scholarly journals Preschool Child Nutritional Status in Nepal in 2016 and Comparative Trends (P11-074-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Angela KC ◽  
Andrew Thorne-Lyman ◽  
Binod Shrestha ◽  
Swetha Manohar ◽  
Patrick Webb ◽  
...  
Keyword(s):  
Preschool Child ◽  
Temporal Trends ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Community Studies ◽  
Growth Standards ◽  
Child Undernutrition ◽  
Z Scores ◽  
Feed The Future ◽  
Health Organization

Abstract Objectives Estimate the national and agro-ecological zonal prevalence of preschool child undernutrition and review temporal trends in the prevalence of undernutrition. Methods In 2016, we conducted the last in a series of 3 (also 2013 and 2014) nationally representative, annual, same-season, mixed-longitudinal nutrition surveys – PoSHAN Community Studies – in the same 21 Village Development Committees sampled across the Mountains, Hills and Tarai of Nepal. Height/length and weight measurements of 5479 children < 5 years were converted to z-scores of height-for-age (HAZ) and weight-for-height (WHZ) based on World Health Organization growth standards. Cut-offs of < -2 z-scores of HAZ and WHZ were applied to define stunting and wasting, respectively. Rates of stunting and wasting were compared to four Demographic and Health Surveys of Nepal (NDHS) from 2001–2016. Annual rates of decline in stunting and wasting were calculated. Results Preschool stunting and wasting rates from PoSHAN in 2016 were 34% [95% CI: 29.5 to 38.9%] and 13.7% [11.0 to 16.9%], similar to those observed in the 2016 NDHS: 35.8% [33.5 to 38.3%] and 9.7% [8.4 to 11.1%], respectively. Stunting was highest in the Mountains (40.6%), and wasting in the Tarai (18.9%). PoSHAN surveys revealed an annual decrease in the prevalence of stunting of 1.5% from 2013–2016 and 2.3% from 2011–2016, representing a lesser decline than in the earlier period of 2001–2011 (3.3%) (Figure 1 a). In contrast, neither series of surveys has revealed a marked decline in the national prevalence of wasting over the past 15 years (Figure 1 b). Conclusions The rates of stunting and wasting seen in the PoSHAN survey were comparable to other contemporary surveys in 2016 and suggest that the current rate of decline is inadequate to meet Nepal's 2025 World Health Assembly (WHA) target of reducing stunting to 26.5%. However, wasting has changed very little, threatening the potential to reach Nepal's national WHA target of 5%. Funding Sources Funded by USAID Feed the Future Nutrition Innovation Lab, with assistance from Sight and Life and The Gates Foundation. Supporting Tables, Images and/or Graphs

scholarly journals World Health Organization growth standards: How do Canadian children measure up?

2020 ◽  
Author(s):  
Celia Rodd ◽  
Allison Feely ◽  
Allan B Becker ◽  
Theo J Moraes ◽  
Padmaja Subbarao ◽  
...  
Keyword(s):  
World Health Organization ◽  
Growth Parameters ◽  
Early Recognition ◽  
Area Under The Curve ◽  
Predictive Performance ◽  
World Health ◽  
Growth Standards ◽  
Increased Risk ◽  
Z Scores ◽  
Health Organization

