Child Malnutrition Rates Research Articles

Severe acute malnutrition among children under the age of 5 years.

Severe acute malnutrition (SAM) poses a significant threat to child health globally, particularly in low- and middle-income countries. Zambia, like many Sub-Saharan African nations, faces high rates of child malnutrition, with SAM contributing significantly to under-five mortality. Therefore, this study aimed to determine the prevalence and factors associated with SAM. This retrospective cross-sectional study was conducted at Livingstone University Teaching Hospital in Zambia (LUTH). SAM was defined according to the World Health Organization (WHO) criteria as either weight-for-height less than -3 standard deviations, mid-upper arm circumference (MUAC) less than 115 mm, or presence of bilateral pitting edema in children between 6 months and 5 years old who were attended to between 2020 and 2022. Data abstraction from pediatric patient records was conducted between August 2023 and January 2024. The records without the age and outcome variable were excluded. A total of 429 participants between 6 months and 5 years old were included, with demographic, clinical, and hematological parameters analyzed. Univariable and multivariable logistic regression were employed to investigate factors associated with SAM. Overall, 429 medical records were included in the study and the prevalence of SAM was 27.0% (n = 116). Age group 6-24 months (Adjusted Odds Ratio [AOR]: 11.60; 95% Confidence Interval [CI]: 3.34-40.89, p<0.001), living with HIV (AOR:3.90; 95% CI: 1.14-13.70, p = 0.034), Tuberculosis (TB) (AOR:22.30, 95% CI: 4.53, 110.3, p < 0.001), comorbidities (AOR: 2.50; 95% CI 1.13, 5.88, p = 0.024) and platelet count (AOR: 1.00; 95% CI 1.00, 1.00, p = 0.027) were positively associated with SAM. This study found a high prevalence of SAM, exceeding the WHO target of reducing SAM to 5% by 2025. SAM was associated with younger age (6-24 months), HIV infection, TB, comorbidities and platelet count. Therefore, there is need to enhance strategies aimed at reducing SAM among young children, children living with HIV, TB and comorbidities, particularly by intensive treatment, continuing and strengthening nutrition services.

Evaluating the Role of Households' Food Security Status and Socioeconomic Determinants on Child Mortality in Nigeria

When addressing global development, it is imperative to recognize the relationship between food security and child mortality. Despite the targeted goals of SDGs 2 (zero hunger) and 3 (good health and well-being), Nigeria continues to grapple with relatively high rates of child malnutrition, alongside persistent challenges in child mortality and food insecurity that affect its population significantly. This study employed the Nigeria Living Standard Survey (NLSS) dataset with 11,655 households to estimate the impact of food (in)security on child mortality using the Propensity Score Matching (PSM). The study shows that food insecurity is predominant in the rural northern and urban southern part of Nigeria. Child mortality rates were found to be influenced by various factors such as maternal education, maternal age, geopolitical zones, place of residence, and access to healthcare facilities, showcasing a complex interplay of positive and negative impacts. The empirical estimates revealed that households’ food insecurity had a significant impact on child mortality in Nigeria. Hence, in order to achieve the SDG’s 2 and 3 in Nigeria, a more concerted effort should be geared towards food security and child mortality among the Nigerian rural and urban communities. The insights from this study underscore the importance of prioritizing interventions that drives food security, enhancing nutritional access, and tackling underlying social determinants to substantially reduce child mortality rates. It is imperative for policymakers, healthcare professionals, and communities to integrate complementarity approaches in developing sustainable solutions that safeguard the well-being and prospects of Nigeria's children.

