Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys

AbstractObjectiveTo examine trends in stunting and overweight in Peruvian children, using 2006 WHO Multicentre Growth Reference Study criteria.DesignTrend analyses using nationally representative cross-sectional surveys from Demographic and Health Surveys (1991–2011). We performed logistic regression analyses of stunting and overweight trends in sociodemographic groups (sex, age, urban–rural residence, region, maternal education and household wealth), adjusted for sampling design effects (strata, clusters and sampling weights).SettingPeru.SubjectsChildren aged 0–59 months surveyed in 1991–92 (n 7999), 1996 (n 14 877), 2000 (n 11 754), 2007–08 (n 8232) and 2011 (n 8186).ResultsChild stunting declined (F(1, 5149) = 174·8, P ≤ 0·00) and child overweight was stable in the period 1991–2011 (F(1, 5147) = 0·4, P ≤ 0·54). Over the study period, levels of stunting were highest in rural compared with urban areas, the Andean and Amazon regions compared with the Coast, among children of low-educated mothers and among children living in households in the poorest wealth quintile. The trend in overweight rose among males in coastal areas (F(1, 2250) = 4·779, P ≤ 0·029) and among males in the richest wealth quintile (F(1, 1730) = 5·458, P ≤ 0·020).ConclusionsThe 2011 levels of stunting and overweight were eight times and three and a half times higher, respectively, than the expected levels from the 2006 WHO growth standards. The trend over the study period in stunting declined in most sociodemographic subgroups. The trend in overweight was stable in most sociodemographic subgroups.

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Wasting and Associated Factors among Children under 5 Years in Five South Asian Countries (2014–2018): Analysis of Demographic Health Surveys

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094578 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4578

Author(s):

Nidhi Wali ◽

Kingsley E. E. Agho ◽

Andre M. N. Renzaho

Keyword(s):

South Asia ◽

South Asian ◽

Health Surveys ◽

Associated Factors ◽

Common Factor ◽

Household Wealth ◽

Health Concern ◽

Demographic And Health Surveys ◽

Asian Countries ◽

Sampling Weights

Child wasting continues to be a major public health concern in South Asia, having a prevalence above the emergency threshold. This paper aimed to identify factors associated with wasting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent demographic and health surveys (2014–2018) of five countries in South Asia was combined. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. Wasting prevalence was higher for children aged 0–23 months (25%) as compared to 24–59 months (18%), with variations in prevalence across the South Asian countries. The most common factor associated with child wasting was maternal BMI [adjusted odds ratio (AOR) for 0–23 months = 2.02; 95% CI: (1.52, 2.68); AOR for 24–59 months = 2.54; 95% CI: (1.83, 3.54); AOR for 0–59 months = 2.18; 95% CI: (1.72, 2.77)]. Other factors included maternal height and age, household wealth index, birth interval and order, children born at home, and access to antenatal visits. Study findings suggest need for nutrition specific and sensitive interventions focused on women, as well as adolescents and children under 2 years of age.

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The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: Analysis from four recent Demographic and Health Surveys in Nepal

10.21203/rs.2.13937/v3 ◽

2019 ◽

Author(s):

Kiran Acharya ◽

Yuba Raj Paudel ◽

Dinesh Dharel

Keyword(s):

Vaccination Coverage ◽

Maternal Education ◽

Immunization Coverage ◽

Wealth Quintile ◽

Educational Status ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Relative Index ◽

