Prevalence Of Undernutrition In Children Research Articles

Temporal Trends in the Prevalence of Child Undernutrition in China From 2000 to 2019, With Projections of Prevalence in 2030: Cross-Sectional Analysis.

Although the problem of malnutrition among children in China has greatly improved in recent years, there is a gap compared to developed countries, and there are differences between provinces. Research on long-term comprehensive trends in child growth failure (CGF) in China is needed for further improvement. The purpose of this study was to examine trends in stunting, wasting, and underweight among children younger than 5 years in China from 2000 to 2019, and predict CGF till 2030. We conducted a cross-sectional analysis using data from the local burden of disease (LBD) database. Using Joinpoint Regression Software, we examined trends in CGF among children younger than 5 years in China from 2000 to 2019, and predicted the trends of prevalence in 2030, using the Holt-Winters model with trends but without seasonal components. The assessment was performed with Stata 17 (StataCorp). Data were analyzed from October 17, 2023, to November 22, 2023. In 2019, the prevalences of stunting, wasting, and underweight decreased to 12%, 3%, and 4%, respectively (decreases of 36.9%, 25.0%, and 42.9%, respectively, compared with the values in 2000). The prevalence of CGF decreased rapidly from 2000 to 2010, and the downward trend slowed down after 2010. Most provinces had stagnated processes of trends after 2017. The age group with the highest stunting prevalence was children aged 1 to 4 years, and the highest prevalence of wasting and underweight was noted in early neonatal infants. From 2000 to 2019, the prevalence of CGF declined in all age groups of children. The largest relative decrease in stunting and underweight was noted in children aged 1 to 4 years, and the largest decrease in wasting was noted in early neonatal infants. The prevalences of stunting, wasting, and underweight in China are estimated to decrease to 11.4%, 3.2%, and 4.1%, respectively, by 2030. China has nationally met the World Health Organization's Global Nutrition Targets for 2030 for stunting but not for wasting. This study provides data on the prevalence and trends of CGF among children younger than 5 years and reports declines in CGF. There remain areas with slow progress in China. Most units have achieved the goal for stunting prevalence but not wasting prevalence.

Assessment of prevalence and epidemiological determinants of undernutrition in children of 6-60 months of the age in an urban slum of Mumbai, India

Background: In urban slums, several socio-demographic factors contribute for the occurrence of undernutrition in children of 6-60 months of the age, this study aims at Assessment of prevalence of undernutrition in children of 6-60 months of the age in an urban slum of Mumbai and to study associated factors. Methods: A cross-sectional study was conducted in Urban Slum which is a field practice area of institution. Children of 6-60 months of the age were included in the study and information was gathered by interviewing parents/caretakers and anthropometric measurement of all children confirming to the inclusion criteria were recorded. Data was analysed with SPSS v.22.0 with suitable tests. Results: Prevalence of undernutrition was found 50.6%, more per cent of undernutrition was found in 25-60 months age 100 (54.1%), 90 (53.3%) girls, 132 (51%) nuclear family dwellers, in 43 (64.2%) children whose mothers got married <18 years age. 88 (71.5%) children with undernutrition belonged to Class IV, (B.G Prasad classification), statistically significant association of undernutrition was found with the factors age of child, mother’s education, birth order, birth weight, immunisation status, mother’s age at marriage, exclusive breast feeding, history of acute respiratory infection (ARI) and diarrhoea, and socio-economic status. Conclusions: Study found certain socio-demographic factors like age, gender and birth order of child, type of family, age of mother during marriage and her literacy level, exclusive breast feeding, immunisation and frequency of ARI and diarrhoea associated with undernutrition.

