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Summan A, Nandi A, Laxminarayan R. Analysis of anthropometric outcomes in Indian children during the COVID-19 pandemic using National Family Health Survey data. COMMUNICATIONS MEDICINE 2024; 4:127. [PMID: 38951653 PMCID: PMC11217468 DOI: 10.1038/s43856-024-00543-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/03/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Disruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health. There is currently limited research on the potential effects of the COVID-19 pandemic on stunting, wasting, and underweight status of young children. METHODS We examine the short-term associations between the pandemic and anthropometric outcomes of under-5 children (n = 232,920) in India, using data from the National Family Health Survey (2019-2021). Children surveyed after March 2020 are considered as the post-COVID group, while those surveyed earlier are considered as pre-COVID. Potential biases arising from differences in socioeconomic characteristics of the two groups are mitigated using propensity score matching methods. RESULTS Post-COVID children surveyed in 2020 and 2021 have 1.2% higher underweight rates, 1.2% lower wasting rates, 0.1 lower height-for-age z-scores (HAZ), and 0.04 lower weight-for-height z-scores as compared with matched pre-COVID children. Post-COVID children surveyed in 2020 have 1.6%, 4.6%, and 2.4% higher stunting, underweight, and wasting rates, respectively, and 0.07 lower HAZ, as compared with matched pre-COVID children. Reductions in nutritional status are largest among children from households in the poorest wealth quintiles. CONCLUSIONS These findings indicate a trend towards a recovery in child anthropometric outcomes in 2021 after the initial post-pandemic reductions. The resilience of health and food systems to shocks such as COVID-19 should be strengthened while immediate investments are required to decrease child malnutrition and improve broader child health outcomes.
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Affiliation(s)
- Amit Summan
- One Health Trust, 5636 Connecticut Avenue NW, PO Box 42735, Washington, DC, 20015, USA
| | - Arindam Nandi
- One Health Trust, 5636 Connecticut Avenue NW, PO Box 42735, Washington, DC, 20015, USA.
- The Population Council, 1 Dag Hammarskjold Plaza, New York, NY, 10017, USA.
| | - Ramanan Laxminarayan
- One Health Trust, Obeya Pulse, First Floor, 7/1, Halasur Road, Bengaluru, Karnataka, 560042, India
- High Meadows Environmental Institute, Princeton University, Guyot Hall, Princeton, NJ, 08544, USA
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Odii BC, Harder MK, Huang Y, Chapman A, Sougou NM, Kolopaking R, Gavaravarapu S, Diallo AH, Anggorowati R, Fernandez Rao S, Heffernan C. Sociocultural environmental factors and childhood stunting: qualitative studies - a protocol for the Shared Values theme of the UKRI GCRF Action Against Stunting Hub. BMJ Paediatr Open 2024; 8:e001906. [PMID: 38417927 PMCID: PMC10900418 DOI: 10.1136/bmjpo-2023-001906] [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: 02/11/2023] [Accepted: 05/03/2023] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Stunting is a significant and growing global problem that is resisting scientific attempts to understand it in terms of direct nutrition-related determinants. In recent years, research included more complex, indirect and multifactorial determinants and expanded to include multisectoral and lifestyle-related approaches. The United Kingdom Research Initiative Global Challenges Research Fund's (UKRI GCRF) Action Against Stunting Hub starts on the premise that dominant factors of stunting may vary between contexts and life phases of the child. Thus, the construction of a typology of clustered factors will be more useful to design effective programmes to alleviate it.The Shared Values theme seeks to build a bottom-up holistic picture of interlinked cultural contextual factors that might contribute to child stunting locally, by first eliciting shared values of the groups closest to the problem and then enquiring about details of their relevant daily activities and practices, to reveal links between the two. We define shared values as what groups consider 'valuable, worthwhile and meaningful' to them. METHODS AND ANALYSIS We will recruit 12-25 local stakeholder groups in each site (in India, Indonesia and Senegal) involved in children's food and early learning environments, such as mothers, fathers, grandmothers, teachers, market vendors and health workers. The WeValue InSitu process will be used to assist them to collectively elicit, negotiate and self-articulate their own shared values through exploration of shared tacit knowledge. Focus group discussions held immediately subsequently will ask about daily activities relevant to the children's environment. These contain many examples of cultural contextual factors potentially influencing stunting locally, and intrinsically linked to shared values articulated in the previous session.
