scholarly journals Socioeconomic status and the double burden of malnutrition in Cambodia between 2000 to 2014: overweight mothers and stunted children

2021 ◽  
pp. 1-26
Author(s):  
Michelle K. Nakphong ◽  
Hiram Beltrán-Sánchez
Keyword(s):  
Socioeconomic Status ◽  
Maternal Employment ◽  
Household Survey ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Household Level ◽  
Child Stunting ◽  
Double Burden Of Malnutrition ◽  
The Impact

ABSTRACT Objective: The Cambodian population has experienced an increase in the proportion of stunted children who have overweight mothers during a period of rapid social and economic growth. We aimed to identify socioeconomic factors associated with this household-level double burden over time. Design: We used data from four Cambodia Demographic and Health Surveys from 2000 to 2014 to study the impact of socioeconomic status (SES) on the link between child stunting and overweight mothers in two periods 2000-2005 vs. 2010-2014. We hypothesized that SES would be a primary factor associated with this phenomenon. Participants: We included 14,988 children under age 5, among non-pregnant mothers aged 15-49 years of age and conducted analysis on a subsample of 1,572 children with overweight mothers. Setting: Nationally-representative household survey across all regions. Results: SES factors, specifically household wealth and maternal employment in service or manual occupations (in 2010-2014), are the main drivers of stunting among children of overweight mothers. Children with overweight mothers in the poorest households are more than twice as likely to be stunted than in the richest in both periods (2000-2005: aOR=2.53, 95%CI: 1.25, 5.13; 2010-2014: aOR=2.61, 95%CI: 1.43, 4.77), adjusting for other SES factors, indicating that despite decreasing income inequality, the poorest continue to bear excess risk of a double burden of malnutrition. Maternal short stature also doubled the likelihood of child stunting in both periods, which suggests intergenerational transmission of adversity and physical underdevelopment. Conclusions: Socioeconomic inequalities should be addressed to reduce disparities in the household-level double burden of malnutrition.

scholarly journals Double burden of malnutrition in children aged 24-59 months by socioeconomic status in five South Asian countries: evidence from Demographic and Health Surveys

2019 ◽  
Author(s):  
Fariha Binte Hossain ◽  
Md Shajedur Rahman Shawon ◽  
Md Shehab Uddin Al-Abid ◽  
Sultan Mahmood Sami ◽  
Gourab Adhikary ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Educational Attainment ◽  
South Asian ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Socioeconomic Conditions ◽  
Asian Countries ◽  
Double Burden ◽  
Lower Odds ◽  
Double Burden Of Malnutrition

ABSTRACTBackgroundDeveloping countries are now facing double burden of undernutrition and overnutrition among children and adults. We aimed to explore the double burden of malnutrition among children aged 24-59 months by household’s socioeconomic status in South Asian context.MethodsChildren with valid information on height and weight from the latest Demographic and Health Survey from Bangladesh, India, Pakistan, Maldives, and Nepal were included in this study. Underweight and overweight were defined according to definitions of World Health Organisation and International Obesity Task Force, respectively. We used multiple logistic regressions to estimate the association of socioeconomic status with childhood underweight and overweight.ResultsSouth Asian countries had significant burden of underweight, ranging from 19% in Maldives to 38% in India. Bangladesh, India, and Nepal had prevalence of overweight between 2% and 4%, whereas Pakistan and Maldives had prevalence of 7% and 9%, respectively. Households with higher wealth index and education were consistently associated with lower odds of underweight children. When compared to poorest households, richest households had higher odds of being overweight in Bangladesh (OR 1.96, 95% CI 1.27-3.02) and India (OR 1.53, 95% CI 1.41-1.66) while lower odds of being overweight in Pakistan (OR 0.22, 95% CI 0.14-0.34). Households with higher education were more likely to have overweight children in Bangladesh and India.ConclusionsChildhood underweight is associated with lower socioeconomic conditions while there is a substantial burden of childhood overweight in higher socioeconomic groups. These disparities by socioeconomic conditions should be considered while developing national nutrition programs and strategies.KEY MESSAGESIn South Asia, there is a substantial burden of undernutrition among under-five children while a differential burden of overnutrition is also seen.Household wealth and educational attainment were inversely associated with childhood underweight.Children in households with higher levels of wealth and educational attainment were more likely to be overweight in Bangladesh and India, while evidence supporting such association was not clear for other South Asian countries.The urban-rural difference in the burden of childhood underweight and overweight can be explained by the distributions of households’ socioeconomic status.

