scholarly journals Infant Formula Consumption Is Positively Correlated with Wealth, Within and Between Countries: A Multi-Country Study

2019 ◽  
Vol 150 (4) ◽  
pp. 910-917 ◽  
Author(s):  
Paulo A R Neves ◽  
Giovanna Gatica-Domínguez ◽  
Nigel C Rollins ◽  
Ellen Piwoz ◽  
Phillip Baker ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Strongly Correlated ◽  
Middle Income ◽  
Middle Income Countries ◽  
Family Wealth ◽  
Multiple Indicator ◽  
Breastmilk Substitute ◽  
Graphical Presentation

ABSTRACT Background In contrast with the ample literature on within- and between-country inequalities in breastfeeding practices, there are no multi-country analyses of socioeconomic disparities in breastmilk substitute (BMS) consumption in low- and middle-income countries (LMICs). Objective This study aimed to investigate between- and within-country socioeconomic inequalities in breastfeeding and BMS consumption in LMICs. Methods We examined data from the Demographic Health Surveys and Multiple Indicator Cluster Surveys conducted in 90 LMICs since 2010 to calculate Pearson correlation coefficients between infant feeding indicators and per capita gross domestic product (GDP). Within-country inequalities in exclusive breastfeeding, intake of formula or other types of nonhuman milk (cow/goat) were studied for infants aged 0–5 mo, and for continued breastfeeding at ages 12–15 mo through graphical presentation of coverage wealth quintiles. Results Between-country analyses showed that log GDP was inversely correlated with exclusive (r = −0.37, P < 0.001) and continued breastfeeding (r = −0.74, P < 0.0001), and was positively correlated with formula intake (r = 0.70, P < 0.0001). Continued breastfeeding was inversely correlated with formula (r = −0.79, P < 0.0001), and was less strongly correlated with the intake of other types of nonhuman milk (r = −0.40, P < 0.001). Within-country analyses showed that 69 out of 89 did not have significant disparities in exclusive breastfeeding. Continued breastfeeding was significantly higher in children belonging to the poorest 20% of households compared with the wealthiest 20% in 40 countries (by ∼30 percentage points on average), whereas formula feeding was more common in the wealthiest group in 59 countries. Conclusions BMS intake is positively associated with GDP and negatively associated with continued breastfeeding in LMICs. In most countries, BMS intake is positively associated with family wealth, and will likely become more widespread as countries develop. Urgent action is needed to protect, promote, and support breastfeeding in all income groups and to reduce the intake of BMS, in light of the hazards associated with their use.

scholarly journals Socioeconomic inequalities in the prevalence of underweight, overweight, and obesity among women aged 20–49 in low- and middle-income countries

2019 ◽  
Vol 44 (3) ◽  
pp. 609-616 ◽  
Author(s):  
Ursula Reyes Matos ◽  
Marilia Arndt Mesenburg ◽  
Cesar G. Victora
Keyword(s):  
Pearson Correlation ◽  
National Income ◽  
Correlation Coefficients ◽  
Socioeconomic Inequalities ◽  
Overweight And Obesity ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Prevalence ◽  
Overweight Or Obesity ◽  
Low And Middle Income

Abstract Objective To analyze socioeconomic inequalities in the prevalence of underweight and overweight or obesity in women from low and middle-income countries (LMICs). Methods Using the last available Demographic Health Survey between 2010 and 2016 from 49 LMICs, we estimated the prevalence of underweight (BMI < 18.5 kg/m2) and overweight or obesity combined (BMI ≥ 25 kg/m2) for women aged 20–49 years. We used linear regression to explore the associations between the two outcomes and gross national income (GNI). We assess within-country socioeconomic inequalities using wealth deciles. The slope index of inequality (SII) and the inequality pattern index (IPI) were calculated for each outcome. Negative values of the latter express bottom inequality (when inequality is driven by the poorest deciles) while positive values express top inequality (driven by the richest deciles). Results In total, 931,145 women were studied. The median prevalence of underweight, overweight or obesity combined, and obesity were 7.3% (range 0.2–20.5%), 31.5% (8.8–85.3%), and 10.2% (1.9–48.8%), respectively. Pearson correlation coefficients with log GNI were −0.33 (p = 0.006) for underweight, 0.72 (p < 0.001) for overweight or obesity, and 0.66 (p < 0.001) for obesity. For underweight, the SII was significantly negative in 38 of the 49 countries indicating a higher burden among poor women. There was no evidence of top or bottom inequality. Overweight or obesity increased significantly with wealth in 44 of the 49 countries. Top inequality was observed in low-prevalence countries, and bottom inequality in high-prevalence countries. Conclusion Underweight remains a problem among the poorest women in poor countries, but overweight and obesity are the prevailing problem as national income increases. In low-prevalence countries, overweight or obesity levels are driven by the higher prevalence among the richest women; as national prevalence increases, only the poorest women are relatively preserved from the epidemic.

