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Buccini G, Larrison C, Neupane S, Palapa M, Schincaglia RM, Brown S, Gubert MB. Complex intertwined association between breastfeeding practices and household food insecurity: Systematic review and meta-analysis. MATERNAL & CHILD NUTRITION 2024:e13696. [PMID: 38960401 DOI: 10.1111/mcn.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 07/05/2024]
Abstract
Breastfeeding offers ideal food and nutrition for infants; however, structural barriers may amplify breastfeeding inequities. We aimed to identify whether household food insecurity (HFI) is associated with exclusive and continued breastfeeding (EBF and CBF) as recommended by the World Health Organization/United Nations Children's Fund (UNICEF) Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis, literature searches using 'breastfeeding', 'food insecurity' and 'infant' terms were conducted in PubMed/MEDLINE, Embase, CINAHL, Global Health and LILACS from inception through November 2023, without language restrictions, yielding 1382 publications (PROSPERO:CRD42022329836). Predetermined eligibility criteria yielded the 12 included studies (nine cross-sectional and three cohorts). The risk of bias was assessed through the Effective Public Health Practice Project. Meta-analysis was performed for studies assessing EBF (n = 10), and metaregression was used to explore heterogeneity across studies. Prevalence of EBF ranged from 1.6% to 85.3%, with a lower prevalence among HFI. The pooled effect of the association between HFI and EBF presented an odds ratio (OR) of 0.61 (95% CI = 0.49-0.76) with consistent results across marginal (OR = 0.72, 95% CI = 0.55-0.94), moderate (OR = 0.59, 95% CI = 0.41-0.84) and severe HFI (OR = 0.49, 95% CI = 0.32-0.76). High heterogeneity was found only when HFI was dichotomized. The prevalence of CBF ranged from 35.4% to 78.0%, with inconsistent prevalence among HFI; a meta-analysis was not performed due to the low number of studies (n = 3). We concluded that HFI levels are associated with lower odds of EBF. Integrating service and policy-level strategies, such as screening, referrals, skilled breastfeeding counseling and access to comprehensive nutrition and social programs, could reduce structural inequities and promote adherence to the World Health Organization/UNICEF breastfeeding recommendations among food-insecure families.
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Affiliation(s)
- Gabriela Buccini
- Department of Social and Behavioural Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Cali Larrison
- Department of Social and Behavioural Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Smriti Neupane
- Department of Social and Behavioural Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Maria Palapa
- Department of Social and Behavioural Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Raquel Machado Schincaglia
- Department of Social and Behavioural Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Sara Brown
- School of Nursing, University of California, Irvine, Irvine, California, USA
| | - Muriel B Gubert
- Department of Social and Behavioural Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
- Department of Nutrition, University of Brasilia, Brasilia, Brazil
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Kebede A, Jirström M, Worku A, Alemu K, Berhane HY, Turner C, Ekström EC, Berhane Y. Residential Food Environment, Household Wealth and Maternal Education Association to Preschoolers' Consumption of Plant-Based Vitamin A-Rich Foods: The EAT Addis Survey in Addis Ababa. Nutrients 2022; 14:296. [PMID: 35057477 PMCID: PMC8778225 DOI: 10.3390/nu14020296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 11/29/2022] Open
Abstract
Vitamin A deficiency is common among preschoolers in low-income settings and a serious public health concern due to its association to increased morbidity and mortality. The limited consumption of vitamin A-rich food is contributing to the problem. Many factors may influence children's diet, including residential food environment, household wealth, and maternal education. However, very few studies in low-income settings have examined the relationship of these factors to children's diet together. This study aimed to assess the importance of residential food availability of three plant-based groups of vitamin A-rich foods, household wealth, and maternal education for preschoolers' consumption of plant-based vitamin A-rich foods in Addis Ababa. A multistage sampling procedure was used to enroll 5467 households with under-five children and 233 residential food environments with 2568 vendors. Data were analyzed using a multilevel binary logistic regression model. Overall, 36% (95% CI: 34.26, 36.95) of the study children reportedly consumed at least one plant-based vitamin A-rich food group in the 24-h dietary recall period. The odds of consuming any plant-based vitamin A-rich food were significantly higher among children whose mothers had a higher education level (AOR: 2.55; 95% CI: 2.01, 3.25), those living in the highest wealth quintile households (AOR: 2.37; 95% CI: 1.92, 2.93), and in residentials where vitamin A-rich fruits were available (AOR: 1.20; 95% CI: 1.02, 1.41). Further research in residential food environment is necessary to understand the purchasing habits, affordability, and desirability of plant-based vitamin A-rich foods to widen strategic options to improve its consumption among preschoolers in low-income and low-education communities.
