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Aidam E, Varela V, Abukari F, Torres KA, Nisingizwe MP, Yourkavitch J, Yakubu E, Abubakari A, Ibrahim R, Oot L, Beck K, Azumah S, Issahaku AH, Apoassan Jambeidu J, Abdul-Rahman L, Adu-Asare C, Uyehara M, Cashin K, Karnati R, Kirk CM. Promoting responsive care and early learning practices in Northern Ghana: results from a counselling intervention within nutrition and health services. Public Health Nutr 2024; 27:e77. [PMID: 38328894 DOI: 10.1017/s1368980024000156] [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] [Indexed: 02/09/2024]
Abstract
OBJECTIVE This study assesses change in caregiver practices after integrating responsive care and early learning (RCEL) in nutrition and health services and community platforms in northern Ghana. DESIGN We trained health facility workers and community health volunteers to deliver RCEL counselling to caregivers of children under 2 years of age through existing health facilities and community groups. We assessed changes in caregivers' RCEL practices before and after the intervention with a household questionnaire and caregiver-child observations. SETTING The study took place in Sagnarigu, Gushegu, Wa East and Mamprugu-Moagduri districts from April 2022 to March 2023. Study sites included seventy-nine child welfare clinics (CWC) at Ghana Health Service facilities and eighty village savings and loan association (VSLA) groups. PARTICIPANTS We enrolled 211 adult caregivers in the study sites who had children 0-23 months at baseline and were enrolled in a CWC or a VSLA. RESULTS We observed improvements in RCEL and infant and young child feeding practices, opportunities for early learning (e.g. access to books and playthings) in the home environment and reductions in parental stress. CONCLUSIONS This study demonstrates the effectiveness of integrating RCEL content into existing nutrition and health services. The findings can be used to develop, enhance and advocate for policies integrating RCEL into existing services and platforms in Ghana. Future research may explore the relationship between positive changes in caregiver behaviour and improvements in child development outcomes as well as strategies for enhancing paternal engagement in care practices, improving child supervision and ensuring an enabling environment.
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Affiliation(s)
- Enam Aidam
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
| | - Veronica Varela
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
| | - Fauzia Abukari
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- USAID Advancing Nutrition Ghana, Plot# 11, Jisonaayili-Gurugu, Tamale, Ghana
| | - Kelsey A Torres
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
| | - Marie Paul Nisingizwe
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- University of British Columbia, School of Population and Public Health, 2206 East Mall, Vancouver, BC, Canada
| | - Jennifer Yourkavitch
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- Results for Development, 1111 19th Street NW, Washington, DC, USA
| | - Eliasu Yakubu
- Saha Consulting and Services Limited, P. O. Box 430, Tamale, Ghana
| | - Abdulai Abubakari
- Saha Consulting and Services Limited, P. O. Box 430, Tamale, Ghana
- University for Development Studies, School of Public Health, Department of Global and International Health, P.O. Box TL1350, Tamale, Ghana
| | - Rashida Ibrahim
- Saha Consulting and Services Limited, P. O. Box 430, Tamale, Ghana
| | - Lesley Oot
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
| | - Kathryn Beck
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
| | - Selorme Azumah
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- USAID Advancing Nutrition Ghana, Plot# 11, Jisonaayili-Gurugu, Tamale, Ghana
| | - Al-Hassan Issahaku
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- USAID Advancing Nutrition Ghana, Plot# 11, Jisonaayili-Gurugu, Tamale, Ghana
| | - Joyce Apoassan Jambeidu
- Feed the Future Resilience in Northern Ghana Systems Strengthening, BA184 Dohana Kpema Street Gumani, Tamale, Ghana
- Abt Associates, 10 Fawcett Street, Cambridge, MA, USA
| | - Lutuf Abdul-Rahman
- United States Agency for International Development Ghana, No. 24 Fourth Circular Road, Cantonments, P.O. Box 1630, Accra, Ghana
| | | | - Malia Uyehara
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- JSI Research & Training Institute, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
| | - Kristen Cashin
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- Save the Children US, 501 Kings Highway E, Fairfield, CT, USA
| | - Romilla Karnati
- USAID Advancing Nutrition, 2733 Crystal Drive, Fourth Floor, Arlington, VA22201, USA
- Save the Children US, 501 Kings Highway E, Fairfield, CT, USA
| | - Catherine M Kirk
- ZemiTek LLC, USAID's Global Solution Ventures, 1300 Pennsylvania Avenue NW, Washington, DC, USA
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Kusumawardani HD, Laksono AD, Hidayat T, Supadmi S, Latifah L, Sulasmi S, Ashar H, Musoddaq MA. Stunting Among Children Under Two Years in the Islands Areas: A Cross-sectional Study of the Maluku Region in Indonesia, 2021. J Res Health Sci 2023; 23:e00597. [PMID: 38315912 PMCID: PMC10843314 DOI: 10.34172/jrhs.2023.132] [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: 08/14/2023] [Revised: 10/28/2023] [Accepted: 12/03/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The Maluku region encompasses thousands of islands. The study analyzed factors related to stunting among children under two years old in the Maluku Region of Indonesia. Study Design: A cross-sectional study. METHODS This cross-sectional study examined 4764 children under two years. In addition to nutritional status (stature), the study analyzed ten independent variables (province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, gender, and early initiation of breastfeeding [EIBF]). Finally, the contribution of various factors to stunting was examined using logistic regression. RESULTS Children in Maluku province were 1.13 times more likely than those in North Maluku province to become stunted. In addition, children aged 12-13 months were 4.09 times more likely than<12 months, and boys were 1.87 times more likely than girls to have the patterns of stunting. Children in rural areas were 1.10 times more likely to become stunted than those in urban areas (95% confidence interval: 1.06, 1.14). Divorced/widowed mothers were 1.88 times more likely than married mothers. Mothers of all education levels were more likely than those without formal education, and unemployed mothers were 1.07 times more likely than employed mothers to have stunted children. The possibility of becoming stunted was lower when the children were wealthier. CONCLUSION Nine variables were related to stunted incidence, including province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, and gender.
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Affiliation(s)
| | - Agung Dwi Laksono
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Taufik Hidayat
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Sri Supadmi
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Leny Latifah
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Sri Sulasmi
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
| | - Hadi Ashar
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia
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Shriyan P, Khetrapal S, van Schayck OCP, Babu GR. Maternal depressiveness and infant growth outcomes: Findings from the MAASTHI cohort study in India. J Psychosom Res 2023; 170:111378. [PMID: 37244068 PMCID: PMC7614640 DOI: 10.1016/j.jpsychores.2023.111378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The study aims to examine the association between depressiveness in mothers on infant obesity and stunting at one year of age. METHODS We enrolled 4829 pregnant women, followed them up at public health facilities in Bengaluru for one year after birth. We collected information on women's sociodemographic characteristics, obstetric history, depressive symptoms during pregnancy and delivery within 48 h. We took infant anthropometric measurements at birth and one year. We used chi-square tests, and calculated an unadjusted odds ratio using univariate logistic regression. We used multivariate logistic regression to examine the association between maternal depressiveness, childhood adiposity, and stunting. RESULTS We found that the prevalence of depressiveness was 31.8% in mothers who delivered in public health facilities in Bengaluru. Infants born to mothers with depressiveness at birth had 3.9 times higher odds of having larger waist circumference than infants born to mothers with no depressiveness (AOR: 3.96, 95% Confidence Interval: 1.24,12.58) and 1.9 times higher odds of having a larger sum of skinfold thickness (AOR: 1.99, 95% CI: 1.18,3.38). Additionally, we found that infants born to mothers with depressiveness at birth had 1.7 times higher odds of stunting than infants born to mothers with no depressiveness (AOR: 1.72; 95%CI: 1.22,2.43) after adjusting for confounders. CONCLUSION Our study highlights a high prevalence of depressiveness among mothers seeking antenatal care at a public hospital is associated with an increased risk of infant adiposity and stunting at one year. Further research is needed to understand the underlying mechanisms and identify effective interventions.
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Affiliation(s)
- Prafulla Shriyan
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka 560023, India
| | | | - Onno C P van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands
| | - Giridhara R Babu
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, Karnataka 560023, India; The Wellcome Trust/DBT India Alliance, New Delhi 110025, India.
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Yohana S, Indriyanti R, Suryanti N, Rahayuwati L, Juniarti N, Setiawan AS. Caries Experience among Children with History of Neonatal Stunting. Eur J Dent 2023; 17:687-692. [PMID: 36075267 PMCID: PMC10569887 DOI: 10.1055/s-0042-1750775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
OBJECTIVE Children with neonatal growth retardation (defined as birth length <48cm) are at risk for chronic malnutrition that begins before birth and continues into infancy. Stunting can adversely affect a child's growth and development, including oral health itself, and especially the experience of dental caries. This study analyzed the dental caries experience in children with neonatal growth retardation. MATERIALS AND METHODS: This was a baseline and 1-year follow-up analysis of a cohort of stunted children in a potential stunting site in Bandung City. Annual data collection included interviews with mothers and dental and anthropometric examinations of children. Descriptive analysis was performed in SPSS. STATISTICAL ANALYSIS Data were recorded on paper forms and manually entered into a Microsoft Excel spreadsheet for later analysis using IBM SPSS (version 23.0). After assessment, descriptive statistics was generated prior to bivariate analysis. RESULTS Fifty-five children met the inclusion criteria and participated in the 1-year study. Decay, missing, filling teeth (Dmft) was in the intermediate category (4.13) at baseline and fell into the high category (5.16) at 1-year follow-up, although the increase in caries remained in the low category. CONCLUSION Dysplastic children with a history of neonatal developmental delay experience dental caries beginning in the first year of life and may become more severe later in life.
