WHO Child Growth Research Articles

Factor Associated with Nutritional Status Among Children Aged 6 – 59 Months in Colol Public Health Center: A Cross-Sectional Study Article Sidebar

Objective: Malnutrition is one of the main factors influencing growth and development in children. Undernourishment still became a significant public health issue, including in Indonesia. This study aims to assess the prevalence and risk factors of nutritional status among children aged 6-59 months in Colol Public Health Center, East Manggarai Regency, and Indonesia. Material and Methods: A cross-sectional observational community-based study was conducted in the working area of Colol Public Health Center in August 2023. This study included 138 parents and children aged 6 to 59 months who visited Posyandu, chosen by a simple random cluster sampling technique. The data were collected using a structured questionnaire, secondary data from the Maternal and Child Health (MCH) book, and anthropometrical measurements. Three anthropometric indicators (underweight, stunted, and wasted) were assessed according to the 2006 WHO Child Growth Standards and analyzed by SPSS 25.0. Bivariate and multivariate analyses were used to identify risk factors associated with children’s nutritional status. The statistical significance was stated at p-value <0.05 with 95% confidence intervals. Results: The prevalence of underweight, stunted, and wasted among children aged 6-59 months was 18.8%, 22.4%, and 6.5%, respectively. The multivariable logistic regression model showed that low birth weight increased the risk of underweight (AOR = 13.73 (95% CI: 2.40-78.63)), stunted (AOR = 30.55 (95% CI: 3.16-295.09)), and wasted (AOR = 12.16, 95% (CI: 2.02-73.37)) among children aged 6-59 months. Children with mothers aged <20 or > 35 years old increased odds for underweight (AOR 2.99 (95% CI: 1.13-7.94)). Meanwhile, children aged 24-59 years old were more likely stunted (AOR 4.89 (95% CI: 1.89-12.64)). Conclusion: Undernutrition still becomes a public health problem among children aged under 5 years old in the working area of Colol Public Health Center, East Manggarai Regency. Low birth weight, age of the mother <20 or > 35 years old, and age of the children 24-59 years are significantly associated with nutritional status. The primary health center should cooperate with stakeholders across sectors, especially promoting programs to prevent low birth weight

Understanding the Crisis: Prevalence and Key Determinants of Stunting in Children Aged 2 to 5 Years in an Afghan Refugee Camp in Kohat.

Stunting, characterized by impaired growth and development due to malnutrition and illness, is a significant public health concern with profound implications for cognitive and physical development. This issue is particularly severe in refugee settings, where food insecurity and limited access to healthcare exacerbate the problem. This study aimed to evaluate the prevalence and determinants of stunting among children aged 2 to 5 years in an Afghan refugee camp in Kohat, Pakistan. A cross-sectional observational design was employed, collecting data from children aged 2 to 5 years who had resided in the camp for at least six months. A pre-validated, standardized questionnaire was administered to parents or guardians to gather data on socio-demographic factors, dietary intake, and health history. Stunting was defined as a height-for-age Z-score less than -2 SD from the median of the WHO Child Growth Standards. Anthropometric measurements were taken following WHO guidelines. Bivariate and multivariate logistic regression analyses were conducted to identify predictors of stunting. Out of 384 children, 153 (40%) were found to be stunted. The prevalence was slightly higher among boys (80 out of 153, 52%) compared to girls (73 out of 153, 48%). Significant predictors of stunting included a lack of parental education (adjusted odds ratio (AOR) for fathers 1.8, 95% confidence level (CI) 1.2-2.9; AOR for mothers 2.1, 95% CI 1.3-3.4), a history of infectious diseases (AOR 1.9, 95% CI 1.2-3.0), and low dietary diversity (AOR 2.3, 95% CI 1.4-3.7). The study highlights the high prevalence of stunting among children in the refugee camp, underscoring the need for comprehensive interventions targeting healthcare improvement, parental education, economic support, and dietary diversity to reduce stunting rates and improve children's health outcomes.

Prevalence and sociodemographic factors associated with double burden of malnutrition among children under 5: a cross-sectional analysis of NFHS-4 data in India

BackgroundThe double burden of malnutrition (DBM), characterised by the coexistence of undernutrition and overnutrition, poses a significant public health challenge, particularly in low- and middle-income countries. India, being one of...

