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Grieve E, Mamun AA, de Roos B, Barman BK, Ara G, Roos N, Pounds A, Sneddon AA, Murray F, Ahmed T, Little DC. Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric. BMC Public Health 2023; 23:405. [PMID: 36855076 PMCID: PMC9972605 DOI: 10.1186/s12889-023-15175-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/31/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND This study developed and validated an integrated metric that enhances understanding of linkages between agro-ecological and socio-economic factors that are important for explaining nutritional wellbeing in relation to fish consumption; especially among adolescent girls who are at risk of nutritional deficiency in Bangladesh. Currently, there is no metric that takes account of environmental, cultural and economic contexts when considering fish consumption and dietary health from a policy perspective. METHODS The study was designed as a bi-seasonal survey, repeated in the same population of adolescent girls recruited during the dry and wet seasons. Sampling was stratified by five settings (four aqua-agroecological zones and one processing plant community), with 60 girls recruited in each. Associations between candidate predictors (salinity, diet diversity, religion, socio-economic status and women's autonomy score) and dependent variables representing nutritional outcomes (anthropometry, omega-3 index and micronutrient levels) were explored in multivariable regressions. The fitted model with its predictors was validated, and a risk score derived from responses to a few short questions on religion, salinity zone, female autonomy, diet diversity and tilapia consumption. RESULTS The omega-3 index showed the clearest distinction between seasons, by salinity and religion. Higher female autonomy, religion (being Hindu rather than Muslim), geographical location (living in a high or mid-saline area), and a higher dietary diversity were the strongest predictors of whole blood omega-3 index. The c-index for the prognostic model was 0.83 and 0.76 in the wet and dry season respectively, indicating good predictive accuracy. There appeared to be a clear trend in risk scores differentiating between those 'chronically at risk' and those 'never at risk'. CONCLUSIONS Observational data on different aquaculture-ecozones defined by salinity enabled us to establish linkages between seasonal fish intake, religion, diet diversity, female autonomy and nutritional wellbeing. The purpose of the metric is to reveal these specific linkages in practice. This tool should improve targeting of timely, preventative and cost-effective nutritional interventions to adolescent girls most at-risk from low omega-3 levels in communities where seafood is produced.
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Affiliation(s)
- Eleanor Grieve
- 1 Lilybank Gardens, Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8RZ, UK.
| | - Abdullah-Al Mamun
- Department of Fisheries and Marine Science, Noakhali Science and Technology University, University Road, Noakhali, 3814, Bangladesh
| | - Baukje de Roos
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen, AB25 2ZD, UK
| | - Benoy K Barman
- WorldFish, Bangladesh and South Asia, House 355/A Rd 114, Dhaka, 1212, Bangladesh
| | - Gulshan Ara
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka, 1000, Bangladesh
| | - Nanna Roos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen, Denmark
| | - Alexandra Pounds
- Institute of Aquaculture, University of Stirling, Stirling, FK9 4LA, UK
| | - Alan A Sneddon
- The Rowett Institute, University of Aberdeen, Ashgrove Road W, Aberdeen, AB25 2ZD, UK
| | - Francis Murray
- Institute of Aquaculture, University of Stirling, Stirling, FK9 4LA, UK
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka, 1000, Bangladesh
| | - David C Little
- Institute of Aquaculture, University of Stirling, Stirling, FK9 4LA, UK
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Singh P, Das A, William J, Bruckner T. Fertility, economic development, and suicides among women in India. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1751-1759. [PMID: 33721038 DOI: 10.1007/s00127-021-02054-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/24/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Indian states at greater levels of economic development report more suicides. This relation appears stronger among women relative to men. We test the hypothesis, suggested in the literature, that conflict between rapid economic growth and inadequate female autonomy (approximated using total fertility rate) varies positively with female suicides. METHODS We used state-level data on female suicides for all 35 Indian states and union territories, from 2001 to 2011, from the National Crime Records Bureau. We specified, as our outcome, age-adjusted female suicides per 100,000 population per state-year. We retrieved data on key covariates, namely, gross state domestic product (GSDP) per capita, total fertility rate (TFR), and other control variables from multiple national surveys and publicly available data sources. We examined whether and to what extent age-adjusted female suicides (per 100,000 population) correspond with total fertility rate (lower TFR indicates greater female autonomy and vice versa) within the context of greater economic development (GSDP per capita). Linear longitudinal mixed effect regressions controlled for state-specific random intercepts, son preference (male:female sex ratio at birth), literacy gap (percentage difference between literate males and females), access to health systems (institutional deliveries), female to male employment ratio, and linear time trends. RESULTS At constant levels of GSDP per capita, a one unit decline in TFR corresponds with 0.27 fewer female suicides per 100,000 population (P value = 0.008). Sensitivity tests indicate that this relation does not hold for male age-adjusted suicides (per 100,000 population). CONCLUSION Our findings, if replicated, indicate that at constant levels of economic development, lower TFR (indicating greater female autonomy) may reduce suicide risk among women.
