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Herman H, Chang YJ, Dlamini MD. Cross-cultural adaptation and validation of the medical outcome study social support survey among mothers of children aged 6-23 months in Indonesia. J Pediatr Nurs 2024; 75:e58-e64. [PMID: 38184477 DOI: 10.1016/j.pedn.2023.12.029] [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: 08/19/2023] [Revised: 12/28/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Social support significantly influences a mother's adherence to complementary feeding guidelines, with family support fostering a positive attitude towards this practice. The Medical Outcome Study Social Support Survey (MOS-SSS) is a multidimensional scale designed to evaluate functional aspects of social support, but no instrument has been validated for Indonesia. PURPOSE The study aims to validate the MOS-SSS instrument for measuring mothers' social support in providing complementary food to infants and young children aged 6-23 months in Indonesia. METHODS A cross-sectional survey was conducted on 196 mothers with children aged 6-23 months in West Sumatera, Indonesia. The MOS-SSS's internal consistency was assessed using Cronbach alpha, composite reliability, and split-half analysis, while its construct validity was evaluated using convergent and discriminant validity. RESULTS The Indonesian version of the MOS-SSS among mothers with children aged 6-23 months has been found to be satisfactory in content validity through translation and expert review. The questionnaire exhibits strong convergent and discriminant validity, reliable construct reliability, and internal consistency. CONCLUSIONS AND IMPLICATIONS The MOS-SSS questionnaire was found to be reliable and valid in measuring the social support mothers perceive in providing complementary feeding to their infants and young children. Future research should explore the psychometric properties of the Indonesian version of the MOS-SSS in various populations, including pregnant women, lactating mothers, and women with special conditions.
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Affiliation(s)
- Hermalinda Herman
- Department of Maternity and Pediatric Nursing, Faculty of Nursing, Universitas Andalas, Padang, West Sumatera 25163, Indonesia.
| | - Ying-Ju Chang
- Professor, Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Maggie Dumsile Dlamini
- Doctoral Student Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Nursing, Eswatini Christian Medical University, Lomkiri Portion 69 of Farm 73, Zone 4, Mbabane, Hhohho, Swaziland
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Singh S, Rajak R. Barriers in utilization and provisioning of obstetric care services (OCS) in India: a mixed-methods systematic review. BMC Pregnancy Childbirth 2024; 24:16. [PMID: 38166775 PMCID: PMC10759396 DOI: 10.1186/s12884-023-06189-x] [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: 12/10/2022] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Despite the reduction in the maternal mortality ratio, barriers in obstetric care services (OCS) remain a significant risk factor for adverse maternal and perinatal outcomes in India. This review covers the 'continuum of care' (ANC, child delivery, and PNC services) and identifies multiple barriers in provisioning as well as utilization of OCS in India. We conducted a systematic review to understand the barriers using a mixed-methods approach. METHODS PubMed, Scopus, Web of Science, Google Scholar, and Science Direct databases were searched from 1 January 2000 to 30 June 2022. The methodological quality of the included studies was assessed using appropriate tools. After a full-text review of 164 studies, total of 56 studies (33 quantitative, 18 qualitative, and 5 mixed-methods studies) were finally included in the review. All the barriers were classified into five major themes: (i) individual and interpersonal barriers, (ii) social and cultural barriers, (iii) structural barriers, (iv) logistical barriers, and (v) organizational barriers. A thematic synthesis approach was used to present the findings of the included studies. RESULTS Lack of knowledge and awareness and less family support in availing the required OCS were key individual and interpersonal barriers. Negative social and cultural practices, such as belief in traditional herbs/healers, dietary restrictions, and discarding colostrum were frequently reported barriers, especially in rural settings. Poor economic status and high health service costs were the most often cited barriers to low institutional delivery and delayed ANC services. Long distances to health facilities and poor road conditions were the most frequently reported logistical barriers. On the provisioning side, poor quality of treatment, shortage of drugs and equipment, and non-cooperative attitude of health professionals were the most significant barriers. CONCLUSION This review identified several important barriers ranging from individual and cultural to structural, logistical, and organizational, which are prevalent in India. To mitigate the barriers, the governments need to develop strategies at the individual and organizational levels. Innovative interventions and program implementation at the community and village levels could also be contributory steps towards improving OCS utilization in India.