Index Of Inequality ◽

Over Time

Abstract Background Despite policy intention to reach disadvantaged populations, inequalities in child health care use and health outcomes persist in Nepal. The current study aimed to investigate the trend of full vaccination coverage among infants and its equity gaps between Nepal Demographic and Health Surveys (NDHS) 2001 and 2016.Methods Using data from NDHS conducted in 2001, 2006, 2011 and 2016, we investigated the trend of coverage of six antigens:Bacille Calmette Guerin (BCG), Diptheria, Pertussis, Tetanus (DPT), Polio, and Measles during their infancy among children aged 12-23 months. We presented trends and correlates of vaccination coverage by different socio-demographic factors. We measured inequalities in full vaccination coverage by wealth quintile and maternal education using absolute measure (slope index of inequality) and relative measures (Relative index of inequality, concentration index) of inequalities.Results Full immunization coverage among infants steadily increased from 65.6% in 2001 to 87.0% in 2011; however, it decreased to 77.8% in 2016. Province 2 had a significantly lower full vaccination coverage compared to Province1.Although decreasing over time, there were significant inequalities by household wealth quintiles and maternal educational status. The slope index of inequality (SII) for wealth quintiles decreased from -32.3 [-45.5,-19.1] in 2001 to an SII of-8.4 [-18.6,-1.7] in 2016. Similarly, the SII for education decreased from -61.8 [-73.5,-50.1] in 2001 to an SII of -30.5 [-40.7,-20.2] in 2016. Similarly, the relative index of inequality (RII) also showed an improvement over time, indicating the narrowing equity gap. Additionally, concentration index on full immunization coverage by wealth quintiles dropped from 0.21 (0.12-0.28) in 2001 to 0.054 (-0.01-0.12) in 2016. Absolute and relative inequalities were persistently larger by maternal educational status compared to household wealth quintiles throughout the study period.Conclusion Full vaccination coverage in Nepal increased from 2001 until 2011 but saw a significant decrement away from the national target after 2011. However, the equity gap by household wealth quintile and maternal education status has narrowed over time. National Immunization programs need to give higher emphasis to infants born to mothers with less education, those born in the poorer wealth quintile households, and those living in Province 2.

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Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008–2009

Public Health Nutrition ◽

10.1017/s1368980012002856 ◽

2012 ◽

Vol 15 (9) ◽

pp. 1715-1727 ◽

Cited By ~ 40

Author(s):

Peninah K Masibo ◽

Donald Makoka

Keyword(s):

Health Survey ◽

Urban Areas ◽

Child Nutrition ◽

Maternal Education ◽

Sampling Technique ◽

Household Wealth ◽

Demographic And Health Survey ◽

Demographic And Health Surveys ◽

Double Burden ◽

Percentage Points

AbstractObjectiveTo report on the trends and determinants of undernutrition among children <5 years old in Kenya.DesignData from four nationwide Kenya Demographic and Health Surveys, conducted in 1993, 1998, 2003 and 2008–2009, were analysed. The Demographic and Health Survey utilizes a multistage stratified sampling technique.SettingNationwide covering rural and urban areas in Kenya.SubjectsThe analysis included 4757, 4433, 4892 and 4958 Kenyan children aged <5 years in 1993, 1998, 2003 and 2009–2009, respectively.ResultsThe prevalence of stunting decreased by 4·6 percentage points from 39·9 % in 1993 to 35·3 % in 2008–2009, while underweight decreased by 2·7 percentage points from 18·7 % in 1993 to 16·0 % in 2008–2009. The effects of household wealth, maternal education and current maternal nutritional status on child nutrition outcomes have changed dynamically in more recent years in Kenya. Inadequate hygiene facilities increased the likelihood of chronic undernutrition in at least three of the surveys. Small size of the child at birth, childhood diarrhoea and male gender increased the likelihood of undernutrition in at least three of the surveys. Childhood undernutrition occurred concurrently with maternal overnutrition in some households.ConclusionsThe analysis reveals a slow decline of undernutrition among young children in Kenya over the last three decades. However, stunting and underweight still remain of public health significance. There is evidence of an emerging trend of a malnutrition double burden demonstrated by stunted and underweight children whose mothers are overweight.

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Trends and factors associated with the nutritional status of adolescent girls in Ghana: a secondary analysis of the 2003–2014 Ghana demographic and health survey (GDHS) data

Public Health Nutrition ◽

10.1017/s1368980021003827 ◽

2021 ◽

pp. 1-16

Author(s):

Fusta Azupogo ◽

Abdul-Razak Abizari ◽

Elisabetta Aurino ◽

Aulo Gelli ◽

Saskia JM Osendarp ◽

...