Abstract Background World Health Organization (WHO) growth standards for children aged 0 to 5 years describe growth under optimal conditions and were adopted for use in Canada in 2012. We are seeking to validate these charts in a well-characterized, longitudinal cohort of healthy, Canadian youngsters, assess tracking over time, and evaluate the prognostic implications of early growth. Methods Data from 2,795 mother–infant dyads from the CHILD birth cohort were classified by feeding modality at 6 months as exclusively breastfed, partially breastfed, or formula-fed. WHO z-scores (z) were calculated at birth, 3 months, 1 year, and 3 years. Receiver operator characteristics (ROC) assessed the predictive performance of early weight (WT), weight-for-length (WfL), or body mass index (BMI) z-scores for overweight/obesity at 3 years. Results Compared to WHO standards, Canadian children at birth had lower median WfLz (−0.73) and BMIz (−0.29), with more positive scores by 3 years (WfLz=BMIz=0.58). At both 1 and 3 years, formula feeding was associated with higher scores than breastfeeding, even after regression adjustment for covariates. Head circumference z-score was typically positive at all times and regardless of feeding modality. At 1 year, ROC area under the curve was 0.79 for WTz, WfLz, and BMIz, and BMIz&gt;0.88 identified children with increased risk of overweight/obesity (BMIz &gt;2) at age 3 years (20.3% versus 3.0%, P&lt;0.001). Conclusions Compared to WHO growth charts, Canadian children at 3 years show an upward shift in BMIz and WfLz, particularly when formula-fed. Infant growth parameters may identify infants with increased risk of overweight/obesity at age 3 years; early recognition may allow targeting infants at higher risk.

scholarly journals The prevalence and associated factors of undernutrition among under-five children in South Sudan using the standardized monitoring and assessment of relief and transitions (SMART) methodology

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jackline Kiarie ◽  
Sarah Karanja ◽  
Julius Busiri ◽  
Diana Mukami ◽  
Colleta Kiilu
Keyword(s):  
South Sudan ◽  
Child Growth ◽  
World Health ◽  
Large Displacements ◽  
Younger Child ◽  
Growth Standards ◽  
Under Five ◽  
Z Scores ◽  
Health Organization ◽  
Child Age

Abstract Background Conflict regions bear the heaviest brunt of food insecurity and undernutrition. South Sudan is one of the fragile countries following years of conflict that led to large displacements. Moderate to severe undernutrition among under-five children has been associated with elevated morbidity and mortality. This study, therefore, was conducted to assess the magnitude and factors influencing undernutrition (wasting, underweight and stunting) among children aged 6 to 59 months in Yambio County, South Sudan. Methods A cross-sectional study was conducted from 26 October to 6 November 2018 in Yambio County, South Sudan among 630 children aged 6–59 months from the 348 households surveyed in 39 clusters using two-stage cluster sampling design. Data were collected using questionnaires and nutritional anthropometric measurements. The Standardized Monitoring and Assessment of Relief and Transitions (SMART) Methodology was followed to obtain the prevalence of wasting, underweight and stunting based on respective z scores and according to the 2006 world health organization child growth standards. Data were exported to Stata version 16 for further analysis. Bivariate analysis of independent variables and undernutrition was done using binary logistic regression. Mixed effects logistic regression analysis was conducted to control for possible confounders and account for random effects at household and cluster levels. Unadjusted and adjusted odds ratios (cOR and aOR) with 95% confidence intervals (CI) and p-values were computed. P-values of ≤0.05 were considered statistically significant. Results The prevalence of undernutrition explained by wasting (weight-for-height Z-score (WHZ) < − 2), underweight (weight-for-age z-scores (WAZ) < − 2) and stunting (height-for-age z-scores (WHZ) < − 2) were 2.3% (1.3–4.1, 95% CI), 4.8% (3.1–7.5, 95% CI) and 23.8% (19.1–29.2, 95% CI). Male sex (aOR [95% CI], p-value: 5.6 [1.10–30.04], p = 0.038), older child’s age (aOR [95% CI], p-value: 30.4 [2.65–347.60], p = 0.006) and non-residents (cOR [95% CI], p-value: 4.2 [1.4–12.2] p = 0.009) were associated with increased risk of wasting. Household size (cOR [95% CI], p-value: 1.09 [1.01–1.18] p = 0.029) and younger child age (cOR [95% CI], p-value: 4.2 [1.34–13.23] p = 0.014) were significantly associated with underweight. Younger child age (aOR [95% CI], p-value: 5.4 [1.82–16.44] p = 0.003) and agricultural livelihood (aOR [95% CI], p-value: 3.4 [1.61–7.02] p = 0.001) were associated with stunting. Conclusion Based on a cut off of less than − 2 standard deviations for 2006 World Health Organization (WHO) child growth standards, the wasting prevalence was very low, underweight prevalence was low while stunting prevalence was high. The county lies in the only livelihood region in South Sudan with bimodal reliable rainfall pattern and it seems that the impact of the 2016 conflicts that lead to large displacements may not have greatly affected under-five undernutrition. Interventions targeted at improving food diversity, increasing nutrition knowledge and enhancing resilience in male children might reduce undernutrition. In the short-term, investment in continued surveillance of nutritional status should be a main focus.

