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Nambiar A, Agnihotri SB, Arunachalam D, Singh A. Undernutrition among children and its determinants across the parliamentary constituencies of India: a geospatial analysis. J Biosoc Sci 2024; 56:338-356. [PMID: 37987163 DOI: 10.1017/s0021932023000251] [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: 11/22/2023]
Abstract
In India, undernutrition among children has been extremely critical for the last few decades. Most analyses of undernutrition among Indian children have used the administrative boundaries of a state or a district level as a unit of analysis. This paper departs from such a practice and focuses instead on the political boundaries of a parliamentary constituency (PC) as the unit of analysis. The PC is a critical geopolitical unit where political parties and party candidates make election promises and implement programmes to improve the socio-economic condition of their electorate. A focus on child undernutrition at this level has the potential for greater policy and political traction and could lead to a paradigm shift in the strategy to tackle the problem by creating a demand for political accountability. Different dimensions and new approaches are also required to evaluate the socio-economic status and generate concrete evidence to find solutions to the problem. Given the significance of advanced analytical methods and models embedded into geographic information system (GIS), the current study, for the first time, uses GIS tools and techniques at the PC level, conducting in-depth analysis of undernutrition and its predictors. Hence, this paper examines the spatial heterogeneity in undernutrition across PCs by using geospatial techniques such as univariate and bivariate local indicator of spatial association and spatial regression models. The analysis highlights the high-low burden areas in terms of local hotspots and identifies the potential spatial risk factors of undernutrition across the constituencies. Striking variations in the prevalence of undernutrition across the constituencies were observed. Most of these constituencies that performed poorly both in terms of child nutrition and socio-economic indicators were located in the northern, western, and eastern parts of India. A statistically significant association of biological, socio-economic, and environmental factors such as women's body mass index, anaemia in children, poverty, household sanitation facilities, and institutional births was established. The results highlight the need to bring in a mechanism of political accountability that directly connects elected representatives to maternal and child health outcomes. The spatial variability and pattern of undernutrition indicators and their correlates indicate that priority setting in research may also be greatly influenced by the neighbourhood association.
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Affiliation(s)
- Apoorva Nambiar
- IITB-Monash Research Academy, IIT Bombay, Powai, Mumbai, India
- Centre for Technology Alternatives for Rural Areas, IIT Bombay, Powai, Mumbai, India
- School of Social Sciences, Monash University, Clayton, VIC, Australia
| | - Satish B Agnihotri
- Centre for Technology Alternatives for Rural Areas, IIT Bombay, Powai, Mumbai, India
| | | | - Ashish Singh
- Shailesh J. Mehta School of Management, IIT Bombay, Powai, Mumbai, India
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Banerjee K, Sahoo H, Govil D. Financial stress, health and malnourishment among older adults in India. BMC Geriatr 2023; 23:861. [PMID: 38102552 PMCID: PMC10724991 DOI: 10.1186/s12877-023-04532-7] [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: 03/22/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
As India's elderly population grows rapidly, there is a demand for robust policy tools for geriatric health management. This study focuses on unveiling the impact of financial stress and insecurity in diverse economic sectors on adult malnutrition in India. Further, we explore the connections of adult malnourishment with mental and physical health outcomes. Analysis has been done using data of 59,764 respondents aged 45 years and above from the Longitudinal Ageing Study in India (LASI- Wave I) (2017-19). A modified Malnutrition Universal Screening Tool (MUST) has been used to assess the risk of adult malnutrition. It categorizes malnutrition into Low Risk, High Risk Group 1 (HRG1-undernourished), and High Risk Group 2 (HRG2-over-nourished). Approximately 26% of adults were classified in HRG1, characterized by low body mass index, recent hospital admissions, and affiliation with food-insecure households. Around 25% adults belonged to HRG2 characterized by high body mass index and waist-to-hip ratio. The relative risk ratios from the multinomial logit generalized structural equation model indicate that the risk of being in HRG1 was 20-40% higher among respondents not presently working or receiving pension benefits, as well as those involved in agricultural work. The risk of being in HRG2 doubles if the respondent was diagnosed with some chronic disease during the last 12 months. A higher composite cognition score reduces the risk of being in HRG1 by 4%, while it increases the risk of being in HRG2 by 3%. Additionally, experiencing episodic depression raises the risk of being in HRG1 by 10%. Financial insecurity, particularly in the informal and agricultural sectors, coupled with poor mental health, hinders positive nutritional outcomes. Extending universal pro-poor policies to fortify food security in resource poor households and integrating mental health variables in nutrition policies can be beneficial to address adult malnourishment in India.
