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Arntson L, McLaughlin KR, Smit E. Factors influencing fever care-seeking for children under five years of age in The Gambia: a secondary analysis of 2019-20 DHS data. Malar J 2024; 23:124. [PMID: 38678245 PMCID: PMC11056064 DOI: 10.1186/s12936-024-04951-w] [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: 02/09/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Malaria contributes to excess child mortality in The Gambia. Children under five are at risk of severe malaria and death if not treated promptly and appropriately. It is crucial that a child with fever receive appropriate care from a trained provider. The aim was to identify influences on child fever care-seeking in The Gambia to inform malaria control strategies. METHODS This cross-sectional analysis of The Gambia 2019-20 Demographic and Health Survey used logistic regression analysis to identify associations between source of care for a child with fever (public or private healthcare provider, other, or no treatment) and mother, child, and household characteristics. RESULTS Only 52.0% of mothers sought care from a trained healthcare provider for a child with fever-45.1% from a public facility and 7.0% from the private sector. 35.2% of mothers did not seek treatment. Mothers in urban households were 2.67 times as likely (aOR, 95% CI 1.504-4.736) as mothers in rural households to seek care from an informal source (e.g., pharmacy) versus not seeking treatment, and 0.29 times as likely (aOR, 95% CI 0.165-0.515) as mothers in rural households to seek care from a public provider versus informal source. Mothers in wealthier households were 2.30 times as likely (aOR, 95% CI 1.274-4.164) as mothers in poorer households to seek care from an informal source versus no treatment and half as likely as mothers in poorer households to seek care from a public provider versus informal source (aOR 0.53, 95% CI 0.291-0.959). CONCLUSIONS Maintaining The Gambia's malaria control achievements will require the active engagement and oversight of private pharmacies along with continued integrated community case management to reach mothers who do not seek care for a child with fever, and remove challenges to seeking appropriate care from trained providers. Whether influenced by convenience, costs, perceived urgency, or other factors, given the likelihood of urban mothers and mothers in wealthier households to seek care from private pharmacies, it will be necessary to incorporate private pharmacies into malaria control strategies while building public sector capacity and workforce, and initiating more effective attitude and behavioural change among mothers and households.
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Affiliation(s)
- Laura Arntson
- Oregon State University College of Health, 160 SW 26th St, Corvallis, OR, 97331, USA.
| | - Katherine R McLaughlin
- Department of Statistics, Oregon State University, 239 Weniger Hall, Corvallis, OR, 97331, USA
| | - Ellen Smit
- Oregon State University College of Health, 160 SW 26th St, Corvallis, OR, 97331, USA
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Pradhan MR, Saikia D, Mondal S, Mudi PK. Prevalence and predictors of minimum acceptable diet (MAD) feeding among tribal children aged 6-23 months in India. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2024; 69:90-101. [PMID: 38634682 DOI: 10.1080/19485565.2024.2344481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Minimum acceptable diet (MAD) that combines minimum dietary diversity (MDD) and minimum meal frequency (MMF) is one of the eight core indicators for assessing infant and young child feeding (IYCF) practices for children aged 6-23 months. With low MAD, young children and infants are more susceptible to undernutrition. The study assesses the prevalence and predictors of MAD among tribal children aged 6-23 months in India. Descriptive, bivariate, and multivariate analyzes were performed on data from 6326 tribal children of the National Family Health Survey (2019-21). Stata was used for the analyzes, with a 5% significance level. Only 12% of tribal children were fed with a MAD, while 24% had MDD and 34% MMF. Children aged 18-23 months had a three times higher chance of MAD than their 6-8 months counterparts. Children receiving Integrated Child Development Services (ICDS), children of mothers with ten or more years of schooling, children whose mothers were exposed to mass media, and whose mothers had 4+ antenatal care visits in their last pregnancy had a higher likelihood of MAD. The study concludes that MAD among tribal children aged 6-23 months is unsatisfactory and varies significantly by socio-demographic characteristics, suggesting targeted intervention.