SmartKC

2021 ◽  
Vol 5 (4) ◽  
pp. 1-27
Author(s):  
Siddhartha Gairola ◽  
Murtuza Bohra ◽  
Nadeem Shaheer ◽  
Navya Jayaprakash ◽  
Pallavi Joshi ◽  
...  
Keyword(s):  
Low Cost ◽  
Pearson Correlation ◽  
Step Method ◽  
Middle Income ◽  
Middle Income Countries ◽  
Large Populations ◽  
Pixel Location ◽  
3D Printed ◽  
Working Distance ◽  
Fitting In

Keratoconus is a severe eye disease affecting the cornea (the clear, dome-shaped outer surface of the eye), causing it to become thin and develop a conical bulge. The diagnosis of keratoconus requires sophisticated ophthalmic devices which are non-portable and very expensive. This makes early detection of keratoconus inaccessible to large populations in low-and middle-income countries, making it a leading cause for partial/complete blindness among such populations. We propose SmartKC, a low-cost, smartphone-based keratoconus diagnosis system comprising of a 3D-printed placido's disc attachment, an LED light strip, and an intelligent smartphone app to capture the reflection of the placido rings on the cornea. An image processing pipeline analyzes the corneal image and uses the smartphone's camera parameters, the placido rings' 3D location, the pixel location of the reflected placido rings and the setup's working distance to construct the corneal surface, via the Arc-Step method and Zernike polynomials based surface fitting. In a clinical study with 101 distinct eyes, we found that SmartKC achieves a sensitivity of 87.8% and a specificity of 80.4%. Moreover, the quantitative curvature estimates (sim-K) strongly correlate with a gold-standard medical device (Pearson correlation coefficient = 0.77). Our results indicate that SmartKC has the potential to be used as a keratoconus screening tool under real-world medical settings.

PATTERN OF SCHOOL ABSENTEEISM IN SOME SELECTED COUNTRIES

2021 ◽  
pp. 1-12
Keyword(s):  
Conditional Cash Transfer ◽  
Rural Students ◽  
Cash Transfer ◽  
School Absenteeism ◽  
Wealth Status ◽  
Middle Income ◽  
Primary Level ◽  
Middle Income Countries ◽  
Multiple Indicator Cluster Survey ◽  
Multiple Indicator

School absenteeism is treated as a barrier towards quality education. It is related to school dropout, depression, anxiety and academic performance. This study uses Multiple Indicator Cluster Survey dataset to analyze the pattern of school absenteeism in five lower middle-income countries: Bangladesh, Djibouti, Nigeria, Ukraine and Vietnam. Primary and secondary level students are considered in this study. Authors accomplish descriptive analyses to trace out the pattern of school absenteeism. This study finds that nearly one-third students in Bangladesh, about half of the students in Djibouti and more than half students in Vietnam missed at least one instructional day in a week. Additionally, more than 80 percent students in Nigeria and Ukraine missed one instructional day in a week. This study reveals that age and wealth status are negatively related to school absenteeism. Furthermore, it is evident that tendency of school absenteeism is higher among rural and primary level students. Thus, this study suggests for providing conditional cash transfer among primary level students and specific incentive for rural students to address the problem of absenteeism.

scholarly journals Improving exclusive breastfeeding in low and middle‐income countries: A systematic review

2019 ◽  
Vol 15 (3) ◽  
Author(s):  
Tolulope Florence Olufunlayo ◽  
Alero Ann Roberts ◽  
Christine MacArthur ◽  
Neil Thomas ◽  
Kofoworola Abimbola Odeyemi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Exclusive Breastfeeding ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Impact of maternal mental health interventions on child-related outcomes in low- and middle-income countries: a systematic review and meta-analysis

2020 ◽  
Vol 29 ◽  
Author(s):  
W. A. Tol ◽  
M. C. Greene ◽  
M. E. Lasater ◽  
K. Le Roch ◽  
C. Bizouerne ◽  
...  
Keyword(s):  
Mental Health ◽  
Exclusive Breastfeeding ◽  
Home Visiting ◽  
Health Workers ◽  
Maternal Mental Health ◽  
Meta Analysis ◽  
Middle Income ◽  
Middle Income Countries ◽  
Child Height ◽  
Low And Middle Income

