Determinants Of Child Malnutrition Research Articles

Determinants of Child Malnutrition and Infant and Young Child Feeding Approaches in Cambodia.

Women's diets often decrease with regard to amounts per meal and day as well as diversity if a household's access to food is limited. The result is a monotonous diet that, in particular, negatively affects women's nutritional status during pregnancy and lactation and, thus, the infant. The infant's diet is of utmost importance, as it needs to meet the nutrient requirements especially during the first 2 years of life, a critical window for the child's healthy development. In Cambodia, infant and young child feeding (IYCF) practices are poor. Preparation of a special complementary meal in addition to breast milk feeds for children aged 6-23 months is often not a common habit. Instead, children eat watery, plain rice porridges that do not meet the nutrient requirements at this young age. A lack of adequate caring practices such as responsive feeding exacerbates the risk of malnutrition. Caregivers are often unaware of the importance of nutrition during the first 2 years of life regarding its effects on children's growth. In 2012, a randomized controlled trial (RCT) was started in two provinces of northern Cambodia: Oddar Meanchey and Preah Vihear. To contribute to reducing child mortality by addressing malnutrition among children 6-23 months of age, the Food and Agriculture Organization of the United Nations (FAO) implemented a nutrition-sensitive agriculture project with nutrition-specific actions, i.e. a nutrition education intervention was embedded in a food security project. Wealth, a child's age, and maternal education were identified as determinants of a child's dietary diversity. The older the child and/or the wealthier the household, the more diverse the child's diet. Maternal education was positively associated with the child's dietary diversity. Household dietary diversity was significantly associated with child dietary diversity in a model including group, child's age, maternal education, and wealth as confounders. The RCT also showed that a 2- to 3-month nutrition education programme carried out by government and community health volunteers as well as local NGOs addressing caregivers with a child between 5 and 18 months of age has great potential to improve IYCF practices. Since no impact on average height-for-age Z-scores could be demonstrated in this RCT, we suggest for Cambodia that (1) more emphasis be put on animal-source food and other protein sources in nutrition education, (2) nutrition education be implemented in the community through trained government and community members including peers as trainers, (3) sessions on family nutrition be included in the curriculum and the continuation of breastfeeding be emphasized, and (4) nutrition education be institutionalized, including continuous in-service training for sustainability.

Determinants of malnutrition in Indian children: new evidence from IDHS through CIAF

The purpose of this paper is to highlight the determinants of malnutrition in children (under 5 years) in urban and rural areas of India. The ultimate objective is to frame policy proposals for children’s nutritional welfare. In this empirical study, logit model is applied to 9,381 observations of urban and 18,418 of rural areas. The composite index of anthropometric failure is constructed to use it as an indicator of malnutrition. The results revealed that probability for anthropometric failure increases by age, birth-order and duration of breastfeeding. The birth-interval, delivery of the child in hospital, wealth index of the household, mother’s BMI and mother’s education turned out to be negatively affecting children’s malnutrition in both urban and rural areas. Gender of the child has no significant effect on malnutrition in both urban and rural communities. From the policy perspective enlarging the birth-interval through family planning programs and squeezing the duration of breastfeeding by giving supplement food at subsidized rates may contribute to enhance children’s nutritional status. For the long-run socioeconomic status of the household and BMI of mothers require attention of policy makers. To break the intergenerational cycle of malnutrition, the nutritional status of today’s girls in the age of adolescent is recommended to be improved. The findings of study may support academicians, policy makers and social activists for human development programs in India.

Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil.

OBJECTIVETo analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil.METHODSData were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model.RESULTSA sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother’s education, toilet and tap water availability, children’s medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting.CONCLUSIONSSocioeconomic development, along with health interventions, may have contributed to improvements in children’s nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.