Evaluation of Nutritional Status using Head Circumference among Bhil, Dhodia and Kinnaura tribal Preschool Children, India

Background: Undernutrition is a major problem in developing countries, especially among tribal pre-school children. Many studies have been undertaken on preschool tribal children in different parts of India, but by considering different ecological zones, no previous studies have been taken into account for determining nutritional status using head circumference. Head circumference for age Z-score (HCAZ) is also a useful index for determining the nutritional status of pre-school children. Objectives: The aim of the study is to assess the nutritional status based on head circumference of preschool children of the Bhil, Dhodia and Kinnaura tribes. Methods: The present study was undertaken among 509 boys and 476 girls. Among which, 168 boys and 185 girls belonged to the Bhil tribe from Barmer district, 164 boys and 142 girls belonged to the Dhodia tribe from Valsad district, and 177 boys and 149 girls belonged to the Kinnaura tribe from Kinnaur district. WHO Child Growth Standards (2007) were utilized to determine Z-scores for head circumference for age (HCAZ). The standard formula was used to compute HCAZ: Z-score= (X- Median value of WHO 2007)/ standard deviation, WHO (2007). Moderately undernourished: <-2SD and severely undernourished: <-3SD were considered following the WHO standard (2007). Results: From this study, it was found that among Bhil preschool children, 28.3% of boys and girls are undernourished, 33.6% of boys and 31.3% of girls are suffering from malnutrition among Dhodia boys, and 13.5% of boys and 17.2% of girls are undernourished among Kinnaura tribe. Conclusion: Regular intervention programmes need to be done by the authority to spread awareness among the people of these tribal communities so that the health condition of preschool children improves.

Factors Affecting Stunted Status in Children Under Two Years at Karya Mulia Public Health Center 2023

Background Stunted (short stature), defined as a height-for-age condition less than two standard deviations below the median of the WHO child growth standards, is caused by inadequate nutritional intake during the first 1000 days of life. Various factors contribute to the stunted status in children. Therefore, this research focuses on factors that can be examined at primary healthcare facilities, such as public health centers, and their relationship with the stunted status in children. Objective To determine the relationship between birth weight, basic complete immunization, and vitamin A supplementation on the stunted status of children aged 12-23 months at Karya Mulia Public Health Center, Pontianak, in the year 2023. Methods This study employed an analytical design with a cross-sectional approach. A total of 86 research samples were selected using total sampling techniques that met the sample criteria. Bivariate analysis was conducted using the fisher’s exact test and chi-square test. Results The results indicate no significant relationship between birth weight (0.623), basic complete immunization (0.342), and vitamin A supplementation (0.602) on the stunted status of children aged 12-24 months at Karya Mulia Public Health Center in 2023, statistically with p-value > 0.05. Conclusions There is no relationship between birth weight, basic complete immunization status, and vitamin A supplementation on the stunted status of children aged 12-23 months at Karya Mulia Public Health Center.

Nutritional Status and Body Composition at Diagnosis, of South Indian Children with Acute Lymphoblastic Leukaemia (ALL).

Accurate estimation of body composition, particularly, Body Cell Mass (BCM), which is independent of hydration status is important in children with cancer. This study aimed to accurately measure the anthropometry and body composition of children with Acute Lymphoblastic Leukaemia (ALL) at diagnosis and compare them with healthy children from South India. This was a cross-sectional study in children aged 2 to 8 y with ALL from St. John's Medical College Hospital, Bengaluru, and age and sex-matched, normal-weight children recruited as controls from communities. Anthropometry (weight, height, circumferences), skinfolds and body composition measurements using a whole-body potassium counter were performed. Body mass index-for-age, weight and height for age z-scores were calculated using WHO child growth standards. Biochemical markers, dietary intake and physical activity details were recorded. Categorical and continuous variables were analyzed by chi-square and independent t-tests respectively. Results: The mean age of the children with ALL (n = 39) was 4.6±1.9 y and control group (n=39) was 4.7±1.9 y; 61.5% were boys. The prevalence of underweight, overweight/obesity and stunting were 17.9%, 7.7%, and 10.3% respectively. The mean weight and height, of children with ALL and children in the control group were 16.8±6.2 kg and 16.4±4.1 kg, 104.3±14.9 cm and 105.1±12.2 cm, respectively with no statistical difference. Children with ALL showed lower body cell mass index kg/m2 (4.6± 0.8), compared to children in the control group (4.7±0.9) p=0.527, but higher fat mass index kg/m2 (3.6±1.1 vs. 3.4±0.8) p=0.276. At diagnosis, anthropometric and body composition measurements were similar between children with ALL and children in the control group. The BCM showed a non-significant trend of being lower in children with ALL, which requires close monitoring during treatment. Evaluating early-stage nutritional status and body composition can help in planning appropriate interventions during treatment to prevent long term non-communicable diseases.