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Affiliation(s)
- Siska Yohana
- Dentist Education Program, Faculty of Dentistry, Universitas Padjadjaran, Jawa Barat, Indonesia
| | - Ratna Indriyanti
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Jawa Barat, Indonesia
| | - Netty Suryanti
- Department of Community Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Jawa Barat, Indonesia
| | - Laili Rahayuwati
- Department of Community Nursing, Faculty of Nursing, Universitas Padjadjaran, Jawa Barat, Indonesia
| | - Neti Juniarti
- Department of Community Nursing, Faculty of Nursing, Universitas Padjadjaran, Jawa Barat, Indonesia
| | - Arlette S. Setiawan
- Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Jawa Barat, Indonesia
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Wemakor A, Bukari M, Atariba R. Household food insecurity, low maternal social support and maternal common mental disorders in East Mamprusi Municipality, Ghana. BMC Public Health 2023; 23:1255. [PMID: 37380991 DOI: 10.1186/s12889-023-16157-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/20/2023] [Indexed: 06/30/2023] Open
Abstract
INTRODUCTION Both household food insecurity and maternal common mental disorders are public health concerns in Ghana but studies on them, and their interrelatedness are scarce. Social support is an independent determinant of mental health but can also moderate the link between risk factors and mental illness. Identifying the risk factors of mental illness may provide opportunities for intervention and help reduce disease burden and impact. This study examined the association between household food insecurity or low maternal social support and maternal common mental disorders in East Mamprusi Municipality, Ghana. METHODS This was a community-based, cross-sectional study involving 400 mothers with children 6-23 months selected using multi-stage sampling. Summary scores for household food insecurity, maternal social support, and maternal common mental disorders were measured using Food Insecurity Experience Scale (FIES), Medical Outcome Study Social Support Scale (SSS), and WHO Self-Reporting Questionnaire 20 items (SRQ-20) respectively in personal interviews. Poisson regression models were fitted to determine the association of household food insecurity or low maternal social support with maternal common mental disorders, controlling for selected socio-demographic variables. RESULTS The mean age of the participants was 26.7 (± 6.68) years, and the mean FIES, SSS, and SRQ-20 scores were 5.62 [95% Confidence Interval (CI): 5.29-5.96] out of 8, 43.12 (95% CI: 41.34-44.90) out of 100, and 7.91 (95% CI: 7.38-8.45) out of 19 respectively. About two-thirds of the households (71.9%), and 72.7% and 49.5% of the women had food insecurity, low social support and probable common mental disorder respectively. In the adjusted analyses, a unit increase in FIES score was associated to a 4% increment in the predicted SRQ-20 score [Incident Risk Ratio (IRR) 1.04; 95% Confidence Interval (CI): 1.02, 1.06; p = 0.001], and the predicted SRQ-20 score of the women belonging to low social support category was 38% higher compared to that of women of high social support category (IRR 1.38; 95% CI: 1.14, 1.66; p = 0.001). CONCLUSION The prevalence of household food insecurity and common mental disorders among mothers are high, and both household food insecurity and low social support are significantly related to common mental disorders in women. Interventions to reduce both household food insecurity, and common mental disorders in women are warranted, and should include social support for women.
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Affiliation(s)
- Anthony Wemakor
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana.
| | - Mohammed Bukari
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana
| | - Raymond Atariba
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P. O. Box TL 1883, Tamale, Ghana
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Ricci H, Nakiranda R, Malan L, Kruger HS, Visser M, Ricci C, Faber M, Smuts CM. Association between maternal postpartum depressive symptoms, socioeconomic factors, and birth outcomes with infant growth in South Africa. Sci Rep 2023; 13:5696. [PMID: 37029213 PMCID: PMC10080513 DOI: 10.1038/s41598-023-32653-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/30/2023] [Indexed: 04/09/2023] Open
Abstract
This study aimed to investigate the association between maternal postpartum depressive symptoms, household demographic, socioeconomic, and infant characteristics with infant physical growth, and how these factors correlate to determine latent factors. This study was based on the baseline data of a 6-month randomised controlled trial aimed at providing an egg a day to infants aged 6 to 9-months from a low socioeconomic community in South Africa. Information collected on household demographic, socioeconomic, and infant characteristics was by face-to-face structured interviews, and trained assessors took anthropometric measurements. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess maternal postpartum depressive symptoms. The analysis was based on 428 mother-infant pairs. Total EPDS score and its subscales score were not associated with stunting or underweight risk. However, a three- to four-fold increased risk of stunting and underweight, respectively was observed for premature birth. Low birthweight was associated with an estimated six-fold increased risk of underweight and stunting. Being female was associated with about 50% reduced risk of stunting and underweight. In conclusion, more robust studies are needed to substantiate these findings, with more awareness creation on the consequences of LBW and prematurity on the physical growth of infants from resource-limited settings.
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Affiliation(s)
- Hannah Ricci
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa.
- North-West University (Africa Unit for Transdisciplinary Health Research (AUTHeR)), Potchefstroom, South Africa.
| | - Regina Nakiranda
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Linda Malan
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Herculina S Kruger
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Marina Visser
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
| | - Cristian Ricci
- North-West University (Africa Unit for Transdisciplinary Health Research (AUTHeR)), Potchefstroom, South Africa
| | - Mieke Faber
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
- South African Medical Research Council (Non-Communicable Diseases Research Unit), Tygerberg, South Africa
| | - Cornelius M Smuts
- North-West University (Centre of Excellence for Nutrition), Potchefstroom, South Africa
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Examining maternal depression, birthweight and linear growth: Findings from the South African National Income Dynamics Study. SOUTH AFRICAN JOURNAL OF CHILD HEALTH 2022. [DOI: 10.7196/sajch.2022.v16i4.1875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background. Literature is inconclusive regarding an association between maternal depression, low birthweight (LBW) and stunting in early childhood. While some studies have found an association, others have not. Maternal food insecurity is a risk factor for both maternal depression and reduced linear growth in early childhood.
Objective. This study examined the relationship between maternal depression, food insecurity, LBW and stunting in the first five years of life. The study employed longitudinal data of South African women and children from the National Income Dynamics Study (NIDS).
Methods. Mothers were classified into four groups: food insecure and depressed; food insecure only; depressed only; and neither food insecure nor depressed. During data collection, 22% of women were pregnant and the remaining 78% were pre-conception. The primary outcomes were low birthweight and height-for-age (HAZ) scores. Generalised Linear Mixed Effects (GLME) models were used to account for women having more than one child. GLME models with a Gaussian link function were used to compare mean differences in birthweight and HAZ scores. Multivariable regression models were used to examine factors associated with depression.
Results. Food insecurity was significantly associated with depression among pre-conceptional and pregnant women. There was no statistically significant difference in birthweight or linear growth across groups, but this may be influenced by proximity of depression measurement in relation to outcomes.
Conclusion. Food insecurity is a potentially modifiable risk factor for depression and may be a confounding factor in studies that have found associations between depression and child health outcomes.
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Laksono AD, Sukoco NEW, Rachmawati T, Wulandari RD. Factors Related to Stunting Incidence in Toddlers with Working Mothers in Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10654. [PMID: 36078367 PMCID: PMC9518173 DOI: 10.3390/ijerph191710654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
Previous studies have suggested that a toddler stunting is closely related to maternal characteristics. Working mothers, as a group, are vulnerable to having a stunted toddler. The present research aimed to analyze factors related to stunting incidence in toddlers with working mothers in Indonesia. The study sampled 44,071 toddlers with working mothers. The final stage used a multinomial logistic regression test. The study found that working mothers living in rural areas have a higher probability of having stunted or severely stunted toddlers. Maternal age partially affects the incidence of stunted toddlers in Indonesia. Mothers in the ≤19 age group are 1.461 (95% CI 1.140-1.872) times more likely than those in the ≥45 group to have a severely stunted toddler. Those who were never married were 1.433 (95% CI 1.006-2.043) times more likely than those who were divorced/widowed to have a severely stunted toddler. A married mother was 0.734 (95% CI 0.617-0.872) times less likely to have a severely stunted toddler than a divorced/widowed mother. Better education is protective against working mothers having stunted toddlers. Moreover, the present study found that the toddler's age determined the incidence of stunted toddlers. This study concluded that there are five variables related to stunting incidence in toddlers with working mothers in Indonesia: residence, age, marital status, education, and toddler age.
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Affiliation(s)
- Agung Dwi Laksono
- National Research and Innovation Agency, Government of Indonesia, Jakarta 10340, Indonesia
| | - Noor Edi Widya Sukoco
- National Research and Innovation Agency, Government of Indonesia, Jakarta 10340, Indonesia
| | - Tety Rachmawati
- National Research and Innovation Agency, Government of Indonesia, Jakarta 10340, Indonesia
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Njuki J, Eissler S, Malapit H, Meinzen-Dick R, Bryan E, Quisumbing A. A review of evidence on gender equality, women’s empowerment, and food systems. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Maulina R, Qomaruddin MB, Sumarmi S, Fahrul A, Haryuni S. Antenatal Depression as a Stunting Risk Factor: A Systematic Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Depression during pregnancy is often found and ignored even though depression has a negative impact not only on the mother but also on the fetus to adulthood. Stunting is a problem of lack of nutritional status that begins during pregnancy.