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Affiliation(s)
- Benita Chinenye Odii
- Department of Environmental Science and Engineering, Fudan University, Shanghai, PR China
- Department of Linguistics, Igbo and Other Nigerian Languages, University of Nigeria, Nsukka, Enugu, Nigeria
| | - Marie K Harder
- Department of Environmental Science and Engineering, Fudan University, Shanghai, PR China
- Values and Sustainability Research Group, School of Architecture, Technology and Engineering, University of Brighton, Brighton, UK
| | - Yanyan Huang
- Department of Environmental Science and Engineering, Fudan University, Shanghai, PR China
| | - Annabel Chapman
- Values and Sustainability Research Group, School of Architecture, Technology and Engineering, University of Brighton, Brighton, UK
| | - Ndèye Marième Sougou
- Preventive Medicine and Public Health, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Risatianti Kolopaking
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional, Universitas Indonesia, Jakarta, Indonesia
- Faculty of Psychology, UIN Syarif Hidayatullah, Jakarta, Indonesia
| | - SubbaRao Gavaravarapu
- Nutrition Information, Communication & Health Education (NICHE) Division, ICMR-National Institute of Nutrition (NIN), Department of Health Research, Ministry of Health & Family Welfare, Govt. of India, Hyderabad, India
| | - Amadou H Diallo
- International Research Laboratory (IRL 3189) Environnement, santé et sociétés, CNRS, UCAD, Dakar, Senegal
| | - Rita Anggorowati
- Southeast Asian Ministers of Education Organization Regional Center for Food and Nutrition (SEAMEO RECFON)-Pusat Kajian Gizi Regional, Universitas Indonesia, Jakarta, Indonesia
- Indonesia Creative Education Institute (ICEI), Bandung, Indonesia
| | - Sylvia Fernandez Rao
- Indian Council of Medical Research, Behavioral Science Unit, Extension and Training Division, Department of Health Research, National Institute of Nutrition, Hyderabad, India
| | - Claire Heffernan
- London International Development Centre, London School of Hygiene & Tropical Medicine, London, UK
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Moreno JM, Chapman AJ, Ebido CC, Sougou NM, Diallo AH, Tening RN, Dial FB, Massonnié J, Firoozmand M, Niang CEHA, Heffernan C, Harder MK. Local contextual factors of child stunting found via shared values of stakeholder groups: an exploratory case study in Kaffrine, Senegal. Public Health Nutr 2023; 26:2418-2432. [PMID: 37288526 PMCID: PMC10641654 DOI: 10.1017/s1368980023001088] [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: 09/12/2022] [Revised: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This work aims to demonstrate an original approach to identify links between locally situated shared values and contextual factors of stunting. Stunting results from multi-factorial and multi-sectoral determinants, but interventions typically neglect locally situated lived experiences, which contributes to problematic designs that are not meaningful for those concerned and/or relatively ineffective. DESIGN This case study investigates relevant contextual factors in two steps: by first facilitating local stakeholder groups (n 11) to crystallise their shared-values-in-action using a specialised method from sustainability studies (WeValue_InSitu (WVIS)). Secondly, participants (n 44) have focus group discussions (FGD) about everyday practices around child feeding/food systems, education and/or family life. Because the first step strongly grounds participants in local shared values, the FGD can reveal deep links between contextual factors and potential influences on stunting. SETTING Kaffrine, Senegal, an 'Action Against Stunting Hub' site. December 2020. PARTICIPANTS Eleven stakeholder groups of mothers, fathers, grandmothers, pre-school teachers, community health workers, farmers, market traders and public administrators. RESULTS Local contextual factors of stunting were identified, including traditional beliefs concerning eating and growing practices; fathers as decision-makers; health worker trust; financial non-autonomy for women; insufficient water for preferred crops; merchants' non-access to quality produce; religious teachings and social structures affecting children's food environment. CONCLUSIONS Local contextual factors were identified. Pre-knowledge of these could significantly improve effectiveness of intervention designs locally, with possible applicability at other sites. The WVIS approach proved efficient and useful for making tangible contextual factors and their potential links to stunting, via a lens of local shared values, showing general promise for intervention research.
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Affiliation(s)
- Juan Manuel Moreno
- Values and Sustainability Research Group, School of Architecture, Technology and Engineering, University of Brighton, BrightonBN2 4GJ, UK
| | - Annabel J Chapman
- Values and Sustainability Research Group, School of Architecture, Technology and Engineering, University of Brighton, BrightonBN2 4GJ, UK
| | - Chike C Ebido
- Department of Environmental Science and Engineering, Fudan University, Shanghai, People’s Republic of China
- Department of Zoology and Environmental Biology, University of Nigeria, Nsukka, Nigeria
| | - Ndèye Marième Sougou
- Preventive Medicine and Public Health, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Amadou H Diallo
- International Research Laboratory (IRL 3189), Environnement santé et sociétés/CNRS /UCAD, Dakar, Senegal
| | - Rahel Neh Tening
- Department of Environmental Science and Engineering, Fudan University, Shanghai, People’s Republic of China
| | - Fatou Binetou Dial
- Laboratory of Cultural Anthropology, IFAN, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Jessica Massonnié
- Department of Psychology and Human Development, University College London, Institute of Education, London, UK
- Faculty of Humanities and Social Sciences, School of Education, Languages and Linguistics, University of Portsmouth, Portsmouth, UK
| | - Mahsa Firoozmand
- Values and Sustainability Research Group, School of Architecture, Technology and Engineering, University of Brighton, BrightonBN2 4GJ, UK
| | | | | | - Marie K Harder
- Values and Sustainability Research Group, School of Architecture, Technology and Engineering, University of Brighton, BrightonBN2 4GJ, UK
- Department of Environmental Science and Engineering, Fudan University, Shanghai, People’s Republic of China
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Atalell KA, Techane MA, Terefe B, Tamir TT. Mapping stunted children in Ethiopia using two decades of data between 2000 and 2019. A geospatial analysis through the Bayesian approach. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:113. [PMID: 37885003 PMCID: PMC10601230 DOI: 10.1186/s41043-023-00412-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 07/08/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Childhood stunting is a major public health problem globally, resulting in poor cognition and educational performance, low adult wages, low productivity, and an increased risk of nutrition-related chronic diseases in adulthood life. Accurate and reliable data on the prevalence of stunting over time with a sub-national estimate are scarce in Ethiopia. OBJECTIVE Our objective was to investigate the spatiotemporal distributions and ecological level drivers of stunting among under-five children over time in Ethiopia. METHODS A geospatial analysis using the Bayesian framework was employed to map the spatial variations of stunting among children aged less than five years. The data for the primary outcome were obtained from the Ethiopian Demographic and Health Surveys (2000-2019) and covariates data were accessed from different publicly available credible sources. The spatial binomial regression model was fitted to identify drivers of child stunting using the Bayesian approach. RESULT The national prevalence of stunting was 47.9 in 2000, 43.3 in 2005, 37.3 in 2011, 36.6 in 2016, and 35.9 in 2019, with a total reduction rate of 25%. Substantial spatial clustering of stunting was observed in the Northern (Tigray), Northcentral (Amhara), and Northwestern (Amhara) parts of Ethiopia. Temperature (mean regression coefficient (β): -0.19; 95% credible interval (95% CrI): -0.25, -0.12) and population density (β: -0.012; 95% CrI: -0.016, -0.009) were negatively associated with stunting, whereas travel time to the nearest cities (β: 0.12; 95% CrI: 0.064, 0.17) was positively associated with child stunting in Ethiopia. CONCLUSION The prevalence of stunting varied substantially at subnational and local levels over time. Clustering of stunted children were observed in the Northern parts of Ethiopia. Temperature, population density and travel time to the nearest cities were identified as the drivers of stunting in children. Improving community awareness of child nutrition through community health extension programs should be strengthened.