THE RIGHTS OF STUNTED CHILDREN TO HEALTH SERVICES IN DONGGALA DISTRICT

Children are a gift from God Almighty, whose dignity needs to be protected and their rights guaranteed to grow and develop by their nature. Child health problems in terms of nutrition are one of the priorities of the United Nations. Stunting cases are cases of toddlers who have a length or height that is less than the WHO child growth standards. Article 6 paragraph (1) of the Convention on the Rights of the Child reads "States Parties subscribe to the inherent right of every child to life". The right to health is one of the rights inherent in children and adults. One of the Health Rights for children is the fulfillment of children's nutrition and nutrition, so as not to cause stunting of children. SSGI data from Donggala Regency includes districts that have high stunting cases, with a stunting rate in 2023 of 32.4%. This paper aims to find out and analyze the extent of the convention's implementation on the right of stunting children to health services, the factors that cause the high stunting rate in Donggala Regency, and efforts to provide health services for stunting children.

Influence of maternal and neonatal continuum of care on the risk of intergenerational cycle of stunting: a cross-sectional study

ObjectivesThis study aimed to analyse the influence of the continuum of care during pregnancy and neonatal periods on the risk of intergenerational cycle of stunting.DesignThis study was a cross-sectional study,...

Concurrence of anemia and stunting and associated factors among children aged 6 to 59 months in Peru.

Anemia and stunting are two health problems in the child population; therefore, their concurrence needs to be quantified. We estimated the prevalence of concurrent anemia and stunting (CAS) in children aged 6-59 months and identified the factors associated with this condition. The data came from the Demographic and Health Survey of Peru (DHS), 2022. The study design was cross-sectional and included 19,191 children. Height and hemoglobin measurement followed the specifications of National Health Institute of Peru. To reduce error in measures, the anthropometry personnel was training, the quality of measuring equipment was ensuring, and protocolized techniques and procedures was applying. Hemoglobin concentration was measured in capillary blood using the Hemocue model Hb 201+. Stunting was defined as a height-for-age Z-score less than minus two standard deviations (SD) from the median, following the 2006 WHO child growth standard. Anemia was classified into mild (10.0 to 10.9 g/dL), moderate (7.0 to 9.9 g/dL), severe (< 7.0 g/dL), and no anemia (11.0 to 14.0 g/dL). We performed a bivariate analysis to evaluate factors associated with CAS. To include variables in the multivariate analysis, we applied a statistical criterion (p < 0.10 in the crude analysis) and an epidemiological criterion. We used a binary logistic hierarchical regression model. The prevalence of CAS was 5.6% (95%CI: 5.2 to 5.9). The modifiable factors associated with higher odds of CAS were: "poorest" (aOR: 3.87, 95%CI: 1.99 to 7.5) and "poorer" (aOR: 2.07, 95%CI: 1.08 to 3.98) wealth quintiles, mother with no formal education or primary (aOR: 2.03, 95%CI: 1.46 to 2. 81), father with no formal education or primary (aOR: 1.55, 95%CI: 1.16 to 2.07), no improved water source (aOR: 1.36, 95%CI: 1.10 to 1.68), no roof with improved material (aOR: 1.49, 95%CI: 1.12 to 1.98) and low birth weight (aOR: 7.31, 95%CI: 4.26 to 12.54). In Peru, five out of every 100 children suffer from anemia and stunting simultaneously; there are modifiable factors that, if addressed, could reduce their prevalence.