Functional integration of services during the antenatal period can potentially improve childhood growth parameters beyond infancy: findings from a post-interventional follow-up study in West Bengal, India

BackgroundDespite progress, the prevalence of childhood undernutrition in India remains amongst the highest globally.ObjectiveWe aimed to evaluate the impact of a functional integration interventional package during the antenatal period on childhood growth parameters.MethodsThis is a post-interventional follow-up study of a maternal nutrition interventional study conducted between 2018 and 2019 among women in their first trimester of pregnancy from three districts in West Bengal, India. Pregnant women received a package of augmented interventions from study staff which supplemented those provided to them under the state-run programmes, that included body-mass-index measurement at pregnancy registration, monthly weight monitoring, targeted dietary counselling, supervised supplementary nutrition intake and iron-folic acid supplementation during daily anganwadi center visits. In the current follow-up study conducted in 2021, age-matched pregnant women from the same areas who were pregnant during the same period as in the original study and had received standard-of-care under the state-run programmes were recruited into a comparison group. Study staff collected data regarding maternal height and serial weights that were recorded at antenatal visits in 2018-19, and birth and infant characteristics. Child height and weight were measured during the follow-up visit in 2021, which were used to calculate the relative risks of stunting, wasting and underweight using generalized linear models, to understand the sustained impact of the intervention beyond infancy. Eight-hundred-nine mother-child dyads (406 intervention; 403 comparison) were followed.ResultsMedian age of women in the intervention and comparison group was 23 (IQR 20–25) and 25 (IQR 24–27) years respectively. Median gestational-weight-gain was higher amongst intervention group women (9 vs. 8 kg, p = 0.04). Low-birth-weight prevalence was 29.3% (119/406) and 32.0% (129/403) in the intervention and comparison group. At 12–35 months of age, children born to women in the intervention group had significantly reduced risk of stunting (RR = 0.65, 95% CI 0.44–0.94), wasting (RR = 0.57, 95% CI 0.33–0.97) and underweight (RR = 0.61, 95% CI 0.42–0.88).ConclusionsThese results indicate that functional integration and strengthening of routine antenatal care services including targeted nutritional counselling to expectant mothers can have distal beneficial effects on childhood undernutrition beyond the immediate post-natal period.

Prevalence of Undernutrition and Change Detection among under five years Children of Empowered Action Group States in India: Scrutinizing from National Family Health Survey, 2016–2021

ABSTRACT Change detection and prevalence of child undernutrition among the Empowered Action Group (EAG) states of India were studied using National Family Health Survey-4 and 5 data. The results identified that the prevalence of undernutrition in most of the EAG states is still more than 30%. Although stunting and underweight have decreased in all EAG states, this pattern is higher than that of the national level but the prevalence of wasting has only increased in Bihar. Strengthening public health initiatives and collaborative endeavor between organizations, enhancing mother’s education, increasing awareness, and raising the economic as well as sociopolitical empowerment of mothers are essential for addressing the undernutrition issue.

Undernutrition among children living in refugee camps: a systematic review of prevalence

ObjectivesThis review aimed to provide an overview of the prevalence of undernutrition in children under 5 years old in refugee camps according to the different indicators. In addition, we aimed...

Prevalence and Its Related Factors of Undernutrition among Under 5-Year-Old Children, Fars, Iran 2017-2018

Background: The present study aimed to investigate the prevalence and related factors of under-nutrition among under 5-year-old children in Fars province, Iran.
 Methods: This cross-sectional survey was conducted during 2017-2018 in Fars province of Iran. The study consisted of 606 children (0-59 months) from 13 regions of Fars province. A structured questionnaire collected the data, and under-nutrition indices, including stunting, wasting, and underweight, were investigated by the mixed-effects ordinal logistic regression model.
 Results: The prevalence of stunting, underweight, and wasting were 2%, 4%, and 4.1%, respectively. Low birth weight was a risk factor for three undernutrition indices (P < 0.001; P < 0.001; and P = 0.004). Urban children were significantly more underweight and wasted than rural children (P = 0.001; and P = 0.002, respectively). Under-nutrition rates were impressed by the family size, mother's education, and father's occupation.
 Conclusion: The prevalence of undernutrition in children can be reduced by identifying and controlling significant factors, including birth weight, maternal education, type of settlement, family size, and father's occupation.

Undernutrition and associated factors among children aged 6-59 months in nutrition-sensitive agriculture intervention implemented Basona district, North Shewa Zone, Amhara region, Ethiopia.

