scholarly journals Delivering an Integrated Package of Maternal Nutrition Services in Andhra Pradesh and Telangana (India)

2019 ◽  
Vol 40 (3) ◽  
pp. 393-408
Author(s):  
Vani Sethi ◽  
Khyati Tiwari ◽  
Neha Sareen ◽  
Suneeta Singh ◽  
Chittaranjan Mishra ◽  
...  
Keyword(s):  
Dietary Diversity ◽  
Family Members ◽  
World Health ◽  
Primary Data ◽  
Food Groups ◽  
Space Technology ◽  
Indian States ◽  
Lactating Women ◽  
Nutrition Services ◽  
Feeding Programs

Background: Maternal spot feeding programs operational in southern Indian States are providing a package of nutrition services (food, micronutrient supplementation, deworming, gestation weight gain monitoring, and fortnightly nutrition health education) to pregnant women. These remain to be evaluated. Objective: We evaluated the maternal spot feeding programs in 2 Southern Indian states. Methods: Study design was cross-sectional entailing primary data collection (July to November 2016) on 360 pregnant and lactating women (of infants aged 0-6 months) per state and a review of the scheme’s management information system (MIS) beneficiaries’ records for the time period April 2014 to August 2017. To gain program functioning insights, open-ended interviews (n = 252) with state, district, and block program managers a state-level open space technology workshop was conducted. Results: Average days of meal consumption ranged from 19 to 21 days per month; spot meal enhanced high dietary diversity (≥6 food groups; 57%-59%) and consumption of eggs and milk (74%-96%) among pregnant and lactating women. On-the-spot consumption of iron, folic acid, calcium, and deworming was 18%, 87%, and 56%, respectively; 94% attended at least 1 of the 2 nutrition monthly counseling sessions. Majority (68%) of the beneficiaries were motivated to enroll by self-help groups or family members, suggesting the crucial persuasive role of peers and family members. Conclusion: Maternal spot feeding schemes can potentially deliver nutrition interventions outlined in the World Health Organization antenatal care guidelines 2016 for a positive pregnancy outcome. Research on schemes’ impact on birth outcomes, maternal depression, social norms, and its cost-effectiveness is needed.

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 Concordance of Mother-Child (6–23 Months) Dietary Diversity and Its Associated Factors in Kucha District, Gamo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Tesfaye Guja ◽  
Yabsira Melaku ◽  
Eshetu Andarge
Keyword(s):  
Associated Factors ◽  
Dietary Diversity ◽  
Cross Sectional Study ◽  
World Health ◽  
Southern Ethiopia ◽  
Food Groups ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Mothers And Children

Meeting minimum standards of dietary quality in mothers and children is a challenge in many developing countries including Ethiopia. Emerging evidence suggests that maternal and child dietary diversity is associated, but little is known about the associated factors of concordance of mother-child dietary diversity in Ethiopia and none is documented in the study area. This study examines the concordance between mother-child (6–23 months) dyads dietary diversity and the associated factors in Kucha District, Gamo Zone, Southern Ethiopia. A community-based cross-sectional study was conducted among 791 mother-child (6–23 months) pairs from 11 selected kebeles on March 6 to April 13, 2017. Multistage cluster sampling technique was used to select the study subjects. The sampling frame was obtained from the family folder of health posts in each kebele. The mother-child pairs were selected by the simple random sampling method. The 7 food groups of the World Health Organization (WHO) for children and the 10 food groups of FANTA/FAO 2016 for mothers were used to analyze the dietary diversity. Cohen’s kappa statistics was calculated to see the strength of concordance. The multivariable logistic regression model was fitted to determine factors affecting mother-child dietary diversity concordance. A good concordance was noted between mother-child dietary diversity scores (Kappa = 0.43). Only 56 (7.1%) mothers were negative deviants, and 133 (16.8%) mothers were positive deviants in dietary diversity consumption. Rural residence (AOR = 3.49; 95% CI: 1.90–6.41), having no formal education (AOR = 1.8; 95% CI: 1.08–3.05), not owning milking cow (AOR = 1.7; 95% CI: 1.10–2.56), children with low dietary diversity (AOR = 8.23; 95% CI: 5.17–13.08), and mothers with low dietary diversity (AOR = 0.46; 95% CI: 0.29–0.74) were found to be factors associated with mother-child dietary diversity concordance. An increase in the percentage of children reaching the minimum dietary diversity was greater with a successive increase in maternal dietary diversity. Despite interesting similarities between mothers and children dietary consumption, more than three-quarters of concordants did not achieve the recommended dietary diversity score (were low concordants). Interventions targeting on rural women’s access to high school education, home-based milking cow rearing, and promoting nutrition-sensitive agriculture to meet the dietary requirements of mothers and children in a sustainable manner and public health efforts to improve child nutrition may be strengthened by promoting maternal dietary diversity due to its potential effect on the entire family.

scholarly journals Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy?