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Affiliation(s)
- Adane Kebede
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia
| | - Magnus Jirström
- Department of Human Geography, Lund University, 223 62 Lund, Sweden;
| | - Alemayehu Worku
- School of Public Health, College of Health Science, Addis Ababa University, Addis Ababa 1176, Ethiopia;
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia;
| | - Hanna Y. Berhane
- Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia;
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Christopher Turner
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK;
| | - Eva-Charlotte Ekström
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
| | - Yemane Berhane
- Department of Women’s and Children Health, Uppsala University, 751 85 Uppsala, Sweden; (E.-C.E.); (Y.B.)
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa 26751/1000, Ethiopia
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Abdelmenan S, Berhane HY, Jirström M, Trenholm J, Worku A, Ekström EC, Berhane Y. The Social Stratification of Availability, Affordability, and Consumption of Food in Families with Preschoolers in Addis Ababa; The EAT Addis Study in Ethiopia. Nutrients 2020; 12:nu12103168. [PMID: 33081262 PMCID: PMC7603009 DOI: 10.3390/nu12103168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to understand the quality of diet being consumed among families in Addis Ababa, and to what extent social stratification and perceptions of availability and affordability affect healthy food consumption. Data were collected from 5467 households in a face-to-face interview with mothers/caretakers and analyzed using mixed effect logistic regression models. All family food groups, except fish were perceived to be available by more than 90% of the participants. The food groups cereals/nuts/seeds, other vegetables, and legumes were considered highly affordable (80%) and were the most consumed (>75%). Households with the least educated mothers and those in the lowest wealth quintile had the lowest perception of affordability and also consumption. Consumption of foods rich in micronutrients and animal sources were significantly higher among households with higher perceived affordability, the highest wealth quintile, and with mothers who had better education. Households in Addis Ababa were generally seen to have a monotonous diet, despite the high perceived availability of different food groups within the food environment. There is a considerable difference in consumption of nutrient-rich foods across social strata, hence the cities food policies need to account for social differences in order to improve the nutritional status of the community.
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Affiliation(s)
- Semira Abdelmenan
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, 196 Gondar, Ethiopia
- Correspondence: ; Tel.: +251-116-390026
| | - Hanna Y. Berhane
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
| | - Magnus Jirström
- Department of Human Geography, Lund University, 223 62 Lund, Sweden;
| | - Jill Trenholm
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
| | - Alemayehu Worku
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- School of Public Health, College of Health Sciences, Addis Ababa University, 1176 Addis Ababa, Ethiopia
| | - Eva-Charlotte Ekström
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
| | - Yemane Berhane
- Addis Continental Institute of Public Health, 26751/1000 Addis Ababa, Ethiopia; (H.Y.B.); (A.W.); (E.-C.E.); (Y.B.)
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, 751 85 Uppsala, Sweden;
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Freitas LGD, Cortés MAP, Stein C, Cousin E, Faustino-Silva DD, Hilgert JB. Dietary intake quality and associated factors in one year-old children seen by primary healthcare services. CIENCIA & SAUDE COLETIVA 2020; 25:2561-2570. [PMID: 32667540 DOI: 10.1590/1413-81232020257.14592018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 09/25/2018] [Indexed: 11/22/2022] Open
Abstract
The purpose of this paper was to analyze the food intake quality in one year-old children seen by a primary healthcare (PHC) service. This is a cross-sectional studied nested within a child oral health cohort study which collected data regarding children born in 2013 and monitored in Porto Alegre for two years. We applied a questionnaire on maternal variables and frequency of pediatric appointments, weight and height measurements, and children's food intake. To that end, a score was generated based on the points assigned according to SISVAN (meaning 'food and nutrition monitoring system,' run by the Brazilian Ministry of Health). A multivariate model was calculated using Poisson regression with robust variance. The sample comprised 249 children. We found 30.5% (76) of poor/regular dietary quality, which in the multivariate model was associated to the guardian's educational background, considering up to incomplete high school (PR = 2.14, CI95% = 1.03-4.44) and complete high school (PR = 1.70, CI95% = 0.81-3.54), as well as their failure to see a dentist (PR = 2.54, CI95% = 1.33-4.84) or having seen one before the age of four months (PR = 1.94, CI95% = 1.01-3.72). It is our conclusion that failing to see a dentist within the first year of life and lower maternal schooling negatively impact on children's dietary quality.