IMPACT OF MALNUTRITION ON PEDIATRIC HEART FAILURE ANALYZING Z-SCORES AT PRESENTATION

Pediatric heart failure represents a critical health concern characterized by the heart's inability to effectively pump blood, often resulting from congenital heart defects, myocarditis, and cardiomyopathies. Malnutrition has emerged as a recognized comorbidity in pediatric heart failure, significantly impacting patient outcomes. This study aimed to investigate the relationship between malnutrition and pediatric heart failure by analyzing Z-scores at presentation to guide targeted interventions and improve patient management. The study employed a retrospective observational design and was conducted at the Department of Pediatric Cardiology, Lady Reading Hospital, Peshawar, from January 2023 to January 2024. A total of 764 pediatric patients with heart failure were included in the analysis. Nutritional status was assessed using weight and height measurements, and Z-scores were calculated based on WHO Child Growth Standards. Data analysis was performed using IBM SPSS version 22. Results revealed varying degrees of malnutrition among pediatric heart failure patients, with 62.8% classified as severely malnourished, 28.4% as moderately malnourished, and 8.8% as mildly malnourished. The calculated Z-score of -3.2 indicated significant malnutrition among the study population. Furthermore, a negative correlation (r = -0.32, p &lt; 0.001) between Z-score and left ventricular ejection fraction was observed, suggesting a link between malnutrition severity and cardiac dysfunction. These findings underscore the high prevalence of malnutrition among pediatric heart failure patients and its substantial impact on outcomes. Early nutritional assessment and intervention are crucial for optimizing patient care and enhancing outcomes in children with heart failure. Collaborative, multidisciplinary approaches that integrate cardiac and nutritional management strategies can comprehensively address the diverse needs of this vulnerable population.

Upaya Promotif Dan Preventif Stunting Kepada Pengunjung Posyandu RW 3 Kelurahan Mojosongo, Kecamatan Jebres, Kota Surakarta

Introduction: According to WHO (2015), stunting is a disruption in the growth and development of children due to chronic malnutrition and recurrent infections, which are characterized by body length or height below standard. Furthermore, according to WHO (2020) stunting is short based on length/height according to age which is less than -2 standard deviation (SD) on the WHO child growth curve which occurs due to irreversible conditions due to inadequate nutritional intake and/or recurrent infections/chronic disease that occurs within 1000 first-time days of life. Mojosongo is one of the Villages in Jebres District, Surakarta City. Based on the jateng.prov.go report in 2022, in Mojosongo there are 137 stunting cases that will be handled. Wrong parenting patterns, inappropriate feeding, high cases of young marriages, and lack of knowledge cause the risk of stunting in children. Reflecting on these conditions, this area was chosen to be the target of promotive and preventive efforts in carrying out willing to make the pulic of Indonesia healthier Objective: This activity aims to increase general public understanding about stunting in children. Method: Activities with lecture speaking and give education through leaflet media. Evaluation using a questionnaire both before counseling and after presenting the material.

Interstate migration and its association with the prevalence of stunting in under-five children of the migrant families in Delhi-NCR, India: a cross-sectional study

Background: Interstate migration in India is increasing every year. Children of the migrant families often face poor living conditions and insufficient nutrition, as a result of various socio-economic determinants. This study aimed to understand the association between rural-to-urban migration and under-five stunting, and the various determinants involved. This study allows researchers to make pre and post pandemic comparison of stunting among migrant children in Delhi, since it was carried-out post the second wave of the COVID-19 pandemic. Methods: A community-based cross-sectional survey was carried-out in the bhatti mines area of south Delhi, using a systemic sampling method. 100 households each of migrants and non-migrants were approached, and height of the under-five children was measured. Stunting was estimated using WHO child growth standards. Information on demography and socio-economic determinants was collected from the mothers using a questionnaire. Results: Stunting was recorded in 62% of the migrant under-five children and 27% in the non-migrant children, with a significant difference between the two groups (p value &lt;0.001), indicating a significant association between migration and stunting. Source of drinking water (p&lt;0.05) and recurring episodes of diarrhea (p&lt;0.05) were also found to be strongly associated with under-five stunting. Conclusions: Under-five nutritional deficits lead to compromised immunity and delay in physical and mental growth and development. It is important to recognize and address the diverse needs of the under-five migrant population’s health in order to avoid stunting and other serious manifestations.

