03, 0.29). Food insecure households were using coping strategies such as changing consumption patterns (44%), eating inexpensive foods (72.4%), reducing meal frequency (62.4%) and selling household assets, such as household food utensils (30.8%). The odds of food insecurity among households having large family size (≥ 7) was 3.74 times higher when compared to that of households with family size less than three (AOR = 3.74(1.27, 10.99). Conclusions Household food insecurity was associated with having households headed by uneducated, widowed and guard household heads and having large family size. Food insecure households used both consumption and asset-based coping strategies such as eating less preferred, lower quality or less expensive foods and receiving donation from relatives or friends. Government policies should consider revising the current social protection scheme for pensioners. Special attention should be given to widow pensioners and pensioners with low educational status and with large family sizes.
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Affiliation(s)
| | - Dessalegn Tamiru
- Department of Population and Family Health, Jimma University, Jimma, Ethiopia
| | | | - Meseret Tamiru
- Department of Health, Behaviour and Society, Jimma University, Jimma, Ethiopia
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Madjdian DS, Azupogo F, Osendarp SJ, Bras H, Brouwer ID. Socio-cultural and economic determinants and consequences of adolescent undernutrition and micronutrient deficiencies in LLMICs: a systematic narrative review. Ann N Y Acad Sci 2018. [DOI: 10.1111/nyas.13670] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Dónya S. Madjdian
- Department of Social Sciences, Sociology of Consumption and Households; Wageningen University and Research; Wageningen the Netherlands
| | - Fusta Azupogo
- Department of Human Nutrition, Nutrition and Health over the Life Course; Wageningen University and Research; Wageningen the Netherlands
- Department of Family and Consumer Sciences, Faculty of Agriculture; University for Development Studies; Tamale Ghana
| | - Saskia J.M. Osendarp
- Department of Human Nutrition, Nutrition and Health over the Life Course; Wageningen University and Research; Wageningen the Netherlands
| | - Hilde Bras
- Department of Social Sciences, Sociology of Consumption and Households; Wageningen University and Research; Wageningen the Netherlands
| | - Inge D. Brouwer
- Department of Human Nutrition, Nutrition and Health over the Life Course; Wageningen University and Research; Wageningen the Netherlands
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Jebena MG, Lindstrom D, Lachat C, Belachew T, Kolsteren P. The effect of food insecurity on health status of adolescents in Ethiopia: longitudinal study. BMC Public Health 2017; 17:465. [PMID: 28521757 PMCID: PMC5437384 DOI: 10.1186/s12889-017-4406-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 05/07/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The effect of food insecurity on health and wellbeing of a population has been the subject of much research. Yet, limited research has investigated its effect on adolescents' health and wellbeing in Ethiopia. METHOD We used data from the Jimma Longitudinal Family Survey of Youth which began tracking a cohort of adolescents in 2005 to examine the social, behavioral and economic determinants of their health and well-being. A total of 1,919 sample were included in the main analyses. All youths provided data related to their food insecurity experiences and their health status. A mixed effect logistic regression using random intercept and trend model was used to examine the relationship between food insecurity and their health status. Fixed effects estimates were also computed to check the parsimoniousness of the random intercept and trend model. RESULTS The results indicated that the mean (±SD) age of adolescents was 18.6(±1.4). Nine hundred twenty three (48.1%) of them were female. The magnitude of self-rated health status was relatively unstable ranging from 18.9%, 34.7% to 37.3% in each round. Similarly, 20.4%, 48.4% and 20.6% of adolescents were food insecure during each consecutive round of the survey respectively. Exposure to food insecurity is strongly associated with self-rated health status (β = 0.28, P < 0.001) and poor self-rated health was also more pronounced for some time (β =2.11, P < 0.001) and decline after a turning point (β = -0.38, P < 0.001). CONCLUSIONS These findings imply that any social, nutrition and public health interventions designed to improve adolescent health should consider underlying social determinants of health such as food insecurity.