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Affiliation(s)
- Laura Garcia de Freitas
- Grupo Hospitalar Conceição. Av. Francisco Trein 596, Cristo Redentor. 91350-200 Porto Alegre RS Brasil.
| | - Margarita Alexandra Pena Cortés
- Programa de Pós-Graduação em Medicina e Ciências da Saúde, Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre RS Brasil
| | - Caroline Stein
- Programa de Pós-Graduação em Odontologia, Universidade Federal do Rio Grande do Sul (UFRGS). Porto Alegre RS Brasil
| | - Ewerton Cousin
- Programa de Pós-Graduação em Epidemiologia, UFRGS. Porto Alegre RS Brasil
| | - Daniel Demétrio Faustino-Silva
- Serviço de Saúde Comunitária e Programa de Pós-Graduação Modalidade Mestrado Profissional Avaliação e Produção de Tecnologias para o SUS, Grupo Hospitalar Conceição. Porto Alegre RS Brasil
| | - Juliana Balbinot Hilgert
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, UFRGS. Porto Alegre RS Brasil
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Social Stratification, Diet Diversity and Malnutrition among Preschoolers: A Survey of Addis Ababa, Ethiopia. Nutrients 2020; 12:nu12030712. [PMID: 32156006 PMCID: PMC7146462 DOI: 10.3390/nu12030712] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/03/2020] [Accepted: 03/04/2020] [Indexed: 12/22/2022] Open
Abstract
In Sub-Saharan Africa, being overweight in childhood is rapidly rising while stunting is still remaining at unacceptable levels. A key contributor to this double burden of malnutrition is dietary changes associated with nutrition transition. Although the importance of socio-economic drivers is known, there is limited knowledge about their stratification and relative importance to diet and to different forms of malnutrition. The aim of this study was to assess diet diversity and malnutrition in preschoolers and evaluate the relative importance of socioeconomic resources. Households with children under five (5467) were enrolled using a multi-stage sampling procedure. Standardized tools and procedures were used to collect data on diet, anthropometry and socio-economic factors. Multivariable analysis with cluster adjustment was performed. The prevalence of stunting was 19.6% (18.5-20.6), wasting 3.2% (2.8-3.7), and overweight/obesity 11.4% (10.6-12.2). Stunting, overweight, wasting and limited diet diversity was present in all social strata. Low maternal education was associated with an increased risk of stunting (Adjusted odds ratio (AOR): 1.8; 1.4-2.2), limited diet diversity (AOR: 0.33; 0.26-0.42) and reduced odds of being overweight (AOR: 0.61; 0.44-0.84). Preschoolers in Addis Ababa have limited quality diets and suffer from both under- and over-nutrition. Maternal education was an important explanatory factor for stunting and being overweight. Interventions that promote diet quality for the undernourished whilst also addressing the burgeoning problem of being overweight are needed.
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Pérez W, Contreras M, Peña R, Zelaya E, Persson LÅ, Källestål C. Food insecurity and self-rated health in rural Nicaraguan women of reproductive age: a cross-sectional study. Int J Equity Health 2018; 17:146. [PMID: 30227875 PMCID: PMC6145199 DOI: 10.1186/s12939-018-0854-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/31/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Access to food is a basic necessity, and food insecurity may impair the individual's well-being and health. Self-rated health measurements have frequently been used to assess population health. Little is known, however, as to whether food security is associated with self-rated health in low- and middle-income settings. This study aims at analyzing the association between food security and self-rated health among non-pregnant women of reproductive age in a rural Nicaraguan setting. METHODS Data was taken from the 2014 update of a health and demographic surveillance system in the municipalities of Los Cuatro Santos in northwestern Nicaragua. Fieldworkers interviewed women about their self-rated health using a 5-point Likert scale. Food insecurity was assessed by the household food insecurity access (HFIAS) scale. A multilevel Poisson random-intercept model was used to calculate the prevalence ratio. RESULTS The survey included 5866 women. In total, 89% were food insecure, and 48% had poor self-rated health. Food insecurity was associated with poor self-rated health, and remained so after adjustment for potential confounders and accounting for community dependency. CONCLUSION In this Nicaraguan resource-limited setting, there was an association between food insecurity and poor self-rated health. Food insecurity is a facet of poverty and measures an important missing capability directly related to health.