Keyword(s):

Adolescent Girls ◽

Urban Areas ◽

Secondary Analysis ◽

Prevalence Ratio ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Clear Trend ◽

Cross Sectional ◽

Factors Associated ◽

Pregnant Adolescent

Abstract Objective: We examined the trends over time and the factors associated with malnutrition among adolescent girls in Ghana. Design: Cross-sectional analysis from 3 nationwide Ghana Demographic and Health Surveys conducted in 2003 (n 983), 2008 (n 955) and 2014 (n 857). We used Cox proportional hazard models with sample weighting to model the prevalence ratio (PR) of malnutrition. Setting: Countrywide, covering rural and urban areas in Ghana. Participants: Non-pregnant adolescent girls aged 15–19 years. Results: Compared with 2003, thinness declined marginally (PR 0·88 (95 % CI 0·45, 1·73)) in 2008 and in 2014 (PR 0·71 (95 % CI 0·38, 1·56)). Stunting declined marginally by 19 % in 2008 (PR 0·81 (95 % CI 0·59, 1·12)), flattening out in 2014 (PR 0·81 (95 % CI 0·57, 1·17)). We found an increasing trend of overweight/obesity with the PR peaking in 2014 (PR 1·39 (95 % CI 1·02, 1·88)) compared to 2003. The anaemia prevalence remained severe without a clear trend. A low level of education of the adolescent girl was positively associated with stunting. Increasing age was positively associated with stunting but inversely associated with thinness and anaemia. Girls who ever bore a child were more likely to be anaemic compared to those who never did. A lower level of household wealth and a unit increase in household size was negatively associated with overweight/obesity. Urban dwelling girls were less likely to be stunted. Conclusions: The stagnant burden of under-nutrition and rising over-nutrition emphasise the need for double-duty actions to tackle malnutrition in all its forms in Ghanaian adolescent girls.

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National trends of childhood vaccination coverage in Bangladesh: Understanding gaps from 2011, 2014 and 2017-18 Demographic and Health Surveys data

10.21203/rs.3.rs-722674/v1 ◽

2021 ◽

Author(s):

Satyajit Kundu ◽

Subarna Kundu ◽

Bright Opoku Ahinkorah ◽

Abdul-Aziz Seidu ◽

Joshua Okyere ◽

...

Keyword(s):

Vaccination Coverage ◽

Urban Areas ◽

Health Surveys ◽

Maternal Education ◽

Vaccine Coverage ◽

Immunization Coverage ◽

Childhood Vaccination ◽

Demographic And Health Surveys ◽

Changes Over Time ◽

Over Time

Abstract Background Vaccination is a safe and cost-effective strategy for protecting children from life-threatening diseases. This study aimed to investigate the changes over time in proportion of vaccination coverage across demographic subgroups in Bangladesh. Method Vaccination coverage for children 12–59 months of age was obtained from Bangladesh’s 2011, 2014, and 2017-18 Demographic and Health Surveys. Three multivariable binary logistic regression models with complete vaccination status at each survey data were used to generate adjusted odds ratios to uncover immunization variations across socio-demographic categories. Further, to detect potential geographic disparities, changes over time were analyzed at both the country and district levels. Findings Vaccination coverage grew from 88.1% in 2011 to 89.2% in 2017–2018, indicating a gap of more than ten percent for complete immunization coverage among children aged 12–59 months. Children aged 23–35 were more likely to have full vaccination compared to those aged 12–23 in 2011 (AOR = 1.6, 95% CI = 1.3–1.9), 2014 (AOR = 1.6, 95% CI = 1.3-2.0), and 2017-18 (AOR = 1.4, 95% CI = 1.1–1.7). The likelihood of full vaccination of children increased with maternal education with the highest odds among women with higher education in 2011 (AOR = 7.2, 95% CI = 4.0-12.9), 2014 (AOR = 4.0, 95% CI = 2.7–5.9), and 2017-18 (AOR = 5.8, 95% CI = 3.5–9.6) compared to those with no formal education. Children born to mothers who lived in urban areas were more likely to have full vaccination in 2011 (AOR = 1.5, 95% CI = 1.3–1.8), 2014 (AOR = 1.4, 95% CI = 1.2–1.7), and 2017-18 (AOR = 1.4, 95% CI = 1.1–1.7) compared to those who lived in rural areas. Children born to mothers who had at least 4 ANC visits were more likely to have full vaccination compared to those with less than 3 ANC visits in 2011 (AOR = 1.6, 95% CI = 1.2-2.0), 2014 (AOR = 1.5, 95% CI = 1.2-2.0), and 2017-18 (AOR = 1.6, 95% CI = 1.2–2.1 During these three surveys, Rangpur division had the highest vaccine coverage rate, while Sylhet division had the lowest vaccination coverage. Conclusion Although there was an improvement in these nationally representative surveys from 2011 to 2017-18, a portion of children still needs to be vaccinated to ensure full immunization coverage. To achieve 100% immunization coverage for all Bangladeshi children, policymakers must integrate vaccine programs with personalized health messaging and assurances of health safety for impoverished children and low-educated mothers. Increased institutional deliveries and prenatal care visits by mothers could assist increase their children's vaccination coverage.