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Affiliation(s)
- Mulusew G. Jebena
- Department of Population and Family Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - David Lindstrom
- Department of Sociology, Brown University, Box 1916, Maxcy Hall, Providence, RI 02912 USA
| | - Carl Lachat
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
| | - Tefera Belachew
- Department of Population and Family Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality, Ghent University, Coupure Links 653, 9000 Ghent, Belgium
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Hassen K, Gizaw G, Belachew T. Dual Burden of Malnutrition Among Adolescents of Smallholder Coffee Farming Households of Jimma Zone, Southwest Ethiopia. Food Nutr Bull 2017; 38:196-208. [PMID: 28438035 DOI: 10.1177/0379572117701660] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Substantial evidence is emerging on the coexistence of double burden of malnutrition on adolescents of low-income countries, shaping the health challenges of the upcoming adult generation for the worst. Whether nutritional status markers of adolescents in the cash crop setting are on par with economic gains remains uncertain. Thus, we investigated the nutritional outcomes of adolescents and their determinants in coffee farming households. METHODS The survey was carried out in 3 top coffee-producing districts of Jimma Zone, Ethiopia. Five hundred fifty mothers/caregivers and their respective adolescents were selected using multistage random sampling. Anthropometric data were converted into height-for-age and body-mass-index-for-age Z scores using WHO Anthroplus software and analyzed by SPSS for windows. RESULTS Prevalence of thinness, stunting, and overweight/obesity were 11.6%, 15.6%, and 7.1%, respectively. The odds of stunting among adolescents in households in the lowest wealth tertile was nearly 6-fold higher compared to the highest tertile (adjusted odds ratio [AOR] = 5.6 [2.6-12]). Conversely, the odds of overweight/obesity was higher among adolescents in the households in the middle wealth tertile (AOR = 2.72 [1.08-6.86]) compared to the highest tertile. Adolescents living in households with low-dependent age-groups were more than twice likely to be overweight/obese (AOR = 2.58 [1.06-6.24]). CONCLUSION The current study revealed the presence of substantial dual burden of malnutrition. In such a setting, it is critical to draw a fine line and trade-off for eliminating morbidity and mortality of undernutrition, without triggering the risk of overweight/obesity.
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Affiliation(s)
- Kalkidan Hassen
- 1 Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Getu Gizaw
- 1 Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- 1 Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
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Abate KH, Belachew T. Women's autonomy and men's involvement in child care and feeding as predictors of infant and young child anthropometric indices in coffee farming households of Jimma Zone, South West of Ethiopia. PLoS One 2017; 12:e0172885. [PMID: 28264008 PMCID: PMC5338789 DOI: 10.1371/journal.pone.0172885] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 02/10/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Most of child mortality and under nutrition in developing world were attributed to suboptimal childcare and feeding, which needs detailed investigation beyond the proximal factors. This study was conducted with the aim of assessing associations of women's autonomy and men's involvement with child anthropometric indices in cash crop livelihood areas of South West Ethiopia. METHODS Multi-stage stratified sampling was used to select 749 farming households living in three coffee producing sub-districts of Jimma zone, Ethiopia. Domains of women's Autonomy were measured by a tool adapted from demographic health survey. A model for determination of paternal involvement in childcare was employed. Caring practices were assessed through the WHO Infant and young child feeding practice core indicators. Length and weight measurements were taken in duplicate using standard techniques. Data were analyzed using SPSS for windows version 21. A multivariable linear regression was used to predict weight for height Z-scores and length for age Z-scores after adjusting for various factors. RESULTS The mean (sd) scores of weight for age (WAZ), height for age (HAZ), weight for height (WHZ) and BMI for age (BAZ) was -0.52(1.26), -0.73(1.43), -0.13(1.34) and -0.1(1.39) respectively. The results of multi variable linear regression analyses showed that WHZ scores of children of mothers who had autonomy of conducting big purchase were higher by 0.42 compared to children's whose mothers had not. In addition, a child whose father was involved in childcare and feeding had higher HAZ score by 0.1. Regarding age, as for every month increase in age of child, a 0.04 point decrease in HAZ score and a 0.01 point decrease in WHZ were noted. Similarly, a child living in food insecure households had lower HAZ score by 0.29 compared to child of food secured households. As family size increased by a person a WHZ score of a child is decreased by 0.08. WHZ and HAZ scores of male child was found lower by 0.25 and 0.38 respectively compared to a female child of same age. CONCLUSION Women's autonomy and men's involvement appeared in tandem with better child anthropometric outcomes. Nutrition interventions in such setting should integrate enhancing women's autonomy over resource and men's involvement in childcare and feeding, in addition to food security measures.