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Affiliation(s)
- Wilton Pérez
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Mariela Contreras
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Rodolfo Peña
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Pan American Health Organization, Tegucigalpa, Honduras
| | - Elmer Zelaya
- Asociación para el Desarrollo Económico y Social de El Espino (APRODESE), Cinco Pinos, Nicaragua
| | - Lars-Åke Persson
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
| | - Carina Källestål
- International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
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Abebe Z, Zelalem Anlay D, Biadgo B, Kebede A, Melku T, Enawgaw B, Melku M. High Prevalence of Undernutrition among Children in Gondar Town, Northwest Ethiopia: A Community-Based Cross-Sectional Study. Int J Pediatr 2017; 2017:5367070. [PMID: 29387093 PMCID: PMC5745770 DOI: 10.1155/2017/5367070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/18/2017] [Accepted: 10/31/2017] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE To assess undernutrition and associated factors among children aged 6-59 months in Gondar Town, northwest Ethiopia. METHODS A community-based cross-sectional study was conducted in 2014. Multistage sampling method was used to select study participants. Structured interviewer administered questionnaire and anthropometric measurements were used. Binary logistic regression was fitted to identify associated factors. RESULTS The prevalences of wasting and stunting were 6.8% and 45.7%, respectively. Higher odds of wasting were observed among children whose fathers were daily laborers (AOR = 2.63), children who had eating problem (AOR = 2.96), and those who were not exclusively breast-fed for the first six months (AOR = 5.63). Similarly, higher odds of stunting were found among female children (AOR = 1.65), children who lived in households having four to six families (AOR = 2.14), and children who did not start breast-feeding within one hour of birth (AOR = 0.67). CONCLUSION Childhood undernutrition was a significant problem. Child eating problem, paternal occupation, and exclusive breast-feeding were associated with wasting, whereas family size, child sex, and breast-feeding initiation time were associated with stunting. Therefore, strengthening of early initiation and exclusive breast-feeding, promoting healthcare seeking behavior, and designing social support programme for poor family are recommended to reduce undernutrition.
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Affiliation(s)
- Zegeye Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Degefaye Zelalem Anlay
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belete Biadgo
- Department of Clinical Chemistry, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Asemarie Kebede
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsedalu Melku
- School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bamlaku Enawgaw
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Blandón EZ, Källestål C, Peña R, Perez W, Berglund S, Contreras M, Persson LÅ. Breaking the cycles of poverty: Strategies, achievements, and lessons learned in Los Cuatro Santos, Nicaragua, 1990-2014. Glob Health Action 2017; 10:1272884. [PMID: 28136698 PMCID: PMC5328362 DOI: 10.1080/16549716.2017.1272884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: In a post-war frontier area in north-western Nicaragua that was severely hit by Hurricane Mitch in 1998, local stakeholders embarked on and facilitated multi-dimensional development initiatives to break the cycles of poverty. Objective: The aim of this paper is to describe the process of priority-setting, and the strategies, guiding principles, activities, achievements, and lessons learned in these local development efforts from 1990 to 2014 in the Cuatro Santos area, Nicaragua. Methods: Data were derived from project records and a Health and Demographic Surveillance System that was initiated in 2004. The area had 25,893 inhabitants living in 5,966 households in 2014. Results: A participatory process with local stakeholders and community representatives resulted in a long-term strategic plan. Guiding principles were local ownership, political reconciliation, consensus decision-making, social and gender equity, an environmental and public health perspective, and sustainability. Local data were used in workshops with communities to re-prioritise and formulate new goals. The interventions included water and sanitation, house construction, microcredits, environmental protection, school breakfasts, technical training, university scholarships, home gardening, breastfeeding promotion, and maternity waiting homes. During the last decade, the proportion of individuals living in poverty was reduced from 79 to 47%. Primary school enrolment increased from 70 to 98% after the start of the school breakfast program. Under-five mortality was around 50 per 1,000 live births in 1990 and again peaked after Hurricane Mitch and was approaching 20 per 1,000 in 2014. Several of the interventions have been scaled up as national programs. Conclusions: The lessons learned from the Cuatro Santos initiative underline the importance of a bottom-up approach and local ownership of the development process, the value of local data for monitoring and evaluation, and the need for multi-dimensional local interventions to break the cycles of poverty and gain better health and welfare.