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Correlates of Ghanaian households’ use of climate-friendly and health-promoting fuels: insight from the 2014 demographic and health surveys

10.21203/rs.2.21295/v1 ◽

2020 ◽

Author(s):

Seth Sylvester Dadzie ◽

Paul Lawer Kenney ◽

Nakua Kweku Emmanuel ◽

Agboh Nuake Kofi Herman ◽

Duah Ofori Henry ◽

...

Keyword(s):

Health Surveys ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Multivariable Model ◽

Chi Square ◽

Cross Sectional ◽

The Sustainable Development ◽

Global Mean Temperature ◽

Poor Households ◽

Health Promoting

Abstract Background About five of the Sustainable Development Goals (SDGs) directly calls for clean and climate-friendly household cooking fuels to help mitigate Carbon Dioxide (CO 2 ) and black carbon emissions to ensure that the global mean temperature is kept below 1.5 o C to promote good human health. In developing countries, climate-friendly and health-promoting fuels (CF&HPFs) are generally unaffordable and inaccessible. Studies on the prevalence and the predictors of household use of climate-friendly fuels and health-promoting fuels (CF&HPFs) in Ghana are few and nationally non-representative. To effectively design programs that encourage Ghanaian households to use CF&HPFs, the study estimated the proportion of households currently using CF&HPFs and delineated factors that account for their use.Methods The study used the data of the cross-sectional demographic and health surveys conducted in 2014. Chi-square test of independence was used to identify the predictors that were statistically significant related to households’ use of CF&HPFs for the multivariable model. In the multivariable model, we reported prevalence ratios using the generalized linear model (glm), setting the family to “Poisson” and the link to “log.” The estimation adjusted for the study designed and the household sampling weights.Results The main finding was that rich households were 8.85 times likely to use CF&HPFs compared to poor households. We further found that the following factors were associated with a higher probability of a Ghanaian household to use climate-friendly and health-promoting fuels for cooking: male-headed households, households’ headed by persons between 24years and 55 years, households with heads that were currently married or never married, households with heads that have attained at least a primary level education, households with less than eight members, households with at least two women, and households in Western, Central, Greater Accra, Volta, Eastern, Ashanti, Brong Ahafo, Upper East region.Conclusion Given that the most important correlate of household’s use of CF&HPFs is household wealth, we recommend that significant attention should be given to economic empowerment of citizens in policies and interventions aimed at encouraging Ghanaians to use this type of fuel.

