Inequalities In Undernutrition Research Articles

Spatial Inequality in Undernutrition Among Under-Five Children in Zimbabwe

Spatial Inequality in Undernutrition Among Under-Five Children in Zimbabwe

Factors Associated with Inequality in Undernutrition among Egyptian Children

Factors Associated with Inequality in Undernutrition among Egyptian Children

Inequality in Under-Nutrition among Under-Five Children in Lakhimpur District of Assam

Children of today are citizens of tomorrow, hence improving nutritional status among children becomes extremely important for all the nations. The raw data collected from the Lakhimpur district reveals that the burden of overall nutritional deficiency among children is still too high; on average, two in every five (37%) children had at least one kind of nutritional deficiency. However, the nutritional status of female children has improved over time compared to the male children, but the overall decline is not satisfactory. We have observed a higher inequality of nutritional deficiency among children in Assam by household wealth status (Gini value= 0.498) compared to the mother's education level (Gini value = 0.067). Therefore, it's an urgent need to expand the scope of the ICDS program to provide mass nutrition and health education by making provisions for home visits and primarily targeting pregnant and lactating mothers.

Socioeconomic Inequalities in Women's Undernutrition: Evidence from Nationally Representative Cross-Sectional Bangladesh Demographic and Health Survey 2017-2018.

The objective of this study was to explore the socioeconomic inequalities in undernutrition among ever-married women of reproductive age. We used nationally representative cross-sectional data from the Bangladesh Demographic and Health Survey, 2017–2018. Undernutrition was defined as a body mass index (BMI) of <18.5 kg/m2. The concentration index (C) was used to measure the socioeconomic inequality in the prevalence of women’s undernutrition. A multiple binary logistic regression model was carried out to find out the factors associated with women’s undernutrition. The prevalence of undernutrition among women of 15–49 years was 12%. Among them, 8.5% of women were from urban and 12.7% of women were from rural areas. The prevalence of undernutrition was highest (21.9%) among women who belonged to the adolescent age group (15–19 years). The C showed that undernutrition was more prevalent among the socioeconomically worst-off (poorest) group in Bangladesh (C = −0.26). An adjusted multiple logistic regression model indicated that women less than 19 years of age had higher odds (adjusted odds ratio, AOR: 2.81; 95% confidence interval, CI: 2.23, 3.55) of being undernourished. Women from the poorest wealth quintile (AOR: 3.93, 95% CI: 3.21, 4.81) had higher odds of being undernourished. On the other hand, women who had completed secondary or higher education (AOR: 0.55; 95% CI: 0.49, 0.61), married women who were living with their husbands (AOR: 0.72, 95% CI: 0.61, 0.86), and women exposed to mass media (AOR: 0.87, 95% CI: 0.79, 0.97) were less likely to be undernourished. Intervention strategies should be developed targeting the poorest to combat undernutrition in women of reproductive age in Bangladesh.

The double burden of malnutrition in India: Trends and inequalities (2006–2016)

Rapid urban expansion has important health implications. This study examines trends and inequalities in undernutrition and overnutrition by gender, residence (rural, urban slum, urban non-slum), and wealth among children and adults in India. We used National Family Health Survey data from 2006 and 2016 (n = 311,182 children 0-5y and 972,192 adults 15-54y in total). We calculated differences, slope index of inequality (SII) and concentration index to examine changes over time and inequalities in outcomes by gender, residence, and wealth quintile. Between 2006 and 2016, child stunting prevalence dropped from 48% to 38%, with no gender differences in trends, whereas child overweight/obesity remained at ~7–8%. In both years, stunting prevalence was higher in rural and urban slum households compared to urban non-slum households. Within-residence, wealth inequalities were large for stunting (SII: -33 to -19 percentage points, pp) and declined over time only in urban non-slum households. Among adults, underweight prevalence decreased by ~13 pp but overweight/obesity doubled (10% to 21%) between 2006 and 2016. Rises in overweight/obesity among women were greater in rural and urban slum than urban non-slum households. Within-residence, wealth inequalities were large for both underweight (SII -35 to -12pp) and overweight/obesity (+16 to +29pp) for adults, with the former being more concentrated among poorer households and the latter among wealthier households. In conclusion, India experienced a rapid decline in child and adult undernutrition between 2006 and 2016 across genders and areas of residence. Of great concern, however, is the doubling of adult overweight/obesity in all areas during this period and the rise in wealth inequalities in both rural and urban slum households. With the second largest urban population globally, India needs to aggressively tackle the multiple burdens of malnutrition, especially among rural and urban slum households and develop actions to maintain trends in undernutrition reduction without exacerbating the rapidly rising problems of overweight/obesity.

Spatial and Temporal Inequalities in Undernutrition Among Non-pregnant Women in Ghana: A Multilevel Analysis

Spatial and Temporal Inequalities in Undernutrition Among Non-pregnant Women in Ghana: A Multilevel Analysis

Malnutrition in all its forms by wealth, education and ethnicity in Latin America: who are more affected?