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Affiliation(s)
- Sushmita Singh
- Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India
| | - Rahul Rajak
- Institute of Development Studies, Kolkata, India.
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Pradhan MR, Shete MR. Determinants of nutritional status among under-five children receiving Integrated Child Development Services (ICDS) in India. Nutr Health 2023; 29:575-590. [PMID: 35238244 DOI: 10.1177/02601060221085809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Undernutrition is a significant public health problem and the leading risk factor for India's disease burden. Aim: To understand the determinants of nutritional status among under-five children receiving Integrated Child Development Services (ICDS) in India. Methods: The study used the National Family Health Survey-4 (2015-16) data. The analysis was carried out for under-five children who have availed of any ICDS services in the 12 months preceding the survey (n = 1,27,813). Stunting, wasting, and underweight were estimated following the World Health Organization guideline and used as the outcome variables. The binary logistic regression was conducted to examine the association of ICDS utilization and socioeconomic-demographic predictors with under-five children's nutritional status. STATA (V 13) was used for statistical analyses. Results: A sizable proportion of under-five children receiving any ICDS services suffer from undernutrition. The undernutrition prevalence varied considerably by socioeconomic and demographic characteristics. Logistic regression found an insignificant association of ICDS utilization with the nutritional status of under-five children. Children not immunized in ICDS centers were less likely to be stunted (OR: 0.93; P < 0.01), wasted (OR: 0.93; P < 0.01), and underweight (OR: 0.90; P < 0.01) than their counterparts. The child's age and gender, maternal education and nutrition status, wealth index, social group, region, residence, and region were significant determinants of undernutrition among ICDS beneficiaries. Conclusion: The study suggests the need to ensure all available services to children enrolled in the Anganwadi Center (AWC). The program should also emphasize feeding practices and educate parents about improving child health and nutrition.
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Affiliation(s)
- Manas Ranjan Pradhan
- Assistant Professor, Department of Fertility and Social Demography, International Institute for Population Sciences (IIPS), Govandi Station Road, Deonar, Mumbai, 400088, Maharashtra, India
| | - Mahesh Rajendra Shete
- Data Analyst, Max Institute of Healthcare Management, Indian School of Business, Mohali, India
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Stelle I, Kinshella MLW, Moore SE. Caregiver perceptions of nutrition interventions in infants and children under 24 months of age: a systematic review. Public Health Nutr 2023; 26:1907-1916. [PMID: 37349869 PMCID: PMC10478058 DOI: 10.1017/s1368980023001246] [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] [Received: 01/21/2022] [Revised: 05/19/2023] [Accepted: 06/14/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE Efficacy studies show early nutrition interventions improving infant nutrition status, but understanding caregiver acceptability is required for implementation of such interventions. This systematic review examines caregivers' perceptions of nutrition interventions in young children. DESIGN We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL and PsychINFO from date of online journal inception through December 2020. Interventions included oral (powder/liquid/tablet) and/or intravenous supplementation, food fortification and nutrition counselling. Inclusion criteria included primary research, data presented on caregiver perception and studies published in English. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Studies underwent narrative synthesis using inductive thematic analysis. SETTING No restriction. PARTICIPANTS Caregivers of children under 24 months of age. RESULTS Of 11 798 records identified, thirty-seven publications were included. Interventions included oral supplementation, food fortification and nutrition counselling. Caregivers included mothers (83 %), fathers, grandparents and aunts. Perceptions were gathered through individual interviews, focus group discussions, questionnaires, surveys and ratings. Totally, 89 % of studies noted high acceptability (n 33 most notably increased appetite (n 17). In total, 57 % of studies (n 21) cited low acceptability, commonly from side effects (n 13) such as gastrointestinal issues, appetite loss and stained teeth. CONCLUSIONS Positive perceptions and enthusiasm for interventions were frequently reported. Key to implementation was the increased appetite noted by caregivers. A substantial proportion of studies reported negative perceptions, mainly due to side effects. In future interventions, mitigation and education around common side effects are crucial for acceptability. Understanding both positive and negative caregiver perceptions is important for informing future nutrition interventions and strengthening sustainability and implementation.