scholarly journals Correlates of the double burden of malnutrition among women: an analysis of cross sectional survey data from sub-Saharan Africa

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029545 ◽  
Author(s):  
Dickson Abanimi Amugsi ◽  
Zacharie Tsala Dimbuene ◽  
Catherine Kyobutungi
Keyword(s):  
Household Wealth ◽  
Normal Weight ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
Outcome Variable ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Double Burden ◽  
Double Burden Of Malnutrition ◽  
Sub Saharan

ObjectiveTo investigate the correlates of the double burden of malnutrition (DBM) among women in five sub-Saharan African countries.DesignSecondary analysis of Demographic and Health Surveys (DHS). The outcome variable was body mass index (BMI), a measure of DBM. The BMI was classified into underweight (BMI <18.50 kg/m2), normal weight (18.50–24.99 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (≥30.0 kg/m2).SettingsGhana, Nigeria, Kenya, Mozambique and Democratic Republic of Congo (DRC).SubjectsWomen aged 15–49 years (n=64698).ResultsCompared with normal weight women, number of years of formal education was associated with the likelihood of being overweight and obese in Ghana, Mozambique and Nigeria, while associated with the likelihood of being underweight in Kenya and Nigeria. Older age was associated with the likelihood of being underweight, overweight and obese in all countries. Positive associations were also observed between living in better-off households and overweight and obesity, while a negative association was observed for underweight. Breastfeeding was associated with less likelihood of underweight in DRC and Nigeria, obesity in DRC and Ghana, overweight in Kenya and overweight and obesity in Mozambique and Nigeria relative to normal weight.ConclusionsOur analysis reveals that in all the countries, women who are breastfeeding are less likely to be underweight, overweight and obese. Education, age and household wealth index tend to associate with a higher likelihood of DBM among women. Interventions to address DBM should take into account the variations in the effects of these correlates.

scholarly journals Risk assessment for COVID-19 transmission at household level in sub-Saharan Africa: evidence from DHS

Genus ◽  
2021 ◽  
Vol 77 (1) ◽  
Author(s):  
Olusesan Ayodeji Makinde ◽  
Joshua O. Akinyemi ◽  
Lorretta F. Ntoimo ◽  
Chukwuedozie K. Ajaero ◽  
Dorothy Ononokpono ◽  
...  
Keyword(s):  
Elderly Person ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
Transmission Risk ◽  
Demographic And Health Surveys ◽  
Elderly Persons ◽  
Habitat Conditions ◽  
African Countries ◽  
Household Level ◽  
The Impact

AbstractHousehold habitat conditions matter for diseases transmission and control, especially in the case of the novel coronavirus (COVID-19). These conditions include availability and adequacy of sanitation facilities, and number of persons per room. Despite this, little attention is being paid to these conditions as a pathway to understanding the transmission and prevention of COVID-19, especially in Africa, where household habitat conditions are largely suboptimal. This study assesses household sanitation and isolation capacities to understand the COVID-19 transmission risk at household level across Africa. We conducted a secondary analysis of the Demographic and Health Surveys of 16 African countries implemented between 2015 and 2018 to understand the status of households for prevention of COVID-19 transmission in home. We assessed handwashing capacity and self-isolation capacity using multiple parameters, and identified households with elderly persons, who are most at risk of the disease. We fitted two-level random intercept logit models to explore independent relationships among the three indicators, while controlling for the selected explanatory variables. Handwashing capacity was highest in Tanzania (48.2%), and lowest in Chad (4.2%), varying by household location (urban or rural), as well as household wealth. Isolation capacity was highest in South Africa (77.4%), and lowest in Ethiopia (30.9%). Senegal had the largest proportion of households with an elderly person (42.1%), while Angola (16.4%) had the lowest. There were strong, independent relationships between handwashing and isolation capacities in a majority of countries. Also, strong associations were found between isolation capacity and presence of older persons in households. Household capacity for COVID-19 prevention varied significantly across countries, with those having elderly household members not necessarily having the best handwashing or isolation capacity. In view of the age risk factors of COVID-19 transmission, and its dependence on handwashing and isolation capacities of households, each country needs to use the extant information on its risk status to shape communication and intervention strategies that will help limit the impact of the disease in its population across Africa.

