scholarly journals Differential effects of socio-demographic factors on maternal haemoglobin concentration in three sub-Saharan African Countries

Author(s):  
Dickson A. Amugsi ◽  
Zacharie T. Dimbuene ◽  
Catherine Kyobutungi

AbstractObjectiveTo investigate the effects of socio-demographic factors on maternal haemoglobin (Hb) at different points of the conditional distribution of Hb concentration.MethodsWe analysed the Demographic and Health Surveys data from Ghana, Democratic Republic of the Congo (DRC) and Mozambique, using Hb concentration of mothers aged 15-49 years as an outcome of interest. We utilise quantile regression to estimate the effects of the socio-demographic factors across specific points of the maternal Hb concentration.ResultsThe results showed crucial differences in the effects of socio-demographic factors along the conditional distribution of Hb concentration. In Ghana, maternal education had a positive effect on Hb concentration in the 5th and 10th quantiles. The positive effect of education on maternal Hb concentration occurred across all quantiles in Mozambique, with the largest effect at the lowest quantile (5th) and the smallest effect at the highest quantile (90th). In contrast, maternal education had a negative effect on the Hb concentration of mothers in the 50th, 75th and 90th quantiles in DRC. Maternal body mass index (BMI) had a positive effect on Hb concentration of mothers in the 5th, 10th, 50th and 90th, and 5th to 50th quantiles in Ghana and Mozambique, respectively. Breastfeeding had a significant positive effect on Hb concentration across all countries, with the largest effect on Hb concentration of mothers in the lower quantiles. All the household wealth indices had positive effects on maternal Hb concentration across quantiles in Mozambique, with the largest effect among mothers in the upper quantiles. However, in Ghana, living in a poor wealth index was inversely related with Hb concentration of mothers in the 5th and 10th quantiles.ConclusionsOur results showed that the effects of socio-demographic factors on maternal Hb concentration vary along its distribution. Interventions to address maternal anaemia should take these variations into account to identify the most vulnerable groups.What this study addsQuantile regression can be used effectively to analyse anaemia dataSocio-demographic factors have differential effects on Hb at different points of its distributionInterpreting results based on the mean effect (as in OLS) only provides a partial pictureBreastfeeding has positive effect on maternal Hb concentrationThe use of multicountry data revealed differences and commonalities between countries

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Dickson A. Amugsi ◽  
Zacharie T. Dimbuene ◽  
Catherine Kyobutungi

AbstractLow Haemoglobin concentration (Hb) among women of reproductive age is a severe public health problem in sub-Saharan Africa. This study investigated the effects of putative socio-demographic factors on maternal Hb at different points of the conditional distribution of Hb concentration. We utilised quantile regression to analyse the Demographic and Health Surveys data from Ghana, Democratic Republic of the Congo (DRC) and Mozambique. In Ghana, maternal schooling had a positive effect on Hb of mothers in the 5th and 10th quantiles. A one-year increase in education was associated with an increase in Hb across all quantiles in Mozambique. Conversely, a year increase in schooling was associated with a decrease in Hb of mothers in the three upper quantiles in DRC. A unit change in body mass index had a positive effect on Hb of mothers in the 5th, 10th, 50th and 90th, and 5th to 50th quantiles in Ghana and Mozambique, respectively. We observed differential effects of breastfeeding on maternal Hb across all quantiles in the three countries. The effects of socio-demographic factors on maternal Hb vary at the various points of its distribution. Interventions to address maternal anaemia should take these variations into account to identify the most vulnerable groups.


2019 ◽  
Author(s):  
Dickson A. Amugsi

AbstractAnaemia among children under 5, is a public health problem of serious concern. In Ghana, 8 out of every 10 children are anaemic. This study employed a novel approach to investigate the determinants of normal haemoglobin (Hb) concentration among children aged 6 to 59 months, using data from the Ghana Demographic and Health Surveys. The results showed that a year change in maternal education was positively associated with normal Hb concentration. Children of non-anaemic mothers were 1.67 (CI=1.32, 2.10; P<.001) times more likely to have normal Hb concentration relative to children of anaemic mothers. Compared to mothers who had less than 4 antenatal care (ANC) visits, mothers who had at least 4 ANC visits increased the odds of their children having a normal Hb concentration by 1.62 (CI=1.09, 2.40; P<.018). Children living in middle and rich households had respectively 1.48 (CI=1.06, 2.07; p<.021) and 1.59 (CI=1.08, 2.33; p<.018) increased odds of having a normal Hb concentration relative to those living in poor households. Maternal education, anaemia, ANC attendance, and household wealth index are strong determinants of normal Hb concentration among children in Ghana. Strategies aimed at addressing childhood anaemia should take into account maternal anaemia, education, poverty and ANC attendance.