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Affiliation(s)
- Elmer Zelaya Blandón
- a Asociación para el Desarrollo Económico y Sostenible de El Espino (APRODESE) , Chinandega , Nicaragua.,b UNAN-León , León , Nicaragua
| | - Carina Källestål
- c Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Rodolfo Peña
- c Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden.,d Pan American Health Organization , San Salvador , El Salvador
| | - Wilton Perez
- c Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Staffan Berglund
- e Faculty of Health and Society , Malmö University , Malmö , Sweden
| | - Mariela Contreras
- c Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Lars-Åke Persson
- c Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden.,f Department of Infectious Disease Epidemiology , London School of Hygiene & Tropical Medicine , London , UK
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Joury E, Khairallah M, Sabbah W, Elias K, Bedi R. Inequalities in the frequency of free sugars intake among Syrian 1-year-old infants: a cross-sectional study. BMC Oral Health 2016; 16:94. [PMID: 27608712 PMCID: PMC5017135 DOI: 10.1186/s12903-016-0287-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 08/26/2016] [Indexed: 11/19/2022] Open
Abstract
Background High frequency of free sugars intake, during the first year of life is probably the greatest risk factor for early childhood caries. The latter is a global public health challenge. Very little is known about the social determinants of infant’s frequency of free sugars intake, particularly in low-income countries. Thus, the present study aimed to assess the association between the frequency of free sugars intake among 1-year-old Syrian infants and each of parents’ socioeconomic position (SEP), maternal frequency of free sugars intake and knowledge of infant’s oral health behaviour. Methods Using a cross-sectional design, 323 1-year-old infants, attending vaccination clinics in 3 maternal and child health centres (MCHCs) in Damascus, Syria, were selected. A systematic random sampling was applied using the MCHCs’ monthly vaccination registries. The 3 MCHCs were located in affluent, moderate and deprived areas. Infants’ mothers completed a structured questionnaire on socio-demographics, infant’s and mother’s frequency of free sugars intake from cariogenic foods and beverages, and mother’s knowledge about infant’s oral health behaviour. Binary and multiple regression analyses were performed. The level of significance was set at 5 %. Results The response rate was 100 %. Overall, 42.7 % of infants had high frequency of free sugars intake (>4times a day). Infants whose fathers were not working were more likely to have high frequency of free sugars intake. Similarly, infants whose mothers had low level of knowledge about infant’s oral health behaviour, or high frequency of free sugars intake were more likely to have high frequency of free sugars intake. The association between father’s occupation and infant’s frequency of free sugars intake attenuated after adjustment for mother’s knowledge and frequency of free sugars intake (adjusted OR = 1.5, 1.8, 3.2; 95%CI = 0.5–4.8, 1.1–3, 1.4–7.4; respectively). Conclusions There are socioeconomic inequalities in the frequency of free sugars intake among Syrian 1-year-old infants. Integrated pre/post-natal interventions, targeting mothers from low SEP and aiming at reducing their free sugars intake and improving their knowledge about infant’s oral health behaviour, will potentially reduce socioeconomic inequalities in infant’s frequency of free sugars intake.
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Schmeer KK, Piperata BA. Household food insecurity and child health. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27126348 DOI: 10.1111/mcn.12301] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 12/30/2015] [Accepted: 01/06/2016] [Indexed: 11/29/2022]
Abstract
Food insecurity, the lack of consistent access to sufficient quality and quantity of food, affects an estimated 800 million people around the world. Although household food insecurity is generally associated with poor child nutrition and health in the USA, we know less about household food insecurity and child health in developing countries. Particularly lacking is research assessing how associations between household food insecurity and children's health outcomes may differ by child age and among children beyond age 5 years in low-income settings. We use data from a population-based sample of households with children ages 3-11 years (N = 431) in León, Nicaragua to consider how household food insecurity is associated with three measures of child health: illness, anaemia and low height-for-age. Our results provide new evidence that even mild household food insecurity is detrimental to children's health; and that child age conditions the associations between household food insecurity and child health. We find that food insecurity is especially harmful to health during early childhood, but continues to have significant associations with health into middle childhood (up to ages 7-8 years). We discuss the potential implications of these results for future child health research and policies in low-income countries. © 2016 John Wiley & Sons Ltd.
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Affiliation(s)
- Kammi K Schmeer
- Department of Sociology, The Ohio State University, Columbus, USA
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