AIM: The purpose of this article is to systematically identify the description and relationship between depression during pregnancy and stunting in children.
METHOD: The approach used is the systematic review method to search articles. Articles were identified from 2010-2020 by conducting a literature search with the keywords "antenatal depression" OR "prenatal depression" OR "depression during pregnancy" and "stunting" in the electronic databases dataset by Sciencedirect, Pubmed Research Gate, and Google Scholar.
RESULTS: The search results found 1875 articles selected into 20 journal articles that match the inclusion criteria. CONCLUSION: The results found that depression during pregnancy correlated with risk factors for stunting. As a preventive measure, health workers, especially midwives, can provide psychological care in antenatal care by considering these factors.
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Acheanpong K, Pan X, Kaminga AC, Liu A. Prevalence and risk factors of prenatal depression among pregnant women attending antenatal clinic at Adventist Hospital, Bekwai Municipality, Ghana. Medicine (Baltimore) 2022; 101:e28862. [PMID: 35451379 PMCID: PMC8913126 DOI: 10.1097/md.0000000000028862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/31/2022] [Indexed: 01/04/2023] Open
Abstract
Depression, arising in the perinatal period are a major health issue in low- and middle-income countries. However, little attention has been paid in the research of depression symptoms. This study aimed to estimate the prevalence and risk factors of depression during pregnancy.A cross-sectional study was conducted in pregnant women attending antenatal clinic at Adventist Hospital in the Bekwai Municipality, Ghana, between February and May 2020. Information on sociodemographic, medical, and obstetric factors were collected from the antenatal booklet and prenatal depression symptoms was defined as a patient health questionnaire scores ≥10. Descriptive statistics, Chi-Squared test, and Fisher exact test were used to analyze dichotomous variables. Multivariate logistic regression model was applied to estimate the adjusted odds ratios (AOR) and 95% confidence interval (95% confidence interval [CI]) for risk factors associated with prenatal depression. All statistical analyses were performed using SPSS version 20.0.The prevalence of prenatal depression in this study was 26.9% (95% CI; 24.6%-29.2%). Advance maternal age ≥35years (AOR = 1.49, 95% CI 1.05-2.11, P < .026) and low educational attainment (AOR 2.15, 95% CI 1.23-2.34, P < .007) were significantly higher among women with parental depression compared with maternal age <35years and higher educational attainment respectively. Similarly, nulliparous women (AOR = 4.93, 95% CI 1.60-15.16, P < .005), primiparous women (AOR = 5.42, 95% CI 1.76-16.71, P < .003) and multiparous women (AOR = 4.79, 95% CI 1.61-14.22, P < .005) were significantly higher among women with parental depression compared with grand multiparous woman (≥7 deliveries). Finally, prenatal depression was found to be significantly associated with hypertension in pregnancy (AOR = 1.71, 95% CI: 1.12-2.60, P < .013).Depression during pregnancy is high in the study area and is significantly associated with advance maternal age, low educational attainment, parity less than 7 deliveries, and hypertension during pregnancy.
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Affiliation(s)
- Kwabena Acheanpong
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
- Department of Public Health, Adventist University of Africa, Kenya
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
| | - Atipasa Chiwanda Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha Hunan, China
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Asare H, Rosi A, Scazzina F, Faber M, Smuts CM, Ricci C. Maternal postpartum depression in relation to child undernutrition in low- and middle-income countries: a systematic review and meta-analysis. Eur J Pediatr 2022; 181:979-989. [PMID: 34652508 DOI: 10.1007/s00431-021-04289-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible. Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size.
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Affiliation(s)
- Hannah Asare
- Centre of Excellence for Nutrition, North-West University, 11 Hoffman Street, Potchefstroom, South Africa.
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Francesca Scazzina
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Mieke Faber
- Centre of Excellence for Nutrition, North-West University, 11 Hoffman Street, Potchefstroom, South Africa.,Non-Communicable Diseases Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Cornelius M Smuts
- Centre of Excellence for Nutrition, North-West University, 11 Hoffman Street, Potchefstroom, South Africa
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, South Africa
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Effect of perinatal depression on birth and infant health outcomes: a systematic review and meta-analysis of observational studies from Africa. Arch Public Health 2022; 80:34. [PMID: 35057865 PMCID: PMC8772173 DOI: 10.1186/s13690-022-00792-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/07/2022] [Indexed: 01/10/2023] Open
Abstract
Background Antenatal depression is associated with intrauterine growth retardation, preterm birth, and low birth weight. Infants born to mothers with postnatal depression also may suffer from malnutrition and other health problems. Even though there are few single studies conducted so far, a systematic review of these studies is highly important to highlight the effect of antenatal and perinatal depression on adverse birth and infant health outcomes in Africa. Methods We used the Preferred Report Items for Systematic Review and Meta-analysis (PRISMA) when conducting this study. Databases like CINAHL (EBSCO), MEDLINE (via Ovid and PubMed), PsycINFO, Emcare, Psychiatry Online, and Scopus were searched. In addition, Google Scholar and references from a list of eligible studies were explored. We included good quality observational studies based on Newcastle Ottawa Scale which are published in the English language between 2007 and 2018. Heterogeneity and publication bias were assessed. Meta-analysis with a random effect model was employed to determine the pooled effect sizes with a 95% confidence interval. The review protocol is registered in PROSPERO (CRD42018106714). Result We found three studies (1511 participants) and 11 studies (22,254 participants) conducted on the effect of antenatal depression on birth outcomes and perinatal depression on adverse infant health outcomes, respectively. The overall risk of having adverse birth outcomes was 2.26 (95% CI: 1.43, 3.58) times higher among pregnant mothers with depression. The risk of preterm birth and low birth weight was 1.77 (95% CI: 1.03, 3.04) and 2.98 (95% CI: 1.60, 5.55) respectively. Similarly, the risk of having adverse infant health outcomes namely malnutrition and febrile illness was 1.61 (95% CI: 1.34, 1.95) times higher among mothers who had perinatal depression. Conclusions We have found a significant association between antenatal depression and adverse birth outcomes, low birth weight and preterm birth. Similarly, a significant effect of perinatal depression on adverse infant health outcomes namely, malnutrition, and febrile illnesses was observed. The findings highlight that it is time to integrate mental health services with routine maternal health care services to improve birth outcomes and reduce infant morbidity. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-022-00792-8.
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Nweke M, Ukwuoma M, Adiuku-Brown AC, Ugwu P, Nseka E. Characterization and stratification of the correlates of postpartum depression in sub-Saharan Africa: A systematic review with meta-analysis. WOMEN'S HEALTH 2022; 18:17455057221118773. [PMID: 36039898 PMCID: PMC9434669 DOI: 10.1177/17455057221118773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Postpartum depression (PPD) is a common mental health challenge in
resource-constrained sub-Saharan Africa (SSA). Characterizing its correlates
will aid prediction, early detection, and pre-emptive interventions. This review
aimed to systematically synthesize and stratify PPD correlates in sub-Saharan
Africa. The review was structured as per the Preferred Reporting Item for
Systematic Reviews and Meta-Analyses. We included studies that reported the
correlates of PPD in SSA. We searched PubMed, Medline, CINAHL, Academic Search
Complete, and PsycINFO for relevant peer-reviewed literature. The correlates of
PPD constituted the primary outcome. A random effect model was fitted to
estimate the pooled correlation coefficient per correlate. The clinical
relevance of correlates was stratified based on strength of correlation (r) and
recurrence (f). The mean age of the participants was 27.0 ± 6.0 years, and 68.6%
of participants had completed at least secondary education. The correlates of
PPD in SSA were intimate partner violence (IPV) ((risk weight (rw) = 2.8;
r = 0.212 (confidence interval (CI): 0.11–0.31), poor social support (PSS)
(rw = 1.9; r = 0.250 (0.133–0.361)), unwanted pregnancy (UP) (rw = 1.6;
r = 0.279 (CI: 0.14–0.41); I2 = 95.89), and maternal age (MA)
(rw = 0.96; r = 0.27 (CI: 0.154–0.37)), among others. A cumulative risk weight
of ⩾0.95 was predictive of PPD and marks the critical point at which preemptive
interventions should be instituted. The stratification of risk PPD factors and
computation of risk stability index are useful in identifying the clinical
significant risk factors. The provision of critical risk point will simplify
early detection thus facilitating cost-effectiveness. Of the correlates of PPD
in SSA, IPV, PSS, UP, and MA are the most important. Targeted screening and
pre-emptive interventions for women with high risk weight may be a reasonable
strategy both in the short and long term.