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The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: Analysis from four recent Demographic and Health Surveys in Nepal

10.21203/rs.2.13937/v4 ◽

2019 ◽

Author(s):

Kiran Acharya ◽

Yuba Raj Paudel ◽

Dinesh Dharel

Keyword(s):

Vaccination Coverage ◽

Maternal Education ◽

Immunization Coverage ◽

Wealth Quintile ◽

Educational Status ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Relative Index ◽

Index Of Inequality ◽

Over Time

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Trends and determinants of stunting among under-5s: evidence from the 1995, 2001, 2006 and 2011 Uganda Demographic and Health Surveys

Public Health Nutrition ◽

10.1017/s1368980018001982 ◽

2018 ◽

Vol 21 (16) ◽

pp. 2915-2928 ◽

Cited By ~ 4

Author(s):

Ying Ying Yang ◽

Gabriella Kaddu ◽

David Ngendahimana ◽

Hope Barkoukis ◽

Darcy Freedman ◽

...

Keyword(s):

Health Surveys ◽

Maternal Education ◽

Vulnerable Groups ◽

Health Concern ◽

Demographic And Health Surveys ◽

Linear Regression Models ◽

Wealth Creation ◽

Sampling Weights ◽

The Impact ◽

Childhood Stunting

AbstractObjectiveTo describe trends of childhood stunting among under-5s in Uganda and to assess the impact of maternal education, wealth and residence on stunting.DesignSerial and pooled cross-sectional analyses of data from Uganda Demographic and Health Surveys (UDHS) of 1995, 2001, 2006 and 2011. Prevalence of stunting and mean height-for-age Z-score were computed by maternal education, wealth index, region and other sociodemographic characteristics. Multivariable logistic and linear regression models were fitted to survey-specific and pooled data to estimate independent associations between covariates and stunting or Z-score. Sampling weights were applied in all analyses.SettingUganda.SubjectsChildren aged <5 years.ResultsWeighted sample size was 14 747 children. Stunting prevalence decreased from 44·8% in 1995 to 33·2% in 2011. UDHS reported stunting as 38% in 1995, underestimating the decline because of transitioning from National Center for Health Statistics/Centers for Disease Control and Prevention standards to WHO standards. Nevertheless, one in three Ugandan children was still stunted by 2011. South Western, Mid Western, Kampala and East Central regions had highest odds of stunting. Being born in a poor or middle-income household, of a teen mother, without secondary education were associated with stunting. Other persistent stunting predictors included small birth size, male gender and age 2–3 years.ConclusionsSustained decrease in stunting suggests that child nutrition interventions have been successful; however, current prevalence does not meet Millennium Development Goals. Stunting remains a public health concern and must be addressed. Customizing established measures such as female education and wealth creation while targeting the most vulnerable groups may further reduce childhood stunting.

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The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: analysis from four recent demographic and health surveys in Nepal

BMC Public Health ◽

10.1186/s12889-019-7995-3 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Kiran Acharya ◽

Yuba Raj Paudel ◽

Dinesh Dharel

Keyword(s):