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Affiliation(s)
- Isabella Stelle
- Department of Women and Children’s Health, King’s College London, St Thomas’ Hospital, Westminster Bridge Rd, LondonSE1 7EH, UK
| | - Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology and BC Children’s Hospital Research Institute, University of British Columbia, VancouverBC, Canada
| | - Sophie E Moore
- Department of Women and Children’s Health, King’s College London, St Thomas’ Hospital, Westminster Bridge Rd, LondonSE1 7EH, UK
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Fajara, The Gambia
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Paramashanti BA, Dibley MJ, Huda TM, Prabandari YS, Alam NA. Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation. Int Breastfeed J 2023; 18:48. [PMID: 37653430 PMCID: PMC10472632 DOI: 10.1186/s13006-023-00586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 08/25/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Global and Indonesian guidelines suggest that breastfeeding should continue for at least the first two years of life. While many studies have focused on six-month exclusive breastfeeding practices, little is known about why mothers do not sustain breastfeeding beyond this period. This qualitative study aimed to explore factors influencing breastfeeding continuation and formula feeding beyond six months, regardless of any additional food consumed, focusing on Indonesia's rural and urban areas. METHODS We collected the data through 46 in-depth interviews in Pati District and Surakarta City, Central Java, Indonesia. Participants were mothers, grandmothers, health care practitioners, and village kader (frontline female health workers). We used thematic analysis combining deductive and inductive techniques for analysing the data. RESULTS Rural mothers practised breastfeeding and intended to breastfeed for a longer duration than urban mothers. Maternal attitude towards breastfeeding, breastfeeding knowledge, previous experiences, and other breastfeeding strategies (e.g., enhancing maternal dietary quality) positively influenced breastfeeding sustainability. In the urban setting, mothers encountered several breastfeeding barriers, such as perceived breast milk insufficiency and child hunger and satiety, child biting, and breastfeeding refusal, causing them to provide formula milk as a breast milk substitute or supplement. In addition, families, communities, health practitioners, and employment influenced maternal decisions in breastfeeding continuation and formula-feeding practices. CONCLUSIONS Optimal breastfeeding practices up to two years of age are determined by the individual and setting (i.e., community, healthcare, employment) factors. Providing breastfeeding education covering practical breastfeeding guidance will encourage mothers to breastfeed for longer. Such interventions should involve families, communities, health workers, and the work environment as a breastfeeding support system. Policymakers should develop, enforce, and monitor the implementation of breastfeeding policies to protect, promote, and support breastfeeding in households, communities, health systems, and work settings.
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Affiliation(s)
- Bunga Astria Paramashanti
- Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia.
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Yayi Suryo Prabandari
- Department of Health Behavior, Environment, and Social Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Schneider L, Ollila S, Mutanen M. The usefulness of nutrition and health videos displayed on mobile phones in rural Uganda: Experiences of community health workers and mothers. MATERNAL & CHILD NUTRITION 2022; 18:e13322. [PMID: 35075791 PMCID: PMC8932732 DOI: 10.1111/mcn.13322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 12/24/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Lauriina Schneider
- Department of Food and Nutrition, Faculty of Agriculture and Forestry University of Helsinki Helsinki Finland
| | - Sari Ollila
- Department of Food and Nutrition, Faculty of Agriculture and Forestry University of Helsinki Helsinki Finland
| | - Marja Mutanen
- Department of Food and Nutrition, Faculty of Agriculture and Forestry University of Helsinki Helsinki Finland
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Roshania RP, Giri R, Cunningham SA, Young MF, Webb-Girard A, Das A, Mala GS, Srikantiah S, Mahapatra T, Ramakrishnan U. Early life migration and undernutrition among circular migrant children: An observational study in the brick kilns of Bihar, India. J Glob Health 2022; 12:04008. [PMID: 35136599 PMCID: PMC8818295 DOI: 10.7189/jogh.12.04008] [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] [Indexed: 11/16/2022] Open
Abstract
