Global Nutrition Targets Research Articles

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000\u20132018

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.

Optimal breastfeeding: Solid foundation to transform the nutrition landscape of Africa for national development

Nutrition forms the foundation for good health and wellbeing of people and nations. The nutrition landscape of Africa shows that many African countries are not on course to meeting the global nutrition targets. Only 5 out of 54 African countries are on course to achieving the global targets of 40% reduction of under-five stunting [1]

Nutrition Assessment of Under-Five Children in Sudan: Tracking the Achievement of the Global Nutrition Targets.

Background: Malnutrition places a heavy burden on the health, well-being, and sustainable development of populations in Sudan, especially a country affected by conflict, which continues to experience high levels of food insecurity, undernutrition, and micronutrient deficiencies; 3.3 million are acutely malnourished, with 522,000 children suffering from severe acute malnutrition and approximately 2.2 million children requiring treatment for moderate acute malnutrition. This study aims to describe the nutritional status of children under five years old and identify the progress toward the achievement of the Global Nutrition Targets. Methods: This is a secondary data analysis of a quantitative survey, using the second-round of the Simple Spatial Survey Method (S3M II) in Sudan in the period 2018–2019. The analysis used an area-based sampling methodology in all 18 Sudanese states. Data from the WHO Tracking Tools of the Global Nutrition Targets was used to reflect the progress in achieving the targets in Sudan. Results: Global stunting prevalence was at 36.35 percent including moderate stunting prevalence and severe stunting prevalence (21.25 percent and 15.06 percent respectively). Global wasting prevalence was 13.6 percent including moderate wasting prevalence and severe wasting prevalence (10.8 percent and 2.7 percent respectively). Sudan has made great progress in achieving the target of increasing exclusive breastfeeding. However, despite the welcome commitments by the Government and all stakeholders, Sudan is still struggling to implement strategies, policies, and regulatory measures to address malnutrition and achieve the Global Nutrition Targets in 2025 and the Sustainable Developmental Goals in 2030. Therefore, more than ever, there is a need for comprehensive, multi-sectoral action to address malnutrition in all its forms.

Mise à jour de la situation nutritionnelle en République du Bénin

Background: Nutrition is a major determinant of health and an essential factor in the development of countries. Faced with food insecurity and malnutrition, Benin has implemented policies and programs aiming to reduce the progression of this burden. Aims: To take inventory of nutritional status and interventions implemented to reduce the prevalence of different forms of malnutrition and food insecurity in Benin. Methods: A review of nutritional and food data available at the national level and consultation of intervention management reports was carried out from May to July 2020 and then, the data were compiled and structured. Results: Even though Benin has natural resources and remarkable biodiversity, the country faces a double nutritional burden marked by undernutrition: stunting (32%), anemia (71.5%), underweight (17%), wasting (5%) in children under 5 years, exclusive breastfeeding rate (42%) and over-nutrition: obesity (7.4%), diabetes (12.4%) in adults. Food insecurity remains persistent in 9.6% of households and undernourishment concerns 7.4%. The main interventions at the community level are made by the National Integrated School Feeding Program and the Coordinated Early Childhood Nutrition and Development Project. In addition, are the implementation of essential nutrition actions and nutrition-sensitive interventions involving different sectors such as, non-governmental organizations and technical and financial partners. Conclusion: Food and nutrition situation in Benin has been slightly improved thanks to the implementation of multisectoral coordination of interventions. Nonetheless, many challenges remain to be addressed, including the scaling up of successful interventions and advocacy for a substantial mobilization of resources in order to achieve global nutrition targets and sustainable development goals. Keywords: Nutritional status, Diet, Intervention, Benin.

