Composite Index of Anthropometric Failure (CIAF) among Sonowal Kachari tribal preschool children of flood effected region of Assam, India

Mapping stunted children in Ethiopia using two decades of data between 2000 and 2019. A geospatial analysis through the Bayesian approach

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.

Anthropometric failures and its associated factors among preschool-aged children in a rural community in southwest Ethiopia

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.

Socio-economic inequality in anthropometric failure among children aged under 5 years in India: evidence from the Comprehensive National Nutrition Survey 2016-18

BACKGROUND

Conventional indicators used to access the nutritional status of children tend to underestimate the overall undernutrition in the presence of multiple anthropometric failures. Further, factors contributing to the rich-poor gap in the composite index of anthropometric failure (CIAF) have not been explored. This study aims to estimate the prevalence of CIAF and quantify the contribution of factors that explain the rich-poor gap in CIAF.

METHODS

The present study used data of 38,060 children under the age of five years and their biological mothers, drawn from the nationally representative Comprehensive National Nutrition Survey of children and adolescents aged 0-19 years in India. The CIAF outcome variable in this study provide an overall prevalence of undernutrition, with six mutually exclusive anthropometric measurements of height-for-age, height-for-weight, and weight-for-age, calculated using the World Health Organization (WHO) Multicenter Growth Reference Study. Multivariate regression and decomposition analysis were used to examine the association between covariates with CIAF and to estimate the contribution of different covariates in the existing rich-poor gap.

RESULTS

An overall CIAF prevalence of 48.2% among children aged aged under 5 years of age was found in this study. 6.0% children had all three forms of anthropometric failures. The odds of CIAF were more likely among children belonging to poorest households (AOR: 2.41, 95% CI: 2.12-2.75) and those residing in urban area (AOR: 1.06, 95% CI 1.00-1.11). Children of underweight mothers and those with high parity were at higher risk of CIAF (AOR: 1.51, 95% CI: 1.42-1.61) and (AOR: 1.15, 95% CI: 1.08-1.22), respectively. Children of mother exposed to mass media were at lower risk of CIAF (AOR: 0.87, 95% CI: 0.81-0.93).

CONCLUSION

This study estimated a composite index to assess the overall anthropometric failure, which also provides a broader understanding of the extent and pattern of undernutrition among children. Findings show that maternal covariates contribute the most to the rich-poor gap. As well, the findings suggest that intervention programs with a targeted approach are crucial to reach the most vulnerable groups and to reduce the overall burden of undernutrition.

Determinants of Anthropometric Failure Among Tribal Children Younger than 5 Years of Age in Palghar, Maharashtra, India

BACKGROUND

Measuring undernutrition using composite index of anthropometric failure (CIAF) and identifying its determinants in tribal regions is essential to recognize the true burden of undernutrition in these settings.

OBJECTIVE

To determine anthropometric failure and its determinants among tribal children younger than 5 years in Palghar, Maharashtra, India.

METHODS

A cross-sectional survey employing CIAF was performed in children <5 years to estimate undernutrition in the tribal district of Palghar in Maharashtra, India. Anthropometric measurements, maternal and child characteristics were recorded from 577 mother-child pairs in 9 villages.

RESULTS

As per Z score, prevalence of stunting, wasting, and underweight were 48%, 13%, and 43%, respectively. According to CIAF, 66% of children had at least one manifestation of undernutrition and 40% had more than one manifestation of undernutrition. Odds of anthropometric failure were 1.5 times higher among children of mothers who were illiterate (adjusted odds ratio [AOR] =1.57, 95% CI: 1.0-2.3), children who had birth weight >2.5 kg had lesser odds (AOR: 0.63, 95% CI: 0.4-0.9) of anthropometric failure, and children who had initiated early breastfeeding had 1.5 times higher odds of anthropometric failure (crude odds ratio: 1.5, 95% CI: 1.0-2.1). However, when adjusted for other independent variables, the results were not significant.

CONCLUSION

The alarming proportion of anthropometric failure among tribal children calls for urgent short-term interventions to correct undernutrition and long-term interventions to improve maternal literacy and awareness to prevent and manage child undernutrition.