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Affiliation(s)
- Kajori Banerjee
- Department of Quantitative Techniques, Anil Surendra Modi School of Commerce (ASMSOC), SVKM's Narsee Monjee Institute of Management Studies (NMIMS) Deemed-to-University, Mumbai, Maharashtra, 400056, India.
| | - Harihar Sahoo
- Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
| | - Dipti Govil
- Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
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Sumon IH, Hossain M, Ar Salan S, Kabir MA, Majumder AK. Determinants of coexisting forms of undernutrition among under-five children: Evidence from the Bangladesh demographic and health surveys. Food Sci Nutr 2023; 11:5258-5269. [PMID: 37701232 PMCID: PMC10494611 DOI: 10.1002/fsn3.3484] [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: 10/11/2022] [Revised: 05/14/2023] [Accepted: 05/26/2023] [Indexed: 09/14/2023] Open
Abstract
In many underdeveloped and developing countries, epidemiological and nutritional transitions are leading to an increase in malnutrition, resulting in pediatric diseases and eventually deaths. Therefore, this study intents to determine the important factors of the presence of coexisting forms of malnutrition (CFM), i.e., pediatric undernutrition. This study used the latest Bangladesh Demographic and Health Survey (BDHS)-2017/18 dataset consisting of 7127 under-five children. The logistic regression model has been utilized to gain explicit and in-depth knowledge of the relationship between the presence of pediatric undernutrition with socioeconomic and demographic factors. Findings revealed that about 31%, 22%, and 8% suffered from stunted, underweight, and wasted, respectively. The prevalence of stunted, underweighted, wasted, and CFM among children in the Sylhet division is higher than in any other region. A child of a secondary-level completed mother is 27.6% (OR: 0.724, 95% CI: 0.58-0.90) less likely to suffer from undernutrition than a child of an uneducated mother. The rate of undernutrition of children was less among children of highly educated parents. Age, birth order of the child, twin status, mother's age, body mass index (BMI), working status, parental educational qualification, cooking fuel, toilet facility, region, residence, and wealth index are important for determining the nutritional status of a child. The authors believe that the study findings will be helpful to the policymakers to take proper actions for achieving the sustainable development goal (SDGs) by reducing pediatric undernutrition in Bangladesh by 2030.
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Affiliation(s)
| | - Moyazzem Hossain
- Department of StatisticsJahangirnagar UniversitySavar, DhakaBangladesh
| | - Sifat Ar Salan
- Department of StatisticsJahangirnagar UniversitySavar, DhakaBangladesh
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Roshania RP, Webb-Girard A, Das A, Giri R, Mala GS, Srikantiah S, Young MF, Mahapatra T, Ramakrishnan U. Food Environments, Food Security, and Household Food Availability of Circular Migrant Families: A Mixed-Methods Study Among Brick Kiln Laborers in Bihar, India. Food Nutr Bull 2023; 44:88-99. [PMID: 36797714 PMCID: PMC10495700 DOI: 10.1177/03795721231152057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Circular migration is the dominant pattern of movement in India and is a livelihood strategy used by many food insecure rural households. Repeated shifts in food environments have important implications on household food security and dietary patterns but have not been studied. OBJECTIVE To explore differences in the food environment, food security, and food availability between home and destination spaces. METHODS Mixed-methods research was conducted among circular migrant families working and residing on brick kilns in the state of Bihar. Utilizing stratified cluster sampling, 2 rounds of cross-sectional data were collected from 2564 families. Additionally, 25 in-depth interviews were conducted with circular migrant parents, kiln owners, and labor contractors. The Food Insecurity Experience Scale was validated for use in our study population. Bivariate analyses were conducted to estimate the association of food insecurity with sociodemographic variables. Qualitative data were analyzed using descriptive thematic methods. RESULTS Seventy percent of respondents utilized at least one nonmarket source of food at the origin; at the destination, sources of food were limited to the private market. Despite higher food prices at the destination, perceived food affordability was higher during periods of migration, resulting in improved food security. Tubers, rice, and wheat were typically available in the household daily, whereas fruits, eggs, and dairy were typically unavailable during the week. CONCLUSIONS Circular migration can enable short-term food security by improving food affordability. Policy frameworks must address the root causes of chronic food insecurity, especially among rural-to-rural circular migrant families.
