Anthropometric Status Of Children Research Articles

Child-eating behaviour as predictor of anthropometric status of preschool children aged 2–4 years in Umuahia South LGA Abia State, Nigeria

Introduction and objectiveEating behaviour at the childhood level plays a vital role in the outcome of the nutritional status and the overall health of an individual. The study was focused on the association between anthropometric status and child eating behaviour.MethodologyA community-based cross-sectional survey purposively enrolled consenting participants from 256 households with preschool children aged 2–4 years. The parents/legal guardians were interviewed on the eating behaviour of their children using a validated semi-structured child-eating behaviour scale, and anthropometric measurement of the children were taken. WHO Anthro-software for child growth standards was used to categorize anthropometric status of the preschool children. Paired sample t-test was performed to compare child-eating behaviour by gender, while regression and correlation analysis was performed to determine the extent to which child-eating behaviour predicted anthropometric status at 5% level of significance.ResultsMean comparison of child eating behaviour by gender showed significant difference (P < 0.05) between male and female children in their eating behaviour with respect to enjoyment of food and satiety responsiveness. Some of the children were wasted (26.6%), stunted (20.7%) and underweight (16.4%). A significant association (P < 0.05) was observed between body mass index-for-age and food fussiness behaviour of the children. There was also a significant difference (P < 0.05) between weight-for-age and food fussiness behaviour of the children.ConclusionThe study showed that child eating behaviour may have contributed to the anthropometric status of the children, however, differences in their eating behaviours by gender was observed.

Household dairy production, dairy intake, and anthropometric outcomes in rural Bangladesh

We assess whether ownership of dairy cows is associated with a greater likelihood of consuming dairy products and with child anthropometric status in rural Bangladesh. Consistent with the assumption of imperfectly functioning markets for dairy products, ownership of dairy cows increases the likelihood that a child 6–59 months consumes milk by 7.7 percentage points with no difference in this association between boys and girls. This association nearly doubles in magnitude when we consider households that own a dairy cow that produced milk in the last year. This result is robust to the controls we use and the way in which we measure dairy cow ownership. Even when we saturate our model with child, maternal, household, wealth, as well as village fixed effects, we retain an association between dairy cow ownership and height-for-age z scores (HAZ) that is meaningful in magnitude – 0.13 standard deviations – and statistically significant at the one percent level. For children in the 12–23.9 month age group, ownership of a dairy cow is associated with a 0.37 SD increase in HAZ and a reduction of 11.3 percentage points in stunting. There is no statistically significant association with weight-for-height or wasting. These associations do not differ between boys and girls.

Active Feeding Behavior Compensates for Low Interest in Food among Young Nicaraguan Children

The association of caregivers' feeding behavior with young children's anthropometric status was examined in 80 poor urban families from Nicaragua. Caregiver and child behaviors observed during eating were recorded for midday meals, snacks and bottle feeds. Two kinds of scales were constructed. The Active Feeding Scale measured the caregiver's attempts to encourage or promote the child's food ingestion through behaviors such as verbal encouragement, threatening, offering more food or demonstrating eating. The Child Demand Scale measured the child's interest and enthusiasm for food. Results suggested the following: 1) there were significant differences in caregiver encouragement of feeding by meal type (midday meal, snack or bottle-feed); 2) mothers were significantly more likely to encourage eating than were other caregivers; and 3) active feeding was not associated with child anthropometric status but often appeared to be associated with child disinterest in the meal. It is suggested that active feeding may be used to compensate for child disinterest in food rather than to enhance the child's growth and developmental trajectory. The importance of lack of child interest in food, probably related to poor appetite, needs to be recognized and incorporated into nutrition education programs.

Dietary diversity and nutritional status of children attending early childhood development centres in Vhembe District, Limpopo province, South Africa.