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Affiliation(s)
- Kalkidan Hassen Abate
- Department of Population and family health College of health Sciences, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Population and family health College of health Sciences, Jimma University, Jimma, Ethiopia
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Alemu ZA, Ahmed AA, Yalew AW, Birhanu BS. Non random distribution of child undernutrition in Ethiopia: spatial analysis from the 2011 Ethiopia demographic and health survey. Int J Equity Health 2016; 15:198. [PMID: 27912766 PMCID: PMC5135763 DOI: 10.1186/s12939-016-0480-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 11/10/2016] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Child undernutrition showed geographical inequalities due to variations in contextual determinants from area to area which indicates that location is an important factor in child undernutrition. However, there are limited studies on spatial epidemiology of child undernutrition in Ethiopia. This study was aimed to identify the SaTScan spatial clusters of child undernutrition in Ethiopia. METHODS Nutritional indices of children (0-59 months) with Global Positioning System (GPS) location data were accessed from the 2011 Ethiopia Demographic and Health Survey (EDHS) after getting permission from the MEASURES Demographic and Health Survey (DHS) Program. The Bernoulli Model was fitted using SaTScan™ software, version 9.4. for SaTScan cluster analysis. Log Likelihood Ratio (LLR) test was used for each SaTScan cluster and size of the scanning SaTScan cluster to test the alternative hypothesis that there is an elevated risk within the SaTScan cluster compared to outside the SaTScan cluster. Less than 0.05 for LLR was considered as statistically significant level. RESULTS The SaTScan spatial analysis result detected Liben, Afder and Borena administrative zones around the South East Ethiopia as the most likely primary spatial SaTScan clusters (LLR = 28.98, p < 0.001) for wasting. In the Northern, Middle, North East and North West areas of Ethiopia particularly from all administrative zones of Amhara, Tigray, Afar, Ben. Gumz regional states and East Welega and North Showa zones from Oromiya Regional State (LLR = 60.27, p < 0.0001) were detected as the most likely primary SaTScan clusters for child underweight. Also in the Northern, Middle, North East and North West areas of all administrative zones of Tigray, Amhara, Ben. Gumz and Afar regional states and West and North Showa and East Welega from Oromiya Regional States (LLR = 97.28, P < 0.0001) were primary SaTScan clusters for child stunting. CONCLUSION The study showed geographical variability of child stunting, underweight and wasting in the Country which demands risk based local nutritional interventions. Further study will be important to assess the temporal nature of the problem and to identify community level factors that create this spatial variation.
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Affiliation(s)
- Zewdie Aderaw Alemu
- Public Health Department, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia. .,School of Public Health, College of Health Sciences, Addis Ababa University, P.O.Box 14 575, Addis Ababa, Ethiopia.
| | - Ahmed Ali Ahmed
- School of Public Health, College of Health Sciences, Addis Ababa University, P.O.Box 14 575, Addis Ababa, Ethiopia
| | - Alemayehu Worku Yalew
- School of Public Health, College of Health Sciences, Addis Ababa University, P.O.Box 14 575, Addis Ababa, Ethiopia
| | - Belay Simanie Birhanu
- Center for Environment and Development, College of Developmental Studies, Addis Ababa University, P. O. Box 56649, Addis Ababa, Ethiopia
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Jebena MG, Lindstrom D, Belachew T, Hadley C, Lachat C, Verstraeten R, De Cock N, Kolsteren P. Food Insecurity and Common Mental Disorders among Ethiopian Youth: Structural Equation Modeling. PLoS One 2016; 11:e0165931. [PMID: 27846283 PMCID: PMC5113011 DOI: 10.1371/journal.pone.0165931] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/20/2016] [Indexed: 12/14/2022] Open
Abstract
Background Although the consequences of food insecurity on physical health and nutritional status of youth living have been reported, its effect on their mental health remains less investigated in developing countries. The aim of this study was to examine the pathways through which food insecurity is associated with poor mental health status among youth living in Ethiopia. Methods We used data from Jimma Longitudinal Family Survey of Youth (JLFSY) collected in 2009/10. A total of 1,521 youth were included in the analysis. We measured food insecurity using a 5-items scale and common mental disorders using the 20-item Self-Reporting Questionnaire (SRQ-20). Structural and generalized equation modeling using maximum likelihood estimation method was used to analyze the data. Results The prevalence of common mental disorders was 30.8% (95% CI: 28.6, 33.2). Food insecurity was independently associated with common mental disorders (β = 0.323, P<0.05). Most (91.8%) of the effect of food insecurity on common mental disorders was direct and only 8.2% of their relationship was partially mediated by physical health. In addition, poor self-rated health (β = 0.285, P<0.05), high socioeconomic status (β = -0.076, P<0.05), parental education (β = 0.183, P<0.05), living in urban area (β = 0.139, P<0.05), and female-headed household (β = 0.192, P<0.05) were associated with common mental disorders. Conclusions Food insecurity is directly associated with common mental disorders among youth in Ethiopia. Interventions that aim to improve mental health status of youth should consider strategies to improve access to sufficient, safe and nutritious food.