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Bansal A, Dwivedi LK, Shirisha P. Sterilization incentives and associated regret among ever married women in India, NFHS, 2015–16. BMC Health Serv Res 2022; 22:1063. [PMID: 35986319 PMCID: PMC9392240 DOI: 10.1186/s12913-022-08401-8] [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: 01/31/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Sterilization is the only family planning method that involves relatively large amount compensation. So, the study attempts to examine the role of incentives received against the sterilization procedures on the reporting of sterilization regret in India. Methods The study used data from the fourth round of National Family Health Survey, 2015–16, which gathered the information on sterilization regret from 1,94,207 ever-married women. Multivariate logistic analysis and predicted probabilities approach was used to study the effect of compensation received on the sterilization regret in India. Results Results show that women who have received compensation were 33% less likely to report sterilization regret. It was found that 70% of women who undergone sterilization in public facility didn’t incur any expenditure, rather received incentives. It is observed that women who had undergone operation in private facility spent a large amount than women who had done their operation in public facility. The regret in the private facility mainly results from high out of pocket expenditure on sterilization procedures. Around eight percent of women regretted getting sterilized in a private hospital and received some compensation amount, vis a vis the six percent who regretted undergoing sterilization in public facility and received compensation. Conclusion The study calls for a need to standardize the cost of sterilization procedure in India's health facilities. A good alternative for reducing the cost could be Public–Private Partnership.
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Al-Waleedi AA, Bin-Ghouth AS. Malnutrition among hospitalized children 12-59 months of age in Abyan and Lahj Governorates / Yemen. BMC Nutr 2022; 8:78. [PMID: 35962407 PMCID: PMC9373284 DOI: 10.1186/s40795-022-00574-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The analysis of acute malnutrition in 2018 for the Integrated Phase Classification of Food Security in Yemen shows that high malnutrition rates are present in Abyan governorate (23%) and Lahj governorate (21%). This analysis was community based addressed all children and mostly due to problems related to food intake. The role of diseases was not yet addressed in Yemen. The aim of this study is to assess acute and chronic malnutrition among hospitalized children at 12-59 months of age in Lahj and Abyan governorates in Yemen. METHODOLOGY A cross-sectional, multi-center study is designed. The assessment of the nutritional status was measured by standardized anthropometry of 951 sick children at 12-59 months of age. RESULTS The prevalence of Global acute malnutrition (GAM) among the sick children seeking care in health facilities in Lahj and Abyan is 21%. More specifically; the prevalence of moderate acute malnutrition (MAM) is 15.1% while the prevalence of severe acute malnutrition (SAM) is 6.2%. The prevalence of acute malnutrition (wasting) among the studied sick children in lahj is 23.4% while in Abyan is 19.3%. The prevalence of MAM in Lahj is 17.7% and the prevalence of SAM is 5.7%. The prevalence of acute malnutrition (wasting) in Abyan is 12.6% while the prevalence of SAM in Abyan is 6.7%. The prevalence of acute malnutrition among male children (25.2%) is significantly higher than among female children (17.5%). The prevalence of the chronic malnutrition (Stunting) in the studied sick children is 41.3%; the prevalence of stunting in Lahj is 41% while in Abyan is 41.7%. CONCLUSIONS High acute and chronic malnutrition rates were identified among sick children seeking care in health facilities in lahj and Abyan, and higher than the SPHERE indicators of malnutrition. Boys are more exposed than girls to acute and chronic malnutrition.
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Affiliation(s)
- Ali Ahmed Al-Waleedi
- Department of Public Health and Community Medicine, Faculty of Medicine, University of Aden, Aden, Yemen
| | - Abdulla Salem Bin-Ghouth
- Department of Community Medicine, Hadharamout University College of Medicine (HUCOM), Hadhramout University, 8892, Mukalla, Fwah, Yemen.