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Affiliation(s)
- Manas Ranjan Pradhan
- Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Daisy Saikia
- Research Scholar, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Sourav Mondal
- Research Scholar, International Institute for Population Sciences (IIPS), Mumbai, India
| | - Prasanna Kumar Mudi
- Research Scholar, International Institute for Population Sciences (IIPS), Mumbai, India
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Singh G, Jha A. Role of Women's Empowerment in Improving the Nutritional Status of Children Under Five Years of Age: An Insight From the National Family Health Survey-5. Cureus 2024; 16:e59410. [PMID: 38826598 PMCID: PMC11139634 DOI: 10.7759/cureus.59410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2024] [Indexed: 06/04/2024] Open
Abstract
Background Childhood malnutrition remains a global concern, especially in low- and middle-income countries, and is known to create an intergenerational cycle of illness and poverty. Women's empowerment has gained global recognition as a potential catalyst for improving child nutrition. The objective of this research was to investigate the association between women's empowerment factors and the nutritional status of children under five years of age. Methods The study used data from the National Family Health Survey-5, conducted in India between 2019 and 2021 by the International Institute of Population Sciences, Mumbai. A weighted sample of 29,491 mother-child pairs was analyzed. The odds ratio for women's empowerment and sociodemographic factors associated with the nutritional status of children under five years of age was calculated using Pearson's chi-square test and multiple logistic regression. Results The study found that the sex of the child (OR = 1.066, 95% CI: 1.017 to 1.117; p-value: 0.008), birth order (OR = 0.824, 95% CI: 0.780 to 0.871; p-value < 0.001), education of the mother (OR = 1.356, 95% CI: 1.255 to 1.464; p-value < 0.001), education of the father (OR = 1.227, 95% CI: 1.140 to 1.320; p-value < 0.001), having a bank or savings account that she uses (OR = 1.151, 95% CI: 1.084 to 1.221; p-value < 0.001), having a mobile phone that she uses (OR = 1.184, 95% CI: 1.125 to 1.246; p-value < 0.001), and wealth index (OR = 1.597, 95% CI: 1.514 to 1.684; p-value < 0.001) were significant predictors of undernutrition in children under the age of five (U5). Conclusion Women's empowerment factors play a significant role in improving childhood nutrition. In the study, male sex, higher birth order, lower parental education, poor wealth index, maternal lack of access to a bank or a savings account, and lack of mobile phone ownership were found to be significant predictors of undernutrition in children U5. The findings underscore the importance of family planning, financial inclusion, access to mobile phones, and higher education for women as important factors that can help improve the nutritional status of children under five years of age. Policymakers can utilize these insights to make targeted strategies for women's empowerment, thus improving the nutritional status of children. However, being a secondary data analysis, our research is constrained by the variables available in the dataset. Further research is required to better comprehend the complex relationship between women empowerment and child nutrition.
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Affiliation(s)
- Gaurav Singh
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND
| | - Anupriya Jha
- Department of Community & Family Medicine, All India Institute of Medical Sciences, Raipur, Raipur, IND
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Terefe B, Jembere MM, Abie Mekonnen B. Minimum meal frequency practice and associated factors among children aged 6-23 months old in The Gambia: a multilevel mixed effect analysis. Sci Rep 2023; 13:22607. [PMID: 38114621 PMCID: PMC10730716 DOI: 10.1038/s41598-023-49748-0] [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: 08/18/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
A proxy measure for a child's energy needs, minimum meal frequency (MMF) looks at how often children were fed things other than breast milk. Infants and young children who do not consume enough food frequently are more likely to suffer from malnutrition, which can lead to increased morbidity and mortality as well as stunting and micronutrient deficiencies. There is no MMF recommended by studies in The Gambia. Hence, the purpose of this study was to evaluate the practice of MMF and the factors that influence it in children aged 6-23 months in The Gambia. Data from The Gambian Demographic and Health Survey (GDHS-2019/20) were used to identify factors affecting the MMF at individual and community levels. A multi-level regression model and weighted samples of 2100 children were employed for the investigation. After being examined by a p-value of < 0.25 in the binary regression, factors with a p-value of < 0.05 were judged statistically significant. This study found that about 57.95% had provided MMF. Primary and secondary educated mothers (aOR = 1.44, CI 1.11, 1.87), and (aOR = 1.43, CI 1.09, 1.86), wealthiest (aOR = 1.76, CI 1.04, 2.99), 35-49 years old mothers (aOR = 1.35, CI 1.01, 1.79), female household head (aOR = 0.72, CI 0.53, 0.98), breastfeeding status(aOR = 0.10, CI 0.07, 0.15), currently working (aOR = 1.27, CI 1.04, 1.56), 12-17 months child (aOR = 1.40, CI 1.13, 1.73), 18-23 months child (aOR = 1.44, CI 1.08, 1.91) have shown association with MMF. Regarding regions Mansakonko, Kerewan, Kuntaur, and Janjanbureh local government areas have shown (aOR = 3.51, CI 1.77, 6.97), (aOR = 5.17, CI 2.67, 9.99), (aOR = 2.26, CI 1.14, 4.47), and (aOR = 2.35, CI 1.19, 4.64) as compared to Banjul local government area. Comparing MMF in The Gambia to WHO standards, it must be considered low. Encouragement of women and coordinated enhancement of the current nutritional intervention are therefore effective in boosting children's consumption of a variety of foods.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Amhara, Ethiopia.