2006 ◽  
Vol 9 (5) ◽  
pp. 644-650 ◽  
Author(s):  
NP Steyn ◽  
JH Nel ◽  
G Nantel ◽  
G Kennedy ◽  
D Labadarios
Keyword(s):  
Sensitivity And Specificity ◽  
Dietary Diversity ◽  
Pearson Correlation ◽  
Child Growth ◽  
World Health ◽  
Food Groups ◽  
Nutrient Adequacy ◽  
Z Scores ◽  
Food Variety ◽  
The Mean

AbstractObjectiveTo assess whether a food variety score (FVS) and/or a dietary diversity score (DDS) are good indicators of nutrient adequacy of the diet of South African children.MethodsSecondary data analyses were undertaken with nationally representative data of 1–8-year-old children (n = 2200) studied in the National Food Consumption Study in 1999. An average FVS (mean number of different food items consumed from all possible items eaten) and DDS (mean number of food groups out of nine possible groups) were calculated. A nutrient adequacy ratio (NAR) is the ratio of a subject's nutrient intake to the estimated average requirement calculated using the Food and Agriculture Organization/World Health Organization (2002) recommended nutrient intakes for children. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a percentage. MAR was used as a composite indicator for micronutrient adequacy. Pearson correlation coefficients between FVS, DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. The relationships between MAR and DDS and between anthropometric Z-scores and DDS were also evaluated.ResultsThe children had a mean FVS of 5.5 (standard deviation (SD) 2.5) and a mean DDS of 3.6 (SD 1.4). The mean MAR (ideal = 100%) was 50%, and was lowest (45%) in the 7–8-year-old group. The items with the highest frequency of consumption were from the cereal, roots and tuber group (99.6%), followed by the ‘other group’ (87.6%) comprising items such as tea, sugar, jam and sweets. The dairy group was consumed by 55.8%, meat group by 54.1%, fats by 38.9%, other vegetables by 30.8%, vitamin-A-rich by 23.8%, other fruit by 22%, legumes and nuts by 19.7% and eggs by 13.3%. There was a high correlation between MAR and both FVS (r = 0.726; P < 0.0001) and DDS (r = 0.657; P < 0.0001), indicating that either FVS or DDS can be used as an indicator of the micronutrient adequacy of the diet. Furthermore, MAR, DDS and FVS showed significant correlations with height-for-age and weight-for-age Z-scores, indicating a strong relationship between dietary diversity and indicators of child growth. A DDS of 4 and an FVS of 6 were shown to be the best indicators of MAR less than 50%, since they provided the best sensitivity and specificity.ConclusionEither FVS or DDS can be used as a simple and quick indicator of the micronutrient adequacy of the diet.

scholarly journals Nutritional outcomes of empowerment and market integration for women in rural India

Food Security ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1243-1256 ◽  
Author(s):  
Soumya Gupta ◽  
Vidya Vemireddy ◽  
Prabhu L. Pingali
Keyword(s):  
Market Integration ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Women's Empowerment ◽  
Reproductive Age ◽  
Women’S Empowerment ◽  
Primary Data ◽  
Food Groups ◽  
Explanatory Factors ◽  
Per Capita

Abstract Over half of all women of reproductive age are affected by anaemia in India. In this paper we study the role that both household market integration and women’s empowerment in agriculture can play in determining women’s dietary diversity. Our analysis is based on primary data from 3600 households across India on agriculture, nutrition and anthropometric outcomes. We account for market integration by way of per capita household purchases (quantity) of cereals and non- cereal food groups, such as pulses, meat/ fish/ poultry, fruits and vegetables, eggs and dairy. We construct an adapted version of the Abbreviated Women’s Empowerment in Agriculture Index (A-WEAI) that is context- specific and agriculture- oriented. After controlling for individual, household and village- level explanatory factors, we find that – for a given level of per capita market purchases – women who are empowered in their agricultural decisions have significantly higher dietary diversity scores relative to women who are disempowered of such decisions. More specifically it is women’s empowerment in two areas: input in production decisions and membership in self- help groups that supports this result. Women’s empowerment also enhances dietary diversity in the presence of disaggregated per capita purchases of non-cereals such as pulses, meat, dairy and eggs. This highlights the importance of reorienting India’s agricultural price and procurement policies beyond staple grains to ensure better dietary diversity.