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Affiliation(s)
- Martins Nweke
- Department of Physiotherapy, Evangel University Akaeze, Ebonyi State, Nigeria
| | - Maryjane Ukwuoma
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Ada C. Adiuku-Brown
- Department of Obstetrics and Gynaecology, College of medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Princewill Ugwu
- Department of Physiology, University of Nigeria Enugu Campus, Enugu, Nigeria
| | - Elizabeth Nseka
- Department of Medical Rehabilitation, University of Nigeria Enugu Campus, Enugu, Nigeria
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Oktaviana W, Keliat BA, Wardani IY, Pratiwi A. Effectiveness health education and infant therapeutic group therapy on baby aged 0-6 months to prevent stunting risk factors: mother depression. J Public Health Res 2021; 11. [PMID: 35244360 PMCID: PMC8941314 DOI: 10.4081/jphr.2021.2740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Stunting is a global and national problem that can be detected at the age of 2. Therefore, before this age, promotion efforts must be conducted to prevent stunting risk factors in the future. This study aims to determine the effect of health education and infant’s Therapeutic Group Therapy on stunting’s risk factor: maternal postpartum depression in Indonesia. Design and methods: This study employed a quasi-experimental design with a pre-test and post-test with a control group. This study employed a purposive sampling technique, with 96 respondents divided into two groups. Intervention group 1 consisted of 48 people who received health education, and group 2 consisted of 48 people who received health education and infant’s Therapeutic Group Therapy. The data were collected using the Depression Inventory-II questionnaire with a bivariate analysis of the Wilcoxon test and frequency distribution. Results: The results show that health education and infant’s Therapeutic Group Therapy significantly influence the risky factors in stunting: maternal depression. It can be concluded that there were significant changes in maternal postpartum depression in intervention group 1 and intervention group 2, but in intervention group 2 who got Health Promotion and Therapeutic Group Therapy for Infants there was a bigger and more significant decrease. Conclusions: Nursing action, infants’ Therapeutic Group Therapy, and health education are recommended to prevent risk factors for stunting: mother depression. The results of this study are expected to underlie the development of mental health promotion to prevent stunted against maternal depression and preventive programs. In addition, the research is expected to underly provision of curative and rehabilitative programs for stunted. Significance for public health The prevalence of stunting in Indonesia is large. Stunting is a global and national problem that can be detected at the age of 2. Promotion efforts must be conducted to prevent stunting risk factors in the future. In Indonesia, there has never been an assessment related to maternal mental health conditions, including a history of depression in mothers and stunting stunting risk factor in baby with age 0-6 month. Depression experienced by mothers during pregnancy is one of the risk factors for causing stunting in children in the future. This study determined the effect of health education and infant's Therapeutic Group Therapy on stunting's risk factor: maternal postpartum depression in Indonesia. The results show that health education and infant's Therapeutic Group Therapy significantly influence the risky factors in stunting: maternal depression. Nursing action, infants' Therapeutic Group Therapy, and health education are recommended to prevent risk factors for stunting: mother depression.
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Affiliation(s)
- Wita Oktaviana
- Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Budi Anna Keliat
- Department of Mental Health Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Ice Yulia Wardani
- Department of Mental Health Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Adella Pratiwi
- Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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Apriliana T, Keliat BA, Mustikasari M, Primasari Y. A contributing factor of maternal pregnancy depression in the occurrence of stunting on toddlers. J Public Health Res 2021; 11. [PMID: 35244359 PMCID: PMC8941310 DOI: 10.4081/jphr.2021.2738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Toddlers are a vulnerable population to nutritional problems including stunting. Stunting can have negative impact on toddlers’ health. One of the factors causing stunting in toddlers is maternal pregnancy depression. This study aims to determine the relationship between maternal pregnancy depression and the incidence of stunting in toddlers. Design and Methods: The research design employed a descriptive correlative with quota sampling technique. The research respondents were 140 mothers of toddlers in Indonesia such as West Java, East Java, Jakarta, Yogyakarta, Bali, North Sumatra, Riau, South Kalimantan, West Kalimantan, North Sulawesi, NTT, NTB, Maluku, Papua. The data were collected by using demographic method and the Edinburgh Postpartum Depression Scale (EPDS). The statistical tests employed correlation tests. Results: The analysis reveal that 26.4% toddlers in this study are stunted and 73.6% were not stunted. Maternal pregnancy depression has a significant relationship with the incidence of stunted toddlers (p=0.044; r=0.170). Conclusions: The results of this study are expected to underlie the development of mental health promotion to prevent stunted toddlers against maternal depression and preventive programs. In addition, the research is expected to underly provision of curative and rehabilitative programs for stunted toddlers. Significance for public health The prevalence of stunting in Indonesia is considered large. In Indonesia, there has never been an assessment related to maternal mental health conditions, including a history of depression in mothers who have children with stunting. Depression experienced by mothers during pregnancy is one of the risk factors for causing stunting in children. The research result shows a correlation between pregnancy depression and the occurrence of stunting in toddlers. The results of this study are expected to be the basis for developing mental health promotion, preventive programs related to pregnancy depression and rehabilitative programs for stunting toddlers.
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Affiliation(s)
- Tanti Apriliana
- Faculty of Nursing of Universitas Indonesia, Depok, West Java.
| | - Budi Anna Keliat
- Department of Mental Health Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
| | - Mustikasari Mustikasari
- Department of Mental Health Nursing, Faculty of Nursing, Universitas Indonesia, Depok, West Java.
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Miller LC, Neupane S, Sparling TM, Shrestha M, Joshi N, Lohani M, Thorne-Lyman A. Maternal depression is associated with less dietary diversity among rural Nepali children. MATERNAL AND CHILD NUTRITION 2021; 17:e13221. [PMID: 34132034 PMCID: PMC8476425 DOI: 10.1111/mcn.13221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/21/2021] [Accepted: 05/06/2021] [Indexed: 12/17/2022]
Abstract
Maternal depression has been associated with adverse child growth and development; less is known about its relation to children's diet. In a cross-sectional study embedded at endline of a longitudinal community development intervention, mothers of 629 children (age 23-66 months) in rural Nepal responded to household and children's diet questionnaires and were screened for depression. Child anthropometry and development (Ages and Stages Questionnaire) were assessed. Regression models examined children's diet, growth and development, adjusting for household, child and maternal characteristics. The prevalence of maternal depression was 21%. Maternal depression was associated with 11% lower likelihood that the child consumed one additional food group [Poisson regression, adjusted relative risk (aRR) 0.89, 95% confidence intervals (95% CI 0.81, 0.99), p = 0.024] and 13% lower likelihood that the child consumed one additional animal source food (ASF) [aRR 0.87, (95% CI 0.76, 1.01), p = 0.061] compared with children of nondepressed mothers. However, maternal depression was not associated with either child anthropometry or development: these outcomes were strongly associated with better home child-rearing quality. Stunting also related to child age and intervention group; child development related to mother's education and household wealth. This study suggests a correlation between maternal depression and child dietary diversity. This association could be due to unmeasured confounders, and therefore, further research is warranted. Understanding the relationship of depression to child outcomes-and the role of other potentially compensatory household factors-could help address some of the earliest, modifiable influences in a child's life and contribute to innovative approaches to improve child well-being.
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Affiliation(s)
- Laurie C Miller
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Sumanta Neupane
- International Food Policy Research Institute, New Delhi, India
| | - Thalia M Sparling
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.,Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Merina Shrestha
- Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | | | - Andrew Thorne-Lyman
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Baumgartner JN, Ali M, Gallis JA, Lillie M, Owusu R, Abubakr-Bibilazu S, Adam H, Aborigo R, McEwan E, Zhou Y, Kim ET, Mackness J, Williams JKA, Hembling J. Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial. Glob Ment Health (Camb) 2021; 8:e18. [PMID: 34104458 PMCID: PMC8157813 DOI: 10.1017/gmh.2021.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/09/2021] [Accepted: 04/22/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children. METHODS This cRCT randomized 32 women's groups - 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted. RESULTS In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges. CONCLUSIONS This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.
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Affiliation(s)
- Joy Noel Baumgartner
- University of North Carolina at Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC27516, USA
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Mohammed Ali
- Catholic Relief Services Country Office, Tamale, Ghana
| | - John A. Gallis
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Duke Department of Biostatistics and Bioinformatics, Durham, NC, USA
| | - Margaret Lillie
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Raymond Owusu
- Catholic Relief Services Country Office, Tamale, Ghana
| | | | - Haliq Adam
- Catholic Relief Services Country Office, Tamale, Ghana
| | | | - Elena McEwan
- Catholic Relief Services Head Quarters, Baltimore, MD, USA
| | - Yunji Zhou
- Duke Global Health Institute, Duke University, Durham, NC, USA
- Duke Department of Biostatistics and Bioinformatics, Durham, NC, USA
| | | | | | | | - John Hembling
- Catholic Relief Services Head Quarters, Baltimore, MD, USA
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Dadi AF, Miller ER, Woodman RJ, Azale T, Mwanri L. Effect of perinatal depression on risk of adverse infant health outcomes in mother-infant dyads in Gondar town: a causal analysis. BMC Pregnancy Childbirth 2021; 21:255. [PMID: 33771103 PMCID: PMC7995776 DOI: 10.1186/s12884-021-03733-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximately one-third of pregnant and postnatal women in Ethiopia experience depression posing a substantial health burden for these women and their families. Although associations between postnatal depression and worse infant health have been observed, there have been no studies to date assessing the causal effects of perinatal depression on infant health in Ethiopia. We applied longitudinal data and recently developed causal inference methods that reduce the risk of bias to estimate associations between perinatal depression and infant diarrhea, Acute Respiratory Infection (ARI), and malnutrition in Gondar Town, Ethiopia. METHODS A cohort of 866 mother-infant dyads were followed from infant birth for 6 months and the cumulative incidence of ARI, diarrhea, and malnutrition were assessed. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess the presence of maternal depression, the Integrated Management of Newborn and Childhood Illnesses (IMNCI) guidelines were used to identify infant ARI and diarrhea, and the mid upper arm circumference (MUAC) was used to identify infant malnutrition. The risk difference (RD) due to maternal depression for each outcome was estimated using targeted maximum likelihood estimation (TMLE), a doubly robust causal inference method used to reduce bias in observational studies. RESULTS The cumulative incidence of diarrhea, ARI and malnutrition during 6-month follow-up was 17.0% (95%CI: 14.5, 19.6), 21.6% (95%CI: 18.89, 24.49), and 14.4% (95%CI: 12.2, 16.9), respectively. There was no association between antenatal depression and ARI (RD = - 1.3%; 95%CI: - 21.0, 18.5), diarrhea (RD = 0.8%; 95%CI: - 9.2, 10.9), or malnutrition (RD = -7.3%; 95%CI: - 22.0, 21.8). Similarly, postnatal depression was not associated with diarrhea (RD = -2.4%; 95%CI: - 9.6, 4.9), ARI (RD = - 3.2%; 95%CI: - 12.4, 5.9), or malnutrition (RD = 0.9%; 95%CI: - 7.6, 9.5). CONCLUSION There was no evidence for an association between perinatal depression and the risk of infant diarrhea, ARI, and malnutrition amongst women in Gondar Town. Previous reports suggesting increased risks resulting from maternal depression may be due to unobserved confounding.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
- Flinders University, College of Medicine and Public health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5054, Australia.