Mise à jour de la situation nutritionnelle en République du Bénin

Background: Nutrition is a major determinant of health and an essential factor in the development of countries. Faced with food insecurity and malnutrition, Benin has implemented policies and programs aiming to reduce the progression of this burden. Aims: To take inventory of nutritional status and interventions implemented to reduce the prevalence of different forms of malnutrition and food insecurity in Benin. Methods: A review of nutritional and food data available at the national level and consultation of intervention management reports was carried out from May to July 2020 and then, the data were compiled and structured. Results: Even though Benin has natural resources and remarkable biodiversity, the country faces a double nutritional burden marked by undernutrition: stunting (32%), anemia (71.5%), underweight (17%), wasting (5%) in children under 5 years, exclusive breastfeeding rate (42%) and over-nutrition: obesity (7.4%), diabetes (12.4%) in adults. Food insecurity remains persistent in 9.6% of households and undernourishment concerns 7.4%. The main interventions at the community level are made by the National Integrated School Feeding Program and the Coordinated Early Childhood Nutrition and Development Project. In addition, are the implementation of essential nutrition actions and nutrition-sensitive interventions involving different sectors such as, non-governmental organizations and technical and financial partners. Conclusion: Food and nutrition situation in Benin has been slightly improved thanks to the implementation of multisectoral coordination of interventions. Nonetheless, many challenges remain to be addressed, including the scaling up of successful interventions and advocacy for a substantial mobilization of resources in order to achieve global nutrition targets and sustainable development goals. Keywords: Nutritional status, Diet, Intervention, Benin.

Effectiveness of Nutrition Interventions on World Health Organization Global Nutrition Targets: An Evidence Summary.

Effectiveness of Nutrition Interventions on World Health Organization Global Nutrition Targets: An Evidence Summary.

Nutrition data use and needs: Findings from an online survey of global nutrition stakeholders.

BackgroundThere is growing global demand for country-specific information to track nutritional status and its determinants, including intervention coverage. Periodic population-based surveys form the backbone of most national nutrition information systems. However, data on the coverage of many nutrition specific and sensitive interventions remain sparse.MethodsAn online survey was administered to the international nutrition community in 2018 through relevant listservs and professional networks to characterize their use of nutrition-related indicators and data sources. Respondents were asked about their professional background, access and use of specific indicators and data sources in the previous year, and unmet data needs. Results were tabulated by respondent characteristics and χ2 tests used for statistical testing.ResultsComplete survey responses were received from 235 respondents, the majority from non-governmental organizations and research communities, and few from governments. Demographic Health Surveys (DHS) were the most frequently accessed country-specific data source and the Global Nutrition Report (GNR) was the most accessed consolidated data source, each accessed by approximately 75% of respondents. Respondents with a multi-country focus were more likely to have accessed DHS than those with a single-country focus (85% vs 60%, P < 0.001). Similarly, respondents with a multi-country focus were more likely to have accessed the GNR compared to those with a single-country focus (82% vs 66%, P < 0.05). The most commonly accessed indicators overall were the prevalence of exclusive breastfeeding (69%), child minimum dietary diversity (66%), under-5 stunting (65%), and under-5 wasting (65%). Reported data gaps included adult and household diet quality indicators (n = 32), nutrition-sensitive intervention coverage (n = 25), and infant and young child feeding promotion coverage (n = 11). Lack of data availability for the desired geographic level (82%) or demographic group of interest (82%) and out-of-date data (77%) were common data challenges experienced by respondents.ConclusionsThe survey results highlight the continued need for high-quality, actionable nutrition data to help facilitate progress towards national and global nutrition targets.

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.

Determinants of stunting during the first 1,000 days of life in Bangladesh: A review.

Stunting is a major problem in Bangladesh, with a prevalence of 31% in 2017. The prevalence of stunting in children aged under two has reduced by only 6% since 2004. After children reach 2 years of age, the consequences of stunting become almost irreversible. This paper seeks to examine and analyze the determinants associated with stunting during the first 1,000 days of life in Bangladesh to assist in developing evidence‐based interventions in Bangladesh. A literature review was conducted comprehensively on all relevant peer‐reviewed and gray literature of studies conducted in Bangladesh. The existing literature was searched and examined using the World Health Organization (WHO) conceptual framework for stunting. Evidence indicates that low maternal weight, lack of maternal education, severe food insecurity, lack of access to suitable nutrition, nonexclusive breastfeeding, pathogen‐specific diarrhea, and low weight and height at birth are associated with early childhood stunting in Bangladesh. The relation of the quality of drinking water with stunting is not clear in Bangladesh. Literature about the association between stunting and determinants such as the political economy, education systems, and agriculture and food systems is not found. This synthesis shows that the factors of stunting are multifaceted. As such, a multi‐sectoral approach is essential in Bangladesh, employing evidence‐based interventions to address the determinants that contribute to the risk of stunting to achieve the global nutrition target by 2025.