scholarly journals Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data

2012 ◽  
Vol 12 (50) ◽  
pp. 5895-5914
Author(s):  
AD Disha ◽  
◽  
R Rawat ◽  
A Subandoro ◽  
P Menon
Keyword(s):  
Breast Feeding ◽  
Health Survey ◽  
Dietary Diversity ◽  
Demographic And Health Survey ◽  
Complementary Food ◽  
World Health ◽  
Food Groups ◽  
Z Score ◽  
Diet Diversity ◽  
Exclusive Breast Feeding

Data from the 2005 Ethiopia Demographic and Health Survey (EDHS) and the 2007 Zambia Demographic Health Survey (ZDHS) were analyzed to examine the association between World Health Organization (WHO) recommended IYCF indicators and nutritional status among children 0- 23 months of age in Ethiopia and Zambia. A total of 1810 and 2512 children within this age group from Ethiopia and Zambia , respectively , were included in the analysis. Exclusive breast -feeding among children 0- 5.9 months of age is low in both Ethiopia (43 % ) and Zambia (51 % ). Timely introduction of complementary food is lower in Ethiopia (61 %) compared to Zambia (90 %). Only 7 percent of children between 6- 23 months of age consumed diets that met the minimum dietary diversity requirement of four or more food groups consumed per day compared to 37 % in Zambia. Multiple linear and logistic regression analyses using appropriate measures to account for the complex survey design were applied to examine the associations between IYCF practices and child anthropometry. Linear regression results show that exclusive breast -feeding (EBF) is positively associated with weight -for -height z -score (WHZ) (effect size (ES) 0.65; p<0.001) and weight -for- age z -score (W AZ) (ES 0.28; p<0.01) in Zambia. In Ethiopia, EBF under 6 months of age is negatively associated with height -for- age z - score (HAZ) (ES 0.81; p<0.01). Timely introduction of complementary food between 6- 8 months of age was positively associated with HAZ (ES 1.19; p<0.01) in Zambia. Higher dietary diversity score was associated with higher HAZ (ES 0.23, p<0.001 in Ethiopia; ES 0.12, p<0.01 in Zambia) and WAZ (ES 0.17, p<0.001 in Ethiopia; ES 0.04, p<0.10 in Zambia) in both countries. The findings demonstrate the need to reinforce age - appropriate IYCF practices to address child undernutrition. Special attention is needed to improve the complementary feeding practices, particularly diet diversity for children 6 -23 months of age , while sustaining a focus on EBF among children under 6 months of age, in order to improve overall nutrition al status of young children in Ethiopia and Zambia.

scholarly journals Participation in communal day care centre feeding programs is associated with higher diet quantity but not quality among rural Ghanaian children

2012 ◽  
Vol 12 (49) ◽  
pp. 5802-5821
Author(s):  
KB Harding ◽  
◽  
GS Marquis ◽  
EK Colecraft ◽  
A Lartey ◽  
...  
Keyword(s):  
Day Care ◽  
Dietary Diversity ◽  
Dietary Quality ◽  
Dietary Intakes ◽  
Food Groups ◽  
Sustainable Food ◽  
Feeding Programs ◽  
Iron And Zinc ◽  
Day Care Centres ◽  
Daily Intakes

Communal School Feeding Programs (SFP) are based on local foods brought by children from home which are cooked and shared at school. These programs may be a sustainable food-based strategy for improving children’s diets in low-resource areas. The objective of this study was to compare the dietary intakes of children who attend Day Care Centres (DCC) with communal SFP to children who do not attend any DCC or school in rural Ghana. Interviewer-administered questionnaires were used to collect dietary and other household information for 104 DCC and 89 non-DCC children aged two to five years living in two communities. In addition, the DCC lunches (ingredients and servings of each food preparation) were weighed. The Day Care Centres’ lunch was higher in energy (by 64 kcal; p<0.001), but lower in calcium (by 18 mg; p=0.002), iron (by 1.3 mg; p<0.001) and zinc (by 0.2 mg; p=0.046) than the non-DCC lunch. DCC children ate more times in a day (4.2 ± 0.8 vs. 3.4 ± 0.6, p<0.001), had greater dietary diversity (7.2 ± 0.6 vs. 6.7 ± 1.0 food groups, p<0.001) and had higher daily intakes of energy (1140 ± 320 vs. 878 ± 240 kcal; p<0.001), calcium (282 ± 139 vs. 244 ± 118 mg; p=0.048), iron (12.4 ± 6.4 vs. 10.7 ± 4.7 mg; p=0.048) and zinc (0.40 ± 0.15 vs. 0.35 ± 0.11 mg; p=0.019) than non-DCC children. However, after controlling for total energy intake and other dietary, health and sociodemographic variables, daily iron and zinc intakes were lower in the DCC compared to the non-DCC group. Participation in the communal SFP was associated with higher quantity but not quality of children’s diets. Communal SFP offer an opportunity to address specific population’s micronutrient needs, using interventions to improve dietary quality such as point-of-use fortification, commercially fortified foods, or processed animal source food products.