Malnutrition in under five children in Turbhe stores urban slums in Navi Mumbai

Background: Malnutrition is a problem not only in rural area but also among the urban poor. Also, the urban poor are a neglected segment of population in terms of basic services and amenities. Nutrition in children is affected by various determinants including mother’s level of knowledge, attitudes and practices. Hence, this study was conducted in an urban slum setting to understand the extent and determinants of malnutrition in children below five years of age. Aims & Objectives: The study objectives were to understand the knowledge, attitude and practices of mothers with respect to nutrition of their under five children and to measure the extent of malnutrition in the sample population of under five children. Materials and Methods: This was a cross sectional study and data was collected on a sample of 300 children under five years and their mothers selected through cluster sampling technique in Turbhe stores urban slum community of Navi Mumbai. Using a semi-structured interview schedule, Knowledge, Attitude and Practice (KAP) on nutrition among mothers of these children were assessed and anthropometric measurements were taken. The study used the World Health Organization (WHO) guidelines for measuring malnutrition. Data was entered and analyzed using SPSS, version 20. z score analysis for malnutrition assessment was done using the appropriate WHO software. Results: The knowledge levels of mothers regarding breast-feeding were mixed. Majority (88%) of the mothers were aware that only breast-feeding is required post-delivery, and duration of breast-feeding could be more than six months. there was a gap in knowledge about breast-feeding practice during infant illness. Only 9% of mothers had the correct knowledge to increase breast feeding if the infant was ill and 20% felt breast feeding should be decreased during illness of child. Mothers had very poor knowledge about nutritious food. The attitude score was created using the Likert scale with a minimum score of 16 and maximum score of 64. The mean attitude score was 54.29 with a standard deviation of 5.24. In terms of breast-feeding practices, 74 (24.6%) mothers did not initiate breast-feeding within one hour of birth, and only 21 (7%) mothers increased breast feed frequency during illness of child. Conclusion: The study found gaps in knowledge about breast-feeding practices among mothers and very poor practices related to adequate nutrition for children. Stunting was seen in more than 50 % of children. However, the mothers had a very positive overall attitude about improving nutrition of their children and were willing to learn about it. This provides an opportunity for a targeted intervention among the mothers of these children in the community

Determinants of Nutritional Status in Children living in Mashhad, Iran

Introduction: Children are one of the most vulnerable groups to sub-optimal nutritional intake in most societies. We have investigated some of the potential determinants of malnutrition in children of 2-5 years of age. Methods and Materials: A cross sectional study was conducted to determine the relationship between nutritional status (weight for age, height for age and weight for height) and dietary and socioeconomic factors in 671 children (24-59 months of age) from selected health centers in Mashhad city, Iran. Children were assessed for weight and height and the care givers were interviewed and a questionnaire was completed by the interviewers. The data were analyzed using SPSS13 software and the Z-scores were calculated using the WHO anthropometric software package. Results: The study showed that 24.4% of children were mildly underweight, 4.3% were underweight, 13% were mildly stunted, 23.6% of children were mildly wasted and 3.1% were stunted. Educational attainment, whether the children had been breast feed, average daily consumption of milk, feeding practices and type of first food were found to be the main factors determining nutritional status in our study. Conclusion: A higher daily consumption of milk, lower age at which first solid food was started; lower age for consumption of meat and good feeding practices may resolve malnutrition in this population. These findings support the need for a family-based prevention program that focus on guiding parents to foster appropriate feeding practices as well as to promote healthy food intake in the children. Future research should determine the cost-effectiveness of both short- and long-term interventions for child malnutrition.

Determinants of child malnutrition in rural and urban Ecuadorian highlands.