Background India holds the world's largest burden of chronic and acute child undernutrition. Poverty and systemic inequities are basic causes of undernutrition that also drive households to engage in circular migration for livelihood. Short-term, temporary movement of the whole family, including young children, is common; yet, the nutritional implications of recurrent movements beginning in early life has not been studied. We sought to estimate the association of repeat and early life migration with stunting and wasting outcomes among circular migrant children under three. Methods Using a stratified cluster design, we conducted two waves of primary data collection among 2564 randomly selected circular migrant children under three years of age temporarily residing across 1156 brick kilns in Bihar, India. We conducted multilevel modeling to estimate the association of the number of migration episodes and age at first migration with stunting (<-2 standard deviations (SD) height-for-age z scores (HAZ)) and wasting (<-2 SD weight-for-height z-scores (WHZ)) and examined the determinants of nutrition status among migrant children, including diet, illness, food security and the health environment. Results The overall prevalence of stunting was 51.6%. Among children who were either born during migration or first migrated before six months of age, those who experienced multiple episodes of migration were more likely to be stunted compared to those who migrated once (adjusted odds ratio (aOR) = 2.10; 95% confidence interval (CI) = 1.30-3.41). Children were over three times as likely to be wasted in the summer compared to the winter (aOR = 3.28; 95% CI = 2.68-4.01); in the summer, the overall prevalence of wasting was 38.8%. Public health access indicators such as interaction with frontline health workers at the destination was low (5.3%), whereas feeding indicators such as exclusive breastfeeding among 0-5 months was high (81.1%). Conclusions Policy efforts should ensure continuity of social protection and welfare entitlements between home and destinations for circular migrant families, with an explicit focus on rural-to-rural movement.
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Affiliation(s)
- Reshma P Roshania
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta Georgia, USA
| | - Rakesh Giri
- CARE India Solutions for Sustainable Development, Patna Bihar, India
| | - Solveig A Cunningham
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Melissa F Young
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amy Webb-Girard
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Aritra Das
- CARE India Solutions for Sustainable Development, Patna Bihar, India
| | - G S Mala
- CARE India Solutions for Sustainable Development, Patna Bihar, India
| | | | - Tanmay Mahapatra
- CARE India Solutions for Sustainable Development, Patna Bihar, India
| | - Usha Ramakrishnan
- Nutrition and Health Sciences, Laney Graduate School, Emory University, Atlanta Georgia, USA
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Bansal SC, Odedra R, Talati K, Morgaonkar VA, Shinde M, Nimbalkar SM. Infant and young child feeding (IYCF) practices and their determinants in two Urban districts of India. J Family Med Prim Care 2021; 10:3137-3143. [PMID: 34660459 PMCID: PMC8483104 DOI: 10.4103/jfmpc.jfmpc_184_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: It is essential to maintain optimal nutrition during the early years of life when the growth rate is maximum. Aims and Objectives: Our study investigated the prevalence of various feeding practices. We also explored their association with different sociodemographic, biomedical variables, and childhood morbidity. Methodology: This was a cross-sectional community-based study. Data were collected through a questionnaire-based survey of mothers of school-going children aged 2–6 years in the districts of Anand and Vadodara, Gujarat. Results: A total of 367 mothers participated in the study. About 78% of the mothers did early initiation of breastfeeding within 1 h of birth, and 68% gave colostrum to the newborn. Around 30% of the mothers practiced bottle feeding, and 25% gave prelacteal feeds. Most mothers received good family support for breastfeeding (93.73%). On univariate analysis, we found the following associations of feeding practices—breastfeeding initiation with the gender of the baby (P value—0.006) and type of delivery (P value < 0.001); the duration of exclusive breastfeeding with the time difference between two deliveries (P value—0.027) and maternal age (P value—0.004); prelacteal feeds with the type of delivery (P value—0.034); feeding difficulty with the time difference between two deliveries (P value < 0.001) and breastfeeding at night with maternal education (P value—0.002). The time of the initiation of breastfeeding was associated with cough and cold episodes. No other association was found between breastfeeding variables and health indicators. Conclusion: Maternal age, maternal education, the time difference between two deliveries, the type of delivery, and gender of the baby were significantly associated with different Infant and Young Child Feeding (IYCF) practices. Identifying these factors might help in the development of strategies for optimizing feeding practices.