scholarly journals Maternal dietary diversity during lactation and associated factors in Palghar district, Maharashtra, India

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261700
Author(s):  
Sunil Rajpal ◽  
Abhishek Kumar ◽  
Ruby Alambusha ◽  
Smriti Sharma ◽  
William Joe
Keyword(s):  
Dietary Diversity ◽  
Outcome Variable ◽  
Lactation Period ◽  
Food Groups ◽  
Lactating Women ◽  
Marginalized Communities ◽  
Food Items ◽  
Health And Nutrition ◽  
Lactating Mothers ◽  
Daily Diet

Dietary adequacy and diversity during the lactation period are necessary to ensure good health and nutrition among women and children. Behavioral interventions pertaining to health and nutrition counselling during pregnancy and lactation are critical for awareness about dietary diversity. The issue assumes salience for marginalized communities because of the Covid-19 pandemic and associated economic and societal disruptions. This paper assesses the dietary patterns among 400 lactating mothers in the tribal-dominated district of Palghar in Maharashtra, India in 2020. The study is based on primary data regarding consumption of 10 food groups among women across 10 food groups based on 24-hour recall period. The primary outcome variable was binary information regarding Minimum Dietary Diversity defined as consumption from at least 5 food groups. Econometric analysis based on multilevel models and item-response theory is applied to identify food groups that were most difficult to be received by mothers during the early and late lactation period. We find that the daily diet of lactating mothers in Palghar primarily consists of grains, white roots, tubers, and pulses. In contrast, the intake of dairy, eggs, and non-vegetarian food items is much lower. Only Half of the lactating women (56.5 percent; 95% CI: 37.4; 73.8) have a minimum diversified diet (MDD). The prevalence of lactating women with MDD was higher among households with higher income (73.1 percent; 95% CI: 45.2; 89.9) than those in lower income group (50.7 percent; 95% CI: 42.3; 58.9). Lactating Women (in early phase) who received health and nutrition counseling services are more likely (OR: 2.37; 95% CI: 0.90; 6.26) to consume a diversified diet. Food groups such as fruits, meat, poultry, fish, nuts, and seeds were among the rare food items in daily diet. The dietary pattern lacking in fruits, nuts, and heme (iron) sources indicates more significant risks of micronutrient deficiencies. The findings call for improving dietary diversity among lactating mothers, particularly from the marginalized communities, and are driven by low consumption of dairy products or various fruits and vegetables. Among the different food items, the consumption of micronutrient-rich seeds and nuts is most difficult to be accessed by lactating mothers. Also, diet-centric counseling and informing lactating mothers of its benefits are necessary to increase dietary diversity for improving maternal and child nutrition.

scholarly journals Household food insecurity is associated with low dietary diversity among pregnant and lactating women in rural Malawi

2018 ◽  
Vol 22 (4) ◽  
pp. 697-705 ◽  
Author(s):  
Yunhee Kang ◽  
Kristen M Hurley ◽  
Julie Ruel-Bergeron ◽  
Assumpta Bou Monclus ◽  
Rachel Oemcke ◽  
...  
Keyword(s):  
Food Insecurity ◽  
Pregnant Women ◽  
Dietary Diversity ◽  
Cross Sectional Study ◽  
Household Food Insecurity ◽  
Food Groups ◽  
Cross Sectional ◽  
Lactating Women ◽  
Rural Districts ◽  
Household Food