Policy on healthy practices to improve the nutritional status of children under 5 years of age

In the jungle region of Peru, child malnutrition rates are still high, which is reflected in the lack of comprehensive policies that promote healthy feeding practices for children under 5 years of age. Therefore, there is little implementation of regional strategies to address nutritional problems in the child population. The objective was to evaluate the reality of a policy based on healthy practices to improve the nutritional status of children under 5 years of age in the region. The type of research was basic, the design was based on a systematic review based on previous studies, evaluations and data collected in the San Martín region. The population and sample were mothers of children under 5 years of age residing in the San Martín region, whose nutritional and feeding data were collected in studies and official records. A systematic review methodology was used to analyze the effectiveness of the regional policy on healthy practices. The instruments included databases, health records and evaluations of implemented programs. This review article examines the strategies, programs and outcomes of regional policy in order to evaluate their effectiveness in addressing malnutrition and improving the quality of life of children in this geographic area. Results, the healthy practices policy demonstrated a significant improvement in the nutritional status of children under 5 years of age in the San Martín region. A reduction in malnutrition rates and an increase in the adoption of healthier eating habits was observed. In conclusion, based on the articles reviewed, the implementation of a policy focused on healthy practices is successful in improving the nutritional status of children under 5 years of age in the San Martín region. Additionally, the importance of continuing to promote evidence-based interventions to address childhood malnutrition and promote appropriate eating habits from an early age is highlighted.

Effect of Low Protein Diet on Bone Structure of Young Wistar Mice.

&lt;b&gt;Background and Objective:&lt;/b&gt; Malnutrition and stunting are major unresolved problems in Indonesia. Protein deficiency can cause stunted growth, as well as make physical and cognitive abilities cannot reach their maximum potential. During childhood the need for protein must be fulfilled so that the peak of bone formation during adolescence can be perfect. In malnourished children, a low protein diet will lead to thinning of the bone cortex. Due to the high rate of stunting and malnutrition in children due to protein deficiency, a study was conducted on the effects of feeding low protein diet on rat bones. &lt;b&gt;Materials and Methods:&lt;/b&gt; Male Wistar rats (n = 10) at 6-8 weeks old (body weight around 250 g), control groups were fed a normal chow diet and low protein diet groups were given low protein chow diet (protein 5%) for 18 weeks, then the rats were sacrificed and the femoral bones were isolated. Body weight, femur weight, femur length were checked and bone density was examined using X-ray. &lt;b&gt;Results:&lt;/b&gt; The body proportions of the low protein group rats were smaller and thinner than those of the control group. This difference is supported by the significant weight loss starting from the sixth week after low protein feeding. There are significant differences in body weight and femur weight between the control and low protein diet groups. Bone density decreases significantly in low protein diet group. Macroscopically, the femur length of the low protein group was shorter than the control group, however the femur length did not show significant differences statistically between the two groups. &lt;b&gt;Conclusion:&lt;/b&gt; A low protein diet decreased the body weight of the rats, also causing impaired bone growth characterized by decreasing femur weight. The low protein diet also caused osteoporosis in the bones.

Strategies for Sustained Empowerment of Community Health Workers: A Qualitative Analysis of the Comprehensive Rural Health Project in Jamkhed, India.

To understand the core aspects of an empowerment-based Community Health Worker (CHW) training program, we studied the model of the Comprehensive Rural Health Project (CRHP) in Jamkhed, India-an organization known for facilitating empowerment of women as Village Health Workers (VHWs) and agents of community change. We define empowerment as a means by which individuals gain health and development-related skills and knowledge to facilitate positive change within their lives and communities. Using VHW training observations and semi-structured interviews with health workers and senior trainers, 6 themes were developed and applied in 4 focus group sessions with 18 multigenerational VHWs trained by the CRHP. Transcripts were qualitatively analyzed under 6 themes-selection, baseline training, continuing education and support, community participation, community empowerment, and commitment and longevity. Empowerment of VHWs was found to be an intentional process involving the creation of safe and supportive environments conducive to long-term participatory and experiential learning with professionals who facilitate and mentor. The impact of the baseline training is maintained through ongoing program-VHW interactions and knowledge reinforcement in both the field and training center. Importantly, these interactions reinforce VHWs' credibility and confidence in communities served. Community participation was found to be of key importance starting at the selection phase. The methods used for selection, training and ongoing support are critical to developing a cadre of competent, effective and motivated VHWs as well as fostering long-lasting self-development and leadership skills. Downstream effectiveness of community empowerment on health outcomes is demonstrated through indicators such as access to safe deliveries, declining child malnutrition rates, high vaccination rates as well as reductions in stigmatization of illness and caste discrimination.