The present study assessed dietary diversity and anthropometric status of children attending early development centres in South Africa. In the Vhembe District of Limpopo province, South Africa, 273 children were conveniently chosen from 8 randomly selected early childhood development centres for a cross-sectional study. Data were gathered via a questionnaire administered by the interviewer in June 2021. Height, body weight and mid-upper arm circumference were measured to assess anthropometric status. A 24-h dietary recall was obtained to provide information on dietary diversity. The prevalence of underweight, wasting and stunting was 9, 4 and 26 %, respectively. More than half of the children had a low dietary diversity score, according to the Food and Agriculture Organization scoring system for children. Grains, roots, tubers, dairy products, other fruits and vegetables, and flesh-based foods were the highest consumed food groups. The lowest consumption was for eggs, vitamin A-rich fruits and vegetables, legumes and nuts. Height for age and weight for age were significantly associated with dietary diversity score, but not weight for height. Children who did not meet the reference value of greater than 4 for dietary diversity had a significant risk of being underweight (AOR 0⋅25, 95 % CI 0⋅08, 0⋅75) and stunted (AOR 0⋅32, 95 % CI 0⋅14, 0⋅74). The nutritional status of the children was impacted by a lack of adequate dietary diversity. Young children in rural areas need to receive a wide range of food to promote greater diversification of diets in order to diminish the risk of undernutrition.

INCREASING EARLY DETECTION OF CHILDHOOD GROWTH DISORDERS WITH CHRONIC DISEASES IN COVID-19 ERA

Impaired growth is still a problem that needs attention in Indonesia. There are still many incidents of children with short stature due to lack of nutrition, undernourished toddlers, and even malnutrition. Therefore, the detection of child growth still needs to be improved. The Covid-19 pandemic has made parents of patients afraid and anxious to take their children to health facilities, so that monitoring of their growth is neglected, especially in pediatric patients with chronic diseases. This community service activity is intended to provide training to parents of patients on how to measure anthropometric status in pediatric patients with chronic diseases so that parents are expected to be able to screen or detect growth disorders early and independently. Therefore, education and training are held with the aim of increasing the knowledge and skills of parents in examining the anthropometric status of children. Evaluation is done by asking questions and practicing anthropometric status checks at the beginning and end of the activity and good numbers of material uptake by participants are obtained so that participants can independently assess the child's anthropometric status and get an increase in skills. The knowledge of the patient's parents about awareness of growth and development screening is still lacking so that it can affect the detection of developmental disorders in children. With this activity, it can provide the ability of the patient's parents to equip themselves to monitor the growth of their child.

Impact of Maternal Nutrition Education on Dietary Practices of School Going Children (3-6 years of age)

Nutrition (Nutritional) education is a kind of education that is important to improve the health status of people. School children are undergoing rapid mental and physical development. Therefore, an appropriate diet is critical throughout this stage of life to ensure normal and healthy growth. As a result, nutrition education should begin at a young age for children Objective: To evaluate the impact of nutrition education of mothers on the dietary habits of school-going children aged 3-6 years Methods: A Quasi-Experimental study was executed on 77 children of class playgroup to class 1 studying in the Government girl’s school of Garhi Shahu, Lahore. Firstly, anthropometric data were collected through the children and secondly socio-demographic and dietary knowledge of mothers of selected children were noted through pre-designed questionnaires and interview method. The mothers were then given 45 minutes of nutrition education and a dietary change course, and some informative dietary guidelines leaflets and a weekly healthy kid’s school lunch planner were given to the mothers which they were requested to implement in the daily routine of children. After three months again the anthropometrics and questionnaires were assessed and compared with the initial findings Results: After nutrition education, the percentage of children who followed the servings of healthy food groups and avoided consumption of harmful meals (fast, fried, processed foods), unhealthy beverages (carbonated drinks), and intake of fruits and vegetables increased dramatically. After the intervention, the percentage of children who followed recommended nutritional, lifestyle, and physical activity guidelines, as well as healthy school lunch practices, improved statistically significantly (P&lt;0.005). The percentage of children who skipped meals on daily basis was 20% decreased to 8%. Before the intervention, 63% of mothers say that their children consumed breakfast regularly and after the intervention, it increases to 75%. The children's anthropometric status improved significantly, with a P&lt;0.005 significance level Conclusions: In this study, nutrition education had a significant impact on the school-going children in their anthropometry measurements, healthy school lunch boxes, and awareness of their mothers about healthy eating practices. Seminars and camps should be arranged in schools to educate the mothers and the students at a young age regarding their health and healthy eating to reduce the nutritional deficiencies and diseases