AbstractObjectiveTo examine the association between household food insecurity and dietary diversity in the past 24h (dietary diversity score (DDS, range: 0–9); minimum dietary diversity (MDD, consumption of three or more food groups); consumption of nine separate food groups) among pregnant and lactating women in rural Malawi.DesignCross-sectional study.SettingTwo rural districts in Central Malawi.SubjectsPregnant (n 589) and lactating (n 641) women.ResultsOf surveyed pregnant and lactating women, 66·7 and 68·6 %, respectively, experienced moderate or severe food insecurity and only 32·4 and 28·1 %, respectively, met MDD. Compared with food-secure pregnant women, those who reported severe food insecurity had a 0·36 lower DDS (P<0·05) and more than threefold higher risk (OR; 95 % CI) of not consuming meat/fish (3·19; CI 1·68, 6·03). The risk of not consuming eggs (3·77; 1·04, 13·7) was higher among moderately food-insecure pregnant women. Compared with food-secure lactating women, those who reported mild, moderate and severe food insecurity showed a 0·36, 0·44 and 0·62 lower DDS, respectively (all P<0·05). The risk of not achieving MDD was higher among moderately (1·95; 1·06, 3·59) and severely (2·82; 1·53, 5·22) food-insecure lactating women. The risk of not consuming meat/fish and eggs increased in a dose–response manner among lactating women experiencing mild (1·75; 1·01, 3·03 and 2·81; 1·09, 7·25), moderate (2·66; 1·47, 4·82 and 3·75; 1·40, 10·0) and severe (5·33; 2·63, 10·8 and 3·47; 1·19, 10·1) food insecurity.ConclusionsAddressing food insecurity during and after pregnancy needs to be considered when designing nutrition programmes aiming to increase dietary diversity in rural Malawi.

scholarly journals Breastfeeding and the Risk of Illness among Young Children in Rural China

2019 ◽  
Vol 16 (1) ◽  
pp. 136 ◽  
Author(s):  
Shanshan Li ◽  
Ai Yue ◽  
Cody Abbey ◽  
Alexis Medina ◽  
Yaojiang Shi
Keyword(s):  
Rural Areas ◽  
Dietary Diversity ◽  
Rural China ◽  
Shaanxi Province ◽  
World Health ◽  
Asia Pacific ◽  
Food Groups ◽  
Health Organization ◽  
The Relationship ◽  
Specific Food

Poor rural areas in China exhibit the country’s highest rates of child mortality, often stemming from preventable health conditions such as diarrhea and respiratory infection. In this study, we investigate the association between breastfeeding and disease among children aged 6–24 months in poor rural counties in China. To do this, we conducted a longitudinal, quantitative analysis of socioeconomic demographics, health outcomes, and breastfeeding practices for 1802 child–caregiver dyads across 11 nationally designated poverty counties in southern Shaanxi Province in 2013–2014. We found low rates of continued breastfeeding that decreased as children developed: from 58.2% at 6–12 months, to 21.6% at 12–18 months, and finally to 5.2% at 18–24 months. These suboptimal rates are lower than all but one other country in the Asia-Pacific region. We further found that only 18.3% of children 6–12 months old met the World Health Organization (WHO)-recommended threshold for minimum dietary diversity, defined as consuming four or more of seven specific food groups. Breastfeeding was strongly associated with lower rates of both diarrhea and cough in bivariate and multivariate analyses. As the first analysis to use longitudinal data to examine the relationship between continued breastfeeding and child illness in China, our study confirms the need for programmatic interventions that promote continued breastfeeding in order to improve toddler health in the region.

scholarly journals Are Women in Rural India Really Consuming a Less Diverse Diet?

2020 ◽  
Vol 41 (3) ◽  
pp. 318-331
Author(s):  
Soumya Gupta ◽  
Naveen Sunder ◽  
Prabhu L. Pingali
Keyword(s):  
Vitamin A ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Primary Data ◽  
Rural India ◽  
Food Groups ◽  
Diet Diversity ◽  
Household Members ◽  
The Difference ◽  
Food Consumed

Background: It is widely considered that women have less diverse diets than other household members. However, it has been challenging to establish this empirically since women’s diet diversity is measured differently from that of other household members. Objective: In this article, we compare women’s dietary diversity with that of their respective households and thereby generate a measure of “dietary gap.” Methods: We measure women’s “dietary gap” by using the difference of homogenized household and woman dietary scores (using the same scales). This is done using primary data on 3600 households from 4 districts in India. Additionally, we show the robustness of our results to variations in scale and recall periods used to construct the diet diversity scores. Results: Mean difference tests indicate that women consistently consume 0.1 to 0.5 fewer food groups relative to other household members, with the results being statistically significant at the 1% level. The food groups driving this dietary gap are nonstaples like Vitamin A-rich fruits and vegetables, meat/fish/poultry, and dairy. Conclusions: Results point toward the discrimination faced by women in the variety of the food consumed, the importance of considering comparability in creating indices of diet diversity, and the need to collect more detailed information on diets. To our knowledge, this is one of the first studies to examine dietary discrimination faced by women using common scales.

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