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Affiliation(s)
- Kendalem Asmare Atalell
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masresha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Picbougoum TB, Somda MAS, Zango SH, Lohmann J, De Allegri M, Saidou H, Hien H, Meda N, Robert A. Nutritional status of children under five years and associated factors in 24 districts of Burkina Faso. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001248. [PMID: 37523345 PMCID: PMC10389710 DOI: 10.1371/journal.pgph.0001248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 07/04/2023] [Indexed: 08/02/2023]
Abstract
Malnutrition in children is a serious health problem, especially in Sub-Saharan Africa, with heavy socioeconomic burdens. The prevalence of stunting remains high in Burkina Faso. There is a need to further investigate undernutrition and identify the major factors contributing to its persistence. We aimed to assess the nutritional status of children aged under five years and the associated factors of undernutrition in Burkina Faso. We conducted a second study using a baseline household survey of the impact assessment of a performance-based financing program. The analysis focused on data of 10,032 children aged 0-59 months collected from households in 537 villages. Anthropometric indicators were assessed using the World Health Organization standards, and their association with children, mothers, and households' characteristics were assessed using logistic regression. Stunting occurred in 40.1% of children, wasting in 25.1%, and underweight in 34%. Children having both stunting, wasting, and underweight were 7.3%. Stunting and underweight was associated with the sex. Stunting was associated with ethnic groups: Fulani with AdjOR = 1.20 (95%CI: 1.01-1.42), household economic level: poorest AdjOR = 1.25 (95%CI: 1.10-1.43), two and more children aged under five years in households: AdjOR = 1.16 (95%CI: 1.05-1.27), distance more than 5km from household to health facility: with Adj OR = 1.21 (95%CI: 1.10-1.35) and household food insecurity. This study identified the modifiable factors that determine the high prevalence of undernutrition in Burkina Faso. Strategies and interventions to improve the health and economic status of the community are needed to reduce the occurrence of undernutrition.
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Affiliation(s)
- T Bernadette Picbougoum
- Institut National de Santé Publique (INSP)/ Centre MURAZ, Bobo-Dioulasso, Burkina Faso
- Institut de Recherche Expérimentale et Clinique, Pôle Epidémiologie et Biostatistique, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - M A Serge Somda
- Institut National de Santé Publique (INSP)/ Centre MURAZ, Bobo-Dioulasso, Burkina Faso
- Université Nazi Boni, Unité de Formation et de Recherche/Sciences et Technique, Bobo-Dioulasso, Burkina Faso
| | - S Henri Zango
- Institut National de Santé Publique (INSP)/ Centre MURAZ, Bobo-Dioulasso, Burkina Faso
- Institut de Recherche Expérimentale et Clinique, Pôle Epidémiologie et Biostatistique, Université catholique de Louvain (UCLouvain), Brussels, Belgium
- Institut de Recherche en Sciences de la Santé (IRSS), Direction Régionale du Centre-Ouest, Nanoro, Burkina Faso
| | - Julia Lohmann
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Institute of Global Health, Heidelberg University Hospital and Medical Faculty, Heidelberg, Germany
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany
| | | | - Hervé Hien
- Institut National de Santé Publique (INSP)/ Centre MURAZ, Bobo-Dioulasso, Burkina Faso
- Institut de Recherche en Sciences de la Santé (IRSS), Direction Régionale de l'Ouest, Bobo-Dioulasso, Burkina Faso
| | - Nicolas Meda
- Université Joseph Ki-Zerbo, UFR/SDS, Ouagadougou, Burkina Faso
| | - Annie Robert
- Institut de Recherche Expérimentale et Clinique, Pôle Epidémiologie et Biostatistique, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Takele BA, Gezie LD, Alamneh TS. Pooled prevalence of stunting and associated factors among children aged 6-59 months in Sub-Saharan Africa countries: A Bayesian multilevel approach. PLoS One 2022; 17:e0275889. [PMID: 36228030 PMCID: PMC9560624 DOI: 10.1371/journal.pone.0275889] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background Over 155 million children under five suffer from stunting, and it is responsible for over one million deaths and 54.9 million Disability Adjusted Life Years (DALYS) of under-five children worldwide. These predominantly occurred in low-and middle-income countries like sub-Saharan Africa. Stunted children begin their lives at a marked disadvantage. Some of these are; poor cognition and educational performance, low adult wages, lost productivity and, when accompanied by excessive weight gain later in childhood, an increased risk of nutrition-related chronic diseases in adult life and the devastating effects of stunting can last a lifetime and even affect the next generation. Despite this, its magnitude rises in the past 25 years in sub-Saharan Africa. Studies that capture the pooled prevalence and associated factors of stunting among children aged 6–59 months in sub-Saharan Africa are limited. Therefore, this study was carried out on the basis of the Bayesian approach to