Nexus between maternal underweight and child anthropometric status in South and South-East Asian countries

ObjectivesMaternal underweight and childhood malnutrition are life-threatening public health concerns in several South and South-East Asian nations. The aim of this study was to better design interventions and prevent malnutrition of children in the region by exploring the association of maternal underweight with children's anthropometric status. MethodsThe Demographic and Health Survey's (DHS) most recent nationally representative data from eight South and South-East Asian states, collected between 2014 and 2018, were pooled for the present study. A multivariable logistic regression model was designed to explore the association between maternal underweight and child anthropometric status. Owing to the hierarchical structure of the DHS data, the study also employed the multilevel logistic regression technique. ResultsAmong the total participants (N = 213 730), 22.66% of women were found to be underweight, whereas 39.03%, 35.88%, and 22.11% of their children had stunting, underweight, and wasting, respectively. The logistic regression model showed that the children from underweight mothers were 1.27 (95% confidence interval [CI]. 1.24–1.30), 1.69 (95% CI, 1.65–1.73), and 1.48 (95% CI, 1.45–1.52) times more likely to experience stunting, underweight, and wasting, respectively, than those with healthy-weight mothers. The significant association between maternal underweight and stunting, underweight, as well as wasting was additionally established by the multilevel logistic regression analysis. ConclusionsFindings indicate that maternal underweight is positively associated with children's anthropometric status, such as stunting, underweight, and wasting. The information from this research will guide actors and policymakers to scale up interventions with all-inclusive nutritional issues and promote healthier weight status among mothers to ensure higher odds of healthier anthropometric status in their children in the South and South-East Asian countries.

The Correlation Between Age at Onset and Metabolic Control with Anthropometrics Status in Children with Type 1 Diabetes

Background: Type 1 Diabetes is the most prevalent chronic disease in childhood. The most common cause of T1DM is an autoimmune process. Age at onset and metabolic control can affect the anthropometric status of children with T1DM. This research intends to find the correlation between age at onset and metabolic control with the anthropometrics status of children with T1DM because it is still controversial. Methods: The design was a cross-sectional study. The inclusion criteria were medical records of patients with Type 1 Diabetes aged 2-18 years old who regularly control to pediatric endocrinology outpatient clinic, Dr. Soetomo Hospital, Surabaya from January 2020 – December 2021. Data collected were age at onset, HbA1c levels, height, and weight. The correlation between variables was analyzed by using Pearson test. Result: Twenty-six patients joined the study. The mean onset was 8.38 ± 3.07 years. One (3.8%) patient had good metabolic control, 8 (30.8%) intermediate, and 17 (65.4%) had poor metabolic control. Around 73.1% had normal height and 65.4% had normal weight. The correlation of age at onset, height, and weight was [(r=0.774, p=&lt;0.000); (r=0.555, p=0.003)] respectively. The correlation of metabolic control, height, and weight was [(r=0.224=0.271); −0.36, p=0.86)]. Conclusion: There is a correlation between age at onset and anthropometrics status. It is very important to monitor height and weight in Type 1 Diabetes Mellitus patient.

Migration, economic crisis and child growth in rural Guatemala: Insights from the Great Recession

Migration has been demonstrated by various studies to be closely linked to improvements in individual- and household-level outcomes. In this paper, rather than examining the effects of migration, we explore whether an economic shock in United States affected migrant households in rural Guatemala. Treating the Great Recession as a natural experiment affecting migrant and non-migrant households differently, we put the spotlight on the effect of the shock on child anthropometry, including longer-term indicators of height-for-age z-scores (HAZ). Panel data on children, and multiple children in households enable both double- and triple-difference estimation. In relative terms, migrant households fared much worse than non-migrant households over the period. Large advantages in child anthropometric status for the youngest children in migrant households in 2008, just prior to the crisis, were substantially diminished four years later. The findings underscore the possible fragility of the benefits of migration, particularly in the face of a substantial economic shock, and point to the potential importance of deepening social safety nets.