The Effect of Ecological Management on Regional Health Inequality.

Ecological management has been implemented to improve individual well-being. However, it remains unclear whether this management has improved health inequality over time. Aiming to examine whether health inequality is caused by ecological management in China, we harnessed a macro-level dataset from 2001 to 2019 across 31 Chinese provinces-combined with gene and dietary culture data-and utilized a bilateral approach to pair provincial data. Empirical results of system Generalized Method of Moments (sys-GMM) estimations in benchmark and extensive models which suggest a negative and statistically significant causal effect of ecological management on health inequality. Specifically, ecological management contributes to decreasing the inequality in the population death rate, the death rate among pregnant women, the underweight newborn rate, the child malnutrition rate, and the infectious disease mortality. The results are robust to weak instruments in the sys-GMM setting and a delayed effect of ecological management. Additionally, the heterogeneity analysis shows that the causal effect of ecological management on decreasing regional health inequality is more significant and higher for subsamples in identical regions than in different regions.

Health cadres empowerment program through smartphone application-based educational videos to promote child growth and development.

Indonesia's health care system relies on non-health professionals called cadres to operate child health promotion programs in the Public Health Center (Puskesmas). Despite this effort, the child malnutrition rate remains high. This study aimed to identify and develop health promotion media that can assist health cadres in promoting child health. This study was divided into three-phase. The first phase was the need assessment using focus group discussion and knowledge, attitude, and practice (KAP); the second phase is video development, which involves medical students, general practitioners, pediatricians, and health promotion experts; and the third phase was video viewing by cadres and post-viewing tests for health cadres. A comparison of pre-test and post-test participants' total scores was performed with the student's T-test. Need assessment showed that the knowledge of the cadres needs improvement and there was a need for proper educational media material that can be used by the Puskesmas. Five videos were produced, four videos were about children's nutritional intake recommendations during four different age groups and one video was about the information and invitation to come to Integrated Health Service Post (Posyandu). There was a significant improvement from pre-test total scores to post-test total scores (p < 0.001). Smartphone application-based educational videos are effective and reliable child health promotion media for Puskesmas staff and parents.

A LOGISTIC REGRESSION ANALYSIS OF DETERMINANTS OF CHILD MALNUTRITION IN UTTAR PRADESH, INDIA

This paper examines the effects of socio-economic determinants on child malnutrition in Uttar Pradesh- the most populous and malnourished state of India. Using data from NFHS-4, this study highlights district-wide variations in nutritional status of children less than five years in the state. The percentage of stunted, wasted, and underweight have been taken as dependent variables, while main explanatory variables of child malnutrition were female education, maternal malnutrition (BMI), breastfeeding practices, children's place of residence, father’s education, wealth index of household, family planning, sex of the child, sex of the household and age cohort of mother. Logistic regression models have been applied in order to observe the association between explanatory variables and malnutrition. The findings revealed a high incidence of less stunted, wasted, and underweight infants in case of an educated parents, particularly educational level of mother. Wealth index representing the possession of assets by the household found to be an important indicator in the sense that children born to households with richer and richest quintiles showing better-nourished children aged under-5. The modern method of using contraceptive, breastfeeding practices, maternal malnutrition were also important indicators influencing the rate of malnutrition in children. The study suggested that imparting education to females, breastfeeding practices, economic status, and contraceptive use can play an important role in reducing nutritional status of children. &nbsp;

Fish and complementary feeding practices for young children: Qualitative research findings from coastal Kenya.