| | - Emma R Miller
- Flinders University, College of Medicine and Public health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5054, Australia
| | - Richard J Woodman
- Flinders University, College of Medicine and Public health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5054, Australia
| | - Telake Azale
- Department of Health promotion and Behavioral sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lillian Mwanri
- Flinders University, College of Medicine and Public health, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5054, Australia
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Permatasari TAE, Rizqiya F, Kusumaningati W, Suryaalamsah II, Hermiwahyoeni Z. The effect of nutrition and reproductive health education of pregnant women in Indonesia using quasi experimental study. BMC Pregnancy Childbirth 2021; 21:180. [PMID: 33663418 PMCID: PMC7934425 DOI: 10.1186/s12884-021-03676-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Almost one-third of children under 5 years old in Indonesia suffer from stunting. Stunting can be prevented optimally during pregnancy as the initial phase of the first 1000 days of life. This study aims to determine the effect of nutrition and reproductive health education of pregnant women in Bogor Regency, Indonesia. METHODS A quasi-experimental study was conducted among 194 pregnant women from August to November 2019. The pregnant women were randomly selected from four different villages in Bogor Regency. The intervention group (n = 97) received 2 h of nutrition and reproductive health education in small groups (four or five mothers per group) every 2 weeks for 3 consecutive months. This interactive education was given by facilitators using techniques such as lectures, role-playing, simulation, and games. The control group (n = 97) received regular health care services. A structured questionnaire was applied to collect data consisting of maternal characteristics, nutritional and reproductive health knowledge, attitudes, and practices in the intervention and control groups. Data were analysed using t-test and chi-square analysis. RESULTS Pregnant women in the intervention group indicated a significant increase in knowledge, attitudes, and practices regarding nutrition and reproductive health after receiving education. The pre-test and post-test mean scores in the intervention group were 55.1 and 83.1 for overall knowledge, 40.2 and 49.0 for attitudes, and 36.2 and 40.2 for practices, respectively. In the control group, there was no significant difference between the pre-test and post-test mean scores for these three variables. There was a significant difference (P < 0.001) in the post-test mean between the intervention group and the control group, but the difference was not significant (P > 0.05) in the pre-test. CONCLUSION Providing nutrition and reproductive health education through small groups with interactive methods improves the knowledge, attitudes, and practices of pregnant women. This intervention has the potential to be replicated and developed for large-scale implementation by optimising collaboration between government, non-governmental organizations, and maternal and child health service providers.
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Affiliation(s)
- Tria Astika Endah Permatasari
- Department of Nutrition, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Central Jakarta, 10510, Indonesia.
| | - Fauza Rizqiya
- Department of Nutrition, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Central Jakarta, 10510, Indonesia
| | - Walliyana Kusumaningati
- Department of Nutrition, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Central Jakarta, 10510, Indonesia
| | - Inne Indraaryani Suryaalamsah
- Department of Nutrition, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Central Jakarta, 10510, Indonesia
| | - Zahrofa Hermiwahyoeni
- Central of the National Population and Family Planning Agency, East Jakarta, 13650, Indonesia
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Alarcón-Guevara S, Peñafiel-Sam J, Chang-Cabanillas S, Pereyra-Elías R. Maternal depressive symptoms are not associated with child anaemia: A cross-sectional population study in Peru, 2015. Child Care Health Dev 2021; 47:228-242. [PMID: 33150967 DOI: 10.1111/cch.12827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Approximately, one in three Peruvian children aged 6 to 59 months old have anaemia. Maternal depression, which may be disabling and affect the proper care of children, is associated with chronic malnutrition in their offspring. Therefore, the aim of this study is to evaluate if there is an association between depressive symptoms of mothers with the presence of anaemia in their children. METHODS Analytical cross-sectional study of the Peruvian Demographic Health Survey 2015, which is nationally representative. Depressive symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) using a score of 10 as cut-off. The presence of anaemia was measured using HemoCue® and was considered positive when the haemoglobin was less than 11 g/dl. RESULTS Crude and adjusted prevalence ratios (PR and aPR) were calculated with 95% confidence interval (CI), using generalized linear models of the Poisson family. We analysed 6683 mother-child binomials. The prevalence of anaemia in the children and depressive symptoms in women were 28.7% (95% CI: 27.3-30.2) and 6.9% (95% CI: 6.1-7.9), respectively. We found no statistically significant association between these variables in the bivariable analysis or in the different multivariable models (aPR: 1.05, 95% CI: 0.85-1.30). The sample did not have moderate or severe malnutrition. CONCLUSIONS There is no statistically significant difference between the prevalence of anaemia in children of mothers with or without depressive symptoms. We recommend continuing research in this field to determine more associate factors to childhood anaemia in order to improve primary prevention interventions. Ideally, conducting longitudinal studies such as prospectives cohorts to determine risk factors should be done.
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Affiliation(s)
| | | | | | - Reneé Pereyra-Elías
- School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.,National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Idele P, Banati P. We Are All in This Together: COVID-19 and a Call to Action for Mental Health of Children and Adolescents. Front Psychiatry 2021; 11:589834. [PMID: 33643080 PMCID: PMC7905025 DOI: 10.3389/fpsyt.2020.589834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/23/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Prerna Banati
- UNICEF West and Central Africa Regional Office, Dakar, Senegal
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Dadi AF, Miller ER, Mwanri L. Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:416. [PMID: 32698779 PMCID: PMC7374875 DOI: 10.1186/s12884-020-03092-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 07/03/2020] [Indexed: 02/08/2023] Open
Abstract
Background Postnatal Depression (PND) is a mood disorder that steals motherhood and affects the health and development of a newborn. While the impact of PND on motherhood and newborn in developed countries are well described, its epidemiology and health consequences in infant is not well known in middle-and low-income countries. The objective of this review was to determine the burden and association of PND with adverse infant health outcomes in low-and middle- income countries. Methods We searched observational studies written in the English language and conducted in middle-and low-income countries between December 1st, 2007, and December 31st, 2017. The CINHAL, MEDLINE, Emcare, PubMed, Psych Info, and Scopus databases were searched for the following search terms: PND, acute respiratory infection, pneumonia, diarrhea, exclusive breastfeeding, common infant illnesses, and malnutrition. We excluded studies in which the primary outcomes were not measured following a standardized approach. We have meta-analyzed the estimates from primary studies by adjusting for possible publication bias and heterogeneity. The analysis was conducted in Stata 14. The study was registered in PROSPERO protocol number CRD42017082624. Result Fifty-eight studies on PND prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes were included. PND prevalence was higher in the low-income countries (Pooled prevalence (PP) = 25.8%; 95%CI: 17.9–33.8%) than in the middle-income countries (PP = 20.8%; 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PND. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR) = 1.31; 95%CI: 1.17–1.48). Malnutrition (1.39; 1.21–1.61), non-exclusive breastfeeding (1.55; 1.39–1.74), and common infant illnesses (2.55; 1.41–4.61) were the main adverse health outcomes identified. Conclusions One in four and one in five postnatal mothers were depressed in low and middle-income countries, respectively. Causes of depression could be explained by social, maternal, and psychological constructs. High risk of adverse infant health outcomes was associated with PND. Timely screening of PND and evidence-based interventions were a pressing need in low and middle-income countries.
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Affiliation(s)
- Abel Fekadu Dadi
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. .,College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia.
| | - Emma R Miller
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
| | - Lillian Mwanri
- College of Medicine and Public Health, Flinders University, Health Sciences Building, Sturt Road, Bedford Park, Adelaide, SA, 5001, Australia
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Lillie M, Gallis JA, Hembling J, Owusu RK, Ali M, Abubakr-Bibilazu S, Aborigo R, Adam H, McEwan E, Awoonor-Williams JK, Baumgartner JN. Prevalence and Correlates of Depression Among Pregnant Women Enrolled in a Maternal and Newborn Health Program in Rural Northern Ghana: a Cross-sectional Survey. GLOBAL SOCIAL WELFARE : RESEARCH, POLICY & PRACTICE 2020; 7:131-140. [PMID: 32509505 PMCID: PMC7252621 DOI: 10.1007/s40609-020-00170-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Women in many sub-Saharan African countries are at elevated risk of depression during pregnancy. However, there are still gaps in the estimates of antenatal depression and associated risk factors in very low-resource settings such as Northern Ghana. This study describes the prevalence of depression among rural pregnant women, participating in a maternal and child health program, in Ghana, and examines associated risk factors for depression. Pregnant women who were registered for group-based maternal and child health community programs were recruited for study participation from 32 communities in two rural districts in Northern Ghana (n = 374). Baseline surveys were conducted and depression was assessed using the Patient Health Questionnaire (PHQ-9). Bivariate and multivariable analyses used a modified Poisson and generalized estimating equations (GEE) model. Of the women in our study population, 19.7% reported symptoms indicative of moderate to severe depression (PHQ-9 score ≥ 10), with 14.1% endorsing suicidal ideation in the last 2 weeks. Bivariate analyses revealed that lower hopefulness, moderate and severe hunger, experiences of emotional, physical, and/or sexual intimate partner violence (IPV), and insufficient social support from female relatives were associated with symptoms indicating moderate to severe depression. In the multivariable analyses, low hopefulness, household hunger, emotional IPV, physical and/or sexual IPV, and insufficient female relative support remained significantly associated with depression. Antenatal depression is associated with unmet basic needs and safety. Perinatal mental health programming must take an ecological perspective and address personal, familial, and community-level factors.