To summarise the findings from this supplemental issue on the distribution of malnutrition (stunting/short stature, anaemia and overweight) by wealth, education and ethnicity within and between ten Latin American countries. We retrieved information from each country's article and estimated the average difference in the prevalence of malnutrition between groups. We estimated the associations between countries' malnutrition prevalence and GDP, percentage of women with high education and percentage of non-indigenous ethnicity. Nationally representative surveys from ten Latin American countries conducted between 2005 and 2017. Children (<5 years), adolescent women (11-19 years) and adult women (20-49 years). Socially disadvantaged groups (low wealth, low education and indigenous ethnicity) had on average 15-21 (range across indicators and age groups) percentage points (pp) higher prevalence of stunting/short stature and 3-11 pp higher prevalence of anaemia. For overweight or obesity, adult women with low education had a 17 pp higher prevalence; differences were small among children <5 years, and results varied by country for adolescents by education, and for adults and adolescents by wealth and ethnicity. A moderate and strong correlation (-0·58 and-0·71) was only found between stunting/short stature prevalence and countries' GDP per capita and percentage of non-indigenous households. Overweight was equally distributed among children; findings were mixed for ethnicity and wealth, whereas education was a protective factor among adult women. There is an urgent need to address the deep inequalities in undernutrition and prevent the emerging inequalities in excess weight from developing further.

Socio-economic inequality in malnutrition among children in India: an analysis of 640 districts from National Family Health Survey (2015\u201316)

BackgroundDespite a fast-growing economy and the largest anti-malnutrition programme, India has the world’s worst level of child malnutrition. Despite India’s 50% increase in GDP since 1991, more than one third of the world’s malnourished children live in India. Among these, half of the children under age 3 years are underweight and a third of wealthiest children are over-nutrient. One of the major causes for malnutrition in India is economic inequality. Therefore, using the data from the fourth round of National Family Health Survey (2015–16), present study aims to examine the socio-economic inequality in childhood malnutrition across 640 districts of India.MethodConcentration curve and generalized concentration index were used to examine the socioeconomic inequalities in malnutrition. However, regression-based decomposition methodology was used to decomposes the causes of inequality in childhood malnutrition.ResultResult shows that about 38% children in India were stunted and 35% were underweight during 2015–16. Prevalence of stunting and underweight children varies considerably across Indian districts (13 to 65% and 7 to 67% respectively). Districts having the higher share of undernourished children is coming from the particular regions like central, east and west part of the country. On an average about 35% of household in a district having the access of safe drinking water and 42% of household in a district exposed to open defecation. The study found the inverse relationship between district’s economic development with childhood stunting and underweight. The concentration of stunted as well as underweight children were found in least developed districts of India. Decomposition approach found that practice of open defecation is positively influenced the inequality in stunting and underweight. Further, inequality in undernutrition is accelerated by the height and education of the mother, and availability of safe drinking water in a district.ConclusionsThe districts that lied out in a spectrum of developmental diversity are required some specific set of information’s that covering socio-economic, demographic and health-related quality of life of people in those backward districts. More generally, policies to avail improved water and sanitation facility to public and female literacy should be continued. It is also important to see that the benefits of both infrastructure and more general economic development are spread more evenly across districts.

Risk factors and socioeconomic inequalities in undernutrition among children 0-59 months of age in India

In the majority of low- and middle-income counties, child health-care dissimilarities are further aggravated by nutritional status (i.e., stunting, underweight, and wasting). In India, child malnutrition is the most important contributor to disease burden. The present study uses data from the 4th round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. We considered anthropometric indicators of unit-level data of 2, 48, and 174 children aged 0-59 months. This study examines the socio-economic inequality in nutritional status and their determinants among under-5 year children. The factors considered in the analysis were categorized as child age in months, mother’s educational status, mother’s nutritional-status, type of caste, wealth index, birth order, and size of a child at birth. In this study, multivariate logistic regression and concentration index (CI) have been employed to explore the effect of various factors on the child’s nutritional status. The binary logistic analysis has demonstrated a significant association between child nutritional status and mother’s education, mother’s nutritional status, type of caste, wealth index, birth order, and size of a child at birth. The results show that the CI for stunting, underweight, and wasting were −0.14, −0.16, and −0.08. Therefore, these factors were significantly high in poorer households. Our study suggests that the nutrition-specific programs to encourage nutritional adequacy, diversity, reduces the nutritional burden, and growth of child’s in India.

Infant nutrition and growth: trends and inequalities in four population-based birth cohorts in Pelotas, Brazil, 1982-2015.