How do nutrition professionals working in low-income countries perceive and prioritize actions to prevent wasting? A mixed-methods study.

Despite a shared commitment to achieving global nutrition targets, development and emergency‐humanitarian actors tend to prioritize different nutrition outcomes and actions. New approaches are needed to bridge the divide between these communities and to strengthen the overall evidence base for prevention of wasting. To better understand how these different groups perceive and prioritize actions for wasting prevention, key informant interviews (n = 21) were conducted, and an online survey was fielded among nutrition professionals working in low‐income countries (n = 107). Additionally, nutrition policy and strategy documents for select global and country institutions (n = 12) were analysed to identify interventions and approaches for addressing different forms of undernutrition. The findings of this study suggest that at both global and country levels, development actors tend to prioritize stunting prevention, and emergency‐humanitarian actors tend to prioritize treatment of acute malnutrition. It was less common for wasting prevention to be mentioned as an explicit priority. Many interventions were perceived by respondents to influence both stunting and wasting despite limited published evidence of effectiveness on wasting for water, sanitation and hygiene, growth monitoring and promotion, breastfeeding promotion and micronutrient supplementation. To help unify the nutrition community around prevention of wasting, the discourse about priority interventions should shift from ‘stunting versus wasting’ and ‘prevention versus treatment’ to a life‐course framing around child survival, growth and development. Respondents identified a need for more programme and research funding that prioritizes both wasting and stunting as outcomes. They also suggest leveraging existing national coordination bodies that bring development and emergency‐humanitarian partners together.

Global, Regional, and National Prevalence of Anemia and Its Causes in 204 Countries and Territories, 1990–2019

Abstract Objectives To estimate the total prevalence of anemia by severity and quantify the contribution attributable to 35 underlying causes for 204 countries and territories by age and sex from 1990 to 2019. Methods We conducted a systematic review for data on mean and standard deviation of hemoglobin (Hb) by age and sex. Using a 3-step spatio-temporal Gaussian process regression, we estimated mean and standard deviation Hb by location, age, and sex from 1990 to 2019. We then calculated the total distribution of hemoglobin for each location, year, age, and sex and quantified the prevalence of anemia by severity (mild, moderate, and severe). Finally, using a counterfactual analysis, we calculated the portion of total anemia prevalence attributable to 35 causes using cause-specific Hb shifts, cause prevalence, and the overall Hb distribution for each location, year, age, and sex. Results All ages anemia prevalence was 22.8% (95% CI: 22.6–23.1) globally in 2019, a decrease from 27.0% (26.7–27.2) in 1990. While prevalence decreased over this time, total cases of anemia increased from 1.42 (1.41–1.43) billion in 1990 to 1.74 (1.72–1.76) billion in 2019. Prevalence was highest among children under five years, with a combined prevalence of 39.7% (39.0–40.4) in 2019. Globally, 54.1% (53.8–54.4) of anemia cases were mild, 42.5% (42.2–42.7) were moderate, and 3.4% (3.3–3.5) were severe. Anemia was responsible for 58.6 (40.14–81.1) million years lived with disability in 2019. The regions with the highest burden were Western Sub-Saharan Africa, South Asia, and Central Sub-Saharan Africa. The top three contributing causes globally were Dietary iron deficiency, Vitamin A deficiency, and Beta-thalassemia trait, respectively. Conclusions Despite reductions in anemia prevalence globally, the burden of anemia remains persistently high in many regions. An increased focus on interventions is needed to accelerate progress toward meeting Global Nutrition Target 2, a 50% reduction of anemia in women of reproductive age by 2025, and to alleviate the substantial health loss in children under five years of age. These estimates of total burden of anemia by severity and its underlying causes allow for more precise targeting of interventions to the highest-burden regions and the causes contributing the most to total prevalence. Funding Sources Funding was provided by the Bill and Melinda Gates Foundation.