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Affiliation(s)
- Mulusew G. Jebena
- Population and Family Health, Jimma University, Jimma, Ethiopia
- Department of Food Safety and Food Quality,Ghent University, Coupure Links, Ghent, Belgium
- * E-mail:
| | - David Lindstrom
- Department of Sociology, Brown University, Providence, Rhode Island, United States of America
| | - Tefera Belachew
- Population and Family Health, Jimma University, Jimma, Ethiopia
| | - Craig Hadley
- Deparment of Anthropology, Emory University, Atlanta, Georgia, United States of America
| | - Carl Lachat
- Department of Food Safety and Food Quality,Ghent University, Coupure Links, Ghent, Belgium
| | - Roos Verstraeten
- Nutrition and Child Health Unit, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Nathalie De Cock
- Department of Food Safety and Food Quality,Ghent University, Coupure Links, Ghent, Belgium
| | - Patrick Kolsteren
- Department of Food Safety and Food Quality,Ghent University, Coupure Links, Ghent, Belgium
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Juwara A, Huang N, Chien LY, Chen HJ. Stunting and weight statuses of adolescents differ between public and private schools in urban Gambia. Int J Public Health 2016; 61:717-726. [PMID: 27220546 DOI: 10.1007/s00038-016-0836-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 03/18/2016] [Accepted: 05/11/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This study assessed the disparity in nutritional status of adolescents between public and private schools in urban Gambia. METHODS This is a school-based cross-sectional study in six private and six public upper basic schools in urban Gambia. This study recruited 491 students from public and 469 students from private schools (13-15 years of age). RESULTS The prevalence of stunting (WHO height-for-age Z < -2SD) was 13.4 % for public school students and 4.5 % for private schools. After adjustment for children's sex, age, and family socioeconomic status, the differences in prevalence of stunting and underweight were significant between public and private schools. Private school students are more likely to be overweight/obese (WHO BMI-for-age Z > +1SD) (OR = 2.85, 95 % CI 1.55-5.22), but less likely to be thin (BMI-for-age Z < -2SD) (OR = 0.61 [0.39-0.96]), compared to public school students. Children from lower income families had lower odds for overweight/obese than normal weight, compared to those from higher income families (OR = 0.34 [0.15-0.76]). CONCLUSIONS Public and private schools in urban regions of the Gambia may face different nutritional challenges due to differences in school environment and resources.
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Affiliation(s)
- Alimatou Juwara
- International Health Program, National Yang-Ming University, Taipei, Taiwan
| | - Nicole Huang
- International Health Program, National Yang-Ming University, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Ying Chien
- International Health Program, National Yang-Ming University, Taipei, Taiwan.,Institute of Clinical and Community Health Nursing, School of Nursing, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Jen Chen
- International Health Program, National Yang-Ming University, Taipei, Taiwan. .,Institute of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong St., Medical Building II, R213, Beitou District, Taipei, 112, Taiwan, ROC.
