Childhood growth and education migration among ethnic Tibetan children from Nepal.

Abstract

Ethnographic work among high altitude populations has shown that children are highly mobile-the most recent expression of this is the educational migration of children born at high altitude to boarding schools at lower altitudes. The impact of these patterns of migration on size for age are unknown. We investigated the association between growth in weight and height and educational migration in ethnic Tibetan children living in and out of their natal communities. Five hundred and fifty eight children ages three to sixteen from the Nubri Valley, Nepal participated in this study. Three hundred children were living in natal villages and 258 were attending boarding schools in Kathmandu. Height, weight, and skinfold thicknesses were collected and matched to demographic data from the community. There was no association between altitude of family residence and size for age z-scores. Males had lower z-scores than females; z-scores for both groups declined with age. Differences in size for age among children in boarding schools were associated with two factors: sex and type of boarding school (individual sponsor or group funded). Individuals attending individually sponsored schools had greater size for age compared to children in group funded schools or in their natal villages; younger children in collectively funded schools were smaller than village peers. Despite popular perceptions, educational outmigration in Himalayan communities may not be associated with improved child growth outcomes and investment in community level schools may be a practical solution for improving child growth and physical and mental health.