Global, Regional, and National Prevalence and Trends in Infant Breastfeeding Status in 204 Countries and Territories, 1990–2019

Abstract Objectives To estimate prevalence of breastfeeding (exclusive, predominant, partial, and none) and trends for infants under six months of age for 204 countries and territories from 1990 to 2019. Methods We conducted a systematic review for data on breastfeeding status for children under six months of age. We used survey and food diary data to categorize breastfeeding status into exclusive, predominant, partial, and none. Using a 3-step spatio-temporal Gaussian process regression, we modeled the prevalence of each breastfeeding category in 204 countries and territories, 1990 to 2019. Results Global prevalence of exclusive breastfeeding in infants less than six months of age was 43.5% (95% CI 42.7–44.3) in 2019, up from 34.0% (32.7–35.3) in 1990. Globally, non-exclusive breastfeeding was distributed 30.5% (29.8–31.1) predominant, 16.6% (16.2–17.0) partial, and 9.4% (8.9–10.0) no breastfeeding in 2019. Each of these categories experienced a decline in prevalence since 1990, when non-exclusive breastfeeding was 37.0% (36.0–38.1) predominant, 18.7% (18.1–19.4) partial, and 10.2% (9.5–11.0%) no breastfeeding. Exclusive breastfeeding was highest in Andean Latin America (59.7% [57.4–61.9]), Oceania (56.8% [53.2–60.0]), and South Asia (53.9% [53.2–60.0]). There was marked geographic variation in the distribution of non-exclusive breastfeeding types. Predominant breastfeeding was highest in Western Sub-Saharan Africa (51.5% [49.8–53.2]) and Central Asia (47.2% [45.3–49.0), partial breastfeeding was highest in Southern Latin America (31.1% [28.4–34.0]) and the Caribbean (29.3% [27.6–31.1]), and no breastfeeding was highest in High-income North America (36.7% [31.0–42.5]) and Australasia (32.4% [26.3–36.4]). Conclusions Since 1990, global prevalence of exclusive breastfeeding has increased nearly 10 percentage points. Nonetheless, many countries are not on track to meet the WHO Global Nutrition Target of at least 50% of infants under 6 months exclusively breastfeeding. These cross-nationally comparable estimates of current levels and trends in breastfeeding status provide useful data for targeting interventions to improve breastfeeding practices and to help alleviate the associated global burden of infant malnutrition. Funding Sources Funding for this research was provided by the Bill and Melinda Gates Foundation.

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic.

Implementing the Baby Friendly Hospital Initiative in a Tertiary Health Facility: Lessons from the University of Port Harcourt Teaching Hospital, Nigeria

Background: As part of Nigeria’s effort to attain the targets of the 1990 Innocenti Declaration, the Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. The 2005 Innocenti Declaration reiterated the need for the Initiative by asking governments to “revitalize” it and maintain “the Global Criteria as the minimum requirement for all facilities”. The Nigerian government adopted the Initiative and in response to the national directive for tertiary health facilities to become Baby Friendly, the University of Port Harcourt Teaching Hospital (UPTH) established its BFHI Committee in 1992, with a multi-departmental and multi-disciplinary membership. Although the Baby Friendly Hospitals designated following this directive have largely not been reassessed, the BFHI Committee of the UPTH has remained active, implementing relevant activities at the facility and within and outside Rivers State.&#x0D; Aims: To share experiences with sustaining BFHI activities without adequate support in a tertiary health facility with a goal to stimulating commitment to the establishment and sustenance of similar committees in similar health facilities.&#x0D; Place and Duration of Study: University of Port Harcourt Teaching Hospital, Nigeria; 27 years.&#x0D; Methodology: From the inception of the Committee, an administrative structure comprising of the Steering Committee and its Chairman, the Coordinator and Secretary was set up. Information on the activities of the Committee was extracted from the reports of activities, Minutes of Meetings and other publications of the Committee. These were analysed for presentation. &#x0D; Results: Established in 1992 to drive the hospital’s mandate to become Baby Friendly, the Committee has sustained the efforts to promote, protect and support breastfeeding through capacity development, provision of technical support to Departments and facilities, promotion of research and support of the implementation of the Ten Steps to Successful Breastfeeding, the International Code of Marketing of Breast milk Substitutes, HIV and Infant Feeding Counselling, Facility Based Management of Severe Acute Malnutrition and others.&#x0D; Some of the achievements of the Committee during the period 1992-2019 are:&#x0D; &#x0D; Sustained implementation of activities in support of the Ten Steps to Successful Breastfeeding (operating the Crèche, Mother’s Room, Nutrition Clinic and Breastfeeding Room in the Special Care Baby Unit, Nutrition education and the distribution of Information, Education and Communication materials on breastfeeding and the Code).&#x0D; Celebration of the World Breastfeeding Week and mobilization of stakeholders to celebrate the Week since 1997.&#x0D; Awareness creation on the Code for improved compliance within and outside Rivers State&#x0D; Integration of breastfeeding education into the curricula of health workers&#x0D; The Conduct of the 2015 World Breastfeeding Trends Initiative Assessment in Nigeria&#x0D; &#x0D; Challenges: include changes in leadership with some leaders not showing commitment to the mandate of the Committee; Lack of funds, lack of dedicated staff for breastfeeding promotion in the hospital and pressure from infant food industries.&#x0D; Conclusion: Successful and continued implementation of the Baby Friendly Hospital Initiative with its expansion to the BFH Community Initiative will contribute to improved breastfeeding practices and therefore the attainment of the global nutrition targets. While mitigating the challenges to effective implementation of the Committee’s activities, tertiary health facilities should reposition themselves to promote, protect and support the initiative for the realization of relevant global nutrition targets.