1970 ◽  
Vol 7 (2) ◽  
pp. 85-89
Author(s):  
Muhammad Irfan ◽  
Syed Mustansir Hussain Zaidi ◽  
Hira Fatima Waseem

Background: Diarrhea founds to be the major cause of morbidity and mortality in children less than five years. Various factors are associated with diarrhea but socio-demographic factors are the main key elements, which associated with diarrhea. Methods: This study was examined association of socio-demographic factors with diarrhea in children less than five years of age of Sindh, Pakistan, using data from the Multiple Indicator Cluster Survey (MICS) conducted from January 2014 to August 2014. Data were collected for 18,108 children in whom 16,449 children had complete data of demographic variables being included in the analysis. Bivariate analysis was done using Pearson's Chi square test and multivariate analysis being done using binary logistic regression. Results: We found increased risk of diarrhea among children lives in rural areas while household wealth index quintile was also associated with diarrhea. Children in the poor, middle and fourth wealth index quintiles being at increased risk of diarrhea compared to children in the richest wealth index quintile. The highest risk of diarrhea was found for the child having mother with no education as well as children aged 12-23 months. Conclusion: Age of child, mother education and wealth index found significant with diarrhea while Male children, child aged 12-23 months, child with no mother education, child from rural areas and child from poor households found with high risk of diarrhea.


2014 ◽  
Vol 17 (11) ◽  
pp. 2407-2418 ◽  
Author(s):  
Helga Bjørnøy Urke ◽  
Maurice B Mittelmark ◽  
Martín Valdivia

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.


2019 ◽  
Author(s):  
Kiran Acharya ◽  
Yuba Raj Paudel ◽  
Dinesh Dharel

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.


Author(s):  
Tanveer Bano ◽  
Abhishek Agarwal ◽  
Sunil Kumar Garg ◽  
Harivansh Chopra ◽  
Seema Jain ◽  
...  

Background: Iron deficiency anaemia constitutes more than half of the anaemia burden among the under 5 children. In addition to socio-demographic factors, the maternal factors plays an important role in determining childhood anaemia. The objective of the study was to determine the prevalence of anaemia among 1-3 year old children and to find their association with maternal factors.Methods: The present cross sectional study was conducted in a sub centre village under Machhra CHC. Sample size was calculated as 182 by taking the prevalence of anaemia as 79% with 7.5% relative precision and 95% confidence interval. From the list of 404 children obtained from MCTS data, 200 children were selected randomly. Detailed information regarding socio demographic factors and maternal factors was obtained on a pre tested and pre designed questionnaire. Hemoglobin levels were estimated using haemo check rapid diagnostic kit. The data was collected and analyzed on epi info 3.7.2 using appropriate statistical tests.Results: Out of 200 children 77.5% of them were suffering from mild to severe anaemia. Among all the maternal factors studied maternal education, iron folic acid consumption during pregnancy, birth order of the index case and history of exclusive breast feeding were found to be significantly associated with prevalence of anaemia among the children.Conclusions: The present study revealed a high prevalence of anaemia in children and maternal factors plays an important role in determining the disease. 


2012 ◽  
Vol 15 (9) ◽  
pp. 1715-1727 ◽  
Author(s):  
Peninah K Masibo ◽  
Donald Makoka

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.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 389-389
Author(s):  
Nadia Akseer ◽  
Rebecca A Heidkamp ◽  
Andrew Thorne-Lyman