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Shahid M, Liu Y, Ameer W, Qureshi MG, Ahmed F, Tang K. Comparison of Different Nutritional Screening Approaches and the Determinants of Malnutrition in Under-Five Children in a Marginalized District of Punjab Province, Pakistan. CHILDREN 2022; 9:children9071096. [PMID: 35884079 PMCID: PMC9316579 DOI: 10.3390/children9071096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 01/10/2023]
Abstract
Objectives: This research measures the occurrence of malnutrition amongst under-five children in the Rahimyar Khan district of Southern Punjab in Pakistan. Employing different anthropometric measurement approaches such as (1) conventional indices (HAZ, WAZ, and WHZ), (2) CIAF, (3) BMI-for-age, and (4) MUAC, we compare their estimated results and examine the relationship between socioeconomic determinants and different anthropometric indicators. Methods: The study employs a proportional purposive random sampling method to collect data from 384 rural households in the community-based study using a self-administered survey and following the Lady Health Workers (LHWs) registered records. The nutritional status of 517 under-five children is measured with references to WHO (2009) child growth standards. Furthermore, the investigation used the model of binary logistic regression to measure the impact of socioeconomic factors on child malnutrition. Results: Compared with other approaches, the CIAF identifies more malnourished children (63%). The results of binary logistic regression illustrate that all the explanatory variables indicate a more significant empirical association with CIAF than conventional indices, BMI-for-age, and MUAC. Conclusion: CIAF is a more reliable tool for assessing child nutrition because it not only demonstrates more accurate estimates of malnutrition but also recognizes children with multiple anthropometric failures.
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Affiliation(s)
- Muhammad Shahid
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China;
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing 100029, China
| | - Yongshuan Liu
- Party Committee Office, University of International Business and Economics (UIBE), Beijing 100029, China;
| | - Waqar Ameer
- Department of Economics, Shandong Business and Technology University, Yantai 264005, China;
| | - Madeeha Gohar Qureshi
- Department of Economics, Pakistan Institute of Development Economics, Islamabad 44000, Pakistan;
| | - Farooq Ahmed
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China;
- Department of Anthropology, Quaid-i-Azam University, Islamabad 44400, Pakistan
- Correspondence: (F.A.); (K.T.); Tel.: +86-13671129425 (K.T.)
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China;
- Correspondence: (F.A.); (K.T.); Tel.: +86-13671129425 (K.T.)
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Shankar Mishra P, Jamadar M, Tripathy A, Anand A. Understanding the Socio-Economic Vulnerability in Child Malnutrition Between Migrants and Non-Migrants Children (12-59 Months) in India: Evidence from a Cross-Sectional Study. CHILD INDICATORS RESEARCH 2022; 15:1871-1888. [PMID: 35601140 PMCID: PMC9108133 DOI: 10.1007/s12187-022-09943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
India has witnessed increasing trends in internal migration over the last three decades. In India, migrant children are not a homogeneous group and their reasons for movement and vulnerabilities vary across socio-economic stratum. For some children, migration may open possibilities and is associated with expanding social and economic spheres, but for many others, it may bring serious risks. Therefore, the study has been carried out to understand socio-economic vulnerability in child nutrition with migration status and other contributing factors in India. This study used data from the National Family Health Survey, the fourth in the NFHS series which was conducted in 2015-2016 (NFHS-4). We were interested in looking at the children age 12-59 months for their nutritional indicators such as stunting and underweight across migrants and non-migrants children. This resulted in a sample of 199,448 children in selected age group and among them 33.1% children belongs to the migrant family as compared to 67% of non-migrant children. Overall, 44.2% of children were stunted and 39.5% were underweight among non-migrant children as compared to 37.4% & 32.8% of migrant children were stunted and underweight respectively. Further, the results showed that among the social groups, scheduled caste children were found a high variation in underweight (34% vs. 41.6%) and stunting (36% vs. 46%) between migrants and non-migrants children. Similar trend of malnourishment is found in the poor wealth quintile, for rural residents and low educated women with non-migrant status. Those children who were poor but non-migrant were more likely to be malnourished as underweight [aOR; 1.15, CI: 1.11-1.18] and stunted [aOR; 1.17, CI:1.13-1.20] as compared to migrant status children in the same category of the household. Similarly in reference to scheduled caste migrant group, the scheduled caste non-migrant were more likely to be underweight [aOR; 1.15, CI: 1.09-1.20] and stunted [aOR; 1.18, CI: 1.12-1.23] than the children with migrant status. There were huge differences between migrant and non-migrant children in nutritional statuses. Education, caste and wealth index are found to be an important variables to explain the differential between migrants and non-migrants in child's nutritional aspects. Children associated with poor socio-economic vulnerability and non-migrant category need to be taken care of more and a community targeted approach is required to understand the gaps. The programs such as ICDS, and Poshan Abhiyan need to be revamped adding the migration aspect of the families and children in terms of their health and nutritional aspects.