In Ethiopia, child malnutrition is a significant public health problem. To address the problem, Nutrition-Sensitive Agriculture (NSA) program was introduced. However, there is a paucity of evidence about the prevalence of child undernutrition in NSA-implemented districts. Therefore, this study aimed to assess the prevalence of undernutrition among children aged 6-59 months in NSA-implemented districts. A community-based cross-sectional study was conducted by enrolling 422 children aged 6-59 months paired with their mothers. A systematic sampling technique was used to select respondents. Data were collected by Open Data Kit (ODK) data collection platform, and Stata version 16 was used for analysis. The multivariable logistic analysis model was fitted to assess the association between variables, and 95% CI was estimated to measure the strength of the association. The level of statistical significance was declared at a p-value of less than 0.05 in the multivariable model. Overall, 406 respondents participated in the study, and a response rate of 96.2% was obtained. The prevalence of stunting, wasting, and underweight was 24.1% (95% CI: 19.9-28.4), 8.87% (95% CI: 6.3-12.1) and 19.95% (95% CI: 16.2-24.2), respectively. Household food insecurity was significantly associated with being underweight (AOR: 3.31, 95% CI (1.7-6.3). Child dietary diversity (AOR: 0.06, 95% CI: 0.01-0.48) and being a beneficiary of the NSA (AOR: 0.12, 95% CI: 0.02-0.96) program were associated with wasting. Lack of ANC visits and diarrhea in the past two weeks was associated with stunting and wasting, respectively. The prevalence of malnutrition was a moderate public health problem. Wasting was more prevalent than the recent national and Amhara region averages. However, the prevalence of stunting and underweight was lower than the national average and other studies conducted in Ethiopia. Healthcare providers should work to increase dietary diversity, ANC visits, and reduce diarrheal disease.

Comparative Study on the Prevalence of Malnutrition among Public Primary School Pupils in Rural and Urban Communities in Warri South

Malnutrition among primary school-age children has continued to pose a major public health issue, especially in developing countries. Nigeria is ranked amongst the top ten countries with the highest prevalence of undernutrition in children while about 2,300 children die daily in Nigeria as a result of malnutrition. Hence, the study was conducted to determine and compare the prevalence of malnutrition among public school pupils in rural and urban communities in Warri South LGA. This school-based comparative cross-sectional study made use of a bio-data form that collected socio-demographic details and anthropometric measurements of the pupils. The nutritional status of the pupils was obtained using WHO AnthroPlus software, while the resulting data were analysed and presented accordingly. The result showed that a total of 330 pupils (165 each from urban and rural public primary schools) were recruited, out of which more of the pupils in urban areas were younger, had parents who were better educated and employed while those from rural areas had higher family sizes. However, there was no difference in the sex and type of family of the pupils. The prevalence of malnutrition was reported as 36.7% with the prevalent form of malnutrition discovered as underweight (35.0%), followed by stunting (13.9%), overweight/obese (8.5%), and wasting (7.2%). Wasting, stunting, and overweight were higher among urban pupils, while the rate of underweight was higher among rural children. This high prevalence of undernutrition among urban pupils could be attributed to poor nutrition arising from a myriad of interrelated circumstances such as poor feeding, eating practices, and recurrent infection. Hence, the need for improved sensitisation of mothers concerning correct childhood feeding and provision of balanced nutrition.

Linkages between malaria and malnutrition in co-endemic regions of India

IntroductionMalaria and malnutrition are key public health challenges in India. However, the relationship between them is poorly understood. Here, we aimed to elucidate the potential interactions between the two health...

Prevalence of Sugar-Sweetened Food Consumption in Rural Bangladeshi Children Aged 6–24 Months