This study examines barriers to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. Study findings indicate that young child fish consumption is impacted by factors related to accessibility, food preferences, and caregiver’s knowledge and beliefs about fish during the complementary feeding period. These factors are influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings are impacted by underlying cultural norms, potentially limiting fish consumption. To our knowledge, this is the first study conducted in the coastal region of Kenya to focus on understanding fish consumption attitudes and beliefs during the complementary feeding phase. Our findings represent a critical first step towards the creation of more effective policies and interventions to address the significant nutritional disparities that exist in the study population.

Determinants of malnutrition of under-five children among rural households in the southwest, Nigeria

Malnutrition has been attributed to many deaths among under-five children in most of the developing countries including Nigeria. Understanding the determinants of malnutrition can provide insights in designing interventions for reducing the high rates of child malnutrition. This study focused on what determines the malnutrition of under-five children among rural households in the southwest, Nigeria. A multistage sampling technique was employed to select 395 households that had 487 under-five children. Data were collected on child’s, mother’s, household’s and community characteristics using a pre-tested structured questionnaire. Information on the child’s nutrition status was obtained using Mid Upper Arm Circumference (MUAC) tape. The data were analyzed using descriptive statistics and logit model with STATA 14 statistical package. The results revealed that the average age of under-five children was about 25 months and over 50% of them are girls with a malnutrition rate of 44.0%. The child’s sex, the child’s birth interval, cultivated farm size, mother’s education, water source, and distance to nearest health center significantly determined the child’s malnutrition in rural areas of southwest Nigeria. Given the findings of this research, it is suggested that; mothers should be advised to use contraceptives for child spacing; farmers should be enlightened on the need to implement modern farming practices that lead to optimum yield per land cultivated rather than increasing the size of cultivated farmland; there should be an improvement on women’s education as well as a potable water source; and health care facilities close to respondents’ residence should be provided.

Association of malnutrition with renal function in children with kidney disease

Background: Malnutrition is a serious and lasting burden worldwide. Woman, infants, children, and adolescents are at particular risk of malnutrition. Prevalence of malnutrition children under 5 years in 2020 was 45 million were estimated to be wasted, and 38.9 million were overweight or obese. Around 45% of deaths among children under 5 years old were related to undernutrition, especially in low- and middle-income countries. Children with kidney disease was a risk factor to become a malnutrition. Malnutrition increases morbidity and mortality in children with kidney disease. Earlier studies showed a high prevalence rate of malnutrition in children with chronic kidney disease. Objectives: The aim of the study to associate malnutrition with renal function in children with kidney disease. Methods: A cross-sectional study was conducted on children with kidney disease aged 2-17 years who met the inclusion criteria who were hospitalized at the Inpatient Department/SMF Department of Child Health Sciences, Dr. Hospital. Soetomo, Surabaya from October to December 2020 after taking approval from parents and institutional ethics committee in the department of Pediatrics. Detailed anthropometric measurements were taken and grading of malnutrition was calculated according to WHO, CDC, and Waterlow criteria. Serum creatinine was measured for each sample. Results: There were 157 samples met the inclusion criteria. Sex between male and female almost balanced (54.8%:45.2%) and the median age was 13 years-old. The most frequent diagnosis in this group was lupus nephritic (68%). Forty eight percent of total samples were malnutrition, which most of them were moderate malnutrition. Estimated glomerular filtration rate of moderate malnutrition was normal in 12 (23.5%) cases, decreased in 39 (76.5%) cases. A significant statistically was showed between malnutrition with severe estimated glomerular filtration rate (P 0.000) Conclusions: Malnutrition was a common finding in nutritional status of children with kidney disease. There was a correlation between nutritional status and renal function in children with kidney disease.