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Affiliation(s)
- Prem Shankar Mishra
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, 560072 Karnataka India
| | - Mudassar Jamadar
- Centre for Research in Urban Affairs, Institute for Social and Economic Change, Bangalore, 560072 Karnataka India
| | - Abhipsa Tripathy
- Department of Statistics, Utkal University, Bhubaneswar, Odisha 751004 India
| | - Ankit Anand
- Population Research Centre, Institute for Social and Economic Change, Bengaluru, 560072 Karnataka India
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Shahid M, Cao Y, Ahmed F, Raza S, Guo J, Malik NI, Rauf U, Qureshi MG, Saheed R, Maryam R. Does Mothers' Awareness of Health and Nutrition Matter? A Case Study of Child Malnutrition in Marginalized Rural Community of Punjab, Pakistan. Front Public Health 2022; 10:792164. [PMID: 35211439 PMCID: PMC8863129 DOI: 10.3389/fpubh.2022.792164] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
Maternal nutritional awareness might reduce the risk of malnutrition in children. This study assesses the impact of mothers' nutritional and health awareness (MNHA) on the nutritional status of pre-school children in rural South Punjab. Using a proportionate purposive simple random sampling technique we collect data with the help of a self-administered questionnaire on height, age, the weight of children, and socio-economic profile from 384 rural households in one of the marginalized districts of Punjab. The study applied the binary logistic regression model to compute the probability of malnutrition. The results indicate that malnutrition was high in the district (the prevalence rate for underweight is 46.1%, for stunting 34.83%, and for wasting is 15.49%). Around 91.84% of malnourished children belonged to the low MNHA category compared to medium (5.61%) and high (2.55%) MNHA categories. The results further show that the prevalence of moderate and severe stunting, wasting, and underweight in low MNHA categories was much higher with large differences compared to both medium and high MNHA categories. The binary logistic regression results depict that, across the household deprivation index (HDS), the odds of a child becoming malnourished were lower in households HDS-2 category (OR = 0.02, 95% CI: 0.01–0.89), and odds were also lower in households HDS-3 category (OR = 0.001, 95% CI: 0.001–0.16). Similarly, across the scores of MNHA index, the odds of malnutrition were lower among the children of those mothers who had medium MNHA (OR = 0.04, 95% CI: 0.002–1.24), and also the probability of child malnutrition was lower among the children of mothers who had high MNHA (OR = 0.008, 95% CI: 0.002–0.29). The study urges that well-resourced, targeted, and coordinated health and nutritional education and awareness programs are required to tackle malnutrition.