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Affiliation(s)
- Parvati Singh
- Program in Public Health, University of California, 653 E. Peltason Drive, Irvine, CA, 92617, USA.
| | - Abhery Das
- Program in Public Health, University of California, 653 E. Peltason Drive, Irvine, CA, 92617, USA
| | - Jenesca William
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Tim Bruckner
- Program in Public Health, University of California, 653 E. Peltason Drive, Irvine, CA, 92617, USA.,Center for Population, Inequality, and Policy (CPIP), University of California, Irvine, USA
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Abstract
Literature identified female empowerment as a predictor of positive health behaviour. However, in the context of conservative and traditional society, this is yet to be explored. This paper explores the role of female autonomy in contraceptive use among currently married women in northern Nigeria. Nationally representative Nigeria Demographic and Health Survey (NDHS, 2013) data for 18,534 currently married women in northern Nigeria was analysed. Complimentary log-logistic regression (cloglog) was used to analyse the data. Current use of modern contraceptive was 6.6% among currently married women in northern Nigeria. Results show that female autonomy was significantly associated with modern contraceptive use. Respondents' education, wealth status and desire for no more children were associated with higher contraceptive use. Despite the conservative and religious context of northern Nigeria, female autonomy significantly predicts modern contraceptive use. Thus, empowering women in northern Nigeria, especially by education, will enable them to participate in healthy contraceptive decision making.
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Affiliation(s)
- Olatunji Alabi
- Demography and Social Statistics, Federal University, Birnin Kebbi, Kebbi State, Nigeria.,Demography and Population Studies Program, School of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Clifford O Odimegwu
- Demography and Population Studies Program, School of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole De-Wet
- Demography and Population Studies Program, School of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joshua O Akinyemi
- Demography and Population Studies Program, School of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria
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Shenton LM, Wagner AL, Carlson BF, Mubarak MY, Boulton ML. Vaccination status of children aged 1-4 years in Afghanistan and associated factors, 2015. Vaccine 2018; 36:5141-5149. [PMID: 30026033 DOI: 10.1016/j.vaccine.2018.07.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Childhood mortality in Afghanistan fell by half between 1990 and 2015, due in part to the government's commitment to improving pediatric immunization services. Although progress has been made, immunization coverage has nonetheless remained low with only 65% of children receiving the third dose of Diphtheria-Pertussis-Tetanus (DPT3) based on WHO estimates. This study aims to calculate the proportion of Afghan children aged 1-4 years who were fully vaccinated, under-vaccinated, or non-vaccinated with government-recommended Expanded Program on Immunization vaccines and identify predictors related to the family's sociodemographic status and maternal autonomy. METHODS Data from the 2015 Afghanistan Demographic and Health Survey was used to calculate the proportion of children who were fully vaccinated (i.e. received all recommended vaccines), under-vaccinated (i.e. received some, but not all), and non-vaccinated (i.e. did not receive any vaccines) according to WHO guidelines. A multivariable multinomial logistic regression model generated odds ratios for under-vaccination and non-vaccination versus full vaccination, and examined associations between independent factors and full vaccination status. RESULTS We found 40.6% of Afghan children age 1-4 were fully vaccinated, 42.4% under-vaccinated, and 17% non-vaccinated. Large disparities characterized immunization coverage among provinces and between urban and rural regions. Birthing in a government institution (vs. non-institutional setting), a higher number of antenatal care visits, and a visit to a health facility in the past 12 months were all associated with increased odds of full immunization. Factors related to maternal autonomy including maternal decision-making and maternal attitudes towards beating were also significantly associated with vaccination status. CONCLUSION Approximately 60% of children in Afghanistan are under-vaccinated or non-vaccinated, leaving millions of children unnecessarily at risk for vaccine-preventable diseases. Engagement with community and religious leaders to create programs that increase women's autonomy and expand access to institutional delivery could lead to downstream increases in childhood vaccination coverage.
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Affiliation(s)
- Luke M Shenton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Abram L Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Bradley F Carlson
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Mohammad Yousuf Mubarak
- Department of Microbiology, Kabul University of Medical Science, Jamal Mina, 3rd District, Next to Ali Abad Teaching Hospital, Kabul, Afghanistan
| | - Matthew L Boulton
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA; Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
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