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Affiliation(s)
- Satvik C Bansal
- Department of Pediatrics, Gajra Raja Medical College, Gwalior, Madhay Pradesh, India
| | - Rahul Odedra
- Medical Officer, Department of Paediatrics, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
| | - Kandarp Talati
- Department of Interdisciplinary Research, Foundation for Diffusion of Innovations, Vadodara, Gujarat, India
| | | | - Mayur Shinde
- Central Research Services, Bhaikaka University, Karamsad, Anand, Gujarat, India
| | - Somashekhar M Nimbalkar
- Professor and Head, Department of Paediatrics, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India
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Dhami MV, Ogbo FA, Akombi-Inyang BJ, Torome R, Agho KE. Understanding the Enablers and Barriers to Appropriate Infants and Young Child Feeding Practices in India: A Systematic Review. Nutrients 2021; 13:825. [PMID: 33801545 PMCID: PMC7998710 DOI: 10.3390/nu13030825] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/30/2021] [Accepted: 02/26/2021] [Indexed: 11/16/2022] Open
Abstract
Despite efforts to promote infant and young child feeding (IYCF) practices, there is no collective review of evidence on IYCF enablers and barriers in India. This review was conducted using 2015 Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Six computerized bibliographic databases, Scopus, PubMed, PsycINFO, CINAHL, Embase, and Ovid MEDLINE, were searched for published studies on factors associated with IYCF practices in India from 1 January 1993, to 30 April 2020. IYCF practices examined were early initiation of breastfeeding, exclusive breastfeeding, continued breastfeeding at one year, introduction to solid semi-solid or soft foods, minimum dietary diversity, minimum meal frequency, minimum acceptable diet, continued breastfeeding at two years, predominant breastfeeding, and bottle feeding. In total, 6968 articles were retrieved, and 46 studies met the inclusion criteria. The common enablers of IYCF were higher maternal socioeconomic status (SES) and more frequent antenatal care visits (ANC) (≥3). Common barriers to IYCF practices were low SES and less frequent ANC. The review showed that the factors associated with IYCF practices in India are largely modifiable and multi-factorial. Improving IYCF practices would require the adoption of both facilities- and community-based policy interventions at the subnational and national levels in India.
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Affiliation(s)
- Mansi Vijaybhai Dhami
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2571, Australia; (F.A.O.); (K.E.A.)
| | - Felix Akpojene Ogbo
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2571, Australia; (F.A.O.); (K.E.A.)
- Barmera Medical Clinic (Lake Bonney Private Medical Clinic), Barmera, SA 5345, Australia;
| | - Blessing Jaka Akombi-Inyang
- School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia;
- School of Social Sciences, Western Sydney University, Penrith, NSW 2571, Australia
| | - Raphael Torome
- Barmera Medical Clinic (Lake Bonney Private Medical Clinic), Barmera, SA 5345, Australia;
| | - Kingsley Emwinyore Agho
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW 2571, Australia; (F.A.O.); (K.E.A.)
- School of Health Sciences, Western Sydney University, Penrith, NSW 2571, Australia
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban 4041, South Africa
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Athavale P, Khadka N, Roy S, Mukherjee P, Chandra Mohan D, Turton B(B, Sokal-Gutierrez K. Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228629. [PMID: 33233797 PMCID: PMC7699964 DOI: 10.3390/ijerph17228629] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/14/2020] [Accepted: 11/15/2020] [Indexed: 12/18/2022]
Abstract
In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and/or acute malnutrition. In children ages 3–6, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02–1.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food/sugary drinks into maternal–child health programs.
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Affiliation(s)
- Priyanka Athavale
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
- School of Medicine, University of California, San Francisco, CA 94143, USA
- Correspondence: ; Tel.: +1-(408)-647-0477
| | - Nehaa Khadka
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
- Fielding School of Public Health, Department of Epidemiology, University of California, Los Angeles, CA 90095, USA
| | - Shampa Roy
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
| | | | - Deepika Chandra Mohan
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
| | | | - Karen Sokal-Gutierrez
- School of Public Health, University of California, Berkeley, CA 94704, USA; (N.K.); (S.R.); (D.C.M.); (K.S.-G.)
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