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Affiliation(s)
| | - John A. Gallis
- Duke Department of Biostatistics and Bioinformatics, Durham, NC USA
| | - John Hembling
- Catholic Relief Services Head Quarters, Baltimore, MD USA
| | | | - Mohammed Ali
- Catholic Relief Services Country Office, Tamale, Ghana
| | | | | | - Haliq Adam
- Catholic Relief Services Country Office, Tamale, Ghana
| | - Elena McEwan
- Catholic Relief Services Head Quarters, Baltimore, MD USA
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Dadi AF, Akalu TY, Baraki AG, Wolde HF. Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis. PLoS One 2020; 15:e0231940. [PMID: 32343736 PMCID: PMC7188237 DOI: 10.1371/journal.pone.0231940] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 04/05/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Postnatal depression (PND) is a major cause of negative health-related behaviors and outcomes during infancy, childhood and adolescent period. In Africa, the burden of postnatal depression is high. However, it is under-investigated hence under-treated. To fill this information gap and to advise further interventions, we aimed at analyzing its epidemiology in Africa. Methods We searched observational studies conducted in Africa and published in between 01/01/2007 and 30/06/2018 in CINHAL, MEDLINE, PsycINFO, Psychiatry online, PubMed, SCOPES, and Emcare databases. We assessed the quality of the studies using the Newcastle Ottawa Scale (NOS) and included studies with good quality. We evaluated the heterogeneity using the Higgins I2 statistics. We used a random-effects model to pool estimates. We assessed publication bias using the funnel plot and Egger's test statistics and adjusted using Tweedie’s and Duval Trim and Fill analysis. The protocol has been registered in the PROSPERO (Protocol No. CRD42018100461). Results Nineteen studies involving 40,953 postnatal mothers were part of this systematic review and meta-analysis. The overall pooled prevalence of PND was 16.84% (95% CI: 14.49% –19.19%). The odds of having PND was higher among women with a poor obstetric condition (POR = 2.11; 95% CI: 1.11–4.01) and history of adverse birth and infant health outcomes (POR = 2.85; 95% CI: 1.29–6.25). Having a history of common mental health disorders (POR = 2.47; 95% CI: 1.51–4.04), poor social support (POR = 2.06; 95% CI: 1.05–4.05), lower economic status (POR = 2.38; 95% CI: 1.75–3.23), and those who had exposure to a different form of intimate partner violence (POR = 2.87; 95% CI: 1.60–5.16) had higher odds of PND. Conclusion While robust prevalence studies are scarce, our review indicated a high prevalence rate of postnatal depression. The analysis also identified postpartum women at increased risk of PND. Therefore, there is a need to design and escalate comprehensive strategies to decrease its burden, focusing on those women at risk of PND.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, Discipline of Public Health, Flinders University, Adelaide, Australia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Adhanom Gebreegziabher Baraki
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
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Drago F, Scharf RJ, Maphula A, Nyathi E, Mahopo TC, Svensen E, Mduma E, Bessong P, Rogawski McQuade ET. Psychosocial and environmental determinants of child cognitive development in rural south africa and tanzania: findings from the mal-ed cohort. BMC Public Health 2020; 20:505. [PMID: 32299410 PMCID: PMC7164138 DOI: 10.1186/s12889-020-08598-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/26/2020] [Indexed: 01/17/2023] Open
Abstract
Background Approximately 66% of children under the age of 5 in Sub-Saharan African countries do not reach their full cognitive potential, the highest percentage in the world. Because the majority of studies investigating child cognitive development have been conducted in high-income countries (HICs), there is limited knowledge regarding the determinants of child development in low- and middle-income countries (LMICs). Methods This analysis includes 401 mother-child dyads from the South Africa and Tanzania sites of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) longitudinal birth cohort study. We investigated the effect of psychosocial and environmental determinants on child cognitive development measured by the Wechsler Preschool Primary Scales of Intelligence (WPPSI) at 5 years of age using multivariable linear regression. Results Socioeconomic status was most strongly associated with child cognitive development (WPSSI Score Difference (SD):14.27, 95% CI:1.96, 26.59). Modest associations between the organization of the home environment and its opportunities for cognitive stimulation and child cognitive development were also found (SD: 3.08, 95% CI: 0.65, 5.52 and SD: 3.18, 95% CI: 0.59, 5.76, respectively). Conclusion This study shows a stronger association with child cognitive development at 5 years of age for socioeconomic status compared to more proximal measures of psychosocial and environmental determinants. A better understanding of the role of these factors is needed to inform interventions aiming to alleviate the burden of compromised cognitive development for children in LMICs.
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Affiliation(s)
- Fabrizio Drago
- University of Virginia School of Medicine, Cardiovascular Research Center, 415 Lane Rd (MR5), Room: G231, PO Box 801394, Charlottesville, VA, 22908, USA.
| | - Rebecca J Scharf
- Department of Pediatrics, University of Virginia, Charlottesville, USA
| | - Angelina Maphula
- Department of Psychology, University of Venda, Thohoyandou, South Africa
| | - Emanuel Nyathi
- Department of Animal Science, University of Venda, Thohoyandou, South Africa
| | - Tjale C Mahopo
- Department of Nutrition, University of Venda, Thohoyandou, South Africa
| | - Erling Svensen
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Estomih Mduma
- Haydom Global Health Research Centre, Haydom, Tanzania
| | - Pascal Bessong
- Department of Microbiology, University of Venda, Thohoyandou, South Africa
| | - Elizabeth T Rogawski McQuade
- Department of Public Health Sciences and Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, USA
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Maternal mental health symptoms are positively associated with child dietary diversity and meal frequency but not nutritional status in Eastern Democratic Republic of Congo. Public Health Nutr 2020; 23:1810-1819. [PMID: 32285766 DOI: 10.1017/s1368980019004087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective was to examine the association between symptoms of maternal mental health problems and child diet and nutritional status in South Kivu, Democratic Republic of Congo. DESIGN Maternal depression and anxiety symptoms were measured by the Hopkins Symptom Checklist-25 (HSCL-25), and post-traumatic stress was measured by the Harvard Trauma Questionnaire (HTQ). Participants were classified as having high psychological distress if their mean item score was in the upper quartile of both measures. Dependent variables included child dietary diversity, meal frequency, height-for-age z score (HAZ), weight-for-age z score (WAZ), weight-for-height z score (WHZ), stunting and underweight. Bivariate and multivariate regression analyses were conducted. SETTING The study was nested in a larger quasi-experimental study evaluating Jenga Jamaa II, a food and nutrition assistance project in Uvira and Fizi territories. PARTICIPANTS In total, 812 mother-child pairs participated. Children ranged from 2·6 to 5·6 years of age. RESULTS HSCL-25 (ß: 0·18, P < 0·05) and HTQ (ß: 0·19, P < 0·05) were statistically significantly associated with higher dietary diversity scores, and all maternal mental health measures were associated with higher meal frequency (HSCL-25: ß: 0·13, P = 0·001; HTQ: ß: 0·12, P = 0·001; high distress: ß: 0·15, P < 0·05) and consumption of at least three meals/snacks per day (HSCL-25: OR: 2·06, HTQ: OR: 1·93, high distress: OR: 2·68, P < 0·001 for all). No significant associations were found with HAZ, WAZ, WHZ, stunting or underweight indicators. CONCLUSIONS More severe symptoms of maternal mental health problems were positively associated with child diet, but not anthropometry indicators. More research is needed to understand the role of maternal mental health in child feeding practices in food insecure and resource-poor settings.
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Promoting maternal mental health in Ghana: An examination of the involvement and professional development needs of nurses and midwives. Nurse Educ Pract 2019; 39:105-110. [PMID: 31446219 DOI: 10.1016/j.nepr.2019.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/13/2019] [Accepted: 08/18/2019] [Indexed: 12/11/2022]
Abstract
Insight into the involvement and professional development needs (PDNs) of non-mental health nurses and midwives with respect to promoting maternal mental health is necessary to integrate mental health services into primary healthcare delivery. Using a cross-sectional survey and self-report methodology, the study investigates the involvement, PDNs, knowledge and attitudes of 309 nurses and midwives in promoting maternal mental health in Ghana. Data were analyzed using descriptive and inferential statistics, namely Analysis of Variance, bivariate and logistic regression, and cluster analysis. The results showed that the majority of the participants (94%) indicated they were involved in promoting maternal mental health. Knowledge about maternal mental health correlated significantly with involvement in promoting maternal mental health (p < .05), whereas attitude towards maternal mental health did not. An overwhelming proportion of the participants (83%-94%) expressed profound interest in professional development education across a range of maternal mental health areas. Enhancing the mental health knowledge-base of nurses and midwives could contribute significantly to promoting maternal mental health.
