Household Water Insecurity Affects Child Nutrition Through Alternative Pathways to WASH: Evidence From India

2021 ◽  
Vol 42 (2) ◽  
pp. 170-187
Author(s):  
Neetu Choudhary ◽  
Roseanne C. Schuster ◽  
Alexandra Brewis ◽  
Amber Wutich
Keyword(s):  
Water Availability ◽  
Structural Equation ◽  
Child Nutrition ◽  
Diarrheal Disease ◽  
Dietary Diversity ◽  
Water Access ◽  
Child Stunting ◽  
Increased Risk ◽  
Household Water ◽  
Regional Water

Background: Household water security matters greatly for child nutrition outcomes in the global South. Water’s role in sanitation/hygiene, via diarrheal disease, is cited as a primary mechanism here. Yet, the relationship between Water along with Sanitation and Hygiene (WASH) and child stunting remains inconclusive. Water-related mechanisms outside of the traditional scope of WASH might assist with explaining this. Objective: We aim to test the mediating role of reduced dietary diversity as an additional potential mechanism in linking worse household water access to increased risk of early childhood stunting, separating its effects from sanitation and diarrhea among children (as a proxy for hygiene) and taking into account regional water availability. Method: We use nationally representative India Demographic and Health Survey (2015-16) data for 58 038 children aged 6 to 23 months, applying generalized structural equation modelling to estimate water’s direct and indirect effects (as mediated through dietary diversity and access to sanitation) on a child’s likelihood of being stunted. Results: Suboptimal water access is significantly associated with elevated likelihood of child stunting. More than 30% of the effect is indirect. In the context of low water access and availability, children’s dietary diversity alone mediates more than 20% of its total effect on child stunting. Conclusion: Beyond the WASH mechanisms, household water access affects child stunting indirectly, mediated through its impacts on children’s dietary diversity. These mediating effects are also moderated by regional water availability. Water interventions in low-water regions should help reduce children’s risk of nutrition-related stunting in households with lowest water access.

scholarly journals Retraction: Chilinda, Z.B., et al. Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6–23 Months in Malawi. Nutrients 2021, 13, 178

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1078
Author(s):  
Zizwani Brian Chilinda ◽  
Mark L. Wahlqvist ◽  
Meei-Shyuan Lee ◽  
Yi-Chen Huang
Keyword(s):  
Dietary Diversity ◽  
Water Access ◽  
Household Water ◽  
Minimum Dietary Diversity

The article cited above [...]

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 Cash transfers and child nutritional outcomes: a systematic review and meta-analysis

2020 ◽  
Vol 5 (12) ◽  
pp. e003621
Author(s):  
James Manley ◽  
Yarlini Balarajan ◽  
Shahira Malm ◽  
Luke Harman ◽  
Jessica Owens ◽  
...  
Keyword(s):  
Child Nutrition ◽  
Social Protection ◽  
Dietary Diversity ◽  
Meta Analysis ◽  
Cash Transfer ◽  
Animal Source Foods ◽  
Animal Source ◽  
Z Scores ◽  
Households With Children ◽  
The Impact

BackgroundCash transfer (CT) programmes are implemented widely to alleviate poverty and provide safety nets to vulnerable households with children. However, evidence on the effects of CTs on child health and nutrition outcomes has been mixed. We systematically reviewed evidence of the impact of CTs on child nutritional status and selected proximate determinants.MethodsWe searched articles published between January 1997 and September 2018 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years old conducted in countries with gross domestic product per capita below US$10 000 at baseline. We conducted meta-analysis using random-effects models to assess the impact of CT programmes on selected child nutrition outcomes and meta-regression analysis to examine the association of programme characteristics with effect sizes.ResultsOut of 2862 articles identified, 74 articles were eligible for inclusion. We find that CTs have significant effects of 0.03±0.03 on height-for-age z-scores (p<0.03) and a decrease of 2.1% in stunting (95% CI −3.5% to −0.7%); consumption of animal-source foods (4.5%, 95% CI 2.9% to 6.0%); dietary diversity (0.73, 95% CI 0.28 to 1.19) and diarrhoea incidence (−2.7%, 95% CI −5.4% to −0.0%; p<0.05). The effects of CTs on weight-for-age z-scores and wasting were not significant (0.02, 95% CI −0.03 to 0.08; p<0.42) and (1.2%, 95% CI: −0.1% to 2.5%; p<0.07), respectively. We found that specific programme characteristics differentially modified the effect on the nutrition outcomes studied.ConclusionWe found that CT programmes targeted to households with young children improved linear growth and contributed to reduced stunting. We found that the likely pathways were through increased dietary diversity, including through the increased consumption of animal-source foods and reduced incidence of diarrhoea. With heightened interest in nutrition-responsive social protection programmes to improve child nutrition, we make recommendations to inform the design and implementation of future programmes.

scholarly journals Socioeconomic and Geographic Pattern of Food Consumption and Dietary Diversity among Children Aged 6–23 Months Old in Ghana