scholarly journals Measuring the Overall Burden of Early Childhood Malnutrition in Ghana: A Comparison of Estimates from Multiple Data Sources

2020 ◽  
Author(s):  
John Paul Kuwornu ◽  
Jonathan Amoyaw ◽  
Taru Manyanga ◽  
Elizabeth J. Cooper ◽  
Elvis Donkoh ◽  
...  
Keyword(s):  
National Level ◽  
Composite Index ◽  
Primary Objective ◽  
Data Sources ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Growth Standards ◽  
Childhood Malnutrition ◽  
Nationally Representative ◽  
Health Organization

Background: Childhood malnutrition contributes to nearly half (45%) of all deaths among children under 5 globally. The United Nations’ Sustainable Development Goals (SDGs) aims to end all forms of malnutrition by 2030; however, measuring progress towards these goals is challenging, particularly in countries with emerging economies where nationally-representative data are limited. The primary objective of this study was to estimate the overall burden of childhood malnutrition in Ghana at national and regional levels using 3 data sources. Methods: Using data from the long-standing Ghana Demographic and Health Surveys (GDHS), Ghana Multiple Indicator Cluster Survey (GMICS), and the emerging Ghana Socioeconomic Panel Survey (GSPS), we compared the prevalence of malnutrition using the extended composite index of anthropometric failure (eCIAF) for the period 2008- 2011. This study included data for children aged 6-59 months and calculated all anthropometric z-scores based on the World Health Organization (WHO) Growth Standards. We tested for differences in malnutrition subtypes using two-group configural frequency analysis (CFA). Results: Of the 10 281 children (6532 from GMICS, 2141 from GDHS and 1608 from GSPS) included in the study, the only demographic difference observed was the children included in the GSPS were slightly older than those included in the GDHS and GMICS (median age of 36 vs 30 vs 33 months, P<.001). Based on the eCIAF, the overall prevalence of malnutrition at the national level was higher among children in the GSPS (57.3%, 95% CI: 53.9%–60.6%), followed by the GDHS (39.7%, 95% CI: 37.0%–42.5%), and then those in the GMICS (31.2%, 95% CI: 29.3%–33.1%). The two-group CFA showed that the 3 data sources also estimated different prevalence rates for most of the malnutrition subtypes included in the eCIAF. Conclusion: Depending on the data source adopted, our estimates of eCIAF showed that between one-third and half of all Ghanaian children aged 6-59 months had at least one form of malnutrition over the period 2008-2011. These eCIAF estimates should complement the commonly reported measures such as stunting and wasting when interpreting the severity of malnutrition in the country to inform policy decisions.

scholarly journals Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6–23 Months in Malawi

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 178
Author(s):  
Zizwani Brian Chilinda ◽  
Mark L. Wahlqvist ◽  
Meei-Shyuan Lee ◽  
Yi-Chen Huang
Keyword(s):  
Young Children ◽  
Dietary Diversity ◽  
World Health ◽  
Food Groups ◽  
Water Access ◽  
Direct Role ◽  
Cross Sectional ◽  
Child Undernutrition ◽  
Health Organization ◽  
Minimum Dietary Diversity

Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother–child dyads, respectively, (26.8 ± 6.8 years, range 15–49 years) and (13.9 ± 4.9 months, range 6–23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, p < 0.001). However, only 5.9% of the mother–child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24–2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.