BackgroundLevels of child undernutrition have declined in many middle-income countries, whereas overweight and obesity have increased. We describe time trends in nutritional indicators at age 1 year in the 1982, 1993, 2004 and 2015 Pelotas (Brazil) Birth Cohorts.MethodsEach study included all children born in the urban area of the city, with over 4 200 births in each cohort. Children were measured at approximately 12 months of age. Anthropometric indicators were calculated according to World Health Organization Growth Standards. Stunting and wasting were defined as <-2 Z scores for length for age and weight for length, and overweight as >2 Z scores for weight for length. Prevalence was stratified by sex, maternal skin colour and family income.ResultsThe prevalence of stunting declined by 53% (from 8.3% to 3.9%) from 1982 to 2015. Wasting prevalence remained stable at low levels (1.8% in 1982 and 1.7% in 2015), whereas overweight increased by 88% (6.5% to 12.2%). Undernutrition was more common among boys, those born to mothers with brown or black skin colour and in the poorest quintile of families. Socioeconomic inequalities in undernutrition decreased markedly over time. Overweight was markedly more common among the rich in 1982, but fast increase among the poor eliminated socioeconomic differences by 2015, when all groups showed similar prevalence.ConclusionsOur results confirm the rapid nutrition transition in Brazil, with marked reduction in levels and inequalities in undernutrition in parallel with a rapid increase in overweight, which became the main nutritional problem for children.

Do socio-economic inequalities in infant growth in rural India operate through maternal size and birth weight?

Background: In total, 3.1 million young children die every year from under-nutrition. Greater understanding of associations between socio-economic status (SES) and the biological factors that shape under-nutrition are required to target interventions.Aim: To establish whether SES inequalities in under-nutrition, proxied by infant size at 12 months, operate through maternal and early infant size measures.Subjects and methods: The sample comprised 347 Indian infants born in 60 villages in rural Andhra Pradesh 2005–2007. Structural equation path models were applied to decompose the total relationship between SES (standard of living index) and length and weight for age Z-scores (LAZ/WAZ) at 12 months into direct and indirect (operating through maternal BMI and height, birthweight Z-score and LAZ/WAZ at 6 months) paths.Results: SES had a direct positive association with LAZ (Standardised coefficient = 0.08, 95% CI = 0.02–0.13) and WAZ at age 12 months (Standardised coefficient = 0.08, 95% CI = 0.02–0.15). It also had additional indirect positive associations through increased maternal height and subsequently increased birthweight and WAZ/LAZ at 6 months, accounting for 35% and 53% of the total effect for WAZ and LAZ, respectively.Conclusion: Findings support targeting evidence based growth interventions towards infants from the poorest families with the shortest mothers. Increasing SES can improve growth for two generations.

Food supplementation for improving the physical and psychosocial health of socio-economically disadvantaged children aged three months to five years.

Undernutrition contributes to five million deaths of children under five each year. Furthermore, throughout the life cycle, undernutrition contributes to increased risk of infection, poor cognitive functioning, chronic disease, and mortality. It is thus important for decision-makers to have evidence about the effectiveness of nutrition interventions for young children.

Regional variation in maternal and childhood undernutrition in Bangladesh: evidence from demographic and health surveys

Undernutrition among mothers and children is currently a major public health and development concern in Bangladesh. In literature relating to nutritional determinants, of particular interest is the geography, as regions with poor nutrition tend to pull down the overall nutritional status of the country. As such, reducing the regional gap can alone reduce overall undernutrition significantly, especially when regional gaps are high. The aim of this study is, therefore, to assess the magnitude of inequalities in undernutrition in children aged under 5 years in Bangladesh and their mothers, and relate this to the administrative divisions of the country. The Bangladesh Demographic and Health Surveys (1996-1997, 1999-2000, 2004 and 2007) were the sources of data, and a total of 16 278 mother-child pairs whose records were complete for the required individual and household-level variables were included in the analysis. Maternal nutritional status was measured by the body mass index (BMI). Weight-for-age, height-for-age and weight-for-height z-scores were calculated by use of the World Health Organization (WHO) Child Growth Standards to assess the nutritional status of children aged under 5 years. General linear model, sequential linear and multinomial logistic regression analyses were done to assess the inequalities in maternal and child nutritional status among the six administrative divisions of Bangladesh. Socioeconomic variables that were controlled for were residency, education and occupation of the mothers and their husbands, house type and possession score in the household. Maternal BMI and prevalence of underweight, stunting and wasting in children aged under 5 years were found to vary significantly according to administrative division. Of the six divisions, Sylhet was found to have highest prevalence of undernourished mothers and children. The trends from 1996 to 2007 also established Sylhet as the poorest-performing region overall. The Sylhet administrative division needs specially focused attention from policy-makers if the overall performance of the health, nutrition and population sector is to reach the targets set by the country.

Food Supplementation for Improving the Physical and Psychosocial Health of Socio‐economically Disadvantaged Children Aged Three Months to Five Years: A Systematic Review

Food Supplementation for Improving the Physical and Psychosocial Health of Socio‐economically Disadvantaged Children Aged Three Months to Five Years: A Systematic Review

Coexistence of social inequalities in undernutrition and obesity in preschool children: population based cross sectional study

Aims: To test for the coexistence of social inequalities in undernutrition and obesity in preschool children. Methods: Retrospective, cross sectional, study of routinely collected data from 74 500 children aged...