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 603
Author(s):  
Isaac Anane ◽  
Fengying Nie ◽  
Jiaqi Huang
Keyword(s):  
Socioeconomic Status ◽  
Food Consumption ◽  
Child Nutrition ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Geographical Location ◽  
Final Analysis ◽  
Food Groups ◽  
Cross Sectional ◽  
Dairy Consumption

Dietary inadequacy is a major challenge among young children in Ghana. Nutritional policies are required for optimum child nutrition and development. This study explored food consumption and dietary diversity by socioeconomic status and geographical location among children aged 6–23 months in Ghana. We used the latest national representative, cross-sectional data from the Ghana Demographic and Health Survey (GDHS-2014). A total of 887 children aged 6–23 months were used in the final analysis. The survey collected data on children’s food consumption through their mothers in the 24 h recall method. Multiple logistic regression models were used to assess the relationship between socioeconomic status and geographical location with food consumption and adequate dietary diversity after adjusting for control variables. The study revealed an association between specific food item consumption, food groups, and dietary diversity by socioeconomic and geographic characteristics. However, dairy consumption increased faster than other nutritional foods when socioeconomic status increased. Furthermore, the study revealed that children’s chances of consuming particular food items and food groups differed across Ghana’s 10 regions. The average probabilities of consuming adequate dietary diversity between the Greater Accra region and Ashanti region were 43% vs. 8% (p < 0.001). Consumption of grains, root, and tubers were relatively higher but low for Vitamin A-rich fruits and vegetables and legumes and nuts for children aged 6–23 months in Ghana. Overall, the mean dietary diversity score was low (3.39; 95% CI: 3.30–3.49) out of eight food groups, and the prevalence of adequate dietary diversity was 22% only. There is a need for policy interventions to ensure appropriate dietary practices to promote healthy growth of children.

scholarly journals A six-week healthy eating intervention with family engagement improves food knowledge and preferences but not dietary diversity among urban preschool children in Sri Lanka

2021 ◽  
pp. 1-22
Author(s):  
Fathima Sirasa ◽  
Lana Mitchell ◽  
Aslan Azhar ◽  
Anoma Chandrasekara ◽  
Neil Harris
Keyword(s):  
Sri Lanka ◽  
Nutrition Education ◽  
Healthy Eating ◽  
Child Nutrition ◽  
Dietary Diversity ◽  
Family Engagement ◽  
Food Preferences ◽  
Healthy Food ◽  
Food Knowledge ◽  
The Impact

Abstract Objective: To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s dietary diversity and its impact pathway components of children’s food knowledge and healthy food preferences. Design: A six-week cluster randomised controlled trial with a MCI consisting of child nutrition education plus family engagement, through parental nutrition education, meal preparation and tasting was compared with two groups: single component intervention (SCI) of child nutrition education, and control, conducted during February to July 2018. Preschool centres were randomly assigned to one of the three arms. Children’s food knowledge, healthy food preferences and dietary diversity scores were collected. Intervention effects were analysed using a pre-post analysis and a difference-in-difference model. Setting: Fourteen preschool centres in an urban area of Kurunegala, Sri Lanka Participants: Child-parent dyads of children aged 4-6 years. Final analyses included 306 (for food knowledge and preferences) and 258 (for dietary diversity) dyads. Results: MCI significantly influenced the impact pathways to children’s dietary diversity by increasing children’s food knowledge and healthy food preferences scores by 3.76 and 2.79 (P<0.001) respectively, but not the dietary diversity score (P=0.603), compared to control arm. Relative to SCI, MCI significantly improved children’s food knowledge score by 1.10 (P<0.001), but no significant effects were noted for other outcome variables. Conclusion: Improved food knowledge and preferences require a positive food environment and time to develop into healthy eating behaviours. Research into dietary diversity should broaden to incorporate the contextual roles of the home and general food environments to more completely understand food choices of children.

What explains the large disparity in child stunting in the Philippines? A decomposition analysis

2021 ◽  
pp. 1-36
Author(s):  
Valerie Gilbert T. Ulep ◽  
Jhanna Uy ◽  
Lyle Daryll Casas
Keyword(s):  
Dietary Diversity ◽  
Probability Model ◽  
Critical Role ◽  
Decomposition Analysis ◽  
The Philippines ◽  
Nutrition Status ◽  
Nutrition Survey ◽  
Child Stunting ◽  
Filipino Children ◽  
Linear Probability

Abstract Objective: About a third of under-five Filipino children are stunted, with significant socio-economic inequality. This study aims to quantify factors that explain the large gap in stunting between poor and non-poor Filipino children. Design: Using the 2015 Philippine National Nutrition Survey (NNS), we conducted a linear probability model to examine the determinants of child stunting then an Oaxaca-Blinder decomposition to explain the factors contributing to the gap in stunting between poor and non-poor children. Setting: Philippines Participants: 1, 881 children aged 6-23 months Results: The overall stunting prevalence was 38.5% with significant gap between poor and non-poor (45.0% vs. 32.0%). Maternal height, education, and maternal nutrition status account for 26%, 18%, and 17% of stunting inequality, respectively. These are followed by quality of prenatal care (12%), dietary diversity (12%), and iron supplementation in children (5%). Conclusions: Maternal factors account for more than 50% of the gap in child stunting in the Philippines. This signifies the critical role of maternal biological and socio-economic circumstances in improving the linear growth of children.