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Boah M, Azupogo F, Amporfro DA, Abada LA. The epidemiology of undernutrition and its determinants in children under five years in Ghana. PLoS One 2019; 14:e0219665. [PMID: 31365528 PMCID: PMC6668784 DOI: 10.1371/journal.pone.0219665] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 06/28/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Understanding the burden and contextual risk factors is critical for developing appropriate interventions to control undernutrition. METHODS This study used data from the 2014 Ghana Demographic and Health Survey to estimate the prevalence of underweight, stunting, and wasting. Single multiple logistic regressions were used to identify the factors associated with underweight, wasting and stunting. The study involved 2720 children aged 0-59 months old and mother pairs. All analyses were done in STATA/IC version 15.0. Statistical significance was set at p<0.05. RESULTS The prevalence of underweight, wasting and stunting were 10.4%, 5.3%, and 18.4% respectively. The age of the child was associated with underweight, wasting and stunting, whereas the sex was associated with wasting and stunting. Normal or overweight/obese maternal body mass index category, high woman's autonomy and middle-class wealth index were associated with a lower odds of undernutrition. The factors that were associated with a higher odds of child undernutrition included: low birth weight (<2.5 kg), minimum dietary diversity score (MDDS), a higher (≥4th) birth order number of child, primary educational level of husband/partner and domicile in the northern region of Ghana. CONCLUSION There is still a high burden of child undernutrition in Ghana. The age, sex, birth weight, birth order and the MDDS of the child were the immediate factors associated with child undernutrition. The intermediate factors that were associated with child undernutrition were mainly maternal related factors and included maternal nutritional status and autonomy. Distal level factors which were associated with a higher odds of child undernutrition were the wealth index of the household, paternal educational status and region of residence. We recommend that interventions and policies for undernutrition should address socioeconomic inequalities at the community level while factoring in women empowerment programmes.
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Affiliation(s)
- Michael Boah
- Ghana Health Service, Bolgatanga, Upper East Region, Ghana
| | - Fusta Azupogo
- Department of Family and Consumer Sciences, Faculty of Agriculture, University for Development Studies, Tamale, Ghana
| | - Daniel Adjei Amporfro
- Department of Social Medicine and Health Service Management, Harbin Medical University, Harbin, China
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Saeed N, Wemakor A. Prevalence and determinants of depression in mothers of children under 5 years in Bole District, Ghana. BMC Res Notes 2019; 12:373. [PMID: 31262347 PMCID: PMC6604414 DOI: 10.1186/s13104-019-4399-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 06/22/2019] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Depression in mothers is a risk factor for poor health, and pregnancy and child outcomes. The objective of the present study was to determine the prevalence of depression and identify its determinants in mothers of children under 5 years in Bole District, Ghana. RESULTS We conducted an analytical cross-sectional study consisting of 244 mothers (mean age 28.7 ± 6.29 years) in Bole District, Ghana. Edinburgh Postnatal Depression Scale was used to screen for depression and the determinants of depression were identified using logistic regression analysis. The prevalence of depression in this study population was 16.8% (95% confidence interval 12.1-22.0%). The independent determinants of depression were marital status, occupation, lighting source and type of cooking fuel. Being currently unmarried (p < 0.001), and using lighting sources other than electricity (p = 0.004) were associated with higher risk of depression while being employed in other occupations (p = 0.001), and not cooking with firewood (p = 0.008) were associated with lower risk of depression. In this study population, the prevalence of depression was relatively high in mothers and was associated with marital status, occupation, lighting source and cooking fuel. Interventions to prevent and treat depression in women should include strategies to improve their socio-economic status and living conditions.
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Affiliation(s)
- Nawaf Saeed
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Anthony Wemakor
- School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
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Jacques N, de Mola CL, Joseph G, Mesenburg MA, da Silveira MF. Prenatal and postnatal maternal depression and infant hospitalization and mortality in the first year of life: A systematic review and meta-analysis. J Affect Disord 2019; 243:201-208. [PMID: 30245252 DOI: 10.1016/j.jad.2018.09.055] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/04/2018] [Accepted: 09/15/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Prenatal and postnatal depression have been well studied in recent decades, but few studies address their relationship with hospitalization and mortality in one-year-old children. OBJECTIVE Review the literature about the effects of maternal depression on hospitalization and mortality of the child from birth to one year of age and conduct a meta-analysis. METHODS A systematic search was performed in the PubMed and LILACS databases. We included original studies that evaluated the effect of prenatal and/or postnatal depressive symptoms on child hospitalization or mortality up to one year of age. Meta-analyses were conducted according to the outcome and stratified by prenatal and postnatal depression, using random effects models. RESULTS Six studies were included in this review (170,371). Children of mothers with prenatal and postnatal depressive symptoms or depression had 1.44 (CI95% 1.10 - 1.89) greater risk of hospitalization, and children of mothers with postnatal depressive symptoms or depression had 1.93 (CI95% 1.02-3.64) greater risk of death before one year of age than those whose mothers did not have the disorder. LIMITATIONS Small number of studies (n < 10), different instrument and cut points were used to evaluate maternal depressive symptoms or diagnose depression. CONCLUSION Maternal depressive symptoms or depression have an unfavorable effect on hospitalization and mortality in children up to one year of age. This finding is relevant to public health and should stimulate the systematic screening of prenatal and postnatal depressive symptoms, so that adequate care can be provided for women and their children.
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Affiliation(s)
- Nadège Jacques
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, n° 1160 3° andar, P.O. 96020-220, Pelotas, Rio Grande Do Sul, Brazil.
| | - Christian Loret de Mola
- Faculty of Nursing, Federal University of Pelotas, Rua Gomes Carneiro, 01 2° andar, P.O. 96010-610, Pelotas, Rio Grande Do Sul, Brazil.
| | - Gary Joseph
- International Center for Equity in Health, Federal University of Pelotas, Rua Marechal Deodoro, 1160 3° andar, P.O. 96020-220, Pelotas, Rio Grande Do Sul, Brazil.
| | - Marilia Arndt Mesenburg
- Post-graduate Program in Epidemiology, Federal University of Pelotas, International Center for Equity in Health, Federal University of Pelotas, Rua Marechal Deodoro, n° 1160 3° andar, P.O. 96020-220, Pelotas, Rio Grande Do Sul, Brazil.
| | - Mariangela Freitas da Silveira
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, n° 1160 3° andar, P.O. 96020-220, Pelotas, Rio Grande Do Sul, Brazil.
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Wemakor A, Iddrisu H. Maternal depression does not affect complementary feeding indicators or stunting status of young children (6-23 months) in Northern Ghana. BMC Res Notes 2018; 11:408. [PMID: 29941023 PMCID: PMC6019211 DOI: 10.1186/s13104-018-3528-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/20/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Maternal depression may affect child feeding practice which is an important determinant of child nutritional status. The objective of this study was to explore the association between maternal depression and WHO complementary feeding indicators [minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)] or stunting status of children (6-23 months) in Tamale Metropolis, Ghana. A community-based cross-sectional study was carried out involving 200 mother-child pairs randomly sampled from three communities in Tamale Metropolis, Ghana. RESULTS The prevalence of MDD, MMF, and MAD were 56.5, 65.0, and 44.0% respectively and 41.0% of the children sampled were stunted. A third of the mothers (33.5%) screened positive for depression. Maternal depression did not influence significantly MDD (p = 0.245), MMF (p = 0.442), and MAD (p = 0.885) or children's risk of stunting (p = 0.872). In conclusion maternal depression and child stunting are prevalent in Northern Ghana but there is a lack of evidence of an association between maternal depression and child feeding practices or nutritional status in this study population. Further research is needed to assess the effect of maternal depression on feeding practices and growth of young children.
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Affiliation(s)
- Anthony Wemakor
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
| | - Habib Iddrisu
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, P O Box TL 1883, Tamale, Ghana
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Sanou AS, Diallo AH, Holding P, Nankabirwa V, Engebretsen IMS, Ndeezi G, Tumwine JK, Meda N, Tylleskär T, Kashala-Abotnes E. Association between stunting and neuro-psychological outcomes among children in Burkina Faso, West Africa. Child Adolesc Psychiatry Ment Health 2018; 12:30. [PMID: 29930702 PMCID: PMC5992697 DOI: 10.1186/s13034-018-0236-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 05/12/2018] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND In Burkina Faso, stunting affects children and is a public health problem. We studied the association between stunting and child's neuro-psychological outcomes at 6-8 years of age in rural Burkina Faso using the Kaufman Assessment Battery for Children, 2nd edition (KABC-II), the Children's Category Test 1 (CCT-1) and the Test of Variable of Attention (TOVA). METHODS We re-enrolled children of a previously community-based Exclusive breastfeeding trial in Burkina Faso. We assessed a total of 532 children aged 6-8 years using KABC-II for memory (Atlantis and Number Recall subtests), spatial abilities (Conceptual Thinking, Face Recognition and Triangle subtests), reasoning (Block Counting subtest), general cognition and CCT-1 for cognitive flexibility. A total 513 children were assessed using the TOVA to measure attention and inhibition. We calculated the Cohen's d to examine the effect size and conducted a linear regression to examine the association. RESULTS The proportion of stunting was 15.6% (83/532). Stunted children performed significantly poorer for memory (Atlantis and Number Recall), spatial abilities (Conceptual Thinking, Face Recognition and Triangle), general cognition and attention with a small effect size compared to non-stunted children. Children who were exposed scored significantly higher errors for cognitive flexibility and inhibition with a small effect size compared to unexposed children. At standardized and unstandardized multivariable regression analysis, stunted children performed significantly poorer for Atlantis (p = 0.001), Number Recall (p = 0.02), Conceptual Thinking (p = 0.01), Triangle (p = 0.001), general cognition (p ≤ 0.0001) and attention (p = 0.04) compared to non-stunted children. Children who were exposed scored significantly higher errors for cognitive flexibility (p = 0.02) and for inhibition (p = 0.02) compared to unexposed children. We adjusted all the results for age, schooling, sex, playing, father education, mother employment and promotion of previous exclusive breastfeeding. CONCLUSION Stunting is associated with poorer neuro-psychological outcomes among children in rural Burkina Faso. Initiatives related to prevention need to be established and advice on nutrition need to be provided.