determine the pooled prevalence and predictors of stunting among children aged 6–59 months in Sub-Saharan Africa. Objective To assess the pooled prevalence of stunting and associated factors among children aged 6–59 months in Sub-Saharan Africa Methods For this study a total of 173,483 weighted samples from the demography and health survey data set of 35 sub-Saharan African countries from 2008 to 2020 were used. After checking Variation between cluster by computing Intraclass Correlation Coefficient, binary logistic regression model was conducted based on hierarchical Bayesian statistical approach to account the hierarchical nature of demography and health survey data and to get reliable estimates by using additional information from the prior distribution. Adjusted odds ratio with 95% credible interval of the best fitted model was used to ascertain the predictors. Results The pooled prevalence of stunting in Sub-Saharan Africa was about 35% (95%CI: 34.87, 35.31). Of the sub-regions, the highest prevalence of stunting was in East Africa, 37% (95%, CI: 36.96, 37.63) followed by Central Africa, 35% (95%CI: (34.93, 35.94). Being male (AOR = 1.27, 95% CrI 1.25, 1.30), small birth size (AOR = 1.29, CrI 1.25, 1.32), home delivery (AOR = 1.17, CrI 1.14, 1.20), and no education of mothers (AOR = 3.07, CrI 2.79, 3.39) were some of the significant predictors of stunting of children. Conclusion and recommendation The prevalence of stunting of children in sub-Saharan Africa is among the highest in the world. Predictors such as being male, being small at birth, a child delivered at home, and, low level of maternal education were some of the predictors of childhood stunting. Stakeholders and non-governmental organizations should consider those contributing factors of stunting when they plan and design nutritional improvement programs.
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Affiliation(s)
- Bayley Adane Takele
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fonseka RW, McDougal L, Raj A, Reed E, Lundgren R, Urada L, Silverman JG. Measuring the impacts of maternal child marriage and maternal intimate partner violence and the moderating effects of proximity to conflict on stunting among children under 5 in post-conflict Sri Lanka. SSM Popul Health 2022; 18:101074. [PMID: 35378865 PMCID: PMC8976144 DOI: 10.1016/j.ssmph.2022.101074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/29/2022] Open
Abstract
This study aimed to understand whether maternal child marriage and past year intimate partner violence (IPV) impact stunting among Sri Lankan children under 5 years old, and, secondarily, whether proximity to conflict is associated with stunting. Additionally, we assessed whether proximity to conflict moderates the relationships between maternal child marriage and past year IPV (sexual, physical, and emotional). We tested these questions using logistic regression analyses of the 2016 Sri Lankan Demographic and Health Survey (n = 4941 mother-child dyads). In country-wide adjusted analyses, we did not find associations between maternal child marriage or IPV and stunting (p > 0.05). Children in districts proximal and central to conflict were significantly less likely to be stunted compared to children in districts distal to conflict (proximal adjusted odds ratio/aOR: 0.43, 95% confidence interval/CI: 0.22–0.82; central aOR: 0.53, CI: 0.29–0.98). We found significant interaction effects on stunting between proximity to conflict and both sexual and emotional IPV, which we further explored in stratified analyses. In districts distal to conflict, maternal sexual IPV was significantly associated with increased odds of stunting (aOR: 2.71, CI: 1.16–6.35), and in districts central to conflict, maternal emotional IPV was significantly associated with increased odds of stunting (aOR: 1.80, CI: 1.13–2.89). Maternal emotional IPV was significantly associated with decreased odds of stunting in districts proximal to conflict (aOR: 0.42, CI: 0.18–0.96). Maternal child marriage and physical IPV were not associated with stunting in Sri Lanka. Variations in associations between maternal IPV and stunting across Sri Lanka may reflect the lasting and differential impact of conflict, as well as differential humanitarian responses which may have improved child nutrition practices and resources in districts central and proximal to conflict. Policies and programs addressing stunting in Sri Lanka should consider the role of maternal IPV as well as community-level variations based on proximity to conflict. Across Sri Lanka, stunting is reduced in areas proximal and central to conflict. Proximity to conflict moderates the impact of sexual and emotional IPV on stunting. Children's vulnerability to stunting and IPV varies by proximity to conflict. Humanitarian aid may have decreased stunting in areas most impacted by conflict.
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Affiliation(s)
- Ruvani W. Fonseka
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health, 9500 Gilman Dr, La Jolla, CA, 92093, USA
- San José State University School of Social Work, 1 Washington Square, San Jose, CA 95112, USA
- Corresponding author. San José State University School of Social Work, 1 Washington Square, San Jose, CA 95112, USA.