Exploring The Interplay of Stunting and Upper Respiratory Infection in Kronjo Health Center: A Cross-Sectional Study

Background: Stunting, a prevalent form of chronic malnutrition, presents a significant public health challenge globally, particularly in low-income nations like Indonesia. This study investigates the prevalence and interaction of stunting and upper respiratory infections (URIs) among toddlers aged 12-59 months in Kronjo Health Center, a rural health center in West Java.&#x0D; Methods: Employing a cross-sectional design with total sampling, data were collected from October to November 2023. Height measurements were interpreted according to WHO child growth standards, and statistical analysis was performed using the Pearson chi-square 2x2 test.&#x0D; Results: The study involved 146 toddlers, with the majority being female (52.7%) and aged 12-23 months (34.9%). Most mothers had a high school education (39.7%), practiced breastfeeding (67.8%), and participated in basic pediatric immunization programs (61%). Additionally, 15 toddlers (10.3%) had a history of low birth weight, and a significant proportion were exposed to household smoking (n = 122; 83.6%) and lived in crowded households with six or more family members (n = 45; 30.8%). The study revealed a stunting prevalence of 46.6% and a URI prevalence of 63% among toddlers aged 12-59 months in Kronjo Health Center. Statistical analysis indicated a significant association between stunting and URIs (p-value = 0.035).&#x0D; Conclusion: This study highlights a significant association between stunting and URI among toddlers aged 12-59 months in Kronjo Health Center, emphasizing the importance of addressing both conditions in rural health settings.

Stunting and its association with education and cognitive outcomes in adulthood: A longitudinal study in Indonesia.

Stunting is associated with adverse outcomes in adulthood. This article specifically aims to analyse the relationship between childhood stunting and education as well as cognitive outcomes for adults in Indonesia. Pooled data from wave one (1) and two (2) of the Indonesia Family Life Survey (IFLS) in 1993 and 1997 identified a sub-sample of 4,379 children aged 0-5 by their height-for-age (HAZ) to be compared for their differences in educational outcomes and cognitive abilities in 2014. HAZ was used to proxy relative height to determine stunting status based on 2006 WHO child's growth standards. Education and cognitive abilities outcomes include years of schooling, age of school entry, grade repetition, and scores for cognitive and math tests. The study employs estimation models of pooled regressions and instrumental variable (IV) to address problems of endogeneity and bias from omitted variables. Stunting and relatively small stature had significant associations with cognitive development, and they worked as intermediaries to cognitive developmental barriers as manifested in reduced educational outcomes. A lack of one SD in HAZ was associated with 0.6 years shortened length of the school, 3% higher chances of dropouts from secondary school, and 0.10-0.23 SD lowered cognitive and numerical scores. Similarly, stunting is associated with decrease cognitive test scores by 0.56-0.8 SD compared to non-stunting, two years less schooling, and 0.4 years of delayed entry to school. As for cognitive abilities, stunting is associated with lower cognitive and numerical abilities by 0.38-0.82 z-scores. Growth retardation during childhood in Indonesia was associated with lower cognitive abilities, particularly during school age, and this correlation faded as individuals grew up. Subsequently, growth retardation is significantly linked to lower educational outcomes. Impaired growth has implications for reduced lifetime earnings potential mediated by diminished cognitive capacity and lower educational attainment. The finding suggests that development in Indonesia during recent decades has not provided an adequate environment to enable children to achieve their potential educational outcomes.