Factors associated with initiation and use of snus among adolescents

2021 ◽  
pp. 140349482110623
Author(s):  
Vibeke Ansteinsson ◽  
Ibrahimu Mdala ◽  
Rune Becher ◽  
Liv Grøtvedt ◽  
Simen E. Kopperud ◽  
...  
Keyword(s):  
Vocational Education ◽  
Structural Equation ◽  
Strong Association ◽  
School Level ◽  
Smoking History ◽  
Tobacco Prevention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Increased Risk ◽  
Educational Plans

Aim: We investigated factors associated with the initiation and continuation of snus use in adolescents in Norway. The associations with adolescents’ own educational plans, the parents’ educational level(s) and tobacco habits were estimated. Methods: In this cross-sectional questionnaire-based study, 1465 patients aged 18–20 years participated. The questionnaire was administered at regular dental examinations in the public dental health service. To assess the association between individual factors and the initiation of tobacco habits, a generalised structural equation model with random effects at the clinic level was used. Binary responses were modelled using multilevel binary logistic regression, while the number of snus boxes used per month was modelled using a multilevel Poisson regression model. Results: Of current (daily and occasional) tobacco users, 85% were snus users, including dual users of both snus and cigarettes. The median age of snus initiation was 16 years. Both parental snus use and smoking were associated with an increased risk of snus initiation, snus use and a higher amount of use. An increased risk of using snus was associated with male gender and with no educational plans or planning for further vocational education. The amount of snus used was higher among current snus users with a prior smoking history and among those planning for further vocational education. Conclusions: These findings may aid in developing and targeting tobacco prevention strategies aimed at young people. Tobacco prevention measures should start at the elementary school level. The strong association with parental tobacco habits underlines the importance of parents’ influence on their children’s tobacco use.

scholarly journals Information Privacy Concerns Among Instagram Users: The Case of Indonesian College Students

2020 ◽  
Vol 6 (2) ◽  
pp. 159
Author(s):  
Eko Wahyu Tyas Darmaningrat ◽  
Hanim Maria Astuti ◽  
Fadhila Alfi
Keyword(s):  
College Students ◽  
Private Information ◽  
Structural Equation ◽  
Personal Information ◽  
Information Privacy ◽  
Risk Awareness ◽  
User Privacy ◽  
Privacy Concerns ◽  
Information Privacy Concerns ◽  
Increased Risk

Background: Teenagers in Indonesia have an open nature and satisfy their desire to exist by uploading photos or videos and writing posts on Instagram. The habit of uploading photos, videos, or writings containing their personal information can be dangerous and potentially cause user privacy problems. Several criminal cases caused by information misuse have occurred in Indonesia.Objective: This paper investigates information privacy concerns among Instagram users in Indonesia, more specifically amongst college students, the largest user group of Instagram in Indonesia.Methods: This study referred to the Internet Users' Information Privacy Concerns (IUIPC) method by collecting data through the distribution of online questionnaires and analyzed the data by using Structural Equation Modelling (SEM).Results: The research finding showed that even though students are mindful of the potential danger of information misuse in Instagram, it does not affect their intention to use Instagram. Other factors that influence Indonesian college students' trust are Instagram's reputation, the number of users who use Instagram, the ease of using Instagram, the skills and knowledge of Indonesian students about Instagram, and the privacy settings that Instagram has.Conclusion: The awareness and concern of Indonesian college students for information privacy will significantly influence the increased risk awareness of information privacy. However, the increase in risk awareness does not directly affect Indonesian college students' behavior to post their private information on Instagram.

scholarly journals Irrigation, drinking water quality, and child nutritional status in northern Ethiopia

2020 ◽  
Vol 10 (3) ◽  
pp. 425-434
Author(s):  
Muhammed A. Usman ◽  
Nicolas Gerber
Keyword(s):  
Water Quality ◽  
Drinking Water ◽  
Nutritional Status ◽  
Child Nutrition ◽  
Dietary Diversity ◽  
Drinking Water Quality ◽  
Irrigated Agriculture ◽  
Northern Ethiopia ◽  
Z Scores ◽  
Child Nutritional Status

Abstract In this paper, we investigate the relationship between household drinking water quality and irrigation and child nutrition using primary household survey data and microbiological water sample testings in two rural districts of Ethiopia. Anthropometric measures such as height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ), and weight-for-height z-scores (WHZ) were used to measure stunting, underweight, and wasting, respectively. Our survey results show that 41% of the children are stunted, 26% underweight, and 8% wasted. More than 58% of household's stored drinking water samples were also contaminated with Escherichia coli bacteria. The multivariate regression results suggest that irrigation farming and on-premises water sources are significantly associated with lower HAZ, while uncontaminated household stored drinking water quality is correlated with higher WAZ. The results also reveal that dietary diversity score and the number of antenatal care visits by the primary caretaker are statistically significant predictors of child nutritional status. These findings, however, cast doubt on the hypothesis that irrigated agriculture exclusively has a positive effect on child nutrition outcomes.

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