BackgroundWhile the prevalence of undernutrition in children has decreased in many low- and middle-income countries since the 1990s, prevalences of overweight and obesity have increased. Frequent consumption of sugar-sweetened food might have contributed to this change, although very little is known about sugar-sweetened food consumption in early life. ObjectivesThe objective of this study was to explore the associations between individual, household, and maternal factors and the prevalence of sugar-sweetened food consumption in 6- to 24-month-old children in Bangladesh. MethodsMultistage sampling was used to select households with children aged 6–24 months in rural Chatmohar, a subdistrict of Bangladesh (n = 1635). Research assistants conducted a 24-hour qualitative dietary recall questionnaire with the enrolled child’s primary caregiver to measure maternal and child dietary patterns. We examined factors associated with the prevalence of child sugar-sweetened food consumption with multivariate logistic regression models. We conducted tests of heterogeneity to explore differential associations between the child sugar-sweetened food consumption prevalence and household income by maternal nutrition knowledge and wealth. ResultsPrimary caregivers reported that 62% of toddlers had consumed sugar-sweetened food in the past 24 hours. A higher prevalence of child sugar-sweetened food consumption was associated with both a higher dietary diversity score (OR, 1.19; 95% CI, 1.09–1.29) and a higher prevalence of maternal sugar-sweetened food consumption (OR, 2.54; 95% CI, 1.97–3.28). At higher levels of maternal nutrition knowledge and wealth, more household income was associated with a lower prevalence of child sugar-sweetened food consumption. ConclusionsAlmost two-thirds of 6- to 24-month-old children in rural Chatmohar, Bangladesh, had consumed sugar-sweetened food in the last day. This is a high and concerning prevalence, and the associated factors identified in this study should be investigated further to identify potential areas of intervention to decrease the prevalence of child sugar consumption in Bangladesh.

IPTEK BAGI MASYARAKAT (IbM) PENYULUHAN TENTANG PEMBERIAN MAKANAN TAMBAHAN (PMT) PADA BALITA DI WILAYAH KERJA PUSKESMAS MULTIWAHANA PALEMBANG TAHUN 2016

Malnutrition is a major problem in the world that does not only occur in developing countries but also in developed countries (Freeman L). More than 3.5 million mothers and children under five every year are caused by malnutrition, and millions more experience permanent physical and mental disabilities as a result of lack of food intake in early life (Lancet, 2011). Based on the 2013 Riskesdas data, the prevalence of undernutrition was 12.1% in 2013. In the province of South Sumatra in 2013 the prevalence of undernutrition in children under five was 12.1% (Ministry of Health, 2014). In children under five with malnutrition, efforts need to be made so that they do not become malnourished and even increase their nutritional status. The effort that needs to be done is by providing additional food (PMT) for recovery (Kemenkes RI, 2011). PMT Recovery is intended as an addition, not as a substitute for the main daily meal. The PMT is based on local food ingredients with regional specialties adapted to local conditions (Directorate General of Nutrition and Maternal and Child Health, Ministry of Health, RI, 2012). This community service aims to improve the nutritional status of toddlers in the work area of ​​the Multiwahana Palembang Health Center by conducting counseling and distributing leaflets/posters about the Provision of Supplementary Foods (PMT) to toddlers to mothers who have babies and toddlers in the work area of ​​the Palembang Multiwahana Health Center. During the outreach activities, the community was very enthusiastic about listening and asking questions about good eating for infants and toddlers. This community service is expected to increase the knowledge and skills of the community in improving the nutritional status of toddlers by providing additional food according to the age of infants and toddlers.

The Shishu Pushti Trial-Extended Peer Counseling for Improving Feeding Practices and Reducing Undernutrition in Children Aged 0-48 Months in Urban Bangladesh: Protocol for a Cluster-Randomized Controlled Trial.

