Nutritional Status Of Under-five Children Research Articles

Effect of quality and quantity of diet on nutritional status of under-five children residing in the rural area: A longitudinal study

ABSTRACT Introduction: Variety and adequacy of intake of food are required to meet the nutritional needs of the children. Due to poverty/illiteracy, poor families depend on a single food group that is, cereals. Due to the pandemic also, the nutrition of the growing children is affected. Objective: To know the effect of quantity and quality of diet on the nutritional status of under-five children. Methodology: This study had 270 children aged between 1 and 4 years registered at Anganwadi as study participants. Information on sociodemographic variables, quantity of calories and proteins consumed, quality of diet, and anthropometry of children was collected. Percentages and paired t-tests were used to find the difference between nutritional status and diet at different intervals, which was found to be statistically significant (P < 0.05). Results: In our study, we found that as the quantity and quality of diet improved nutritional status, especially weight for age, body mass index (BMI) for age Z score also improved. There was a significant difference between calories consumed at the baseline, 6 months and 1 year with P < 0.05. Protein intake was significant between baseline and six months with P < 0.005. Conclusion: Our study found a high percentage of undernutrition and wasting in the under-five population when diet was not sufficient in quality and quantity. As the quality and quantity of diet improved nutritional status also improved.

Burden of undernutrition among under-five Bengali children and its determinants: Findings from Demographic and Health Surveys of Bangladesh and India.

Globally, undernutrition is the leading cause of mortality among under-five children. Bangladesh and India were in the top ten countries in the world for under-five mortality. The aim of the study was to investigate the nutritional status of Bengali under-five children. Data on 25938 under-five children were retrieved from the Bangladesh Demographic and Health Survey 2017-18 (BDHS) and the National Family Health Survey of India 2015-16 (NFHS-4). Stunting, wasting, underweight and thinness were considered to understand the nutritional status of under-five children. Binary logistic regression was used to identify associated factors of undernutrition among children. Over one-quarter of Bengali under-five children were found to be suffering from the problem of stunting (31.9%) and underweight (28.1%), while other nutritional indicators raised serious concern and revealed inter-country disparities. In the cases of wasting, underweight and thinness, the mean z-scores and frequency differences between Bangladesh and India were significant. The nutritional status of Bengali under-five children appeared to have improved in Bangladesh compared to India. Child undernutrition had significant relations with maternal undernutrition in both countries. Girls in Bangladesh had slightly better nutritional status than boys. In Bangladesh, lack of formal education among mothers was a leading cause of child undernutrition. Stunting and underweight coexist with low household wealth index in both counties. The research revealed that various factors were associated with child undernutrition in Bengalis. It has been proposed that programmes promoting maternal education and nutrition, along with household wealth index be prioritised. The study recommends that the Governments of Bangladesh and India should increase the budget for health of children so as to reach the sustainable development goals.

Logistic Regression Analysis of Mode of Delivery Influencing Nutritional Status among Under-Five Children in Bangladesh: Survey in Rural Area of Rajshahi District

Caesarean delivery is a surgical procedure in which a fetus is delivered through an incision in the mother's abdomen and uterus. If there are no complications with women pregnancy or labor, a vaginal birth is safer than a caesarean birth. Worldwide the rates of C-section have gradually increased in the latest decades. The aim of the study was to determine the prevalence of caesarian delivery, and to investigate the impact of caesarian delivery on nutritional status of under-five children in the rural area of Rajshahi district, Bangladesh. This was a cross sectional study. Data was collected from Rajshahi district using multistage sampling. A total number of 540 mothers having at least one under-five children currently living together were considered. In order to data analysis, descriptive statistics, Z-proportional test and both univariable and multivariable logistic regression models were in this study according to our objectives. This study revealed that the prevalence of caesarian delivery among mothers living in the rural area of Rajshahi, Bangladesh was 34.4%. The prevalence of stunting, underweight and wasting among under-five children were 43.70%, 39.63% and 27.96% respectively. The stunting, underweight and wasting under-five children were 32.6%, 28.0% and 29.1% respectively who were born by caesarian delivery, these were significantly (p<0.01) lower compared to children who were born by vaginal delivery. However, the logistic model demonstrated that children who were born by vaginal delivery were more likely to have underweight [COR= 1.617; 95%CI: 1.114-2.347; p<0.05] compared to children who were born by caesarian delivery. After controlled the effect of other independent variables such as mothers’ age, education, occupation, nutritional status, fathers, education, occupation, number of family members, type of family and social class, found that children who were born by vaginal delivery had a 1.589-fold higher chance to have underweight compared to children who were born by caesarian delivery [AOR= 1.589; 95%CI: 1.063-2.377; p<0.05]. This study found the high prevalence in stunting, underweight and wasting among under-five children in the rural area of Bangladesh. Bangladesh government and other non-government organizations should take special attention to overcome the problem. International Journal of Statistical Sciences, Vol. 23(2), November, 2023, pp 107-116