UPAYA PENCEGAHAN STUNTING DENGAN MEDIA EDUKASI TERHADAP PENINGKATAN PENGETAHUAN IBU DI DESA PEJATEN

Stunting in children is one of the serious problems because it is associated with the risk of morbidity and death. According to WHO, stunting is defined as height according to age below -2 of the WHO child growth curve median standard (Fikawati, Sandra, 2017). The achievement of SDG's in 2030 is to end all forms of malnutrition including achieving the 2025 international target for reducing stunting and underweight children (wasting) in toddlers and addressing the nutritional needs of adolescent girls, pregnant and lactating women, and the elderly (RI, 2015). Nationally, in 2018 stunting in Indonesia was 30.8%. While in Banten Province in 2018, as many as 8.54% (44,127 toddlers) of 516,696 toddlers. In Serang Regency 19.55% (14,963 children under five). In the month of weighing toddlers in August 2018, 483 (6.28%) of the 7,692 toddlers at the Kramatwatu Health Center were stunted. And in 2020 the incidence of stunting in Pejaten village was ranked 1st with 107 toddlers out of 619 toddlers (Kramatwatu, 2021). One of the factors associated with the incidence of stunting is still a lack of knowledge or sources of information, so it is necessary to further increase the participation of health workers in so that stunting cases can be prevented. The method is carried out by providing health counseling to increase the knowledge of mothers who have toddlers 0-59 months about stunting prevention

Association Between Infant and Young Child Feeding Practices and Nutritional Status Among Children Aged 6 to 24 Months in Terengganu

Infant and young child feeding practices (IYCF) have an important role in defining children's nutritional status and optimizing a child's development rate in the first two years of life. This study aimed to determine the association between infant and young child feeding practices and the nutritional status of children aged 6 to 24 months in Kuala Nerus and Kuala Terengganu, Terengganu. A total of 293 mothers and children aged between 6 to 24 months were recruited in this cross-sectional study. Anthropometrics comprised weight and height/length. The nutritional status of the children, namely weight-for-age z-scores (WAZ), height/length-for-age z-scores (LAZ) and weight-for-length z-scores (WLZ) were generated based on WHO Child Growth Standard. IYCF practices among participants were determined using a validated questionnaire adapted from FAO. A total of 52.2% boys and 47.8% girls participated in this study. The prevalence of stunting, wasting, and underweight among children were 26.3%, 6.8%, and 14.7% respectively. The majority (70.6%) of the participants have good practice on IYCF. However, there is no significant association between IYCF practices and the nutritional status of the children (p&gt;0.05). In conclusion, the majority of the participants have good practice with IYCF and only 1.7% have poor practice. Therefore, by promoting the IYCF practices, it can be a great tool to assess the health status of the children.

STUNTING PREVENTION THROUGH FIRST 1.000 DAYS OF LIFE (HPK) PROGRAM EDUCATION IN MANUKAN KULON SUB-DISTRICT, TANDES DISTRICT, SURABAYA

The stunting prevalence rate in Indonesia in 2022 is still 21.6%, especially in East Java, the stunting prevalence rate still reaches 19.2%. The Surabaya City Government has a target to declare zero stunting by 2023 through the 1000 HPK Movement. One thousand HPK is the period from conception to the age of 24 months which is an important period to improve children's health because if at this time there is a developmental and functional delay in children, it cannot be changed or only partially reversible. Children are stunted if their height for their age is more than two standard deviations below the median WHO child growth standard. Community service activities in the form of education for the 1000 HPK Movement will be held on Saturday, July 22, 2023 at Balai RW 02 Manukan Kulon Village. Community service activities are carried out in the form of nutrition counseling and interactive dialogue between resource persons and participants. The educational activity was attended by pregnant women, breastfeeding mothers, and mothers who have children less than 2 years old with a total of 35 participants. The results of Wilcoxon's test on the Pre-test and post-test filled by participants showed that there was an increase in the knowledge of education participants about the 1000 HPK Movement. This activity is expected to be a provision for participants in preparing healthy children and avoiding stunting.