Maternal complementary feeding practices and anthropometric status of children (6-23 months) in Abakaliki Nigeria, a facility based study

Sub-optimal complementary feeding practices among children aged 6-23 months is a major cause of under-nutrition in developing countries. This study was designed to assess the complementary feeding practices and nutritional status of children 6-23 months attending an immunization clinic at Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria. The study was descriptive and cross-sectional in design. A total of 320 children were selected using a two-stage sampling technique. WHO/PAHO/UNICEF recommendations and WHO Child Growth Standard charts were used to categorize their complementary feeding and anthropometric indices, respectively. Statistical analysis was performed using descriptive statistics and inferential statistics. Complementary feeding indicators such as timely complementary feed introduction (54.1%) and minimum dietary diversity (68.7%) were met by more than half of the respondents. But overall, complementary feeding practices were considerably poor. Low minimum meal frequency, minimum adequate diet and continued breastfeeding at one year were reported. Wasting, stunting and underweight prevalences were 12.5%, 11.3% and 8.3% respectively. Children who continued breastfeeding at one year (AOR = 0.34; CI= 0.15-0.76) or met minimum dietary diversity criteria (AOR = 0.43; CI= 0.17-1.05) were less likely to be stunted. Increased attention towards breastfeeding continuation and dietary diversity improvement using locally available/affordable food stuffs is needed.

In-utero Exposure to Rainfall Variability and Early Childhood Health

Climate change has drastically altered precipitation patterns across the globe and has caused an increase in rainfall variability, including the incidence of extreme rainfall events such as droughts and floods. Exploiting the exogenous variation in rainfall to which children were exposed during the nine months in utero, we find that rainfall variability adversely affects the anthropometric status of children under five years of age in 55 low and middle-income countries. Moreover, the consequences of fetal exposure to rainfall variability are strongly apparent in the child’s first year of life and linger to some extent at later ages. Our heterogeneity analyses further show that children of disadvantaged backgrounds, such as poor and uneducated households, are especially vulnerable to rainfall variability during gestation.

Are there anthropometric and body composition differences between children with autism spectrum disorder and children with typical development? Analysis by age and spectrum severity in a school population.

This study makes a comparison between the growth status of pre-school and school-age children with autism spectrum disorder and typical development children. Pre-schoolers with autism spectrum disorder were taller than children with typical development. School-age children with autism spectrum disorder were more overweight/obese, had more body fat and a greater waist circumference and waist/height ratio than children with typical development. The presence of autism spectrum disorder and internalizing problems was associated with cardiovascular risk in school-age children.

Modelling children's anthropometric status using Bayesian distributional regression merging socio-economic and remote sensed data from South Asia and sub-Saharan Africa

A history of insufficient nutritional intake is reflected by low anthropometric measures and can lead to growth failures, limited mental development, poor health outcomes and a higher risk of dying. Children below five years are among those most vulnerable and, while improvements in the share of children affected by insufficient nutritional intake has been observed, both sub-Saharan Africa and South Asia have a disproportionately high share of growth failures and large disparities at national and sub-national levels. In this study, we use a Bayesian distributional regression approach to develop models for the standard anthropometric measures, stunting and wasting. This approach allows us to model both the mean and the standard deviation of the underlying response distribution. Accordingly, the whole distribution of the anthropometric measures can be evaluated. This is of particular importance, considering the fact that (severe) growth failures of children are defined having a z-score below −2 (−3), emphasising the need to extend the analysis beyond the conditional mean. In addition, we merge individual data taken from the Demographic and Health Surveys with remote sensed data for a large sample of 38 countries located in sub-Saharan Africa and South Asia for the period 1990–2016, in order to combine individual and household specific characteristics with geophysical and environmental characteristics, and to allow for a comparison over time. Our results show besides gender differences across space, and strong non-linear effects of included socio-economic characteristics, in particular for maternal education and the wealth of the household that, surprisingly, in the presence of socio-economic characteristics, remote sensed data does not contribute to variations in growth failures, and including a pure spatial effect excluding remote sensed data leads to even better results. Further, while all regions showed improvements towards the target of the Sustainable Development Goals (SDGs), our analysis identifies hotspots of growth failures at sub-national levels within India, Nigeria, Niger, and Madagascar, emphasising the need to accelerate progress to reach the target set by the SDGs.