Rempah Lombok: Pendekatan Kearifan Lokal sebagai Strategi Penguatan Praktik MPASI bagi Kader Posyandu

Stunting is a problem of chronic malnutrition in young children. Some of the causes of stunting were inappropriate of complementary feeding practices and lack of support from health cadres. One of the stunting locus areas in Indonesia is East Lombok Regency. An education programme needs to be conducted for stunting prevention, such as education of complementary feeding practices and socialisation of the book called "Rempah Lombok". The book was prepared as a guideline for cadres and mothers to provide recommended complementary feeding with local Lombok recipes. The indicator of the success of this activity was done by giving a question-and-answer quiz directly before and after the education process related to complementary feeding practices. The existence of programmes was expected to guide the cadres and mothers more easily and confidently in providing appropriate complementary feeding practices and improving the nutritional status of under-five children in East Lombok.

Nutritional Status of Under-five Children in Arumeru District, Tanzania

Malnutrition not only hinders development but also indicates that the basic physiological needs of individuals have not been adequately met. This study was conducted to assess the nutritional status of the under-five population among the local community in the Arumeru district. The study's specific goals were to analyse under-five food usage at the household level, examine food intake frequency, and calculate the dietary diversity score among the sampled population. The study was conducted in the Arusha region, whereby a sample size of 382 households was selected from the study area. Data analysis involved the use of descriptive statistics. The findings revealed that children under the age of five in the study area experience both micro and macronutrient deficiencies, indicating a state of food nutrition insecurity. Results also showed that more than 50% of the sampled under five scored less than the WHO’s recommended Household Dietary Diversity score which is 33.3%. However, 54.8% of 62 sampled under five children were underweight (<18.5). Moreover, 46% of the households (HH) had less than four meals for under five per day. The most consumed food group by the under-five was cereal, especially maize which is converted into Ugali and porridge, meat, vegetables, and milk which are most of the time shared with the adults with an average of 8,000 Kcal to 10,000 Kcal per day per head. Based on the results, the paper concludes that children under the age of five in the study area are still facing issues related to overweight and improper feeding practices. Therefore, the paper recommends extension officers (food nutritionists and development partners) to continue changing the mindset of household members through in-house training, which will capacitate the communities in preparing types of food for those under five using their own local resources and food available in their respective surroundings.

Prevalence and Determining Factors of Undernutrition among Under-five Children in Three Local Government Areas of Niger State, Nigeria

The Nigerian economy depression, Covid 19 pandemic, nationwide insecurity, and global warming are quartile factors, that affected the already compromised nutritional status of under-five children in the country, with a resultant increase in morbidity and mortality. A community-based cross-sectional study was undertaken using two-stage cluster sampling method in Suleja, Tafa, and Gurara LGAs of Niger state. Data from 2350 under-fives were collected using questionnaires, and anthropometric measurements. WHO growth standard was used to determine the prevalence; multivariate logistic regression in IBM explored statistically significant independent variables associated with stunting, underweight and wasting using p-value of < 0.05. Prevalence of stunting was 47.4%, underweight 32.7%, and wasting 22.6% respectively. Severe stunting and underweight were higher in Suleja, severe wasting in Gurara, and male children were more affected by all indicators. Age of child, LGA, mother and father education, marital status, exclusive breastfeeding, and duration of breastfeeding; source and buying of drinking water, family type, maternal knowledge about malnutrition, and health seeking behavior of mothers were found as determinants. Under-five mortality is a good indicator of the health, and economic status of any community; thus, the health of under-fives needs the utmost attention. The high prevalence from the study is critical; a critical approach is urgently needed at the family, community, local government, state, and national levels with other stakeholders; to ensure under-fives receive adequate, quality, and affordable nutrients for health, and growth. Accessible, prompt, and sustainable interventions for identified cases are of utmost importance. Keywords: Determinants, Niger state, Prevalence, Undernutrition, Under-five.