BackgroundThe aim of this study is to assess if peer counseling of women improves breastfeeding, complementary feeding practices, and child growth, and thus reduces the prevalence of undernutrition in children up to 4 years of age.ObjectiveLack of exclusive breastfeeding and inappropriate complementary feeding are critical factors in reducing child undernutrition, morbidity, and mortality. There are reported trials of peer counseling to improve breastfeeding; however, they did not examine the efficacy of peer counseling to improve complementary feeding or the long-term impacts on child growth and development.MethodsThis study has used a community-based, cluster-randomized controlled trial with a superiority design and 2 parallel treatment arms. It is assessing the impact of peer counseling, starting in late pregnancy up to 1 year after delivery, on child feeding practices, growth, and development with follow-up until 48 months of age. The study site was Mirpur, a densely populated area in Dhaka. Using satellite maps and geographic information system mapping, we constructed 36 clusters with an average population of 5000 people. We recruited pregnant women in the third trimester aged 16-40 years, with no more than 3 living children. Trained peer counselors visited women at home twice before delivery, 4 times in the first month, monthly from 2 to 6 months, and again at 9 and 12 months. Trained research assistants collected anthropometric measurements. The primary outcome will be differences in child stunting and mean length for age at 6, 12, 15, and 18 months. Secondary outcomes will be differences in the percentage of women exclusively breastfeeding in the mean duration of any breastfeeding and in the percentage of children at 6 and 9 months of age who receive solid, semisolid, or soft foods; and the percentage of children consuming foods from 4 or more food groups at 9, 12, 15, and 18 months. We will assess the mean cognitive function scores from the Ages and Stages Questionnaire (9 and 18 months) and Bayley tests (24 and 36 months).ResultsWe identified 65,535 people in mapped residences, from which we defined 36 clusters and randomly allocated them equally to intervention or control groups stratified by cluster socioeconomic status. From July 2011 to May 2013, we identified 1056 pregnant women and 993 births in the intervention group and 994 pregnancies and 890 births in the control group. At 18 months, 692 children remained in the intervention group and 551 in the control group. From January 2015 to February 2017, we conducted the long-term follow-up of the cohort. We have now completed the data collection and processing and have started analyses.ConclusionsThis study will help fill the evidence gap about the short- and long-term impact of peer counseling on improving infant feeding, preventing childhood undernutrition, and enhancing child cognitive development.Trial RegistrationClinicalTrials.gov NCT01333995; https://clinicaltrials.gov/ct2/show/NCT01333995International Registered Report Identifier (IRRID)DERR1-10.2196/31475

Health profile and nutritional status of rural primary school children in Western Maharashtra. Is school absenteeism associated with undernutrition?

Background: Healthy adulthood thrives on the foundation of a healthy childhood. Earlier studies show different morbidity patterns and prevalence of under-nutrition in children studying in Government primary schools. The present study was undertaken to explore the morbidity pattern and nutritional status of children studying in a government primary school in the field practice area of Rural Health Training Centre of a medical college in Pune, Western Maharashtra. Methodology: A cross-sectional study was done in a Government Primary School during January–February 2019. A total of 134 school children studying in classes 1st to 7th underwent anthropometric measurements, medical examination, dental examination, and haemoglobin estimation to bring out the common morbidities present in children of school-going age. School records of the past 6 months of the academic year 2018–19 were used to know the prevalence of absenteeism among the subjects studied, and an attempt was made to find any association between absenteeism and under-nutrition among school children. Results: Out of 134 children, 26 (19.4%) were stunted, 51 (38.64%) were underweight, and 2 (1.49%) were found to be obese. Dental caries was found in 73 (54.48%) pupils, and it was the commonest morbidity found. Eighty-six (64.18%) of the examined school children were anemic. Thirty-five (26.12%) had ear problems, skin problems were found in 35 (26.12%), 6 (4.48%) had refractive errors, and 2 (1.49%) were having Tachycardia. An association was found between abesentism and underweight (P = 0.02). Conclusions: The present study found that under-nutrition is present among children studying in a rural Government school despite the mid-day meal programme being implemented in the school. Targeted interventions may be planned for undernourished children to improve their nutritional status, and more studies are required to assess their health needs and problems.

Interactions between Food Environment and (Un)healthy Consumption: Evidence along a Rural-Urban Transect in Viet Nam

There is limited evidence on food environment in low and middle-income countries (LMICs) and the application of food environment frameworks and associated metrics in such settings. Our study examines how food environment varies across an urban-peri-urban-rural gradient from three sites in North Viet Nam and its relationship with child undernutrition status and household consumption of processed food. By comparing three food environments, we present a picture of the food environment in a typical emerging economy with specific features such as non-market food sources (own production and food transfers) and dominance of the informal retail sector. We combined quantitative data (static geospatial data at neighborhood level and household survey) and qualitative data (in-depth interviews with shoppers). We found that across the three study sites, traditional open and street markets remain the most important outlets for respondents. Contrary to the common concern that urban households are the major consumers of processed foods, peri-urban and rural areas on average had higher consumption of ultra-processed foods than in urban areas. The low price levels of processed foods and the presence of processed foods even among the traditional convenience stores, those in closest proximity to the rural households, offer potential explanations of this result. Regarding undernutrition, low retail diversity and a household’s dependence on own production have important implications for the high prevalence of child undernutrition in rural areas. Our findings add to the current discussion on the critical role of the food environment on nutrition, such as the potential link between economic marginalization and access to food, and the role of food supply channels in consumption of processed foods.