Midday meals as an early childhood nutrition intervention: evidence from plantation communities in Sri Lanka

BackgroundHigh rates of child malnutrition are a major public health concern in developing countries, particularly among vulnerable communities. Midday meals programs can be effective for combatting childhood malnutrition among older children. However, their use in early childhood is not well documented, particularly within South Asia. Anthropometric measures and other socioeconomic data were collected for children below the age of 5 years living in selected Sri Lankan tea plantations, to assess the effectiveness of midday meals as a nutrition intervention for improving growth among young children.MethodsThe study exploits a natural experiment whereby the provision of the midday meals program is exogenously determined at the plantation level, resulting in comparable treatment and control groups. Longitudinal data was collected on heights and weights of children, between 2013 and 2015. Standardized weight-for-age, height-for-age and weight-for-height, and binary variables for stunting, wasting and underweight are constructed, following WHO guidelines. All modelling uses STATA SE 15. Random-effects regression with instrumental variables is used for modelling standardized growth while random-effects logistic regression is used for the binary outcomes. Robustness analysis involves different estimation methods and subsamples.ResultsThe dataset comprises of longitudinal data from a total of 1279 children across three tea plantations in Sri Lanka, with 799 children in the treatment group and 480 in the control group. Results show significant positive effects of access to the midday meals program, on the growth of children. A child with access to the midday meals intervention reports an average standardized weight-for-age 0.03 (±0.01) and height-for-age 0.05 (±0.01) units higher than a similar child without access to the intervention. Importantly, access to the intervention reduces the likelihood of being underweight by 0.45 and the likelihood of wasting by 0.47. The results are robust to different model specifications and across different subsamples by gender, birthweight and birth-year cohort.ConclusionsMidday meals programs targeting early childhood can be an effective intervention to address high rates of child malnutrition, particularly among vulnerable communities in developing countries like Sri Lanka.

The relative importance of households as a source of variation in child malnutrition: a multilevel analysis in India

BackgroundChild malnutrition remains a major public health issue in India. Along with myriad upstream and social determinants of these adverse outcomes, recent studies have highlighted regional differences in mean child malnutrition rates. This research helps policy makers look between urban and rural communities and states to take a population-level approach to addressing the root causes of child malnutrition. However, one gap in this between-population approach has been the omission of households as a unit of analysis. Households could represent important sources of variation in child malnutrition within communities, districts, and states.MethodsUsing the fourth round of India’s National Family Health Survey from 2015 to 2016, we analyzed four and five-level multilevel models to estimate the proportion of variation in child malnutrition attributable to states, districts, communities, households, and children.ResultsOverall, we found that of the four levels that children were nested in (households, communities, districts, and states), the greatest proportion of variation in child height-for-age Z score, weight-for-age Z score, weight-for-height Z score, hemoglobin, birthweight, stunting, underweight, wasting, anemia, and low birthweight was attributable to households. Furthermore, we found that when the household level is omitted from models, the variance estimates for communities and children are overestimated.ConclusionsThese findings highlight the importance of households as an important source of clustering and variation in child malnutrition outcomes. As such, policies and interventions should address household-level social determinants, such as asset and social deprivations, in order to prevent poor child growth outcomes among the most vulnerable households in India.

The role of complementary feeding in India\u2019s high child malnutrition rates: findings from a comprehensive analysis of NFHS IV (2015\u20132016) data

Relative to its economic growth and poverty levels, Indian children suffer from higher levels of malnutrition than children in many other low- and middle-income countries. Research presented in this article examined the links between infant and young child feeding practices among Indian children and their rates of stunting, underweight, wasting, and anaemia, with a particular focus on the types of semisolid complementary food consumed. It did so through a comprehensive analysis of data on more than 57,000 6-to-23-month-old children obtained from the nationally representative National Family Health Survey IV (2015–2016). One of the key findings was that especially feeding children animal-sourced and vitamin-A-rich food was associated with lower malnutrition rates. The study further interrogated whether livestock ownership and participation in the Integrated Child Development Services programme could be supportive of better complementary child feeding and concluded that daily food receipts from the programme and poultry ownership were indeed linked with significantly higher rates of children following the recommended feeding practices as well as with somewhat lower children’s malnutrition rates.