Abstract Aims Observational studies have shown a relationship between maternal mental health (MMH) and child development, but few studies have evaluated whether MMH interventions improve child-related outcomes, particularly in low- and middle-income countries. The objective of this review is to synthesise findings on the effectiveness of MMH interventions to improve child-related outcomes in low- and middle-income countries (LMICs). Methods We searched for randomised controlled trials conducted in LMICs evaluating interventions with a MMH component and reporting children's outcomes. Meta-analysis was performed on outcomes included in at least two trials. Results We identified 21 trials with 28 284 mother–child dyads. Most trials were conducted in middle-income countries, evaluating home visiting interventions delivered by general health workers, starting in the third trimester of pregnancy. Only ten trials described acceptable methods for blinding outcome assessors. Four trials showed high risk of bias in at least two of the seven domains assessed in this review. Narrative synthesis showed promising but inconclusive findings for child-related outcomes. Meta-analysis identified a sizeable impact of interventions on exclusive breastfeeding (risk ratio = 1.39, 95% confidence interval (CI): 1.13–1.71, ten trials, N = 4749 mother–child dyads, I2 = 61%) and a small effect on child height-for-age at 6-months (std. mean difference = 0.13, 95% CI: 0.02–0.24, three trials, N = 1388, I2 = 0%). Meta-analyses did not identify intervention benefits for child cognitive and other growth outcomes; however, few trials measured these outcomes. Conclusions These findings support the importance of MMH to improve child-related outcomes in LMICs, particularly exclusive breastfeeding. Given, the small number of trials and methodological limitations, more rigorous trials should be conducted.

scholarly journals Intra-cluster correlation coefficients in primary care patients with type 2 diabetes and hypertension

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Lin Lee ◽  
Yvonne Mei Fong Lim ◽  
Kian Boon Law ◽  
Sheamini Sivasampu
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Clinical Outcomes ◽  
Patient Experience ◽  
Correlation Coefficients ◽  
Middle Income ◽  
Processes Of Care ◽  
Middle Income Countries ◽  
Cluster Correlation

Abstract Introduction There are few sources of published data on intra-cluster correlation coefficients (ICCs) amongst patients with type 2 diabetes (T2D) and/or hypertension in primary care, particularly in low- and middle-income countries. ICC values are necessary for determining the sample sizes of cluster randomized trials. Hence, we aim to report the ICC values for a range of measures from a cluster-based interventional study conducted in Malaysia. Method Baseline data from a large study entitled Evaluation of Enhanced Primary Health Care interventions in public health clinics (EnPHC-EVA: Facility) were used in this analysis. Data from 40 public primary care clinics were collected through retrospective chart reviews and a patient exit survey. We calculated the ICCs for processes of care, clinical outcomes and patient experiences in patients with T2D and/or hypertension using the analysis of variance approach. Results Patient experience had the highest ICC values compared to processes of care and clinical outcomes. The ICC values ranged from 0.01 to 0.48 for processes of care. Generally, the ICC values for processes of care for patients with hypertension only are higher than those for T2D patients, with or without hypertension. However, both groups of patients have similar ICCs for antihypertensive medications use. In addition, similar ICC values were observed for clinical outcomes, ranging from 0.01 to 0.09. For patient experience, the ICCs were between 0.03 (proportion of patients who are willing to recommend the clinic to their friends and family) and 0.25 (for Patient Assessment of Chronic Illness Care item 9, Given a copy of my treatment plan). Conclusion The reported ICCs and their respective 95% confidence intervals for T2D and hypertension will be useful for estimating sample sizes and improving efficiency of cluster trials conducted in the primary care setting, particularly for low- and middle-income countries.

scholarly journals Socioeconomic inequities in the health and nutrition of children in low/middle income countries

2010 ◽  
Vol 44 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Fernando C Barros ◽  
Cesar G Victora ◽  
Robert Scherpbier ◽  
Davidson Gwatkin
Keyword(s):  
Access To Health Services ◽  
Middle Income ◽  
Middle Income Countries ◽  
Health And Nutrition ◽  
Life Saving ◽  
Low Middle Income Countries ◽  
Pubmed Database ◽  
Use Of Services ◽  
Multiple Indicator ◽  
Pathogenic Agents

OBJECTIVE: To describe the effects of social inequities on the health and nutrition of children in low and middle income countries. METHODS: We reviewed existing data on socioeconomic disparities within-countries relative to the use of services, nutritional status, morbidity, and mortality. A conceptual framework including five major hierarchical categories affecting inequities was adopted: socioeconomic context and position, differential exposure, differential vulnerability, differential health outcomes, and differential consequences. The search of the PubMed database since 1990 identified 244 articles related to the theme. Results were also analyzed from almost 100 recent national surveys, including Demographic Health Surveys and the UNICEF Multiple Indicator Cluster Surveys. RESULTS: Children from poor families are more likely, relative to those from better-off families, to be exposed to pathogenic agents; once they are exposed, they are more likely to become ill because of their lower resistance and lower coverage with preventive interventions. Once they become ill, they are less likely to have access to health services and the quality of these services is likely to be lower, with less access to life-saving treatments. As a consequence, children from poor family have higher mortality rates and are more likely to be undernourished. CONCLUSIONS: Except for child obesity and inadequate breastfeeding practices, all the other adverse conditions analyzed were more prevalent in children from less well-off families. Careful documentation of the multiple levels of determination of socioeconomic inequities in child health is essential for understanding the nature of this problem and for establishing interventions that can reduce these differences.

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