scholarly journals Time trends in socio-economic, urban-rural and regional disparities in prevalence of obesity among non-pregnant women in Lesotho: evidence from Lesotho demographic and health surveys (2004–2014)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Betregiorgis Zegeye ◽  
Gebretsadik Shibre ◽  
Gashaw Garedew Woldeamanuel
Keyword(s):  
Pregnant Women ◽  
Health Surveys ◽  
Educational Inequality ◽  
Statistical Significance ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Obesity Prevalence ◽  
Urban Rural ◽  
Prevalence Of Obesity ◽  
Health Organization

Abstract Background The growing rates of obesity in developing countries are alarming. There is a paucity of evidence about disparities of obesity in Lesotho. This study examined socioeconomic and area-based inequalities in obesity among non-pregnant women in Lesotho. Methods Data were extracted from the 2004, 2009 and 2014 Lesotho Demographic and Health Surveys (LDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. Obesity prevalence was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, simple and complex as well as relative and absolute summary measures were calculated. A 95% confidence interval was used to measure statistical significance of findings. Results We noticed substantial wealth-driven (D = -21.10, 95% CI; − 25.94, − 16.26), subnational region (PAR = -11.82, 95%CI; − 16.09, − 7.55) and urban-rural (− 9.82, 95% CI; − 13.65, − 5.99) inequalities in obesity prevalence without the inequalities improved over time in all the studied years. However, we did not identify educational inequality in obesity. Conclusions Wealth-driven and geographical inequalities was identified in Lesotho in all the studied time periods while education related inequalities did not appear during the same time period. All population groups in the country need to be reached with interventions to reduce the burden of obesity in the country.

scholarly journals Breastfeeding Practices among Adolescent Mothers and Associated Factors in Bangladesh (2004–2014)

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 557
Author(s):  
Kingsley Agho ◽  
Tahmeed Ahmed ◽  
Catharine Fleming ◽  
Mansi Dhami ◽  
Chundung Miner ◽  
...  
Keyword(s):  
Adolescent Mothers ◽  
Antenatal Clinic ◽  
Economic Benefits ◽  
Bottle Feeding ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Breastfeeding Initiation ◽  
Breastfeeding Practices ◽  
Health Organization ◽  
At Home

Optimal breastfeeding practices among mothers have been proven to have health and economic benefits, but evidence on breastfeeding practices among adolescent mothers in Bangladesh is limited. Hence, this study aims to estimate breastfeeding indicators and factors associated with selected feeding practices. The sample included 2554 children aged 0–23 months of adolescent mothers aged 12–19 years from four Bangladesh Demographic and Health Surveys collected between 2004 and 2014. Breastfeeding indicators were estimated using World Health Organization (WHO) indicators. Selected feeding indicators were examined against potential confounding factors using univariate and multivariate analyses. Only 42.2% of adolescent mothers initiated breastfeeding within the first hour of birth, 53% exclusively breastfed their infants, predominant breastfeeding was 17.3%, and 15.7% bottle-fed their children. Parity (2–3 children), older infants, and adolescent mothers who made postnatal check-up after two days were associated with increased exclusive breastfeeding (EBF) rates. Adolescent mothers aged 12–18 years and who watched television were less likely to delay breastfeeding initiation within the first hour of birth. Adolescent mothers who delivered at home (adjusted OR = 2.63, 95% CI:1.86, 3.74) and made postnatal check-up after two days (adjusted OR = 1.67, 95% CI: 1.21, 2.30) were significantly more likely to delay initiation breastfeeding within the first hour of birth. Adolescent mothers living in the Barisal region and who listened to the radio reported increased odds of predominant breastfeeding, and increased odds for bottle-feeding included male infants, infants aged 0–5 months, adolescent mothers who had eight or more antenatal clinic visits, and the highest wealth quintiles. In order for Bangladesh to meet the Sustainable Development Goals (SDGs) 2 and 3 by 2030, breastfeeding promotion programmes should discourage bottle-feeding among adolescent mothers from the richest households and promote early initiation of breastfeeding especially among adolescent mothers who delivered at home and had a late postnatal check-up after delivery.