Spatial-temporal trends and risk factors for undernutrition and obesity among children (

ObjectivesTo assess space-time trends in malnutrition and associated risk factors among children (<5 years) in South Africa.DesignMultiround national panel survey using multistage random sampling.SettingNational, community based.ParticipantsCommunity-based sample of children and...

Nutrition in the context of the Sustainable Development Goals.

The 2030 Agenda for the Sustainable Development Goals (SDGs) represents a common framework of international cooperation to promote sustainable development. Nutrition is the key point for the SDG 2 ‘End hunger, achieve food security and improved nutrition and promote sustainable agriculture’ and is an essential component for achieving many of the other targets: overall, the nutritional aspects of the SDGs aim to promote healthy and sustainable diets and ensure food security globally. While undernutrition is of minimal concern in the European Union Member States, trends in childhood obesity are still alarming and far from any desirable target. European food production systems have improved over the last years, with immediate impact on several environmental aspects; however, a comprehensive regulatory framework to fulfil the environmental and climate targets is still lacking. Policy actions at multinational level are needed to achieve global nutrition targets designed to guide progress towards tackling all forms of malnutrition while preserving the environment through virtuous food production and food systems.

Mapping child growth failure across low- and middle-income countries

Childhood malnutrition is associated with high morbidity and mortality globally1. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood2. Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years of age (0–59 months), is a specific subset of undernutrition characterized by insufficient height or weight against age-specific growth reference standards3–5. The prevalence of stunting, wasting, or underweight in children under five is the proportion of children with a height-for-age, weight-for-height, or weight-for-age z-score, respectively, that is more than two standard deviations below the World Health Organization’s median growth reference standards for a healthy population6. Subnational estimates of CGF report substantial heterogeneity within countries, but are available primarily at the first administrative level (for example, states or provinces)7; the uneven geographical distribution of CGF has motivated further calls for assessments that can match the local scale of many public health programmes8. Building from our previous work mapping CGF in Africa9, here we provide the first, to our knowledge, mapped high-spatial-resolution estimates of CGF indicators from 2000 to 2017 across 105 low- and middle-income countries (LMICs), where 99% of affected children live1, aggregated to policy-relevant first and second (for example, districts or counties) administrative-level units and national levels. Despite remarkable declines over the study period, many LMICs remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. Large disparities in prevalence and progress exist across and within countries; our maps identify high-prevalence areas even within nations otherwise succeeding in reducing overall CGF prevalence. By highlighting where the highest-need populations reside, these geospatial estimates can support policy-makers in planning interventions that are adapted locally and in efficiently directing resources towards reducing CGF and its health implications.

Market-Driven Food Fortification to Address Dietary Needs.