scholarly journals Double Burden of Malnutrition in Rural Ecuador: Adult Overweight and Child Stunting Co-occur at the Community but Not the Household Level (P10-075-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Gwenyth Lee ◽  
Cynthia Gutierrez ◽  
Andrew Jones ◽  
Nancy Castro ◽  
William Cevallos ◽  
...  
Keyword(s):  
Case Control ◽  
Community Level ◽  
Double Burden ◽  
Mixed Effect ◽  
Children Under Five ◽  
Household Level ◽  
Child Stunting ◽  
Under Five ◽  
Double Burden Of Malnutrition ◽  
Over Time

Abstract Objectives Northern coastal Ecuador has seen rapid market integration since the initiation of a road system in the late 1990 s connecting the region to the Andean mountains. We previously demonstrated that, between 2003 and 2013, living in a relatively remote (less accessible) community was protective against stunting in children under five. Our objectives were to characterize trends in BMI among rural adults over the same period, and to examine the co-occurrence of adult overweight or obesity (OB/OW) and child stunting. Methods Adult anthropometry was collected through a series of case-control studies repeated over a decade across thirty communities (N = 2053). Anthropometry was measured for all children under five in every community (N = 4170). Logistic and mixed-effect Poisson models, weighted to account for the case-control sampling design, were used to estimate the prevalence of OW/OB over time, to examine individual- and household-level risk factors associated with adult OW/OB, and to examine the co-occurrence of adult OW/OB and under-five stunting within households. Results Among men, OW/OB increased over time (35.0% in 2003 to 52.9% by 2013) and was most common in the least remote versus the most remote communities (46.2% versus 26.9% across the study period). Among women, OW/OB was more prevalent (65.4%), but was not associated with community remoteness and did not increase over time. At the community level, the prevalence of under-five stunting was correlated with the prevalence of OW/OB among men (Spearman's ρ = 0.56, P = 0.002) but not women (Spearman's ρ = 0.16, P = 0.404). However, the presence of a stunted child under five within the household was not associated with adult OW/OB (odds ratio 0.87, P = 0.151). Conclusions Changes in food environments and livelihoods due to the presence of roads may have driven increasing OW/OB among men over the study period. The positive association between adult male OW/OB and child stunting at the community level, but not at the household level, suggests that strategies to address the double burden of malnutrition that target the community (e.g., the food environment) are more likely to be effective than interventions targeted to households alone. Funding Sources This project was supported by the National Institutes of Health [R01-AI050038].

scholarly journals Household-level double burden of malnutrition in Ethiopia: a comparison of Addis Ababa and the rural district of Kersa

2021 ◽  
pp. 1-15
Author(s):  
Lilia Bliznashka ◽  
Mia M Blakstad ◽  
Yemane Berhane ◽  
Amare W Tadesse ◽  
Nega Assefa ◽  
...  
Keyword(s):  
Associated Factors ◽  
Addis Ababa ◽  
Rural Households ◽  
Demographic Factors ◽  
Household Wealth ◽  
Housing Quality ◽  
Rural Setting ◽  
Double Burden ◽  
Household Level ◽  
Double Burden Of Malnutrition