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Affiliation(s)
- Anselme Simeon Sanou
- 0000 0004 1936 7443grid.7914.bCentre for International Health (CIH), Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway ,Department of Public Health, Centre MURAZ Research Institute, Ministry of Health, Bobo-Dioulasso, Burkina Faso
| | - Abdoulaye Hama Diallo
- Department of Public Health, Centre MURAZ Research Institute, Ministry of Health, Bobo-Dioulasso, Burkina Faso ,0000 0000 8737 921Xgrid.218069.4Department of Public Health, University of Ouagadougou, Ouagadougou, Burkina Faso
| | | | - Victoria Nankabirwa
- 0000 0004 1936 7443grid.7914.bCentre for International Health (CIH), Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway ,0000 0004 0620 0548grid.11194.3cDepartment of Epidemiology & Biostatistics, School of Public Health, Makerere University, Kampala, Uganda ,0000 0004 1936 7443grid.7914.bCentre for Intervention Science in Maternal and Child Health (CISMAC), Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ingunn Marie S. Engebretsen
- 0000 0004 1936 7443grid.7914.bCentre for International Health (CIH), Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Grace Ndeezi
- 0000 0004 0620 0548grid.11194.3cDepartment of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - James K. Tumwine
- 0000 0004 0620 0548grid.11194.3cDepartment of Paediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Nicolas Meda
- Department of Public Health, Centre MURAZ Research Institute, Ministry of Health, Bobo-Dioulasso, Burkina Faso ,0000 0000 8737 921Xgrid.218069.4Department of Public Health, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Thorkild Tylleskär
- 0000 0004 1936 7443grid.7914.bCentre for International Health (CIH), Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Esperance Kashala-Abotnes
- 0000 0004 1936 7443grid.7914.bCentre for International Health (CIH), Department of Global Public Health and Primary Health Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Maternal depression symptoms are highly prevalent among food-insecure households in Ethiopia. Public Health Nutr 2017; 21:849-856. [DOI: 10.1017/s1368980017003056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectiveWe aimed to evaluate the association between household food insecurity and maternal depression in Ethiopia.Design/Setting/SubjectsIn 2014, we conducted a cross-sectional study in southern Ethiopia, including 591 food-secure and 2500 food-insecure households. We measured depression status of women using the Patient Health Questionnaire-9 validated for Ethiopia, with a cut-off of ≥5. We evaluated household-level food insecurity using a validated Household Food Insecurity Access Scale. We applied Bayesian modelling to evaluate the relationship between food insecurity and maternal depression accounting for other observed characteristics.ResultsAmong the analytic sample, 80·8 (95 % CI 79·4, 82·2) % of women were living in food-insecure households. The overall prevalence of probable depression (mild and moderate forms) was 4·7 (95 % CI 4·1, 5·6) %. All individual depressive symptoms had a significantly higher prevalence in the food-insecure group, except for suicidal ideation (but small numbers; P<0·001). In the Bayesian model adjusting for paternal characteristics, there was a significant dose–response linear relationship (trend) between household food insecurity and maternal depression (P<0·01). The adjusted OR (95 % Bayesian credible interval) for depression for differing levels of food insecurity were: mild food insecurity, 3·29 (1·63, 6·18); moderate, 3·82 (1·91, 7·45); severe, 12·50 (3·38, 32·70).ConclusionsThe study documented a high burden of depression among women who lived in food-insecure households. Given this finding, we recommend integrating mental health in the livelihood programmes in areas suffering from food insecurity.
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Emerson JA, Tol W, Caulfield LE, Doocy S. Maternal Psychological Distress and Perceived Impact on Child Feeding Practices in South Kivu, DR Congo. Food Nutr Bull 2017. [PMID: 28627261 DOI: 10.1177/0379572117714385] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Maternal mental health problems are associated with poor child growth and suboptimal child feeding practices, yet little qualitative research has been conducted to understand mothers' perceptions about how maternal mental ill health and child nutrition are related. OBJECTIVE The objective of the study was to understand maternal perceptions on sources of psychological distress, and how distress impacts functioning, especially related to childcare and feeding practices among mothers of young children in South Kivu, DR Congo. METHODS Mothers of young children who were participating in a larger study were eligible. Using purposive sampling, participants were selected if they had high or low levels of psychological distress, based on their mean item score on measures of symptoms of depression, anxiety, and post-traumatic stress. Twenty in-depth interviews and 2 focus group discussions were conducted, with a total of 35 mothers. Key informant interviews were conducted with 5 local health workers. Audio recordings were transcribed and coded, and the analysis was guided by Grounded Theory methodology. RESULTS Major themes to emerge were that women's husbands were a significant source of distress, with husbands' infidelity, abandonment, and lack of financial support mentioned by participants. Psychological distress resulted in appetite and weight loss, and poor nutritional status made it difficult to breastfeed. Participants perceived psychological distress caused milk insufficiency and difficulty breastfeeding. CONCLUSION Mothers experiencing psychological distress may need greater support for maternal nutrition and breastfeeding, and engaging fathers through responsible parenting interventions may reduce psychological distress and have a positive impact on child health.
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Affiliation(s)
- Jillian A Emerson
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wietse Tol
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,2 Peter C. Alderman Foundation, New York, NY, USA
| | - Laura E Caulfield
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shannon Doocy
- 1 Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Ali Z, Saaka M, Adams AG, Kamwininaang SK, Abizari AR. The effect of maternal and child factors on stunting, wasting and underweight among preschool children in Northern Ghana. BMC Nutr 2017; 3:31. [PMID: 32153813 PMCID: PMC7050753 DOI: 10.1186/s40795-017-0154-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 04/01/2017] [Indexed: 12/13/2022] Open
Abstract
Background Undernutrition among preschool children in Northern region is the highest in Ghana. However, there is scarcity of data on the factors that determine undernutrition in these children. This study investigated the effect of maternal and child factors on undernutrition among preschool children in Northern Ghana. Methods This study was a community based analytical cross-sectional survey on a sample of 425 mother- child pairs drawn from 25 clusters. A semi- structured questionnaire was used to collect data on maternal and child socio-demographic characteristics, feeding practices and anthropometry. Anthropometric indices of Height-for-age Z-scores (HAZ), Weight-for-height Z-scores (WHZ) and Weight-for – age Z-scores (WAZ) were used to classify child stunting, wasting and underweight respectively. Bivariate and multivariate analyses were performed to determine associations between explanatory variables and undernutrition. Results The prevalence of stunting, wasting and underweight were 28.2, 9.9 and 19.3% respectively. Multiple logistic regression analysis showed that, the odds of stunting was higher among male children [AOR = 1.99; 95% CI (1.26–3.13); p = 0.003], children of mothers less than 150 cm in height [AOR = 3.87; 95% CI (1.34–11.20); p = 0.01], mothers 155–159 cm tall [AOR = 2.21; 95% CI (1.34–3.66); p = 0.002], and older children aged 12–23 months [AOR 9.81; 95% CI (2.85–33.76); p < 0.001]. Wasting was significantly higher among male children [AOR = 2.40; 95% CI (1.189–4.844); p = 0.015], consumption of less than four food groups [AOR = 3.733; 95% CI (1.889–7.376); p < 0.001] and among children of underweight mothers [AOR = 3.897; 95% CI (1.404–10.820); p = 0.009]. Male children [AOR = 2.685; 95% CI (1.205–5.98); p = 0.016] and having low birth weight [AOR = 3.778; 95% CI (1.440–9.911); p < 0.001] were associated with higher odds of underweight in children. Conclusion Maternal height associated negatively with stunting but not wasting. Factors that affect low height –for-age z-score (HAZ) may not necessarily be the same as stunting. Infant and child feeding practices as measured by dietary diversity score associated positively with weight-for-height Z-scores than length-for-age Z-scores of young children. Surprisingly, consumption of some specific food groups including, animal source foods, legumes, staples and eggs were associated with lower HAZ but with increased likelihood of higher WHZ among children 6–59 months. Electronic supplementary material The online version of this article (doi:10.1186/s40795-017-0154-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zakari Ali
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
| | - Mahama Saaka
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
| | - Abdul-Ganiyu Adams
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
| | - Stephen K Kamwininaang
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
| | - Abdul-Razak Abizari
- Department of Community Nutrition, School of Allied Health Sciences, University for Development Studies, P O Box 1883, Tamale, Ghana
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