| | - Lotus McDougal
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Anita Raj
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Elizabeth Reed
- San Diego State University School of Public Health, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Rebecka Lundgren
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
| | - Lianne Urada
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
- San Diego State University School of Social Work, 5500 Campanile Drive, San Diego, CA, 92182, USA
| | - Jay G. Silverman
- Center on Gender Equity and Health, University of California San Diego School of Medicine, 9500 Gilman Drive, La Jolla, CA, 92093, USA
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Anthropometric failures and its associated factors among preschool-aged children in a rural community in southwest Ethiopia. PLoS One 2021; 16:e0260368. [PMID: 34843555 PMCID: PMC8629177 DOI: 10.1371/journal.pone.0260368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/08/2021] [Indexed: 11/23/2022] Open
Abstract
Background In 2019, 144 million under-five-year-old children were stunted, and 47 million were wasted globally. In Ethiopia, approximately 350,000 children are estimated to die each year. Preschool aged children need focused attention because this age group not only has special needs, but also forms the platform for growth and development of all children. Under nutrition among preschool children is the result of a complex interplay of diverse elements, such as birth weight, household access to food, availability and use of drinking water. This study aimed at determining the anthropometric failures and associated factors using composite indictors. Methods A community-based cross-sectional study design was used among randomly selected 588 caregivers with pre-school aged children. Under-nutrition of pre-school aged children was computed by using the composite index of anthropometric failure. A multi-stage sampling technique followed by a systematic random sampling technique was used to select study participants. Structured questionnaires were used to collect data. WHO Anthro software was used to calculate height for age, weight for age and weight for height. The overall prevalence of anthropometric failure (CIAF). Both bivariable and multivariable binary logistic regressions were used to identify factors associated with under-nutrition. Results The overall prevalence of under-nutrition among pre-school children was 50.8%, which was significantly associated with being a female (AOR = 1.51, CI: 1.076, 2.12), being from a large family (AOR = 1.78, CI: 1.19, 2.663), having acute respiratory infection (AOR = 1.767, CI: 1.216, 2.566), lack of improved source of drinking water (AOR = 1.484 CI: 1.056, 2.085) and poor dietary diversity score (AOR = 1.5, CI: 1.066, 2.112). Conclusions The study area has a high prevalence of CIAF in pre-school aged children. The CIAF was found to be significantly associated with the sex of the child, family size, ARI within the last two weeks, and dietary diversity score. To promote the use of family planning and the prevention of infectious diseases, health education is required. The government should adapt CIAF as a metric for assessing children’s nutritional status.
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Mengesha HG, Vatanparast H, Feng C, Petrucka P. Modeling the predictors of stunting in Ethiopia: analysis of 2016 Ethiopian demographic health survey data (EDHS). BMC Nutr 2020; 6:52. [PMID: 32974038 PMCID: PMC7507682 DOI: 10.1186/s40795-020-00378-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/03/2020] [Indexed: 02/03/2023] Open
Abstract
Background Despite continued efforts to address malnutrition, there is minimal reduction in the prevalence rates of stunting in developing countries, including Ethiopia. The association between nutritional and socioeconomic factors collected from a national survey in Ethiopia and stunting have not been rigorously analyzed. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic Health Survey (EDHS) data. Methods This study is a secondary data analysis of the 2016 EDHS survey, which included 7909 children aged 6 to59 months. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding, and multicollinearity were checked. Bivariable and multivariable logistic regression were carried out. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. A receiver operative curve was built to estimate the sensitivity and specificity of the model. Results The study identified that 39.2% of children included in this analysis were stunted. Furthermore, 76.47, 84.27, and 92.62% of the children did not consume fruits and vegetables, legumes and lentils, or meat and its products, respectively. Children aged 24 months to 59 months were found to be at 9.71 times higher risk of being stunted compared to their younger counterparts aged 6–24 months (AOR: 9.71; CI: 8.07, 11.6 children). Those children weighing below 9.1 kg were at 27.86 odds of being stunted compared to those weighing 23.3 kg and above. Moreover, mothers with a height below 150 cm (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54), and being male (AOR: 1.4; CI: 1.26, 1.56) were factors associated with stunting. The predictive ability of the model was 77%: if a pair of observations with stunted and non-stunted children were taken, the model correctly ranks 77% of such pair of observations. Conclusion The model indicates that being born male, being from a mother of short stature, living in rural areas, small child size, mother with mild anemia, father having no formal education or primary education only, having low child weight, and being 24–59 months of age increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.
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Affiliation(s)
- Hayelom Gebrekirstos Mengesha
- School of Public Health, University of Saskatchewan, Saskatoon, SK Canada.,Adigrat University, College of Medicine and Health Sciences, Adigrat, Ethiopia
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK Canada
| | - Cindy Feng
- School of Public Health, University of Saskatchewan, Saskatoon, SK Canada
| | - Pammla Petrucka
- College of Nursing, University of Saskatchewan, Saskatoon, SK Canada.,Adjunct Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania
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Weatherspoon DD, Miller S, Ngabitsinze JC, Weatherspoon LJ, Oehmke JF. Stunting, food security, markets and food policy in Rwanda. BMC Public Health 2019; 19:882. [PMID: 31272435 PMCID: PMC6610945 DOI: 10.1186/s12889-019-7208-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/20/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Over the past two decades, Rwanda has experienced impressive economic growth, resulting in considerable improvements in living standards and poverty reduction. Despite these gains, progress on reducing the level of stunting in smallholder rural children, particularly boys, continues to be a serious concern. METHODS Policies, dietary diversity and socio-economic factors that may influence stunting in rural Rwandan children were evaluated using a logit model with clustered variance-covariance estimators based on village membership of the household. RESULTS Stunting of rural children was found to be multidimensionally related to the child's gender, weight and age; the dietary diversity, marriage status and education level of the head of household; mother's height; presence of a family garden or if they owned livestock; environmental factors such as altitude and soil fertility and location relative to a main road en route to a market; and a policy that promoted food production. CONCLUSIONS Findings suggest that agricultural policies may be subsidizing poor dietary behavior in that the aggregation of production encourages households to sell high quality nutritious food such as fruit and vegetables, for more voluminous amounts of nutritionally substandard goods, hence low dietary diversity. However, it is less clear if rural food markets are capable of supplying diverse and nutritious foods at affordable prices on a consistent basis, resulting in a lack of diversity and hence, low nutrient quality diets. Rwanda's next round of food security policies should focus on nutrition insecurity with special emphasis on the lack of protein, micronutrients and calories. Multipronged policies and programs focused on income growth, food security, enhanced access to markets and gender-related nutrition risks from inception through 2 years of age in the rural areas are required to improve rural household health outcomes, stunting in particular.