Effectiveness of Positive Deviance Approach to Reduce Malnutrition among under Five Children: A Systematic Review and Meta-Analysis of Interventional Studies.

The high malnutrition rate in children under five makes this problem one of the public health problems. Various efforts have been made to reduce malnutrition in children under five, one of which is the implementation of community programs with a positive deviance approach which is considered an effective way because the solution to the problem comes from the local community. Thus, we conducted a systematic review and meta-analysis to determine the effect of interventions with a positive deviance approach to reducing under-five children's malnutrition. Systematic searches were conducted using the following journal databases: Science Direct, Pubmed, Proquest, SAGE journal, Web of Science, and Scopus. The article was included if using an intervention design. Data analysis used Review Manager 5.4 software, random effect model, outcome mean of difference, and 95% confidence interval. There were no significant differences between the intervention and control groups on the length for age z-scores (LAZ), weight for age z-scores (WAZ), and weight for height z-scores (WHZ) indicators. There was an increase in LAZ, WAZ, and WHZ scores in the intervention group, with a greater z-score than in the control group. In conclusion, interventions with the positive deviance approach can be used as an alternative to improving the nutritional status of under-five children. However, further research is needed to determine the effective duration of interventions in improving the nutritional status of children.

Spatial variations and determinants of malnutrition among under-five children in Nigeria: A population-based cross-sectional study.

Childhood undernutrition is a major public health challenge in sub-Saharan Africa, particularly Nigeria. Determinants of child malnutrition may have substantial spatial heterogeneity. Failure to account for these small area spatial variations may cause child malnutrition intervention programs and policies to exclude some sub-populations and reduce the effectiveness of such interventions. This study uses the Composite Index of Anthropometric Failure (CIAF) and a geo-additive regression model to investigate Nigeria's prevalence and risk factors of childhood undernutrition. The geo-additive model permits a flexible, joint estimation of linear, non-linear, and spatial effects of some risk factors on the nutritional status of under-five children in Nigeria. We draw on data from the most recent Nigeria Demographic and Health Survey (2018). While the socioeconomic and environmental determinants generally support literature findings, distinct spatial patterns were observed. In particular, we found CIAF hotspots in the northwestern and northeastern districts. Some child-related factors (Male gender: OR = 1.315; 95% Credible Interval (CrI): 1.205, 1.437) and having diarrhoea: OR = 1.256; 95% CrI: 1.098, 1.431) were associated with higher odds of CIAF. Regarding household and maternal characteristics, media exposure was associated with lower odds of CIAF (OR = 0.858; 95% CrI: 0.777, 0.946). Obese maternal BMI was associated with lower odds of CIAF (OR = 0.691; 95% CrI: 0.621, 0.772), whereas, mothers classified as thin were associated with higher odds of CIAF (OR = 1.216; 95% CrI: 1.055, 1.411). Anthropometric failure is highly prevalent in Nigeria and spatially distributed. Therefore, localised interventions that aim to improve the nutritional status of under-five children should be considered to avoid the under-coverage of the regions that deserve more attention.

Household and Community Factors Affecting Nutritional Status of Under-five Children (6-59 months) in Gairo District Using Composite Index of Anthropometric Failure

In Tanzania, where the majority of under-five children are affected, undernutrition is still a significant public health concern. The study aimed at assessing the prevalence of undernutrition and its determinants among under-five children in Gairo District using a Composite Index of Anthropometric Failure (CIAF). A household-based cross-sectional study was employed involving 300 under-five children with their mothers/caregivers in three wards in the Gairo District. Data collection on socio-demographics, dietary diversity, and healthcare factors were collected by interviewer-based semi-structured questionnaires. Anthropometric measurements using standard procedures were performed to collect anthropometric data. Odds ratios with a 95% confidence interval and p-value ≤ 0.05 were used to identify determinants of undernutrition. Prevalence of undernutrition using CIAF was 57.3%, whereby children with single failure were 105 (61%), double failures were 62 (36%) and triple failures were 5 (2.9%). Factors that were significantly associated with undernutrition were the nearest health facility (p = 0.014; OR: 0.504 (0.291-0.873)), place of delivery (p = 0.000; OR: 0.717 (0.107-0.490)), source of drinking water (p = 0.001; OR: 0.452 (0.283-0.722)), type of latrine (p = 0.000; OR: 21.338 (9.807-46.427)), household solid waste disposal method (p = 0.012; OR: 1.806 (0.682-1.964)), birth weight (p = 0.000; OR: 5.400 (2.625-11.109) and marital status (p = 0.00; OR: 0.403 (0.240-0.676)). Therefore, nutrition intervention efforts should be given to the factors reported to positively affect undernutrition.
 Keywords: Undernutrition, factors, Gairo, under-five, CIAF