Analysis Of Determinants Of Stunting Incidents In Children Toddler In The Area Of The Bukal District Health Center, Buol District

According to UNICEF, stunting is defined as the percentage of children aged 0-59 months with a height below minus (moderate and severe stunting) and minus three (chronic stunting) measured by WHO child growth standards. Stunting in toddlers manifests chronic nutritional deficiencies both during pregnancy and during the birth process. This research aims to analyze the determinants of stunting in children under five regarding parenting patterns, access to health services, nutritious food, and clean water and sanitation in the Bukal District Health Center Area, Buol Regency. The research was conducted in the Bukal Community Health Center Working Area, Buol Regency. The sample in this study was the entire population of 322 mothers of toddlers in the Bukal District Health Center Area, Buo Regency. This research was an analytical survey research with a cross-sectional design. Based on the findings, it can be concluded that: There is a relationship between parenting pattern factors and the incidence of stunting in children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, ,There is a relationship between the factor of access to health services and the incidence of stunting. In children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, , There is a relationship between the factor of access to nutritious food and the incidence of stunting in children under five in the Puskesmas area, Bukal District, Buol Regency with a p-value = 0.000, There is a relationship between access to clean water and sanitation and the incidence of stunting with a p-value = 0.000. This study concludes that health services are the most related factor, with a significant value of 0.004 and a Wald value of 8.310, meaning that access to health services has a risk of 8,310 times the risk of stunting.

Evaluating preschool linear growth velocities: an interim reference illustrated in Nepal.

An annualised linear growth velocity (LGV) reference can identify groups of children at risk of growing poorly. As a single velocity reference for all preschool ages does not exist, we present an interim tool, derived from published, normative growth studies, for detecting growth faltering, illustrating its use in Nepali preschoolers. The WHO Child Growth Velocity Standard was adapted to derive 12-month increments and conjoined to the Tanner-Whitehouse Height Velocity Reference data yielding contiguous preschool linear growth annualised velocities. Linear restricted cubic spline regressions were fit to generate sex-specific median and standard normal deviate velocities for ages 0 through 59 months. LGV Z-scores (LGVZ) were constructed, and growth faltering was defined as LGVZ < –2. Use of the reference was illustrated with data from Nepal’s Tarai region. Children contributing the existing growth references and a cohort of 4276 Nepali children assessed from 2013 to 2016. Fitted, smoothed LGV reference curves displayed monotonically decreasing 12-month LGV, exemplified by male/female annual medians of 26·4/25·3, 12·1/12·7, 9·1/9·4, 7·7/7·8 and 7/7 cm/years, starting at 0, 12, 24, 36 and 48 months, respectively. Applying the referent, 31·1 %, 28·6 % and 29·3 % of Nepali children <6, 6–11 and 12–23 months of age, and ∼6 % of children 24–59 months, exhibited growth faltering. Under 24 months, faltering velocities were more prevalent in girls (34·4 %) than boys (25·3 %) (P < 0·05) but comparable (∼6 %) in older preschoolers. A LGV reference, concatenated from extant data, can identify preschool groups at-risk of growth faltering. Application and limitations are discussed.

Factors affecting stunting among 3–12 years old girls of Purba Medinipur, West Bengal, India

Stunting is the impaired growth and development in children caused due to poor nutrition, recurrent infections and lack of psychosocial stimulus. Because stunting affects physical development and inhibits the child from attaining his full cognitive development as an adult, children may never regain the height lost due to stunting. Stunting (Low height-for-age) in infants and young children is a simple, wellknown indicator of undernutrition. The current study sought to determine the effects of socio-economic and demographic factors on the frequency of stunting among Bengalee girls. The study was carried out in the Deshopran block and Haldia municipality area (West Bengal, India). The total number of participants included in the study was 530 Bengalee girls. 53.39% (283) of study participants were urban residents while 46.61% (247) were rural residents. Stunted growth in children was defined as the height for a given age in children less than two standard deviations of the WHO Child Growth Standards. The prevalence of stunting among girls in our study was 11.13%. The predictor variables with substantial associations with stunting in the binary logistic regression (BLR) analyses were further used in the multiple binary logistic regression (MBLR) analyses. Odds ratios with 95% confidence intervals were used to calculate the stunting risk. Results showed that the risk of stunting was significantly associated with low birth weight, presence of younger brothers, a large number of family members and place of delivery. Improving maternal and child access to nutrient-rich food, decreasing infectious disease, and promoting women empowerment initiatives are the main recommendations for resolving the issue.