Abstract Objective: To examine the prevalence of and factors associated with different forms of household-level double burden of malnutrition (DBM) in Ethiopia. Design: We defined DBM using anthropometric measures for adult overweight (BMI ≥ 25 kg/m2), child stunting (height-for-age Z-score <-2 sd) and overweight (weight-for-height Z-score ≥2 sd). We considered sixteen biological, environmental, behavioural and socio-demographic factors. Their association with DBM forms was assessed using generalised linear models. Setting: We used data from two cross-sectional studies in an urban (Addis Ababa, January–February 2018), and rural setting (Kersa District, June–September 2019). Participants: Five hundred ninety-two urban and 862 rural households with an adult man, adult woman and child <5 years. Results: In Addis Ababa, overweight adult and stunted child was the most prevalent DBM form (9 % (95 % CI 7, 12)). Duration of residence in Addis Ababa (adjusted OR (aOR) 1·03 (95 % CI 1·00, 1·06)), Orthodox Christianity (aOR 1·97 (95 % CI 1·01, 3·85)) and household size (aOR 1·24 (95 % CI 1·01, 1·54)) were associated factors. In Kersa, concurrent child overweight and stunting was the most prevalent DBM form (11 % (95 % CI 9, 14)). Housing quality (aOR 0·33 (95 % CI 0·20, 0·53)), household wealth (aOR 1·92 (95 % CI 1·18, 3·11) and sanitation (aOR 2·08 (95 % CI 1·07, 4·04)) were associated factors. After adjusting for multiple comparisons, only housing quality remained a significant factor. Conclusions: DBM prevalence was low among urban and rural Ethiopian households. Environmental, socio-economic and demographic factors emerged as potential associated factors. However, we observed no common associated factors among urban and rural households.

Vulnerability to Natural Disaster and Welfare Effect: A Case Study of Flood Risk in Vietnam’s North Central Region

2021 ◽  
pp. 002190962199349
Author(s):  
Manh-Hung Nguyen ◽  
Dung P Le ◽  
Thang T Vo
Keyword(s):  
Flood Risk ◽  
Sampling Method ◽  
Household Survey ◽  
North Central ◽  
Household Level ◽  
Central Vietnam ◽  
Housing Costs ◽  
Household Vulnerability ◽  
The Impact

This article investigates the impact of flood risk on vulnerability and welfare at the household level in Vietnam. The analytical sample is taken from a household survey conducted in a north central Vietnam community through a three-stage stratified random sampling method. The propensity score matching approach is employed to compare various welfare indicators between flooded and non-flooded households. This study finds that flooding results in significant income losses and imposes higher costs of living, especially housing costs. The two types of households are vulnerable, implying that other natural disasters or socio-economic disadvantages may have adverse effects on households’ livelihoods. The insignificant effect of floods on vulnerability indicates that the flooded households can cope with floods to some extent. However, contrary to family support, formal coping strategies are insufficient or ineffective at reducing household vulnerability to floods.

scholarly journals Urban–Rural Disparities in the Magnitude and Determinants of Stunting among Children under Five in Tanzania: Based on Tanzania Demographic and Health Surveys 1991–2016

2021 ◽  
Vol 18 (10) ◽  
pp. 5184
Author(s):  
Wenjun Zhu ◽  
Si Zhu ◽  
Bruno F. Sunguya ◽  
Jiayan Huang
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
Household Level ◽  
Individual Level ◽  
Child Stunting ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Urban Rural ◽  
The Individual

Our study aims to examine the disparity of under-5 child stunting prevalence between urban and rural areas of Tanzania in the past three decades, and to explore factors affecting the rural–urban disparity. Secondary analyses of Tanzania Demographic and Health Surveys (TDHS) data drawn from 1991–1992, 1996, 1999, 2004–2005, 2009–2010, and 2015–2016 surveys were conducted. Under-5 child stunting prevalence was calculated separately for rural and urban children and its decline trends were examined by chi-square tests. Descriptive analyses were used to present the individual-level, household-level, and societal-level characteristics of children, while multivariable logistic regression analyses were performed to examine determinants of stunting in rural and urban areas, respectively. Additive interaction effects were estimated between residence and other covariates. The results showed that total stunting prevalence was declining in Tanzania, but urban–rural disparity has widened since the decline was slower in the rural area. No interaction effect existed between residence and other determinants, and the urban–rural disparity was mainly caused by the discrepancy of the individual-level and household-level factors between rural and urban households. As various types of determinants exist, multisector nutritional intervention strategies are required to address the child stunting problem. Meanwhile, the intervention should focus on targeting vulnerable children, rather than implementing different policies in rural and urban areas.