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Chowdhury MRK, Khan MMH, Rafiqul Islam M, Perera NKP, Shumack MK, Kader M. Low maternal education and socio-economic status were associated with household food insecurity in children under five with diarrhoea in Bangladesh. Acta Paediatr 2016; 105:555-61. [PMID: 26719122 DOI: 10.1111/apa.13325] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 12/28/2015] [Indexed: 11/30/2022]
Abstract
AIM Household food insecurity (HFI) is insufficient access to nutritionally safe and adequate foods to meet the dietary needs for an active and healthy life. We examined the prevalence and determinants of HFI in Bangladeshi children under five with diarrhoea. METHODS This study included 365 children (55% boys) who had diarrhoea in the two weeks before the 2011 Bangladesh Demographic Health Survey (BDHS-2011). The Household Food Insecurity Access Scale (HFIAS) was used to assess HFI and Pearson's chi-square test and binary logistic regression analysis were used to investigate the association between HFI and multilevel factors. RESULTS The prevalence of HFI among children under five with diarrhoea in the two weeks prior to the BDHS-2011 survey was 48%. HFI was significantly higher among the children of uneducated mothers, who were two times more likely to experience HFI, with an adjusted odds ratio (OR) of 2.14 and children who were from the lowest socio-economic status families, who were more than seven times more likely to experience HFI, with an adjusted OR of 7.55. CONCLUSION Low maternal education and low socio-economic status were significantly associated with HFI in Bangladeshi children under five with diarrhoea and public health campaigns should take this into account.
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Affiliation(s)
- Mohammad Rocky Khan Chowdhury
- Department of Population Science and Human Resource Development; University of Rajshahi; Rajshahi Bangladesh
- Department of Public Health; Faculty of Health Science; First Capital University of Bangladesh; Chuadanga Bangladesh
| | - MMH Khan
- Department of Public Health Medicine; School of Public Health; Bielefeld University; Bielefeld Germany
- Department of Public Health College of Applied Medical Sciences; King Faisal University Hofuf; Saudi Arabia
| | - Md. Rafiqul Islam
- Department of Population Science and Human Resource Development; University of Rajshahi; Rajshahi Bangladesh
| | | | | | - Manzur Kader
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
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Melaku YA, Zello GA, Gill TK, Adams RJ, Shi Z. Prevalence and factors associated with stunting and thinness among adolescent students in Northern Ethiopia: a comparison to World Health Organization standards. Arch Public Health 2015; 73:44. [PMID: 26516456 PMCID: PMC4624644 DOI: 10.1186/s13690-015-0093-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 09/03/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adolescence is last chance for curbing the consequences of malnutrition and breaking the intergenerational cycle of malnutrition and poor health. This study aimed to assess the prevalence and the factors associated with stunting and thinness among in-school adolescents in northern Ethiopia using the 2006 World Health Organization (WHO) standards. METHODS In-school adolescents (n = 348, 10-19 years old) were randomly selected to participate in this cross-sectional study. Anthropometric measurements were carried out to determine the proportion of adolescents who were stunted (height-for-age < -2 Standard Deviation (SD)) and thin (body-mass-index-for-age < -2 SD). T-test was employed to evaluate mean weight and height differences between groups. Pearson chi-square, chi-square trend and Fisher's exact tests were used to explore the crude association of categorical outcome variables and associated factors. Crude and adjusted associations between the outcome variables (stunting and thinness) and independent variables (socio-demographic, eating behavior and sanitation) were also determined using logistic regression. Stata version 11.1 was used to analyze the data. RESULTS The height of the adolescents was 147.6 ± 11.2 cm (mean ± SD) and weight was37.2 ± 9.5 kg. The mean Z-scores of height-for-age and body-mass-index (BMI)-for-age of adolescents were -1.49 and -1.29, respectively. The prevalence of stunting and thinness among adolescents was 28.5 % (boys = 37.7 %; girls = 21.2 %; P = 0.001) and 26.1 % (boys = 32.4; girls = 21.6 %; p = 0.017), respectively. Adolescents in 13-15 year old age group (Adjusted Odds ratio (AOR) = 2.23; 95 % CI: 1.22, 4.08), boys (AOR = 2.53; 95 % CI: 1.52, 4.21) and rural residents (AOR = 2.15; 95 % CI: 1.20, 3.86) had significantly higher odds of being stunted compared to their counterparts. Furthermore, boys had higher (AOR = 1.97; 95 % CI: 1.19, 3.25) odds of being thin compared to girls. Compared to those 10 to 12 years of age, adolescents in 16 to 19 years of age were 53 % (AOR = 0.47; 95 % CI: 0.23, 0.95) less likely to be thin. CONCLUSIONS Undernutrition is widely prevalent among adolescents in northern Ethiopia. Sex, age and area of residence significantly associated with adolescent undernutrition. The study underlines the need for nutrition interventions targeting rural and boy adolescents.