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Affiliation(s)
- Dave D. Weatherspoon
- Agricultural, Food & Resource Economics Department, Michigan State University, Rm. 213C Morrill Hall of Agriculture, 446 W. Circle Dr, East Lansing, MI 48824 USA
| | - Steve Miller
- Agricultural, Food & Resource Economics Department, Rm. 81 Morrill Hall of Agriculture, 446 W. Circle Dr, East Lansing, MI 48824 USA
| | - Jean Chrysostome Ngabitsinze
- Department of Rural Development and Agricultural Economics, College of Agriculture, Animal Sciences and Veterinary Medicine, University of Rwanda, P.O. Box 210, Musanze, 3971 Rwanda
| | - Lorraine J. Weatherspoon
- Department of Food Science and Human Nutrition, Michigan State University, 469 Wilson Road, Rm 140 Trout Food Science Bldg, East Lansing, MI 48824-1224 USA
| | - James F. Oehmke
- United States Agency for International Development, Bureau For Food Security, Ronald Reagan Bldg., 1300 Pennsylvania Ave. NW, Washington, DC 20229 USA
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11
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Workicho A, Belachew T, Argaw A, Ghosh S, Kershaw M, Lachat C, Kolsteren P. Adolescent pregnancy and linear growth of infants: a birth cohort study in rural Ethiopia. Nutr J 2019; 18:22. [PMID: 30940147 PMCID: PMC6806577 DOI: 10.1186/s12937-019-0448-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 03/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidences indicate that the risk of linear growth faltering is higher among children born from young mothers. Although such findings have been documented in various studies, they mainly originate from cross-sectional data and demographic and health surveys which are not designed to capture the growth trajectories of the same group of children. This study aimed to assess the association between young maternal age and linear growth of infants using data from a birth cohort study in Ethiopia. METHODS A total of 1423 mother-infant pairs, from a birth cohort study in rural Ethiopia were included in this study. They were followed for five time points, with three months interval until the infants were 12 months old. However, the analysis was based on 1378 subjects with at least one additional follow-up measurement to the baseline. A team of data collectors including nurses collected questionnaire based data and anthropometric measurements from the dyads. We fitted linear mixed-effects model with random intercept and random slope to determine associations of young maternal age and linear growth of infants over the follow-up period after adjusting for potential confounders. RESULTS Overall, 27.2% of the mothers were adolescents (15-19 years) and the mean ± SD age of the mothers was 20 ± 2 years. Infant Length for Age Z score (LAZ) at birth was negatively associated with maternal age of 15-19 years (β = - 0.24, P = 0.032). However, young maternal age had no significant association with linear growth of the infants over the follow-up time (P = 0.105). Linear growth of infants was associated positively with improved maternal education and iron-folate intake during pregnancy and negatively with infant illness (P < 0.05). CONCLUSION Young maternal age had a significant negative association with LAZ score of infants at birth while its association over time was not influential on their linear growth. The fact that wide spread socio economic and environmental inequalities exist among mothers of all ages may have contributed to the non-significant association between young maternal age and linear growth faltering of infants. This leaves an opportunity to develop comprehensive interventions targeting for the infants to attain optimal catch-up growth.
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Affiliation(s)
- Abdulhalik Workicho
- Department of Epidemiology, Institute of Health, Jimma University, P.O.Box 378, Jimma, Ethiopia
- Department of Food Technology, Safety and Health, Ghent University, Coupure links 653, B 9000 Ghent, Belgium
| | - Tefera Belachew
- Department of Population and Family Health, Institute of Health, Jimma University, P.O.Box 378, Jimma, Ethiopia
| | - Alemayehu Argaw
- Department of Population and Family Health, Institute of Health, Jimma University, P.O.Box 378, Jimma, Ethiopia
- Department of Food Technology, Safety and Health, Ghent University, Coupure links 653, B 9000 Ghent, Belgium
| | - Shibani Ghosh
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA USA
| | - Meghan Kershaw
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA USA
| | - Carl Lachat
- Department of Food Technology, Safety and Health, Ghent University, Coupure links 653, B 9000 Ghent, Belgium
| | - Patrick Kolsteren
- Department of Food Technology, Safety and Health, Ghent University, Coupure links 653, B 9000 Ghent, Belgium
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Vilcins D, Sly PD, Jagals P. Environmental Risk Factors Associated with Child Stunting: A Systematic Review of the Literature. Ann Glob Health 2018. [PMID: 30779500 PMCID: PMC6748290 DOI: 10.29024/aogh.2361] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Stunting, a form of malnutrition characterized by impaired linear growth in the first two years of life, affects one quarter of children globally. While nutritional status remains the key cause of stunting, there is evidence that environmental risk factors are associated with stunting. OBJECTIVE The objective of this review is to explore the current literature and compile the environmental risk factors that have been associated with stunting. Further, we seek to discover which risk factors act independently of nutritional intake. METHODS A systematic search of the literature was performed using PubMed, EMBASE, Scopus, TOXNET, and CINAHL. A search of the grey literature was conducted. Papers were included in this review if they examined an association between childhood stunting and exposure to environmental risk factors. FINDINGS We included 71 reports in the final analysis. The included studies showed that foodborne mycotoxins, a lack of adequate sanitation, dirt floors in the home, poor quality cooking fuels, and inadequate local waste disposal are associated with an increased risk of childhood stunting. Access to safe water sources was studied in a large number of studies, but the results remain inconclusive due to inconsistent study findings. Limited studies were available for arsenic, mercury, and environmental tobacco, and thus their role in stunting remains inconclusive. The identified research did not control for nutritional intake. A causal model identified solid fuel use and foodborne mycotoxins as being environmental risk factors with the potential to have direct effects on childhood growth. CONCLUSIONS A diverse range of environmental risk factors are, to varying degrees, associated with stunting, demonstrating the importance of considering how the environment interacts with nutrition. Health promotion activities may be more effective if they consider environmental factors alongside nutritional interventions.