Levels and trends in key socioeconomic inequalities in childhood undernutrition in Ethiopia: evidence from Ethiopia demographic and health surveys 2000-2019

IntroductionThe global burden of childhood undernutrition is mainly concentrated in low-income and lower-middle-income countries. In Ethiopia, childhood undernutrition varies significantly across different population groups. The present study is aimed at examining the levels and trends in key socioeconomic inequalities in childhood undernutrition in Ethiopia.MethodsThis cross-sectional study was based on a total pooled sample of 48,782 under-five children drawn from five rounds of the Ethiopia Demographic and Health Surveys (2000–2019). We used multilevel binary logistic regression analysis to determine the key socioeconomic determinants of undernutrition among under five children. In addition, we applied concentration index and decomposition rate analysis techniques to explore the levels and trends in key socioeconomic inequalities in childhood undernutrition.ResultsPlace of residence, household wealth status (approximated by asset-based wealth index), and maternal education, among others, were the key socioeconomic variables significantly associated (p < 0.001) with childhood undernutrition in Ethiopia. The level of inequality was the highest with children from rural areas, poor households and uneducated mothers. Absolute socioeconomic inequality in childhood undernutrition prevalence rate was declined by 9.72 during the study period (2000 to 2019).ConclusionChildhood undernutrition was unequally distributed among under-five children in Ethiopia, and largely concentrated among low socioeconomic status population groups. The identified key socioeconomic drivers of inequality in childhood undernutrition can be used to inform localized interventions and communication strategies to improve nutritional status of under-five children in Ethiopia. The study underscores development of poverty reduction strategies that directly address the existing challenges of the food insecurity and childhood undernutrition for the low-income population groups in the country.

Prevalence of enteric bacterial pathogens in diarrheic under-five children and their association with the nutritional status in Bahir Dar Zuria District, Northwest Ethiopia

BackgroundDiarrheal disease is one of the leading causes of child mortality in low and middle-income countries. Low nutritional status and bacterial infections contribute to growth deficiency and death in children. But there is a gap in identifying the bacterial etiology of diarrheal diseases and their association with the nutritional status of under-five children. This study aimed to determine the bacterial etiology of diarrheal diseases and their association with the nutritional status of diarrheic under-five children.MethodsA cross-sectional study was carried out from February 2021 to March 2022 at seven Health Centers in Bahir Dar Zuria district, Ethiopia. A total of 196 diarrheic under-five children visiting the health centers were included in the study. Stool samples were collected from each child for the isolation of Salmonella, Shigella, and E.coli O157:H7. The demographic characteristics and symptoms of children were obtained from parents/guardians. The weight, height, and age of each child were recorded and anthropometric indices were determined by WHO Anthro version 3.2.2 software. The association between bacterial prevalence and the nutritional status of children was analyzed by SPSS version 26 software using Binary logistic regression. All analyses were conducted at a 95% confidence interval and significant association was determined using a p-value < 0.05.ResultsOf the total children included in the study, 13.1% had either E.coli O157:H7, Shigella, or Salmonella. Watery diarrhea and fever were the most clinical characteristics observed in children who are positive for enteric bacteria. The prevalence of stunted, underweight, and wasted was 56.6%, 24.4%, and 13.2% respectively. Children with wasting were significantly associated with Salmonella detection (OR = 7.2, CI, 1.38–38.1, P = 0.02) whereas stunted and underweight were not associated with bacterial prevalence.ConclusionOverall, the prevalence of bacterial pathogens in the study area is high. Stunting, wasting, and being underweight are important nutritional deficits of diarrheic under-five children in the study site. Further studies targeting possible sources of bacteria and determinants of malnutrition in children are suggested. Health sectors found in the district should increase their effort to enhance good nutritional practice through health education and treatment of malnourished children by the provision of micronutrients.