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Affiliation(s)
- Muhammad Shahid
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing, China
| | - Yang Cao
- School of Insurance and Economics, University of International Business and Economics (UIBE), Beijing, China
| | - Farooq Ahmed
- Department of Anthropology, Quaid-I-Azam University, Islamabad, Pakistan.,Department of Anthropology, University of Washington, Seattle, WA, United States
| | - Saqlain Raza
- Respiratory Care Department, College of Applied Medical Sciences in Jubail, Imam Abdulrahman Bin Faisal University, Al Jubail, Saudi Arabia
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha, Pakistan
| | - Umara Rauf
- Department of Psychology, Government College Women University Sialkot, Sialkot, Pakistan
| | - Madeeha Gohar Qureshi
- Department of Economics, Pakistan Institute of Development Economics (PIDE), Islamabad, Pakistan
| | - Rafit Saheed
- School of Public Policy, Pakistan Institute of Development Economics (PIDE), Islamabad, Pakistan
| | - Rohma Maryam
- Department of Biotechnology, Quaid-I-Azam University, Islamabad, Pakistan
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Shahid M, Ahmed F, Ameer W, Guo J, Raza S, Fatima S, Qureshi MG. Prevalence of child malnutrition and household socioeconomic deprivation: A case study of marginalized district in Punjab, Pakistan. PLoS One 2022; 17:e0263470. [PMID: 35271578 PMCID: PMC8912173 DOI: 10.1371/journal.pone.0263470] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/20/2022] [Indexed: 11/18/2022] Open
Abstract
Better socioeconomic status and well-being in households decrease malnutrition and health risks in children. The objective of the present study is to assess the current nutritional status of pre-school children and to correlate the prevalence of malnutrition with Household Deprivation Status (HDS) in one of the deprived districts of the Punjab province in Pakistan. Using primary data collected from 384 households through a proportional purposive random sampling technique, this study calculates the z-scores of weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ). The study has used a cut-off point which is -2 standard deviations below the median of the WHO/NCHS reference population for each anthropometric indicator. The results indicate that the underweight, stunting, and wasting prevalence rates are 46.1%, 34.83%, and 15.49% respectively in district Rahimyar Khan. Also, the expected tendency of malnutrition is worst for HDS-1 and HDS-2 which are the most deprived segments of the population. As the household shifts from HDS-1 to HDS-2 and further to HDS-3, the rates of stunting (HAZ) and underweight (WAZ) decreases but wasting (WHZ) does not. The study concludes that the high prevalence of malnutrition in the district is correlated with overall socio-economic deprivation.
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Affiliation(s)
| | - Farooq Ahmed
- Department of Anthropology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Waqar Ameer
- Department of Economics, Shandong Technology and Business University, Yantai, China
- * E-mail:
| | - Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Saqlain Raza
- Respiratory Care Department, College of Applied Medical Sciences in Jubail, Imam Abdulrahman bin Faisal University, Jubail, Saudi Arabia
| | - Saireen Fatima
- Fazaia Medical College, Air University, Islamabad, Pakistan
| | - Madeeha Gohar Qureshi
- Department of Economics, Pakistan Institute of Development Economics, Islamabad, Pakistan
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Rahman MA, Halder HR, Rahman MS, Parvez M. Poverty and childhood malnutrition: Evidence-based on a nationally representative survey of Bangladesh. PLoS One 2021; 16:e0256235. [PMID: 34424928 PMCID: PMC8382176 DOI: 10.1371/journal.pone.0256235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Malnutrition contributes to children's morbidity and mortality, and the situation undermines the economic growth and development of Bangladesh. Malnutrition is associated with lower levels of education that decrease economic productivity and leads to poverty. The global burden of malnutrition continues to be unacceptably high amid social and economic growth, including in Bangladesh. Therefore, identifying the factors associated with childhood malnutrition and poverty is necessary to stop the vicious cycle of malnutrition leaded poverty. METHODS The study utilized the 2017-18 Bangladesh Demographic and Health Survey (BDHS), accumulating 7,738 mother-child pairs. Associations between potential risk factors and nutritional status were determined using chi-square tests, and multivariate logistic regression models were utilized on significant risk factors to measure their odds ratio (OR) with their 95% confidence intervals (CI). RESULTS The prevalence of moderate and severe wasting was 7.0% and 1.8%, respectively, whereas the prevalence of moderate and severe stunting was 19.2% and 8.0%, while 16.4% and 3.6% of children were moderately and severely underweight. Children from the poorest and poor households were suffering from at least one form of malnutrition. Adjusted ORs were estimated by controlling socio-economic and demographic risk factors, such as poor maternal body mass index, parents' lower education level, use of unhygienic toilet, child age in months, and recent experience of diarrhea and fever. The pattern was almost similar for each malnutrition status (i.e., stunting, underweight, and wasting) in the poorest and poor households. CONCLUSION Bangladesh achieved the Millennium Development Goals, focusing primarily on health-related indicators and working to achieve the Sustainable Development Goals. Even considering this success, the prevalence of malnutrition and poverty in same household remains relatively high compared to other developing countries. Therefore, the study recommends the implementation of nationwide systematic measures to prevent poverty and malnutrition.
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Affiliation(s)
- Md. Ashfikur Rahman
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Henry Ratul Halder
- Statistics Discipline, Science, Engineering and Technology School, Khulna University, Khulna, Bangladesh
- Rady Faculty of Health Sciences, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Md. Sazedur Rahman
- Rady Faculty of Health Sciences, Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mahmood Parvez
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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