Fish and Complementary Feeding Practices for Young Children: Qualitative Research Findings From Coastal Kenya

ObjectivesTo assess the potential barriers and facilitators to fish consumption during the complementary feeding period in two coastal counties of Kenya with high rates of child malnutrition. MethodsThis qualitative study was part of a mixed-methods formative research investigation to examine the role of sustainable fish production and access to fish foods in coastal communities in Kenya. Twenty in-depth interviews were conducted with primary caregivers of children less than five years (n = 12) and community health workers and nutritionists (n = 8) in Kilifi County and Kwale County. Interviews were transcribed, translated and analyzed. A conceptual framework was developed based on the analysis to illustrate major factors and pathways influencing decisions to feed fish in the complementary feeding period. ResultsComplementary feeding practices reported by caregivers showed a low level of fish consumption in young children and delayed introduction of fish to the diet. Findings indicate that fish consumption was impacted by factors related to accessibility, food preferences, and caregiver’s knowledge and beliefs. Access to fish was driven primarily by cost, proximity to locations where different fish types were sold, gendered purchasing behavior and the seasonal availability of fish foods. In some cases, the high cost of fish outweighed positive associations or perceived nutritional benefits when deciding whether to feed fish to children. Caregivers’ knowledge, beliefs, and food preferences also impacted consumption, with mixed perceptions regarding the importance of fish as a source of protein and other nutrients. These direct factors were influenced by prominent community figures such as elder women and health workers, whose own beliefs and understandings were impacted by underlying cultural norms, potentially limiting fish consumption. ConclusionsUnderstanding current attitudes and beliefs toward fish consumption during the complementary feeding phase is a critical first step towards the creation of more effective policies and interventions that incorporate sustainable fish foods to address significant nutritional disparities that exist in the study population. Funding SourcesThis study was supported by the United States Agency for International Development (USAID) Feed the Future Innovation Lab for Fish.

Efeitos do ciclone Idai na produção, disponibilidade e acesso aos alimentos no distrito de Sussundenga em Moçambique

O manuscrito versa sobre os efeitos do Ciclone Idai sobre a diversidade dietética, no distrito de Sussundenga em Moçambique. Considerando que tem sido apontado como o celeiro da província, supõe-se que exista diversidade dietética, Questiona-se por que é que há desnutrição infantil quando supostamente existe diversidade de alimentos, e de forma particular, como é que o ciclone Idai pode ter contribuído para o agravamento. Objetivou-se analisar os efeitos do Ciclone na diversidade dietética, com recurso à observação não participante e anotação em diário de campo, Questionário de Diversidade Dietética e um roteiro de entrevistas. Envolveu 131 mães de escolares, quatro líderes comunitários e um representante do setor de Agricultura. Decorreu entre setembro de 2018 e outubro de 2019. Constatou-se que, seus efeitos sobre a produção, disponibilidade e acesso ao alimento, pois as diferenças das médias foram significativas, podendo ter contribuído para a ampliação das dificuldades para uma dieta diversificada, o que pode ter resultado na elevação das taxas de desnutrição infantil. O ciclone afetou a dieta das famílias. É importante que se priorize a agricultura e criação de animais pecuários para o consumo alimentar, melhorando a diversidade de alimentos, em especial a fonte proteica, para a prevenção da desnutrição infantil.

Community-Based Interventions to Reduce Child Stunting in Rural Guatemala: A Quality Improvement Model.

Rural Guatemala has one of the highest rates of chronic child malnutrition (stunting) in the world, with little progress despite considerable efforts to scale up evidence-based nutrition interventions. Recent literature suggests that one factor limiting impact is inadequate supervisory support for frontline workers. Here we describe a community-based quality improvement intervention in a region with a high rate of stunting. The intervention provided audit and feedback support to frontline nutrition workers through electronic worklists, performance dashboards, and one-on-one feedback sessions. We visualized performance indicators and child nutrition outcomes during the improvement intervention using run charts and control charts. In this small community-based sample (125 households at program initiation), over the two-year improvement period, there were marked improvements in the delivery of program components, such as growth monitoring services and micronutrient supplements. The prevalence of child stunting fell from 42.4 to 30.6%, meeting criteria for special cause variation. The mean length/height-for-age Z-score rose from −1.77 to −1.47, also meeting criteria for special cause variation. In conclusion, the addition of structured performance visualization and audit and feedback components to an existing community-based nutrition program improved child health indicators significantly through improving the fidelity of an existing evidence-based nutrition package.