To identify and compare the sociodemographic determinants of stunting, wasting and overweight among infants of urban and rural areas in the Ecuadorian highlands. Cross-sectional study. Nabon (rural) and Cuenca (urban) cantons, Azuay Province, Ecuador. A total of 703 children aged 0-24 months and their caregivers (227 rural and 476 urban) recruited during the period from June to September 2008. Stunting prevalence was significantly higher in the rural area (37·4 % v. 17·7 %; P < 0·001) while wasting (7·1 %) and overweight (17·1 %) prevalence were more similar between areas. Determinants of stunting for the pooled sample were male gender (OR = 1·43; 95 % CI 1·06, 1·92; P = 0·02), preterm delivery (OR = 1·65; 95 % CI 1·14, 2·38; P = 0·008), child's age (OR = 1·04; 95 % CI 1·01, 1·07; P = 0·011), maternal education (OR = 0·95; 95 % CI 0·92, 0·99; P = 0·025) and facility-based delivery (OR = 0·57; 95 % CI 0·45, 0·74; P < 0·001). The latter was also a determinant of overweight (OR = 0·39; 95 % CI 0·25, 0·62; P < 0·001). Rural determinants of stunting were maternal height (OR = 0·004; 95 % CI 0·00004, 0·39; P = 0·018), diarrhoea prevalence (OR = 2·18; 95 % CI 1·13, 4·21; P = 0·02), socio-economic status (OR = 0·79; 95 % CI 0·64, 0·98; P = 0·030) and child's age (OR = 1·07; 95 % CI 1·02, 1·11; P = 0·005). Urban determinants were: maternal BMI for stunting (OR = 0·91; 95 % CI 0·84, 0·99; P = 0·027), cough prevalence (OR = 0·57; 95 % CI 0·34, 0·96; P = 0·036) and facility-based delivery (OR = 0·25; 95 % CI 0·09, 0·73; P = 0·011) for overweight, and hygiene for wasting (OR = 0·57; 95 % CI 0·36, 0·89; P = 0·013). Infant malnutrition was associated with different sociodemographic determinants between urban and rural areas in the Ecuadorian highlands, a finding which contributes to prioritize the determinants to be assessed in nutritional interventions.

Reynaldo Martorell: driving force in maternal and child nutrition

Reynaldo Martorell: driving force in maternal and child nutrition

Child Malnutrition, Social Development and Health Services in the Andean Region

This paper analyzes the social, ethnic and regional determinants of child malnutrition, as well as the effects of access to health services in the Andean region, by comparing conditions in Ecuador, Peru and Bolivia. These three countries are marked by a high prevalence of stunting and by wide socioeconomic, regional and ethnic disparities. The analysis used Demographic and Health Survey (DHS) data from Peru (1992, 1996 and 2000) and Bolivia (1997), and Living Standards Measurement Study (LSMS) data for Ecuador (1998). The paper adopts an international comparative perspective, analyzing Ecuador in particular detail.

Nutritional Status and Determinants of Malnutrition in Children under Three Years of Age in Nghean, Vietnam

Nutritional Status and Determinants of Malnutrition in Children under Three Years of Age in Nghean, Vietnam

Determinants of Child Malnutrition in Nepal: A Case Analysis from Dhanusha, Central Terai of Nepal

The analysis found that older age children and children whose mothers are illiterate are more likely to be underweight and stunted. Children from families who do not discard rice scum are more advantageous to be well nourished. Colostrum feeding and suffering from diarrhoea have significant effect on underweight but not on stunting. Conclusion The study found that rice scum has significant effect on nutritional status of under three children. Similarly, children are benefited from colostrum feeding and prevention or management of diarrhoea in terms of nutritional status by weight for age but not for stunting, which is similar to the findings from other studies. The analysis shows further need of research to see the effect of rice scum, colostrum feeding and suffering from diarrhoea on nutrition status of children.

Preventing child malnutrition: Health and agriculture as determinants of child malnutrition

Food is the most basic of children's needs and is central to their health, growth, and development. As noted by the Food and Agriculture Organization of the United Nations, malnutrition is the underlying cause of more than half of all children's deaths worldwide. This study investigates the effects agricultural production and health systems have on the incidence of chronic malnutrition in children while controlling for other relevant factors. A multivariate statistical analysis of 137 developing countries reveals that the level of a country's agricultural infrastructure is an important determinant of the rate of chronic malnutrition in children. In addition, total health expenditures, improved water and sanitation, and large medical staffs, along with improved women's status and child care practices are associated with a reduction in child stunting rates.