Differences in the socio-demographic determinants of undernutrition in children aged

ObjectivesThis study investigates the prevalence and determinants of undernutrition among children <5 years living in Bangladesh using the Composite Index of Anthropometric Failure (CIAF) and highlights the differences between urban and rural areas. Study designData are drawn from three cross-sectional Bangladesh Demographic Health Surveys conducted from 2007 to 2014. MethodsA Chi-square test was used to assess the prevalence of <5 years child undernutrition. Logistic regression analysis was performed to identify various sociodemographic risk factors. ResultsThe prevalence of undernutrition based on the CIAF was 52% among children <5 years in Bangladesh. The prevalence of undernutrition in children living in urban areas and rural areas were found to be 45% and 54%, respectively. As per the CIAF, undernutrition was highly prevalent among children in the older age group, children of uneducated and currently working mothers, those of underweight mothers, children of fourth and above in the birth order, children of fathers who were manual labourers, children of households who had no access to television and those in the poorest households whether in urban or rural areas. Children in the older age group, children of uneducated mothers, those with underweight mothers and those from the poorest households provided common key risk factors for undernutrition in both urban and rural areas. Children of fourth and above birth order and not watching television at all were additional risk factors of child undernutrition in rural areas. ConclusionHalf of the children in rural areas and two-fifths of them in urban areas are suffering undernutrition in Bangladesh, and several sociodemographic factors heighten the risks. Also, birth order and watching television were identified as the differential risk factors. This study therefore concludes that evidence-based interventions are needed to reduce the burden of undernutrition in children in the country.

Assessment of an Educational Intervention to Improve Healthy Life Habits in Children Living in Vulnerable Socioeconomic Conditions.

Nutritional condition impacts academic performance and cognitive development. In Peru, the prevalence of chronic undernutrition in children is 6.9%, increasing the risk of mortality and morbidity. This study aimed to develop an educational intervention to achieve an improvement in the healthy habits of children in a primary education school in Lima who live in vulnerable socioeconomic conditions. We conducted a prospective quasi-experimental pre-test and post-test study of an educational intervention. The information was collected through the adaptation of the WHO questionnaire “Global School-based Student Health Survey” (GSHS), with anthropometric variables, socioeconomic level, hygiene and eating habits. One hundred eight students from 5 to 13 years old from Arenitas del Mar School in Lima (Peru) participated. The educational intervention improved eating habits. Fruit and vegetable consumption 3 or more times/day (50.9%) increased after the educational intervention (49% vs. 62.9%,) p < 0.0001. There was an improvement in hygiene habits, such as the frequency of handwashing with soap (32.4% vs. 63.9%) and the frequency of weekly bathing 4–6 times/week (25% vs. 47.5%) p < 0.0001. The educational intervention promoted better healthy living behaviors, eating habits and hygiene. This kind of initiative is a crucial tool to establish healthy living habits.

Dietary adequacy and nutritional status of Meitei community of Manipur, Northeast India

Meitei is the main ethnic community that belongs to the north‐eastern state of Manipur in India. This community is bestowed with rich biodiverse resources with indigenous foods still form an integral part of their diet. However, limited data on the food and nutrient consumption as well as nutritional status of this community are available. This study was carried out on the children, adolescents and women of reproductive age (WRA) of this community from 12 villages, to determine their food consumption pattern and nutritional status. Basic anthropometry and 24‐h dietary intake assessment was conducted. The prevalence of underweight was 27%, stunting was 45% and wasting was 12% in children below 5 years. Stunting was observed among 34% of children 5–17 years of age. About 7% of WRA were undernourished, while 28% were overweight or obese. About 55% of 1–7 year‐old children had mean probability adequacy of 12 micronutrients <0.5, and the adequacy of individual micronutrients namely vitamin A, E and calcium were low. Dietary determinants such as low dietary diversity score, dietary species richness and the lowest tertiles of different food groups' intake (except for sugars, fish and sea foods and spices and condiments) predicted micronutrient inadequacy. In addition to a high prevalence of undernutrition in children and adolescents and overnutrition in WRA, the effect of various dietary determinants on micronutrient adequacy in the study group of the Meitei community are reported.