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Affiliation(s)
- Yohannes Adama Melaku
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- School of Medicine, The University of Adelaide, Adelaide, South Australia Australia
| | | | - Tiffany K. Gill
- School of Medicine, The University of Adelaide, Adelaide, South Australia Australia
| | - Robert J. Adams
- School of Medicine, The University of Adelaide, Adelaide, South Australia Australia
| | - Zumin Shi
- School of Medicine, The University of Adelaide, Adelaide, South Australia Australia
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Humphries DL, Dearden KA, Crookston BT, Fernald LC, Stein AD, Woldehanna T, Penny ME, Behrman JR. Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam. J Nutr 2015; 145:1924-33. [PMID: 26084361 PMCID: PMC4516765 DOI: 10.3945/jn.115.210229] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 05/26/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. OBJECTIVES We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index-for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. METHODS We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n = 1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ∼1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). RESULTS Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, -0.33; India, -0.53; Peru, -0.31; and Vietnam, -0.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, -0.21; India, -0.32; Peru, -0.14; and Vietnam, -0.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8-30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4-19.3%) in other countries. CONCLUSIONS In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam.
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Affiliation(s)
- Debbie L Humphries
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, CT;
| | - Kirk A Dearden
- Department of Global Health, Boston University, Boston, MA
| | | | - Lia C Fernald
- School of Public Health, University of California at Berkeley, Berkeley, CA
| | - Aryeh D Stein
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Tassew Woldehanna
- Department of Economics, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Jere R Behrman
- Departments of Economics and Sociology, University of Pennsylvania, Philadelphia, PA
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Roba AC, Gabriel-Micheal K, Zello GA, Jaffe J, Whiting SJ, Henry CJ. A Low Pulse Food Intake May Contribute to the Poor Nutritional Status and Low Dietary Intakes of Adolescent Girls in Rural Southern Ethiopia. Ecol Food Nutr 2015; 54:240-54. [DOI: 10.1080/03670244.2014.974593] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Xie X, Wu H, Lee T, Wang CMB, Zhou X, Lu Y, Yuan Z, Maddock JE. Gender differences in home environments related to childhood obesity in Nanchang, China. Child Obes 2014; 10:416-23. [PMID: 25302442 DOI: 10.1089/chi.2013.0164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Childhood obesity is rapidly increasing in China, with rates doubling between 2000 and 2010. Several large, epidemiological studies have shown boys to be consistently more likely to be obese than girls. The aim of this study was to investigate gender differences in the home environment and parenting practices related to childhood obesity. METHODS A cross-sectional survey using a convenience sampling of 522 (86.1% response rate) primary caregivers of children ages 2-10 years was conducted in four locations in Nanchang, China, in the spring of 2013 using face-to-face, anonymous questionnaires. RESULTS Boys were significantly (p<0.05) more likely than girls to watch more television (TV) per week, be allowed to have snacks/sweets or soft drinks without permission, and to have sugary drinks at snacks and meals. Girls were significantly more likely than boys to have parental encouragement and support for physical activity, participate in organized sports/group activities, and have fresh fruits accessible. Parents also believed that boys eat too much junk foods or their favorite foods if not controlled. Few differences were noted in the actual physical environment in the home, including access to sports equipment, junk food availability, and access to media. CONCLUSIONS RESULTS indicate that parents tend to be more permissive with boys than girls, allowing them access to unhealthy foods and more TV time. These differences may contribute to the higher prevalence of obesity in boys in China.
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Affiliation(s)
- Xiaoxu Xie
- 1 School of Public Health, Nanchang University , Nanchang, China
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