Abstract Objectives Improving child diet diversity is a policy priority in many settings. Multiple factors influence complementary feeding practices in low-income countries including household food access, caregiver-level factors and cultural practices. Child's dietary data is often available in national surveys (i.e., Demographic and Health Surveys, DHS), but they typically lack diet data from adults. The 2018 Nigeria DHS was among the first to measure food group intake in both young children and women. We describe the relationship between child and maternal diet diversity in Nigeria and highlight implications for design of infant and young child feeding (IYCF) programs. Methods Using the Nigeria DHS 2018 dataset, we estimated consumption of individual food groups in the previous 24 hours as well as minimum dietary diversity for children 6–23 months (MDD-C) and their mothers, women 15–49 years (MDD-W) using WHO-UNICEF definitions. We compare rates of concordance and discordance between n = 8975 mother-child pairs for individual food groups and MDD using McNemar's tests. Probit regression was used to identify drivers of MDD-C. Results Nationally, 22% of children achieve MDD-C; 51% of mothers achieve MDD-W. For both populations, the most commonly consumed group is grains, roots and tubers (&gt;80%) Dairy and eggs are the least consumed. Maternal-child (age 12–23 months) discordance is highest for consumption of legumes and nuts (36%), vitamin A rich fruits and vegetables (39%) and other fruits and vegetables (57%); mothers consume these more frequently. Children are more likely than mothers to consume dairy (19% vs 8%) and eggs (8% vs 4%). Maternal-child food group discordance is consistently higher for children 6–11months than children 12–23 months. Results vary at state level and by maternal age group. Children's MDD probability is increased by MDD-W (27%, P &lt; 0.001), higher maternal education (8%, P &lt; 0.01) and household wealth (7%, P &lt; 0.01). Conclusions Maternal and child diet diversity is suboptimal in Nigeria. Maternal diet is a primary driver of child diet in Nigeria. Legumes and nuts and fruits and vegetables are available but not consistently fed to children; an important finding for IYCF program design. The forthcoming DHS-8 core questionnaire will provide child and maternal diet data for more than 90 countries. Funding Sources Bill & Melinda Gates Foundation.


Jurnal NERS ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 1
Author(s):  
Yoyok Bekti Prasetyo ◽  
Nursalam Nursalam ◽  
Rahmat Hargono ◽  
Ahsan Ahsan

Background: The ability of families to care for avoidant restrictive food intake disorder children is still low. There is only few studies that examined relationship between family factor to ability to care children with avoidant restrictive food intake disorder. The purpose of this study was to identify the influence of socio-demographic factors on the ability of families to represent children with avoidant restrictive food intake disorder.Method: The study design was cross-sectional, and the majority of samples were gathered using the rule of the thumb, totaling 245 participants. The sampling technique used a type of multistage sampling. Data were collected by questionnaire. We then conducted an analysis of the univariate data using frequency distribution, while for the bivariate data, we used the chi-square technique. All of the data was processed using IBM SPSS 23.0 statistics.Results: The results showed that the ability of care from the families (health promotion behavior) of children with avoidant restrictive food intake disorder  was influenced by the socio-demographic factors, namely maternal age (p= 0.010), the number of children (p= 0.047) and education (p= 0.036).Conclusion: Young mothers need appropriate guidance and direction through good health education. Good health education in young mothers can reduce the pressure faced by the mothers when caring for their children with avoidant restrictive food intake disorder. Health promotion behavior is influenced by maternal education and maternal age. Through good mother's education, the mother will be able to provide a good pattern of care to children who experience avoidant restrictive food intake disorder.


2009 ◽  
Vol 12 (10) ◽  
pp. 1871-1877 ◽  
Author(s):  
Nolunkcwe J Bomela

AbstractObjectiveTo investigate the comparative effect of social, economic, health and environmental characteristics on the nutritional status of children aged <3 years in Central Asia.DesignCross-sectional analysis using data from Demographic and Health Surveys.SettingUzbekistan, Kyrgyzstan and Kazakhstan.SubjectsInformation on demographic health was gathered by Macro International Inc., Uzbekistan, Kyrgyzstan and Kazakhstan governments from a random sample of 14 067 households in the three countries. Anthropometric measurements were performed using standardized procedures on all children <3 years of age (n 2358). Only children with plausible Z-scores (n 1989) were selected for subsequent analyses.ResultsThe main results indicated that country of residence, number of people in household, household wealth, birth weight, age of child, knowledge of oral rehydration therapy, maternal education, number of children <5 years of age and source of drinking water were strong predictors of child nutritional status in these countries. Furthermore, chronic malnutrition was most prevalent in all three countries but at varied levels. An unexpected finding was that fully vaccinated children were more likely to be malnourished than children who were partially vaccinated. A further unexpected finding was that breast-feeding especially in children >6 months old had a strong negative association with stunting and underweight.ConclusionsIn summary, the results from both the descriptive and binary logistic regression analysis are similar in terms of the explanatory variables and the statistical significance in the models.


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