scholarly journals Compliance with the 24-Hour Movement Behavior Guidelines and Associations with Adiposity in European Preschoolers: Results from the ToyBox-Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7499
Author(s):  
Marga Decraene ◽  
Vera Verbestel ◽  
Greet Cardon ◽  
Violeta Iotova ◽  
Berthold Koletzko ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Screen Time ◽  
Total Sample ◽  
Cross Sectional Study ◽  
World Health ◽  
Movement Behavior ◽  
Cross Sectional ◽  
Guideline Compliance ◽  
Z Scores ◽  
Health Organization

In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays and weekend days), and the associations with adiposity. This cross-sectional study included 2468 preschoolers (mean age: 4.75 years; 41.9% boys) from six European countries. The associations were investigated in the total sample and in girls and boys separately. PA was objectively assessed by step counts/day. Parent-reported questionnaires provided ST and sleep duration data. Generalized estimating equations were used to analyze the association between guideline compliance and adiposity indicators, i.e., body mass index (BMI) z-score and waist to height ratio (WHR). Only 10.1% of the preschoolers complied with the 24 h movement behavior guidelines, 69.2% with the sleep duration guideline, 39.8% with the ST guideline and 32.7% with the PA guideline. No association was found between guideline compliance with all three movement behaviors and adiposity. However, associations were found for isolated weekday screen time (BMI z-scores and WHR: p = 0.04) and weekend day sleep duration (BMI z-scores and WHR: p = 0.03) guideline compliance with both lower adiposity indicators. The latter association for sleep duration was also found in girls separately (BMI z-scores: p = 0.02; WHR: p = 0.03), but not in boys. Longitudinal studies, including intervention studies, are needed to increase preschoolers’ guideline compliance and to gain more insight into the manifestation of adiposity in children and its association with 24 h movement behaviors from a young age onwards.

Construction of the World Health Organization child growth standards: selection of methods for attained growth curves

2005 ◽  
Vol 25 (2) ◽  
pp. 247-265 ◽  
Author(s):  
E. Borghi ◽  
M. de Onis ◽  
C. Garza ◽  
J. Van den Broeck ◽  
E. A. Frongillo ◽  
...  
Keyword(s):  
World Health Organization ◽  
Growth Curves ◽  
Child Growth ◽  
World Health ◽  
Growth Standards ◽  
The World ◽  
Health Organization ◽  
Selection Of

scholarly journals Geographic Inequalities in Accessing Improved Water and Sanitation Facilities in Nepal

2019 ◽  
Vol 16 (7) ◽  
pp. 1269 ◽  
Author(s):  
Chao Wang ◽  
Jing Pan ◽  
Sanni Yaya ◽  
Ram Bilash Yadav ◽  
Dechao Yao
Keyword(s):  
National Level ◽  
Water Sources ◽  
Wash Water ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Water And Sanitation ◽  
Ecological Zones ◽  
Quality Of Water ◽  
Health Organization

In this study, we aimed to assess the geographic inequalities in access to improved water and sanitation facilities among Nepalese households. We conducted this study based on cross-sectional data obtained from Nepal Demographic and Health Surveys. The quality of water sources and sanitation were defined by World Health Organization (WHO) guidelines. The geographic categories used in the analyses included developmental region, ecological zone, and urbanicity. Percentages of households having access to improved toilet (5.6% in 1996 vs. 40.5% in 2016) and water (19.3% in 1996 vs. 27% in 2016) facilities has been increasing steadily since 1996 with a great proportion of the households still lacking access to these services. The number of households sharing the same toilet and traveling time to reach water sources have also decreased at the same time. Households in Far Western and Mountains had the lowest odds of having access to improved toilet and water facilities. Noticeable progress has been achieved in improving WASH (water, sanitation, and hygiene) coverage at national level, however, it is uneven across developmental and ecological zones. Households in the Far Western and Mountain regions appeared to be the most geographically disadvantaged in terms of having access to improved water and sanitation facilities.

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