scholarly journals 29.E. Workshop: Data analysis, advocacy activities, and actions to counteract the double burden of malnutrition

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Risk Factors ◽  
Global Health ◽  
Chronic Diseases ◽  
World Health ◽  
Special Focus ◽  
Global Level ◽  
Double Burden ◽  
Related Risk ◽  
Double Burden Of Malnutrition ◽  
The Impact

Abstract The burden of non-communicable chronic diseases (NCDs) represents a public health issue of gigantic proportion at global level. Among others, diet has been demonstrated to be a key element to maintain health and prevent NCDs. Today's world is facing the so-called “double burden of malnutrition”, characterized by the coexistence of undernutrition along with overweight, obesity or diet-related NCDs due to a substantial shift toward unhealthy diet high in sugars and ultra-processed foods and concomitant inadequate accessibility of nutritious foods. While interventions to improve diet quality and nutrition knowledge are of paramount importance in order to decrease the burden of NCDs over the next decades, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally. In this context, the EUPHA Food and nutrition section, the EUPHA Chronic diseases section, the EUPHA Health promotion section, in collaboration with the World Health Organization (WHO), aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs, obesity and nutrition-related risk factors as well as ongoing interventions aimed to reduce the double burden of malnutrition. The objectives of the present workshop are the following: To quantify the global burden and temporal trends of NCDs risk factors; To assess the impact of nutrition-related risk factors on NCDs; To provide examples of advocacy activities and actions at global level to improve nutrition education and dietary behaviors; To promote translatable information at global level and drive implementation of knowledge into policy and practice. Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. Given the many actors involved, the workshop will provide a unique occasion to discuss about potential policy approaches in the context of the conference. Key messages There is science-based evidence demonstrating that healthy nutrition is a key factor to maintain global health and prevent chronic non-communicable diseases. Governmental and non-governmental efforts are currently working to counteract malnutrition worldwide.

Maternal Correlates of Poliomyelitis Vaccination Uptake: Evidence from Afghanistan, Pakistan, and Nigeria

2021 ◽  
Author(s):  
Muhammad Muzammil ◽  
Sameen Zafar ◽  
Shazia Aziz ◽  
Muhammad Usman Bhutta ◽  
Rafi Amir-Ud-Din
Keyword(s):  
Multinomial Logistic Regression ◽  
Viral Disease ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Wealth Status ◽  
Vaccination Uptake ◽  
Agriculture Sector ◽  
Polio Vaccination ◽  
Working Status ◽  
The Impact

Poliomyelitis (polio) is a communicable viral disease that mainly affects under-5 children. This study focuses on the impact of women’s empowerment and women’s working status on the uptake of polio vaccination of children in polio-endemic countries, including Pakistan and Afghanistan, and Nigeria, the latter of which has recently been declared polio-free. The polio vaccination status can be divided into no vaccination (NV), incomplete vaccination (IV), and complete vaccination. We used data from the most recent Demographic and Health Surveys (DHS) rounds for this manuscript. Multinomial logistic regression-based estimates suggest that mothers’ working status, empowerment, age, education, father’s education, and household wealth status reduce the risk of NV and IV in the polio-endemic countries (Afghanistan and Pakistan) and Nigeria. In addition, the mothers’ working status, empowerment, age, education, and father’s education increase the child’s healthcare information that helps complete polio vaccination of the child. On the other hand, the children whose mothers work in the agriculture sector or are engaged in a blue-collar job are more likely to remain unvaccinated than women in white-collar jobs. Similarly, mothers engaged in government jobs are more likely to get their children fully vaccinated than unemployed mothers. Thus, as a child’s polio vaccination is strongly dependent on a mother’s working status and empowerment, the focus of public policy on empowering women and promoting their labor force participation may increase polio vaccination uptake, besides adopting other measures to increase immunization.

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