| | - Mahlet Moges Jembere
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Birhanu Abie Mekonnen
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Howlader S, Rahman MA, Rahman MM. Continuation of education after marriage and its associated factors among young adult women: findings from the Bangladesh Demographic and Health Survey 2017-2018. BMJ Open 2023; 13:e078892. [PMID: 37996222 PMCID: PMC10668136 DOI: 10.1136/bmjopen-2023-078892] [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: 08/15/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE To identify the individual and community-level variables associated with the continuation of education among currently married young adult women in Bangladesh. DESIGN Cross-sectional data extracted from the Bangladesh Demographic and Health Survey (BDHS), 2017-2018. The BDHS is a stratified cluster sample of households conducted in two and three stages in both rural and urban settings. A multilevel multinomial logistic regression analysis was employed to identify the associated factors. SETTING Bangladesh. PARTICIPANTS Currently married young adult women aged 15-29 years (n=4595). PRIMARY OUTCOME Continuation of education after marriage was measured in the BDHS by asking respondents, 'Did you continue your studies after marriage?' with the response options: no; yes, less than a year; yes, for 1-2 years; yes, for 3-4 years; and yes, for 5+ years. RESULTS Among young adult women, 28.2% continued education after marriage for different durations of years (<1 year to 5+ years). The odds of continuing education after marriage for <1 year (adjusted OR (aOR): 0.68; 95% CI 0.50 to 0.90), 1-2 years (aOR: 0.67; 95% CI 0.47 to 0.96) and ≥5 years (aOR: 0.38; 95% CI 0.17 to 0.85) were lower among women who justified wife beating compared with women who did justify it. Compared with the high-literate community, women from the low-literate community were less likely to continue education after marriage for <1 year (aOR: 0.53; 95% CI 0.42 to 0.66), 1-2 years (aOR: 0.47; 95% CI 0.36 to 0.61), 3-4 years (aOR: 0.32; 95% CI 0.22 to 0.46), and for ≥5 years (aOR: 0.29; 95% CI 0.17 to 0.48). Several other individual-level and community-level variables, such as age at marriage, first birth interval, partner educational status, household wealth index, community economic status and region, were found to be associated with the continuation of education after marriage for different durations. CONCLUSIONS The proportion of women continuing their education after marriage in this sample is low. This study provides insight into the individual-level and community-level barriers women encounter in continuing their education after marriage. The identification of these barriers helps policy-makers develop effective intervention programmes to promote women's educational attainment.
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Affiliation(s)
- Sihab Howlader
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Aminur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Md Mosfequr Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
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Terefe B, Jembere MM, Assimamaw NT. The prevalence and multilevel analysis of minimum dietary diversity intake and its determinants among 6-23 months old infants in The Gambia: further analysis of the Gambian demographic and health survey data. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:98. [PMID: 37705103 PMCID: PMC10498527 DOI: 10.1186/s41043-023-00442-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Poor infant and young child feeding (IYCF) practices are a significant issue both globally and in developing nations, and they have a significant role in undernutrition, healthy growth, and development, particularly in the first 2 years of life. Improving children's general health and wellbeing requires recognizing and decreasing preventable drivers of malnutrition. Hence, this study aimed to assess the prevalence and possible determinants of minimum dietary diversity among 6-23 months old babies in the Gambia. METHODS Data from the 2019-2020 Gambia demographic and health survey were used. The study included a total of 2100 weighted 6-23 months old children. To identify characteristics significantly linked with minimum dietary diversity among infants, a multilevel fixed-effect analysis approach was used. After adjusting other confounding variables, variables with a p value of 0.25 were incorporated into a multivariable multilevel regression analysis to determine associated variables. An adjusted odds ratio with a 95% confidence interval was then applied. RESULTS Only 22.22% (95% CI 18.55, 21.99) of infants had received the minimum dietary diversity. Mothers, who had mass media exposure (aOR = 2.71, CI = (1.02, 6.21), wealthier (aOR = 1.70, CI = 1.02, 2.85), child age of (aOR = 4.14, CI = 2.98, 5.76), and (aOR = 4.97, CI = 3.54, 6.98), have shown a positive statistical association with the outcome variable, respectively. Regarding regions mothers who came from Kanifing (aOR = 0.49, CI = 0.25, 0.94), Janjanbureh (aOR = 0.38, CI = 0.18, 0.82), and Basse (aOR = 0.51, CI = 0.26, 0.99) had showed less likelihood odds to provide the minimum dietary diversity (MDD) for their babies compared to Banjul local government area, respectively. CONCLUSION The World Health Organization dietary evaluation tool suggests that the MDD value be extremely low, even though it might be slightly higher than the numbers for some nations. The country may need to take drastic measures to tackle child malnutrition.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Po. Box: 196, Gondar, Amhara, Ethiopia.
| | - Mahlet Moges Jembere
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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