Inequality in child undernutrition among urban population in India: a decomposition analysis

BackgroundWith increasing urbanization in India, child growth among urban poor has emerged as a paramount public health concern amidst the continuously growing slum population and deteriorating quality of life. This study analyses child undernutrition among urban poor and non-poor and decomposes the contribution of various factors influencing socio-economic inequality. This paper uses data from two recent rounds of National Family Health Survey (NFHS-3&4) conducted during 2005–06 and 2015–16.MethodsThe concentration index (CI) and the concentration curve (CC) measure socio-economic inequality in child growth in terms of stunting, wasting, and underweight. Wagstaff decomposition further analyses key contributors in CI by segregating significant covariates into five groups-mother’s factor, health-seeking factors, environmental factors, child factors, and socio-economic factors.ResultsThe prevalence of child undernutrition was more pronounced among children from poor socio-economic strata. The concentration index decreased for stunting (− 0.186 to − 0.156), underweight (− 0.213 to − 0.162) and wasting (− 0.116 to − 0.045) from 2005 to 06 to 2015–16 respectively. The steepness in growth was more among urban poor than among urban non-poor in every age interval. Maternal education contributed about 19%, 29%, and 33% to the inequality in stunting, underweight and wasting, respectively during 2005–06. During 2005–06 as well as 2015–16, maternal factors (specifically mother’s education) were the highest contributory factors in explaining rich-poor inequality in stunting as well as underweight. More than 85% of the economic inequality in stunting, underweight, and wasting among urban children were explained by maternal factors, environmental factors, and health-seeking factors.ConclusionAll the nutrition-specific and nutrition-sensitive interventions in urban areas should be prioritized, focusing on urban poor, who are often clustered in low-income slums. Rich-poor inequality in child growth calls out for integration and convergence of nutrition interventions with policy interventions aimed at poverty reduction. There is also a need to expand the scope of the Integrated Child Development Services (ICDS) program to provide mass education regarding nutrition and health by making provisions of home visits of workers primarily focusing on pregnant and lactating mothers.

COVID-19’s Shadow on Undernourished Children (6–23 months): An Evidence-Based Study on Magnitude and its Determinants in Rajasthan