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Affiliation(s)
- Dwan Vilcins
- Child Health Research Centre, The University of Queensland, Center for Children's Health Research, South Brisbane.,School of Public Health, University of Queensland, AU
| | - Peter D Sly
- Child Health Research Centre, The Universit of Queensland, Center for Children's Health Research South Brisbane, AU
| | - Paul Jagals
- Child Health Research Centre, The University of Queensland, Center for Children's Health Research South Brisbane, AU
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Atsu BK, Guure C, Laar AK. Determinants of overweight with concurrent stunting among Ghanaian children. BMC Pediatr 2017; 17:177. [PMID: 28750614 PMCID: PMC5531099 DOI: 10.1186/s12887-017-0928-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 07/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background Malnutrition (undernutrition and overnutrition) is a major public health problem in Ghana –affecting growth and development of individuals and the nation. Stunting and overweight are of particular interest, as recent national surveys show a rising trend of overnutrition and stubbornly high burden of stunting among Ghanaian children. There are currently no data on the simultaneous occurrence of overweight and stunting within individuals in Ghana. This paper presents the burden, the individual-level, and contextual determinants of overweight with concurrent stunting among Ghanaian children. Methods This study analyzed data set of the fourth round of the Ghana Multiple Indicator Cluster Survey (MICS4). Bivariate analyses were used to describe selected characteristics of survey respondents and their children. Hierarchical modelling approach facilitated identification of significant distal, intermediate and proximal factors/determinants of concurrent stunting and overweight. Both crude and adjusted prevalence ratios via a multivariable Poison regression model with their corresponding 95% Confidence Intervals (CI) are reported. Variables with p ≤ 0.25 at the bivariate level were included in the multivariable analysis. An alpha value of 5% was used to indicate significance. Results Of 7550 cases (children) analyzed, the prevalence of stunting was 27.5%; underweight was 17.3%; and wasting was 7.7%. The prevalence of overweight and concurrent overweight and stunting were respectively 2.4% and 1.2%. Children who belonged to the fourth wealth quintile, were more likely to be overweight and concurrently stunted as against children belonging to the poorest quintile (aPR = 1.010; 95% CI, 1.003–1.017). Compared to religious (Christians/Muslim/Traditionalist) household heads, children whose household heads did not belong to any religion had 2 times the rates of the Overweight with concurrent stunting (PR = 2.024; 95% CI, 1.016–4.034). Children with mothers aged 20–34 and 35–49 had an increased though insignificant prevalence ratio of association (aPR = 1.001; 95% CI, 0.994–1.005) and (aPR = 1.001; 95% CI, 0.998–1.012) respectively. Conclusion This analysis determined the prevalence of concurrent stunting and overweight among Ghanaian children to be 1.2%. Four contextual variables (breastfeeding status, religion, geographic region, and wealth index quintile) were associated with overweight with concurrent stunting. We conclude that, only contextual factors are predictive of DBM among children under five living in Ghana.
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Affiliation(s)
- Benedicta K Atsu
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Chris Guure
- Department of Biostastics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Amos K Laar
- Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
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Cruz LMG, Azpeitia GG, Súarez DR, Rodríguez AS, Ferrer JFL, Serra-Majem L. Factors Associated with Stunting among Children Aged 0 to 59 Months from the Central Region of Mozambique. Nutrients 2017; 9:E491. [PMID: 28498315 PMCID: PMC5452221 DOI: 10.3390/nu9050491] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/02/2017] [Accepted: 05/04/2017] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to identify the major socio-demographic, health, and environmental determinants of stunting among children aged 0-59 months from the Tete province (Mozambique) and offering useful information for future healthcare strategies and interventions. A case-control study was conducted among 282 (162 boys; 120 girls) children under five years of age from the central region of Mozambique between 1 May and 3 June 2014. Children with stunting (HAZ < -2 SD according to the WHO Child Growth Standards in 2006) were considered as cases and those who had a Z-score < -2 SD were considered as controls. We collected data related to mothers and children and their environment, and they were assessed in two groups to find a possible association. The software used for data analysis was the SPSS®(version, 21.0) using descriptive statistics, t-test, ANOVA, chi-square analyses, bivariate comparisons, and stepwise multiple logistic regression analysis. The results showed that birth weight, mother's educational status, maternal occupation, living in a rural area, family size, number of children under five years of age in the household, cooking with charcoal, inhabiting wooden or straw housing or housing without proper floors, overall duration of breastfeeding as well as duration of exclusive breastfeeding, and time of initiation of complementary feeding were significantly related to stunting. Thus, appropriate nutritional intervention programmes considering these determinants and the dissemination of knowledge at the population level related to undernutrition are necessary to ameliorate the children´s nutritional status.