Assessment of Nutritional Status of Under-Five Children in an Urban Area of South Delhi, India.

Introduction Malnutrition amongchildren continues to be a severe public health problem worldwide, whether in a developing country like India or a developed nation. Correct estimation of the problem is a prerequisite to planning the measures to control it. Objective To estimate the prevalence of undernutrition among children under five years of age by utilizing the Composite Index of Anthropometric Failure and the WHO growth charts. Methods From January to March 2020, 1332 children under the age of five years participated in a facility-based, descriptive, cross-sectional study at Fatehpur Beri, Urban Primary Health Center. An anthropometric assessment for each participant was done as per the WHO criteria. The data were entered into a Microsoft Office Excel spreadsheet (Microsoft Corporation, Redmond, WA) and analyzed with WHO Anthro software (WHO, Geneva, Switzerland) and a licensed version of SPSS 21 (IBM Corp., Armonk, NY). Continuous data were expressed using appropriate measures of central tendency, while categorical data were expressed in either frequency or proportions. Results The mean age of the study participants was 23.04 ± 18.24 months, and males (53.3%) were more than (46.7%) females. The prevalence of being underweight was 24.5% (327/1332), of which 24.1% (79/327) of children were severely underweight. Of the total study participants, 27.3% (362/1332) were stunted, and 17.8% (237/1332) were wasted, of which 29.1% (69/237) were severely wasted. The prevalence of anthropometric failure was 45%. Conclusions According to the findings of this study, the prevalence of undernutrition among the study participants was substantial. Furthermore, considering weight for age as the sole criterion may underestimate the true prevalence of malnutrition. The findings have critical implications for future interventions and initiatives among children in India.

Impact of decision-making autonomy of women on nutritional status of under-five children in India: A cross-sectional study based on the national family health survey

Impact of decision-making autonomy of women on nutritional status of under-five children in India: A cross-sectional study based on the national family health survey

Nutritional Status of Under-five Children in Sokoto, Nigeria

Background: Malnutrition is the largest risk factor in the world for disability and premature mortality among young children, especially in developing countries. A myriad of socio-economic, cultural, and environmental factors have been identified to either improve or negatively affect a child's nutritional status. Objectives: To assess the nutritional status of children under-five years of age in Sokoto, Nigeria, and determine the associated factors. Methods: A cross-sectional survey of children aged 6-59 months selected through multistage random sampling. Data was obtained using pretested semi-structured questionnaire and the nutritional indices were determined using WHO anthro v3.2.2. Data was analyzed using SPSS version 25. Results: Subjects comprised a total of 353 children with a mean (±S.D) age of 26.8 ±14.9 months. Majority 214(60.6%) were females. Most 330(93.5%) of the caregivers were married majority 180(51.0%) were of low socio-economic status. Two hundred and two (57.2%) of the under-fives had normal weight for age, 144(40.8%) of them were severely stunted, most 290 (82.2%) of them had normal weight for height, and 199(56.7%) had normal mid upper arm circumference. Mother/caregiver's age (p=0.012), marital status (p= 0.007), and child's immunization status (p=0.015) were associated with weight for age, marital status (p=0.028) was associated with the weight for height/length, Child's age group category (p&lt;0.001), social class (p=0.036), and community setting (p=0.031) were associated with the height for age, Marital status (p=0.025), child's age group category (p&lt;0.001), history of recent illness (p=0.046), and community setting (p&lt;0.001) were associated with the mid-upper arm circumference. Conclusion: Under nutrition was the main form of malnutrition among the under-fives, with severe stunting predominating. The nutritional status were influenced by some maternal or caregivers' socio-demographic factors, as well as inadequate child immunization and treatment of acute illnesses.