Vaccination Coverage ◽

Maternal Education ◽

Wealth Quintile ◽

Educational Status ◽

Household Wealth ◽

Demographic And Health Surveys ◽

Relative Index ◽

Index Of Inequality ◽

Maternal Educational Status ◽

Over Time

Abstract Background Despite policy intention to reach disadvantaged populations, inequalities in health care resource use and health outcomes persist in Nepal. The current study aimed to investigate the trend of full vaccination coverage among infants and its equity gaps between Nepal Demographic and Health Surveys (NDHS) 2001 and 2016. Methods Using data from NDHS conducted in 2001, 2006, 2011 and 2016, we investigated the trend of coverage of six antigens: Bacille Calmette Guerin (BCG), Diptheria, Pertussis, Tetanus (DPT), Polio, and Measles during their infancy among children aged 12–23 months. We presented trends and correlates of full vaccination coverage by different socio-demographic factors. We measured inequalities in full vaccination coverage by wealth quintile and maternal education using absolute measure (slope index of inequality) and relative measures (Relative index of inequality, concentration index) of inequalities. Results Full vaccination coverage among infants steadily increased from 65.6% in 2001 to 87.0% in 2011; however, it decreased to 77.8% in 2016. Province 2 had a significantly lower full vaccination coverage compared to Province1.Although decreasing over time, there were significant inequalities by household wealth quintiles and maternal educational status. The slope index of inequality (SII) for wealth quintiles decreased from − 32.3 [− 45.5,-19.1] in 2001 to an SII of-8.4 [− 18.6,-1.7] in 2016. Similarly, the SII for education decreased from − 61.8 [− 73.5,-50.1] in 2001 to an SII of − 30.5 [− 40.7,-20.2] in 2016. Similarly, the relative index of inequality (RII) also showed an improvement over time, indicating the narrowing equity gap. Additionally, concentration index on full vaccination coverage by wealth quintiles dropped from 0.21 (0.12–0.28) in 2001 to 0.054 (− 0.01–0.12) in 2016. Absolute and relative inequalities were persistently larger by maternal educational status compared to household wealth quintiles throughout the study period. Conclusion Full vaccination coverage in Nepal increased from 2001 until 2011 but saw a significant decrement away from the national target after 2011. However, the equity gap by household wealth quintile and maternal education status has narrowed over time. National Immunization programs need to give higher emphasis to infants born to mothers with less education, those born in the poorer wealth quintile households, and those living in Province 2.

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Socio-economic and demographic determinants of female genital mutilation in sub-Saharan Africa: analysis of data from demographic and health surveys

Reproductive Health ◽

10.1186/s12978-020-01015-5 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Bright Opoku Ahinkorah ◽

John Elvis Hagan ◽

Edward Kwabena Ameyaw ◽

Abdul-Aziz Seidu ◽

Eugene Budu ◽

...

Keyword(s):

Female Genital Mutilation ◽

Health Surveys ◽

Wealth Quintile ◽

Household Wealth ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Level Of Education ◽

Genital Mutilation ◽

Sub Saharan ◽

Female Genital

Abstract Background Owing to the severe repercussions associated with female genital mutilation (FGM) and its illicit status in many countries, the WHO, human rights organisations and governments of most sub-Saharan African countries have garnered concerted efforts to end the practice. This study examined the socioeconomic and demographic factors associated with FGM among women and their daughters in sub-Saharan Africa (SSA). Methods We used pooled data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 12 countries in SSA. In this study, two different samples were considered. The first sample was made up of women aged 15–49 who responded to questions on whether they had undergone FGM. The second sample was made up of women aged 15–49 who had at least one daughter and responded to questions on whether their daughter(s) had undergone FGM. Both bivariate and multivariable analyses were performed using STATA version 13.0. Results The results showed that FGM among women and their daughters are significantly associated with household wealth index, with women in the richest wealth quintile (AOR, 0.51 CI 0.48–0.55) and their daughters (AOR, 0.64 CI 0.59–0.70) less likely to undergo FGM compared to those in the poorest wealth quintile. Across education, the odds of women and their daughters undergoing FGM decreased with increasing level of education as women with higher level of education had the lowest propensity of undergoing FGM (AOR, 0.62 CI 0.57–0.68) as well as their daughters (AOR, 0.32 CI 0.24–0.38). FGM among women and their daughters increased with age, with women aged 45–49 (AOR = 1.85, CI 1.73–1.99) and their daughters (AOR = 12.61, CI 10.86–14.64) more likely to undergo FGM. Whiles women in rural areas were less likely to undergo FGM (AOR = 0.81, CI 0.78–0.84), their daughters were more likely to undergo FGM (AOR = 1.09, CI 1.03–1.15). Married women (AOR = 1.67, CI 1.59–1.75) and their daughters (AOR = 8.24, CI 6.88–9.87) had the highest odds of undergoing FGM. Conclusion Based on the findings, there is the need to implement multifaceted interventions such as advocacy and educational strategies like focus group discussions, peer teaching, mentor–mentee programmes at both national and community levels in countries in SSA where FGM is practiced. Other legislative instruments, women capacity-building (e.g., entrepreneurial training), media advocacy and community dialogue could help address the challenges associated with FGM. Future studies could consider the determinants of intention to discontinue or continue the practice using more accurate measures in countries identified with low to high FGM prevalence.

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