Abstract
BackgroundMaternal nutrition is closely linked to the survival and development of children during the first 1000 days of life. Maternal wasting, a measure of malnutrition, is measured using the mid-upper arm circumference. However, in 2019, the rate and distribution of wasting among pregnant and lactating women was not known. We described annual trends and distribution of wasting among pregnant and lactating women (PLW), Uganda, 2015–2018, to inform programming on targeted nutritional interventions.MethodsWe analyzed nutrition surveillance data from the District Health Information System for all PLW from 2015 to 2018. We used the World Health Organization standard thresholds to determine wasting among PLW by year and region, drawing choropleth maps to demonstrate the geographic distribution of wasting among PLW. We used logistic regression to assess wasting trends.ResultsDuring 2015–2018, 268,636 PLW were wasted (prevalence = 5.5%). Of the 15 regions of Uganda, Karamoja (prevalence = 21%) and Lango (prevalence = 17%) registered the highest prevalence while Toro (prevalence = 2.7%) and Kigezi (prevalence = 2.0%) registered the lowest prevalence. The national annual prevalence of wasting among PLW declined by 31% from 2015 to 2018 (OR = 0.69, p < 0.001). Regions in the north had increasing trends of wasting over the period [Lango (OR = 1.6, p < 0.001) and Acholi (OR = 1.2, p < 0.001)], as did regions in the east [(Bugisu (OR = 3.4, p < 0.001), Bukedi (OR = 1.4, p < 0.001), and Busoga (OR = 1.3, p < 0.001)]. The other 11 regions showed declines.ConclusionThe trend of wasting among PLW nationally declined during the study period. Lango and Acholi regions, both of which were experiencing a nutrition state of emergency during this period, had both high and rising rates of wasting, as did the Karamoja region, which experienced the highest wasting rates. We recommended that the Ministry of Health increases its focus on nutrition monitoring for PLW and conduct an analysis to clearly identify the factors underlying malnutrition specific for PLW in these regions.
Highlights
Maternal nutrition is closely linked to the survival and development of children during the first 1000 days of life
Our study focused on wasting because it accounts for higher proportions of intrauterine growth retardation (IUGR) and impaired fetal development, which carry lifelong adverse effects in children [5, 20]
Prevalence of wasting among pregnant and lactating women, overall and by region, Uganda, 2015–2018 Of the 4,848,873 pregnant and lactating women assessed for wasting over the study period, 268,636 (5.5%) were wasted
Summary
Maternal nutrition is closely linked to the survival and development of children during the first 1000 days of life. In 2019, the rate and distribution of wasting among pregnant and lactating women was not known. We described annual trends and distribution of wasting among pregnant and lactating women (PLW), Uganda, 2015– 2018, to inform programming on targeted nutritional interventions. Malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients. It includes both undernutrition, which covers stunting, wasting, and micronutrient deficiencies, and overnutrition [1]. Adequate nutrition is crucial for the survival, health, and development of mothers and their children [4, 5]. Because of this, ending malnutrition among pregnant and lactating women is a critical factor in breaking the cycle of malnutrition in the population
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