The global economic and health-related burden of micronutrient deficiency is very large. Reducing these deficiencies is one of the main objectives of the Global Nutrition Targets 2025 of the WHO. To address this form of malnutrition, the WHO/FAO has defined fortification as one of the possible public health interventions, and voluntary fortification is one of the possible fortification approaches. Voluntary fortification can contribute to meeting nutritional requirements in targeted and untargeted populations as long as specific food vehicles are used and specific consumer demands are addressed. Fortified foods should be consumed regularly and need to be affordable, safe, and meet consumer preferences. Two types of fortified food groups will illustrate this form of fortification, namely targeted fortification with complementary feeding (or fortified infant cereals), and market-driven mass fortification as achieved with fortified condiments.

A study on role of LATCH scoring in duration of exclusive breastfeeding in a rural tertiary care hospital, Puducherry: a prospective study

Background: Exclusive Breastfeeding (EBF) for 6 months is the optimal way of feeding infants. NFHS4 data shows 45.5% of children were exclusively breastfed at 6 months in Puducherry. The Global Nutrition Targets 2025 aims at increasing EBF rates in first 6 months up to at least 50%. The main objective is to find areas of needed intervention using LATCH scoring and to find factors responsible for fall in rates of EBF.Methods: A prospective study was conducted between November 2017 and April 2019 (1½years). Mothers were educated about breastfeeding. LATCH score assessed at 8 and 48 hours of life. At 48hours, score &gt;8 indicates there is a high chance for EBF for next 6 months and score &lt;8 indicates, mother is having difficulty in feeding and are intervened at this point. Data about EBF and reason for early weaning at 6 weeks and 6 months collected.Results: LATCH score at 8 hours was &gt;8 in infants delivered via NVD: 50% as against 9.6% in babies delivered via LSCS. At 48 hours LATCH score improved in both groups: 60.8% in babies delivered via NVD, 38.3% in babies delivered via LSCS. Compared to Primi-mothers, infants born to multigravida mothers had higher scores at 48 hours: 62.2% as against 31.1%. 84% were EBF at 6 weeks. 51% were EBF at 6 months. When mothers with LATCH score &lt;8 at 48 hours were intervened, EBF rate at 6 weeks improved. Most common reason for early weaning at 6 weeks was maternal problems: 6.6% and at 6 months- due to influence of relatives: 27%.Conclusions: LATCH score helps in predicting breastfeeding duration as early as 48 hours of life. Low scores indicate, it requires intervention and identifies the areas of needed intervention. Counselling regarding EBF must include not only mothers but also relatives.

Poor nutrition for under-five children from poor households in Ethiopia: Evidence from 2016 Demographic and Health Survey.

BackgroundEthiopia is commonly affected by drought and famine, and this has taken quite a toll on citizens of the country, particularly the under-five children. Undernutrition among under-five children in Ethiopia is a prominent public health concern, and it lacked attention for decades. However, the government of Ethiopia, together with other stakeholders, committed to overcoming the impact of malnutrition through the transformational plan. Here we show the magnitude of undernutrition among under-five children and the factors predicting the achievement of global nutrition targets set for 2025 at the World Health Assembly.MethodsEthiopian Demographic and Health Survey (EDHS) 2016 was used for this study. A total of 9494 child-mother pairs were included in this analysis. The nutritional status indicators (Height-for-age, Weight-for-height and Weight-for-age) of children were measured and categorized based on the World Health Organization child growth standards. A multilevel logistic regression model adjusted for clusters and sampling weights were used to identify factors associated with stunting, underweight, and wasting. The independent variables were assessed by calculating the odds ratios with 95% confidence interval (CI).ResultThe prevalence of stunting was 38.3% (95% CI: 36.4% to 40.2%), under-weight 23.3% (95%CI: 21.9% to 24.9%) and wasting 10.1% (95%, CI: 9.1% to 11.2%). Sex of the child (male), children older than 24 months, recent experience of diarrhea, household wealth index (poorest), and administrative regions (Tigray, Amhara and developing regions) had a higher risk of undernutrition. On the other hand, children born from overweight mothers and educated mother (primary, secondary or higher) had a lower risk of undernutrition.ConclusionThe burden of undernutrition is still considerably high in Ethiopia. Implimentation of strategies and policies that focus on improving the socioeconomic educatiional status of the community need to be sustained. Generally, actions targeted on factors contributing to undernutrition among under-five children demands immediate attention to achieve national and global nutrition target.