Analysis of the Relationship Between Children's Characteristics, Family Characteristics, Food Intake, Eating Habits, and Disease History with Nutritional Status of Under-Five Children Based on the Composite Index of Anthropometric Failure in Karangkamulyan Village, Cihara District, Lebak Regency, Indonesia in 2020

Composite Index of Anthropometric Failure (CIAF) is an indicator of composite nutritional status assessment (WAZ, HAZ, and WHZ) to describe toddler's nutritional problems. In 2020, malnutrition, unemployment, and poverty in Banten Province were high, the population's income tends to be low. Karangkamulyan is an underdeveloped village with mining areas. This is a secondary study used a cross-sectional study design to analyze the relationship between children's characteristics, family characteristics, food intake, eating habits, and disease history with the toddler's nutritional status based on CIAF in Karangkamulyan Village in 2020. The primary research was conducted in September 2020, instrument used is a questionnaire. The sample was 141 toddlers aged 24-59 months. Data were analyzed by univariate and bivariate. The results found that children under five experienced nutritional problems were 36.2%. The variables related to toddler's nutritional status, is exclusive breastfeeding (p=0.026), energy intake (p=0.026), and vegetable protein consumption habits (p =0.003).

Feeding Practices and Nutritional Status of Children under Five Years Attending at Selected Child Welfare Centre, Dhaka Cantonment

Introduction: Malnutrition is one of the catastrophes on human life and a major public health problem. Children below five years of age are at-risk population and hence malnutrition is the leading cause for morbidity and mortality among them. Feeding practices play a pivotal role in determining the nutritional status of Children. Objectives: To find the nutritional status of under-five children and to assess whether infant feeding practices are correlated with nutritional status. Materials and Methods: This cross-sectional study was carried out from 01 March to 30 June 2012 among 110 conveniently and randomly selected children and their mothers as respondents attending selected child welfare centre (CWC) of Dhaka Cantonment. An electronic weighing scale, a standard height scale and a predesigned structured questionnaire were used. All data were analyzed by SPSS. Association was assessed with Chi square test. The prevalence of malnutrition was assessed by different indices of nutritional status based on Weight for Age Zscore (WAZ), Height for Age Z-score (HAZ) and Weight for Height Z -Score (WHZ). Results: Mean age of study population was 31.3±16 months. Out of total 110 mothers as respondents 62 (56.4%) mothers fed their child colostrum. Majority of the mothers (81.7.0%) exclusively breastfed their child. Most of the mothers (59.1%) did not provide proper complementary feeding and 37.3% mother fed their child pre lacteal feeding. Total underweight children were 32 (29%), total stunted children were 44(40.0%) and total wasted children were 26(23.6%). The prevalence of Stunting was higher among children who had not exclusively breastfed. This study showed that the relationship of pre-lacteal feeding and complementary feeding with WAZ, HAZ and WAZ were statistically significant. Conclusion: This study might serve as an initiative to identify the influences of feeding practices on children’s nutritional status to promote and protect the optimal feeding practices for improving nutritional status of children under five years. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 54-56

Nutritional Status of Under-Five Children and The Relationship with Household Food Wastage and Food Security in Samarahan, Malaysia

Introduction: Malnutrition is prevalent among children in developing countries. The cause of malnutrition, although complex, can be attributed to demographic factors, household food wastage, and food insecurity. This study aims to determine the under-five nutritional status of children and its association with household food wastage and food security in the Samarahan division in Sarawak, Malaysia. Materials and Methods: This is a cross-sectional study involving 304 children from rural areas of Asajaya and Samarahan District using a random sampling technique. An interviewer-administered questionnaire was used to collect data from the parents. The nutritional status of the children was assessed by anthropometry. IBM SPSS Version 27.0 and WHO Anthro version 3.2.2 were used for data analysis. A p-value &lt; 0.05 was considered statistically significant. Results: Analysis revealed that 9.5% of the children were moderately wasted, followed by 5.9% who were severely wasted; 20.4% were moderately stunted and 8.9% were severely stunted. Hierarchical regression analysis indicated that male gender (AOR = 1.931, 95% CI: 1.139, 3.274; p&lt;0.05), low birth weight (AOR =2.645, 95% CI: 1.245, 5.618, p&lt;0.05), poor appetite (AOR = 2.547; 95% CI: 1.298, 4.995, p&lt;0.05), and preventive attitude (AOR = 0.460, 95% CI: 0.227, 0.929, p &lt; 0.05) of household food wastage appeared to be significant predictors of nutritional status. However, household food insecurity had a negative correlation but did not significantly impact the nutritional status. Conclusion: Under-five malnutrition was prevalent in the study area and still a public health concern. Although the study did not find any significant association between household food wastage and food security towards the nutritional status of children, addressing the nutritional problem warranted an appropriate Public Health approach for the specific group, especially the modifiable risk factors such as birth weights, appetite, and attitude.