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Affiliation(s)
- Loida M García Cruz
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
- Clinical Genetics Unit, Complejo Hospitalario Insular-Materno Infantil, 35016 Las Palmas de Gran Canaria, Spain.
| | - Gloria González Azpeitia
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
| | - Desiderio Reyes Súarez
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
| | - Alfredo Santana Rodríguez
- Clinical Genetics Unit, Complejo Hospitalario Insular-Materno Infantil, 35016 Las Palmas de Gran Canaria, Spain.
| | - Juan Francisco Loro Ferrer
- Department of Clinical Sciences, University of Las Palmas de Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain.
| | - Lluis Serra-Majem
- Ciber OBN (CB06/03), Instituto Carlos III, Spanish Government, 28029 Madrid, Spain.
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria/Nutrition Without Borders, 35016 Las Palmas de Gran Canaria, Spain.
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15
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Motbainor A, Worku A, Kumie A. Stunting Is Associated with Food Diversity while Wasting with Food Insecurity among Underfive Children in East and West Gojjam Zones of Amhara Region, Ethiopia. PLoS One 2015; 10:e0133542. [PMID: 26285047 PMCID: PMC4540277 DOI: 10.1371/journal.pone.0133542] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 06/29/2015] [Indexed: 11/20/2022] Open
Abstract
Background Food insecurity has detrimental effects in protecting child undernutrition.This study sought to determine the level of child undernutrition and its association with food insecurity. Methods A community based comparative cross-sectional study design involving multistage sampling technique was implemented from 24th of May to 20th of July 2013. Using two population proportion formula, a total of 4110 randomly selected households were included in the study. Availability of the productive safety net programme was used for grouping the study areas. A multiple linear regression model was used to assess the association between food insecurity and child malnutrition. Clustering effects of localities were controlled during analysis. Results Stunting (37.5%), underweight (22.0%) and wasting (17.1%) were observed in East Gojjam zone, while 38.3% stunting, 22.5% underweight, and 18.6% wasting for the West Gojjam zone. Food insecurity was significantly associated with wasting (β = - 0.108, P < 0.05).Food diversity and number of meals the child ate per day significantly associated with stunting (β = 0.039, P < 0.01) and underweight (β = 0.035, P < 0.05) respectively. Residential area was the significant predictor of all indices. Conclusion The magnitude of child undernutrition was found to be very high in the study areas. Food insecurity was the significant determinant of wasting. Food diversity and number of meals the child ate per day were the significant determinants of stunting and underweight respectively. Child nutrition intervention strategies should take into account food security, dietary diversity, and carefully specified with regard to residential locations. Addressing food insecurity is of paramount importance.
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Affiliation(s)
- Achenef Motbainor
- School of Public Health College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Alemayehu Worku
- School of Public Health College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abera Kumie
- School of Public Health College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Fa JE, Olivero J, Real R, Farfán MA, Márquez AL, Vargas JM, Ziegler S, Wegmann M, Brown D, Margetts B, Nasi R. Disentangling the relative effects of bushmeat availability on human nutrition in central Africa. Sci Rep 2015; 5:8168. [PMID: 25639588 PMCID: PMC4313087 DOI: 10.1038/srep08168] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/08/2015] [Indexed: 11/16/2022] Open
Abstract
We studied links between human malnutrition and wild meat availability within the Rainforest Biotic Zone in central Africa. We distinguished two distinct hunted mammalian diversity distributions, one in the rainforest areas (Deep Rainforest Diversity, DRD) containing taxa of lower hunting sustainability, the other in the northern rainforest-savanna mosaic, with species of greater hunting potential (Marginal Rainforest Diversity, MRD). Wild meat availability, assessed by standing crop mammalian biomass, was greater in MRD than in DRD areas. Predicted bushmeat extraction was also higher in MRD areas. Despite this, stunting of children, a measure of human malnutrition, was greater in MRD areas. Structural equation modeling identified that, in MRD areas, mammal diversity fell away from urban areas, but proximity to these positively influenced higher stunting incidence. In DRD areas, remoteness and distance from dense human settlements and infrastructures explained lower stunting levels. Moreover, stunting was higher away from protected areas. Our results suggest that in MRD areas, forest wildlife rational use for better human nutrition is possible. By contrast, the relatively low human populations in DRD areas currently offer abundant opportunities for the continued protection of more vulnerable mammals and allow dietary needs of local populations to be met.
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Affiliation(s)
- John E Fa
- ICCS, Division of Biology, Imperial College London, Ascot SL5 7PY, UK
| | - Jesús Olivero
- Grupo de Biogeografía, Diversidad y Conservación, Universidad de Málaga, 29071 Málaga, Spain
| | - Raimundo Real
- Grupo de Biogeografía, Diversidad y Conservación, Universidad de Málaga, 29071 Málaga, Spain
| | - Miguel A Farfán
- Grupo de Biogeografía, Diversidad y Conservación, Universidad de Málaga, 29071 Málaga, Spain
| | - Ana L Márquez
- Grupo de Biogeografía, Diversidad y Conservación, Universidad de Málaga, 29071 Málaga, Spain
| | - J Mario Vargas
- Grupo de Biogeografía, Diversidad y Conservación, Universidad de Málaga, 29071 Málaga, Spain
| | - Stefan Ziegler
- WWF Germany, 10117 Berlin, Germany and Department of Ecology and Evolution, University Frankfurt, 60438 Frankfurt on Main, Germany
| | - Martin Wegmann
- DLR Berlin, German Aerospace Center (DLR), 82234 Wessling, Germany, and Department of Remote Sensing, Department of Geography and Geology, University of Würzburg, 97074 Würzburg, Germany
| | - David Brown
- School of Anthropology and Museum Ethnography, University of Oxford, 51/53 Banbury Road, Oxford OX2 6PE, UK
| | - Barrie Margetts
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Robert Nasi
- Consultative Group on International Agricultural Research (CGIAR), CIFOR Headquarters, Bogor 16115, Indonesia
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