Physical fitness and nutritional anthropometric status of children from disadvantaged communities in the Nelson Mandela Bay region.

Information about the relationships between physical fitness, body composition and nutrition has increased in recent years; however, little is known about physical fitness and the coexistence of under-/overnutrition among children living in disadvantaged areas. To determine the physical fitness status and its association with body composition, growth and selected socio-demographics in primary schoolchildren from disadvantaged communities in the Nelson Mandela Bay region. Nine hundred and sixty-five children (49% girls, M=9.5 years) participated in this cross-sectional study. Height and weight were measured to establish body mass index, and height-for-age z-scores. Physical fitness was assessed using tests from the Eurofit Physical Fitness test battery (flexibility, upper/lower body muscular strength and cardiorespiratory fitness). Between-group differences and cross-sectional associations were examined with univariate (Chi2-tests, analyses of variance) and multivariate methods (mixed linear/logistic regression). Most children had normal weight (76.7%), while 4.5% were underweight and 18.7% were overweight/obese. Underweight children and children with stunted growth (11.5%) had lower average upper body strength (p<0.001). Overweight/obese children had lower scores in weight-bearing activities (p<0.001). Children with higher socio-economic status were more likely to be overweight and obese (p<0.001). In the multivariate analyses, sex, age, body mass index, and stunting were associated with children's physical fitness. Fitness assessments seem to be a relevant measure of the current health status of children in disadvantaged settings. Compared to international norms, the children in this study had relatively low scores for both upper- and lower body muscular strength. Therefore, effective school-based intervention programmes should be developed to improve children's physical fitness in disadvantaged schools.

Longitudinal monitoring of the nutritional status of schoolchildren in a public school

Introduction: The nutritional transition in Brazil has also reached the infant population. In this context, studies have demonstrated high prevalence of overweight and obesity in school-aged children.&#x0D; Objective: analyze the nutritional and anthropometric status of children in a public school between the years of 2013 and 2015.&#x0D; Methods: for which a longitudinal study was developed using a 2013 baseline study. The final sample consisted of 73 students with initial age between 3 and 9 years. Socioeconomic, anthropometric and school feeding practices were collected using questionnaires according to the school age. The nutritional status was determined by the collection of measures of weight and height, later these were used for expression z Weight / Age and Height / Age scores. SPSS was used for statistical analysis.&#x0D; Results: The results showed that a significant percentage of schoolchildren remained overweight and obese from the Weight / Age index (21.8%) and at low weight risk by the Height / Age and Weight / Age (4.1% and 3%, 6%). These students presented a growth and weight gain within the norms of normality and the majority presented adequate weight for the age, nevertheless there was an expressive portion of schoolchildren who are underweight and overweight / obese.&#x0D; Conclusions: The nutritional status of children is related to several factors that should be addressed through actions to develop food and nutrition surveillance and food and nutrition education with students to promote healthy eating habits.

Preschool Child Nutritional Status in Nepal in 2016: A National Profile and 40-Year Comparative Trend.