MALNUTRITION

Objective: To find-out the determinants of malnutrition in children between sixmonths to five years age in Bahawalpur. Study Design: This was an observational descriptive cross – sectional study.Setting: At Paediatric Medicine out – patient department in Bahawal Victoria Hospital, Bahawalpur.. Period: From Feb.2005 to March 2007.Subjects: Eleven hundred children with malnutrition having ages six months to five years. Mainoutcome measures. Determinants of malnutrition in children under – 5 in Bahawalpur. Results: This study consistsof 1100 sick children between the ages six months to five years brought by their parents (mother) to the PediatricMedicine out-patient department in Bahawal Victoria Hospital, Bahawalpur. Only the children with malnutrition(undernutrition) were included in the study population. Mothers of these children were interviewed and clinicalexamination of each child was carried-out to find-out the causes of malnutrition in them. According to Gome’sclassification, 39.45% of them had first degree malnutrition, 37.10%, second degree and 23.45%, third degreemalnutrition. Conclusion: The major causes of malnutrition found in our study population included: Illiteracy; food –fads; poverty; lack of breast-feeding; improper weaning; diarrhea and respiratory diseases. All these factors werestatistically significant.

Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia.

There is empirical evidence at the national level that suggests the 1999 Indonesian economic crisis impact was very heterogeneous both between urban and rural areas and across regions. A cross sectional study of the nutritional status of children and its determinants was performed in urban poor areas of Jakarta, and rural areas of Banggai in Central Sulawesi, and Alor-Rote in East Nusa Tenggara. Two-stage cluster sampling was used to obtain 1078 households with under-five children in the urban poor area of Jakarta, and 262 and 631 households with under-five children each for the rural areas of Banggai and Alor-Rote, respectively. Data collection for both studies was performed from January 1999 to June 2001. The study shows that wasting affected more children in the urban poor areas of Jakarta than in the other study areas. On the other hand, stunting and anemia were significantly more severe among children 6-59 months of age in the rural area of Alor-Rote compared to the other study areas. The high prevalence of infectious diseases was significantly related to the higher prevalence of wasting in the study areas of Jakarta and Banggai, and also significantly related to the higher prevalence of stunting and anemia in the study area of Alor-Rote. To avert this kind of health impact of a economic downturn, there is a need to improve the nutritional and health status of under-five children and their mothers through the existing health care system, provide basic health services and improve the capacity of health staff across Indonesia as part of the decentralization process.

Levels and determinants of child malnutrition in Tigray, Northern Ethiopia

This study was part of a project investigating effects of water harvesting schemes on the nutritional status of children and mothers in northern Ethiopia. A community-based cross sectional survey included 321 under-five children and their mothers. More than 90% of the mothers were illiterate. Most reported home delivery; major first feeds for infants were butter, sugar and water at 47%, 15% and 15%, respectively, with only 16% receiving colostrum as the first feed. Only 19% of mothers reported breastfeeding within the first hour of delivery. Breastfeeding continued for one year or longer for 88%. Cereal-based porridge was the most common complementary food (CF) used. The rates of stunting [height-for-age (HAZ) ≤ −2 Z-score], underweight [weight-for-age (WAZ), ≤ −2 Z] and wasting [weight-for-height (WHZ) ≤ −2 Z] were 42.7%, 38.3% and 13.4%, respectively. Both HAZ and WAZ were positively associated with CF (p<0.01). A positive association between WHZ of the children and body mass index (BMI) of the mothers (p=0.002) was also observed. Numbers of children stunted and underweight increased with child age. Suboptimal CF was a major contributor to high malnutrition rates in the region. Educating mothers about exclusive breastfeeding and the timely initiation, preparation and provision of energy dense CF from locally available foods is recommended. (Supported by Institute of Environmental Management, the Netherlands and Mekelle Univ.).