Determinants of Child Malnutrition in Uttar Pradesh

This paper investigates the current state of malnutrition and the possible determinants of child nutrition status at district level children aged less than five years in Uttar Pradesh. Comprehensive nine dimensions including 23 indicators related to various socio-economic characteristics have been examined. The data were accessed from the National Family Health Survey (NFHS-4) for the year 2015-2016, which contained information of children belonging to 76,233 households of the state. Three indicators namely, stunted, wasted and underweight have been considered as comprehensive child malnutrition status. Multiple regression analysis has been used to identify various factors associated with child malnutrition. The study indicates that the prevalence of child malnutrition varied over the districts. Those with very high prevalence of malnutrition were Hamirpur, Sonbhadra, Sitapur, Bahraich and Pilibhit. In contrast, in Gautam Budh Nagar, Ghaziabad, Mathura, Firozabad and Saharanpur the prevalence of malnutrition was lower. Explanatory variables like female literacy rate, breastfeeding, toilet facility, anaemia among pregnant women, gross value from agriculture/gross cropped area and total fertility rate account for change and show a significant effect on both child malnutrition and infant mortality rate. Nutritional education of females, better sanitation facilities in backward areas, better nutrition to females and high food productivity might help in solving the nutrition status of children in Uttar Pradesh.

Stunting and Anemia in Children from Urban Poor Environments in 28 Low and Middle-income Countries: A Meta-analysis of Demographic and Health Survey Data

Child malnutrition remains a global concern with implications not only for children’s health and cognitive function, but also for countries’ economic growth. Recent reports suggest that global nutrition targets will not be met by 2025. Large gaps are evident between and within countries. One of the largest disparities in child malnutrition within counties is between urban and rural children. Large disparities also exist in urban areas that have higher rates of child malnutrition in the urban poor areas or slums. This paper examines stunting and anemia related to an urban poverty measure in children under age 5 in 28 low and middle-income countries with Demographic and Health Survey data. We used the United Nations Human Settlements Programme (UN-HABITAT) definition to define urban poor areas as a proxy for slums. The results show that in several countries, children had a higher risk of stunting and anemia in urban poor areas compared to children in urban non-poor areas. In some countries, this risk was similar to the risk between the rural and urban non-poor. Tests of heterogeneity showed that these results were not homogeneous across countries. These results help to identify areas of greater disadvantage and the required interventions for stunting and anemia.

Associations between Child Snack and Beverage Consumption, Severe Dental Caries, and Malnutrition in Nepal.

The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is poorly understood. This cross-sectional study aims to assess this relationship among a convenience sample of 273 children age six months to less than 12 years in three communities in Nepal, using parent/caregiver interviews, child dental exams, and anthropometric measurements. Fisher’s exact test and independent t-tests examined associations between dietary practices and severe caries and between severe caries and malnutrition, respectively. Children consumed sugar-sweetened beverages and processed snacks frequently: 80% consumed tea with sugar, 60% consumed sweet snacks, and 65% consumed processed savory snacks daily. Overall, 74% of children had untreated tooth decay, and 21% exhibited stunting malnutrition, 14% were underweight, and 6% presented wasting. Significant associations were found between daily consumption of sweets and processed snacks with severe caries and between severe caries and poorer nutritional status. These findings underscore the need to incorporate nutrition and oral health promotion and dental treatment into maternal–child health services and schools and to strengthen policies to reduce children’s access to junk food.