Preschool child anthropometric status has been assessed nationally in Nepal since 1975, with semi-decadal surveys since 1996, plus several recent, short-interval surveys to track progress toward achieving a World Health Assembly (WHA) goal to reduce stunting to 24% by 2025. We report prevalence of preschool child stunting and wasting from a national survey in 2016 and place findings into the context of national trends and alignment for Nepal to attain its WHA 2025 goal. A representative, midyear Policy and Science for Health, Agriculture and Nutrition (PoSHAN) survey was conducted in 2016 on 5479 children <60 months in 4051 households in 21 village development committees. Child weight and height were measured, and sociodemographic factors were assessed. Data from previous surveys (Nepal Demographic Health Surveys, PoSHAN) were also acquired, and rates of stunting (<-2 height-for-age z score) and wasting (<-2 weight-for-height z score) were compared to current World Health Organization standards. Trends were expressed as average annual rates of reduction (AARR). Nationally, in 2016, 34.1% of preschoolers were stunted and 13.7% wasted. Stunting was highest in the Mountains (40.6%) and wasting highest in the Tarai (18.9%). Trend analysis revealed a steady decline (3.8% AARR) in stunting from 2001 to 2013, with virtually no decline from 2013 to 2016. Wasting has been continually high and variable, at ≥8%, since 1975. Following a steady decline in prevalence, preschool child stunting has plateaued at ∼35% in Nepal, while wasting has changed little over time, offering the opportunity to inform, reassess, and adjust, as needed, efforts to reach WHA 2025 goals.

Child Growth During the First 1000 Days of Life in Lebanon: Sex of the Child Matters

Abstract Objectives The study examines the relation between sociodemographic, maternal, and child characteristics and sex-specific anthropometric status of children using a hierarchical conceptual framework. Methods A cross-sectional study of a nationally representative sample of mothers and children aged ≤5 years was conducted in Lebanon. This analysis focuses on children aged 4 months-2 years (n=406) stratified by child's sex. Multiple linear regression models were fitted for length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length z-scores (WLZ) applying a hierarchical conceptual framework with variables at distal, intermediate and proximal levels. Results Overall, means ± SD for LAZ, WAZ and WLZ were: −0.24 ± 1.4, 0.46 ± 1.1 and 0.75 ± 1.2 among boys and −0.08 ± 1.2, 0.41 ± 0.96 and 0.63 ± 1.0 among girls, respectively. At the distal level, maternal and paternal attainment of university degrees were respectively associated with higher LAZ (B: 0.81, 95% CI: 0.1, 1.5) and lower WLZ (B: −0.62, 95% CI: −1.2, −0.09) among boys. On the other hand, higher crowding index was associated with lower LAZ (B: −0.64, 95% CI: −1.14, −0.13) while maternal employment was associated with higher WAZ (B: 0.37, 95% CI: 0.06, 0.67) among girls. At the intermediate level, higher maternal BMI was associated with lower LAZ (B: −0.03, 95% CI: −0.06, −0.00) and higher WLZ (B: 0.03, 95% CI: 0.00, 0.06) among girls. Taller mothers were more likely to have boys and girls with higher LAZ (B: 0.06, 95% CI: 0.03, 0.09 for both) and girls with higher WAZ (B: 0.02, 95% CI: 0.00, 0.05). Among the proximal factors, longer boys and girls at birth had higher WAZ (B: 0.06, 95% CI: 0.004, 0.12 and B: 0.05, 95% CI: 0.005, 0.092, respectively). Breastfeeding for 4 months or more was associated with lower WAZ (B: −0.54, 95% CI: −0.83, −0.24) and WLZ (B: −0.33, 95% CI: −0.62, −0.03) among girls. Conclusions Differentdistal, intermediate, and proximal factors were associated with sex-specific anthropometric indicators in Lebanon. Future research should account for sex differences using similar frameworks to inform interventions to improve child growth. Funding Sources This research was funded by the Lebanese National Council for Scientific Research and the American University of Beirut Research Board.