Economic crisis and malnutrition: socioeconomic determinants of anthropometric status of preschool children and their mothers in an African urban area.

To assess the relative importance of socioeconomic and maternal/prenatal determinants of the nutritional situation of children < 6 years old in an urban African area after several years of economic crisis. Cross-sectional cluster sample survey. Brazzaville, capital city of the Congo. Information on socioeconomic characteristics was gathered from a random sample of 1368 households by house visits and anthropometric measurements were performed using standardized procedures on preschool children (n = 2373) and their mothers (n = 1512). The influence of socioeconomic factors on the nutritional status of children, taking into account adjustment variables such as mother's age and child's age and sex was assessed. For stunting, as well as for the mean height-for-age index among children, the main determinants were economic level of the household (P = 0.048 and P = 0.004, respectively), schooling of the mother (P = 0.004 and P < 10(-3)) and living in the peripheral district (P = 0.005 and P < 10(-3)). The influence of socioeconomic determinants on weight-for-age and wasting was less straightforward. When adjusting, in addition, for maternal and prenatal factors (mother's height and body mass index (BMI) and birth weight), most of the effects of the socioeconomic determinants on the nutritional status of children persisted somewhat, but the effect of the economic level on the stunting became not significant (P = 0.11). The mean BMI of mothers appeared to be related to the economic level of the household (P < 10(-4)), to the marital status (P = 0.01) and to the occupation of the mother (P < 10(-4)). Among the socioeconomic determinants of malnutrition in children, some, such as economic level of the household or schooling of the mother, seem to act mainly through prenatal factors, whereas others, mainly dwelling district characteristics, seem to influence more directly the children's nutritional status.

Determinants of child malnutrition—An intervention model for Botswana

Child malnutrition measured by stunting, wasting, and under-weight is a serious problem in Botswana. There are conflicting reports from previous studies in developing countries on the effect of some of the known factors affecting child malnutrition. We used descriptive statistics, regression, and logistic regression methods to identify the determinants of malnutrition based on data from a national cross-sectional study. There is 29.6% stunting, 14.9% underweight, and 7.1% wasting among children. Ordered logistic regression analysis shows the significance of some of the factors not shown by association statistics, regression analysis, and ordinary logistic regression analysis. Hence it is a better tool in the search for determinants of child malnutrition. The determinants of malnutrition cover biological, social, cultural, economic, and morbidity factors: age, birth-weight, breast-feeding duration, gender of family head, residence, house type, toilet facility, education of mother and father, child caretaker; intake levels of milk and dairy products, staple foods and cereals, and beverages; and incidence of cough and diarrhea. The influence of these factors can be used in the development of strategies of intervention for reducing child malnutrition.

Characteristics and determinants of child nutritional status in Nepal

Herein, we examine characteristics and determinants of child malnutrition in the districts of Bara and Rautahat of the Terai region of Nepal. The sample studied consists of 510 rural children ranging in age from 3 to 10 yr. The Nepali children were found to have one of the highest reported prevalences of stunting (65% were <90% National study for Health Statistics median height for age). The study children were also 1 to 1.5 kg lighter when compared to US children of the same height. Fat deposits, as measured by anthropometric variables and Hb levels were also very low. Multiple regression analysis showed that age, district of residence, household income, breast-feeding, and several specific food items were significant predictors of nutritional status. Association with other factors such as caste and parental schooling, were not evident in multiple regressions. Boys were as likely to be malnourished as girls. Prolonged breastfeeding was associated with greater fat stores, but with reduced stature and low Hb values. Both landholdings and household income were found to be positively and significantly associated with almost all measures of nutritional status.