The prevalence of child undernutrition in India is among the highest in the world, nearly double that of Sub-Saharan Africa, with dire consequences for morbidity, mortality, productivity and economic growth (HNP, World Bank). India is home to most malnourished people in the world (FAO, 2015). According to data tabled in the state assembly, 37% of children below 5 years of age are underweight in the state of Rajasthan. A total of 39% of children in Rajasthan under the age of 5 years are stunted, or too short for their age, which shows that they have been undernourished for quite a while (National Family Health Survey-4—Rajasthan factsheet). Region specific magnitude of under nutrition in young children (6–23 months) at the block level is scarce. The present study carried out by IIHMR University, supported by IPE Global could be of use to the Government, policy makers as well as to the development partners working towards the enhanced nutritional status of the children. The specific objectives of the study were to collect demographic and background information about enrolled children (6–23 months) and to assess the anthropometry based nutritional status as far as wasting, stunting and underweight for the children 6–23 months and its determinants. A cross-sectional survey was undertaken. Three stage sampling method was adopted. Three districts were randomly selected from total districts of Rajasthan and from each selected district, four rural blocks/urban slums based on systematic random sampling were enrolled for the study in Stage 1. For Stage 2, for each selected block 10 villages/urban slums primary sampling unit (PSU) were selected. In the third stage, from each PSU six children in the age group of 6–11 months and 12 children from the age group of 12–23 months based on systematic random sampling were enrolled for the study. It was done from the list available to Accredited Social Health Activist (ASHA)/Anganwadi workers in the respective PSU. Thus, from every district, a sample of 720 respondents comprising two groups of infants was enrolled in the study. Hence, the total sample size for the study was 2,160 for all three selected districts. Socio-demographic and economic indicators of the respondent’s household: Information on the family composition of the household, including age, religion, caste, occupation, income was elicited through pretested semi-structured questionnaire. Anthropometric measurements were taken adopting the standard procedure for the same. WHO Anthro form 3.2.2 programming was utilised for the anthropometric examination to evaluate the magnitude of wasting, stunting and underweight in the enrolled children. A total 92% of the households in the sampled population were the followers of Hinduism. Regarding caste/tribe, around 11% of the households belonged to general category, 16% of the scheduled caste group, while the remaining 28% households were found to be from the scheduled tribe group. The overall pervasiveness of wasting, stunting and underweight was 16.9%, 58.1% and 34.2%, respectively. In case of severe wasting, stunting and underweight among children, it was 6.4%, 36.7% and 12.9% individually. It was revealed that prevalence of undernutrition was higher in males as compared to females in all the three districts. In Rajasthan, existing nutritional status of children, including wasting, stunting and underweight is a cause of concern which may get aggravated due to the current pandemic of COVID-19. Some studied shows that ‘poorer households are much more likely to report much less income during April than richer households compare to income during January and February’. To protect the vulnerable groups, especially women and children, from the effects of this nutritional crisis, there is an urgent need for high-frequency surveillance of vulnerable populations and inter sectoral convergence across segments, including health, agriculture, education, water and sanitation, social protection, commerce and livelihood.

Household Food Insecurity Predicts Childhood Undernutrition: A Cross-Sectional Study in West Oromia (Ethiopia).

Background Despite mixed reports, food insecurity emerges as a predictor of nutritional status, assumably limiting the quantity and quality of dietary intake. In Ethiopia, the prevalence of childhood undernutrition and food insecurity is highly pronounced. However, whether household food insecurity predicts undernutrition in children was not yet well established. Thus, the aim of the present study was to identify the link between household food access and undernutrition in children aged 6–23 months in West Oromia zones, Ethiopia. Methods A cross-sectional study was conducted on a sample of 525 households during June–October 2016. Food access was measured as Household Food Insecurity Access Scale. Semistructured interviewer-administered questionnaires were employed to collect data on sociodemographics, child health, child dietary practices, household food security, and anthropometrics. The height and weight of children aged 6–23 months in each household were measured. Multivariate logistic regression models were constructed to assess the association between household food insecurity and child nutritional status measured from undernutrition indicators. Results Overall, more than two-thirds (69%) of households were classified as food insecure (had insufficient access to adequate food), with a mean (SD) household food access score of 7.9 (7.7). The respective prevalence of mild and moderate food-insecure households was 56.6% and 12.4%. Higher proportions of children in food-insecure households were stunted (41.8% vs. 15.5%), underweight (22.0% vs. 6.1%), and wasted (14.9% vs. 6.1%). Overall, the prevalence of child undernutrition was 21.3% in the target population, with 16.2% stunted, 6.9% underweight, and 6.3% wasted. The present finding shows food-secure households were 54% protective (OR: 0.46, 95% CI: 0.25–0.84) for child undernutrition. Compared to children in food-secure households, children who were reportedly living in moderately food-insecure households were over twice more likely stunted (OR: 2.09, 95% CI: 1.02–4.28) and over 4 times more likely underweight (OR: 4.73, 95% CI: 1.81–12.35). However, household food insecurity was not a correlate for acute malnutrition (wasting) in children. Conclusions The prevalence of household's food insecurity situation is very common and more pronounced among households with undernourished children aged 6–23 months in Ethiopia. The analysis of this work shows that moderately food-insecure households are a salient predictor for composite undernutrition, stunting, and underweight, but not for wasting. Thus, this finding informs the need for multisectoral strategies and policies to combat household's food insecurity and multiple forms of child undernutrition, beyond the socioeconomic wellbeing.