Associations between maternal BMI, breastfeeding practices and infant anthropometric status in Colombia; secondary analysis of ENSIN 2010

BackgroundMaternal malnutrition and infant feeding mode impact short and long term infant and child morbidity and mortality. The period of lactation may provide an opportunity to modulate the risk of disease later in life. Our aim was to estimate the effect of maternal body mass index (BMI) and infant feeding mode, particularly breastfeeding practices, on the anthropometric status of children under 2 years in Colombia.MethodsA secondary analysis was performed using the data from ENSIN 2010. Term infants under 2y, singleton, with a mother older than 18y, were included in the analysis. Outcomes were wasting (WLZ < -2SD), overweight (WLZ > +2SD) and stunting (LAZ < -2SD). Predictors were infant feeding (exclusive and predominant BF constructed from 24-h recall, age at introduction of liquids, semisolids and solids) and maternal BMI. Socioeconomic variables, maternal education and age, conditions during pregnancy and birth weight were analyzed as covariates.ResultsMothers of overweight infants had higher BMI (Mean dif = 1.47 kg/m2; 95% CI = 2.1, 0.8) than those with normal weight infants. Stunting and wasting were not predicted by maternal anthropometry or infant feeding mode. Fewer maternal years of education were associated with wasting (OR = 0.90; 95% CI = 0.86, 0.97; p = 0.003) and stunting (OR = 0.92; 95% CI = 0.89, 0.94; p < 0.0001), while more maternal years of education were associated with overweight (OR = 1.06; 95% CI = 1.02, 1.01; p = 0.001); higher birth weight was associated with overweight (OR = 1.001; 95% CI = 1.00, 1.001; p < 0.0001) and lower birth was associated with stunting (OR = 0.99; 95% CI = 0.89; p < 0.0001) in the final regression model.ConclusionsMaternal BMI is a modifiable target for public health policy to promote healthy infant growth. Infant nutritional status is affected by direct and indirect factors that need to be addressed in further studies.

Child Responsive Budgeting as a Public Finance Management Tool: A case of Karnataka, India

Child Responsive Budgeting (CRB) is a specifically targeted Public Finance Management (PFM) tool to integrate the concerns pertaining to children in the policy planning and budgetary frameworks. This is particularly relevant in the present humanitarian crisis caused by the spread of COVID-19 pandemic, affecting all the three dimensions of human development – in particular income, health and education. I explore the efficacy of ‘child budgeting’ in public financial management (PFM) to deal with the COVID-19 pandemic. I argue that this should be an essential component of government’s fiscal responses. The study is an ex-post analysis of child centric allocation (CCA) in the State Budget of Karnataka from 2017 -18 (accounts) to 2020-21BE and an assessment of budget credibility of these allocations using the fiscal marksmanship and Public Expenditure and Financial Accountability Public Finance Management (PEFA PFM) assessment framework. The analysis brings out serious lacuna in actual utilisation of child centric allocations, indicating poor budget credibility in the allocation for child specific programmes. Besides, the glaring digital divide and the fragile anthropometric status of children in the State of Karnataka, coupled with underspending of child centric allocation in the State Budget, reveals that the State is underequipped to deal with a catastrophic crisis caused by the COVID-19 pandemic, where children are deprived of both healthcare and access to education.

Selective mortality and the anthropometric status of children in low- and middle-income countries

Despite a close relationship between the childrens’ anthropometric status and mortality rates, the highest mortality rates are concentrated in sub-Saharan Africa, while the lowest anthropometric indicators, in particular the height-for-age z-scores, are concentrated in South Asia. This discrepancy should, however, be expected to decrease when one accounts for the survivorship bias, i.e. selective mortality. We analyse whether the survivorship bias can explain these observed differences in three standard anthropometric indicators (stunting, underweight and wasting) by using individual data of children from six waves of Demographic and Health Surveys for a large cross-section of 37 low- and middle-income countries between 1991 and 2016. We use both a matching approach and semi-parametric regression to estimate the values for the anthropometric status of deceased children. The results are twofold: first, both methods reveal that the imputed values for the anthropometric indicators are, on average, between 0.10 and 0.25 standard deviations lower than the observed anthropometric indicators. Second, since the share of deceased children in our sample is below ten per cent, the contribution of the anthropometric status of deceased children to overall anthropometric indicators is small and therefore only influences it marginally.