Effects of maternal employment on child malnutrition in South Asia: An instrumental variable approach

ObjectiveAlthough the association between child malnutrition and maternal employment status has been widely studied in several developing countries, the causal effect of mothers’ employment on their children's health remains largely unknown. The aim of this study was to examine the causal effect of maternal employment on child malnutrition in five South Asian countries. MethodThis study used a data set of >55 200 children ages 0 to 5 y by pooling the most recent Demographic Health Surveys (DHS) from Bangladesh, India, the Maldives, Nepal, and Pakistan. An instrumental variable (IV) method was applied to measure the causal effect of the mother's employment status (working mother) on stunting and underweight among children. ResultsResults showed that of the children in South Asia, 37.9% and 33.6% were stunted and underweight, respectively. The IV estimates suggested that maternal employment significantly increased stunting and underweight in children. For example, the likelihood of stunting and underweight increased by about 9.5% and 6.3% points, respectively, in South Asia when mothers worked. The likelihoods in Bangladesh (39.9 and 26.6%) and Pakistan (28 and 33.4%) were high but were at moderate levels in India (5.3 and 4.2%) and Nepal (8 and 9%). ConclusionsIn the present study, an adverse effect of maternal labor market participation on the nutritional status of under-five children in South Asian countries was found. These findings could be helpful for policymakers in South Asian countries to adopt suitable policies to reduce malnutrition among children, especially for the children of employed mothers.

Nutrition Outcomes of Under-five Children of Smallholder Farm Households: Do Higher Commercialization Levels Lead to Better Nutritional Status?

The study investigated the nutritional status of under-five children of farm households. The study utilized primary data from 352 farm households with 140 under-five children. Household crop commercialization index (CCI) was used to estimate cassava farm household crop sale ratio and categorize the households into four commercialization levels while WHO Anthro software was employed to analyze under-five children anthropometric indices such as weight-for-age z-score (WAZ), height-for-age z-score (HAZ) and weight-for-height z-score (WHZ). Logit regression model (LRM) was used to examine the drivers of under-five children’s nutritional status of farm households. The study found that 42.9%, 7.9% and 3.6% of the children are stunted, underweight and wasted respectively. The highest stunting level was recorded in zero level households (CCI 1). Although, some higher CCI households (medium-high and very-high level) recorded increased percent of stunted children. This revealed that being a member of low or high-level commercialization households may not guarantee better nutritional status of young children of farm households. The results of LRM indicated that the predictors of children nutritional status were child’s age, farm size, access to electricity, healthcare and commercialization variables. Moreover, weak positive and negative relationships exist between CCI and children’s nutrition outcomes as measured by the z-scores. The study recommended maternal nutrition-sensitive education intervention that can improve nutrition knowledge of mothers and provision of infrastructure that enhance increased farm production and promote healthy living among farm households.

Malnutrition in Ethiopia: pattern analysis and associated factors among under-five children

PurposeThis study aims to examine the differences within individuals and clusters in nutritional status and identify socioeconomic factors in the nutritional status of under-five children in Ethiopia.Design/methodology/approachA weighted sub-sample of 5,270 under-five children was drawn from the under-five children data set of the Ethiopian 2019 Mini Demographic and Health Survey. Multilevel modeling was used to look at the association between the nutritional status of children with predictors.FindingsThe proportion of stunting, underweight and wasting among under-five children were 39.3%, 28.6% and 16.3%, respectively. The observed Global Moran Index’s value for child malnutrition (stunting, wasting and underweight) prevalence in Ethiopia were I = 0.204 for stunting, I = 0.152 for wasting and I = 0.195 for underweight at p = 0.000 was statistically significant indicating that spatial variability of malnutrition of under-five children across survey clusters and regions was observed. Moreover, the result of heterogeneity between clusters obtained for stunting, underweight and wasting was significant providing evidence of variation among regional clusters concerning the status of nutrition of under-five children. Child’s age in months, breastfeeding, family educational level, wealth index, place of residence, media access and region were highly significantly associated with childhood malnutrition. The inclusion of the explanatory variables has shown a significant impact on the variation in malnutrition among regions.Practical implicationsEnhance education, expanding the activities regarding nutritional and health services using media, health extension workers, and health institutions.Originality/valueThe study provides the malnutrition situation status of Ethiopian country when the survey carried out.