Maternal Determinants Mediating the Impact of Household Poverty on the Nutritional Status of Children Under 5 Years of Age in Bangladesh

2021 ◽  
pp. 037957212199901
Author(s):  
Probir Kumar Ghosh ◽  
Pritimoy Das ◽  
Doli Rani Goswam ◽  
Ausraful Islam ◽  
Sukanta Chowdhury ◽  
...  
Keyword(s):  
Higher Education ◽  
Nutritional Status ◽  
Maternal Education ◽  
Prevalence Ratio ◽  
Household Wealth ◽  
Population Based ◽  
Maternal Factors ◽  
Household Poverty ◽  
Maternal Determinants ◽  
The Impact

Objectives: We explored the maternal determinants that mediate the effect of household poverty on childhood undernutrition. Methods: We used the population-based Bangladesh Demographic Health Survey data from 2014 for demographic characteristics, child and maternal factors. Results: Of the 7173 under-5 children, 3456 (48.2%) had undernutrition. The prevalence of undernutrition was less common in wealthy households (poorest vs richest: adjusted prevalence ratio [aPR] = 1.37), mothers having history of antenatal care (ANC) visits (no visit vs ≥4 visits: aPR = 1.22), maternal higher education (no education vs higher education: aPR = 1.54), and mothers with good nutritional status (underweight vs healthy: aPR = 1.13). The risk of undernutrition (37.1%) was attributed to household wealth, mediated 55% by maternal factors; of which 20% by maternal education, 21% by ANC visits, and 14% by maternal nutritional status. Conclusions: Our study findings outlined higher maternal education, ≥4 ANC visits and maternal good nutritional status in mediating the impact of household wealth on childhood nutrition.

Subsequent Higher Education After Adolescent Depression: A 15-Year Follow-Up Register Study

2010 ◽  
Vol 25 (7) ◽  
pp. 396-401 ◽  
Author(s):  
U. Jonsson ◽  
H. Bohman ◽  
A. Hjern ◽  
L. von Knorring ◽  
G. Olsson ◽  
...  
Keyword(s):  
Higher Education ◽  
Socioeconomic Status ◽  
School Performance ◽  
Adolescent Depression ◽  
Maternal Education ◽  
Population Based ◽  
Adverse Outcomes ◽  
Swedish Population ◽  
Early School

AbstractBackgroundAdolescent depression has been shown to have a range of adverse outcomes. We used longitudinal data to investigate subsequent higher education in former depressed adolescents.MethodA Swedish population-based investigation of depression in 16–17-year-olds was followed up in national registers 15 years later. Adolescents with depression (n = 361, 78% females) were compared to a group of non-depressed peers of the same age (n = 248, 77% females). The main outcome was graduation from higher education by age 30.ResultsThe adolescent with depression were less likely than their non-depressed peers to have graduated from higher education by age 30, both regarding females (27.7% vs. 36.4%, p < .05) and males (12.7% vs. 28.6%, p < .05). After adjustment for early school performance, socioeconomic status and maternal education, the decreased likelihood of subsequent graduation from higher education remained for depressed males (OR, 0.27; 95% CI, 0.08–0.93) but not for depressed females (OR, 0.93; 95% CI, 0.58–1.49).ConclusionContrary to what previous research has suggested, adolescent depression and its consequences might be particularly destructive to subsequent higher education in males.

scholarly journals Social, economic, health and environmental determinants of child nutritional status in three Central Asian Republics

2009 ◽  
Vol 12 (10) ◽  
pp. 1871-1877 ◽  
Author(s):  
Nolunkcwe J Bomela
Keyword(s):  
Nutritional Status ◽  
Maternal Education ◽  
Social Economic ◽  
Statistical Significance ◽  
Household Wealth ◽  
Binary Logistic Regression Analysis ◽  
Demographic And Health Surveys ◽  
Unexpected Finding ◽  
Economic Health ◽  
Child Nutritional Status

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.

scholarly journals Evaluating the impact of the Baby-Friendly Hospital Initiative on breast-feeding rates: a multi-state analysis

2014 ◽  
Vol 18 (2) ◽  
pp. 189-197 ◽  
Author(s):  
Summer Sherburne Hawkins ◽  
Ariel Dora Stern ◽  
Christopher F Baum ◽  
Matthew W Gillman
Keyword(s):  
Higher Education ◽  
Breast Feeding ◽  
Fixed Effects ◽  
Maternal Education ◽  
Baby Friendly Hospital Initiative ◽  
Feeding Rates ◽  
Exclusive Breast Feeding ◽  
Percentage Points ◽  
Lower Education ◽  
The Impact

AbstractObjectiveTo evaluate the impact of the Baby-Friendly Hospital Initiative (BFHI) on breast-feeding initiation and duration overall and according to maternal education.DesignQuasi-experimental study using data from five states (Alaska, Maine, Nebraska, Ohio, Washington) that participated in the Pregnancy Risk Assessment Monitoring System from 1999 to 2009. Using differences-in-differences models that included year and hospital fixed effects, we compared rates of breast-feeding initiation and duration (any and exclusive breast-feeding for ≥4 weeks) before and after BFHI accreditation between mothers who gave birth in hospitals that were accredited or became accredited and mothers from matched non-BFHI facilities. We stratified analyses into lower and higher education groups.SettingThirteen BFHI hospitals and nineteen matched non-BFHI facilities across five states in the USA.SubjectsMothers (n 11 723) who gave birth in BFHI hospitals and mothers (n 13 604) from nineteen matched non-BFHI facilities.ResultsAlthough we did not find overall differences in breast-feeding initiation between birth facilities that received BFHI accreditation compared with non-Baby-Friendly facilities (adjusted coefficient = 0·024; 95 % CI −0·00, 0·51), breast-feeding initiation increased by 3·8 percentage points among mothers with lower education who delivered in Baby-Friendly facilities (P = 0·05), but not among mothers with higher education (adjusted coefficient = 0·002; 95 % CI −0·04, 0·05). BFHI accreditation also increased exclusive breast-feeding for ≥4 weeks by 4·5 percentage points (P = 0·02) among mothers with lower education who delivered in BFHI facilities.ConclusionsBy increasing breast-feeding initiation and duration among mothers with lower education, the BFHI may reduce socio-economic disparities in breast-feeding.

scholarly journals Methods for Conducting Trends Analysis: Roadmap for Comparing Outcomes from Three National HIV Population-Based Household Surveys in Kenya (2007, 2012, and 2018)

2021 ◽  
Author(s):  
Thomas Achia ◽  
Ismael Flores Cervantes ◽  
Paul Stupp ◽  
Paul Musingila ◽  
Jacques Muthusi ◽  
...  
Keyword(s):  
At Risk ◽  
Low Income ◽  
Sexual Debut ◽  
Household Wealth ◽  
Population Based ◽  
Household Surveys ◽  
Hiv Epidemic ◽  
Hiv Test ◽  
Key Indicators ◽  
The Impact

Abstract BackgroundFor assessing the HIV epidemic in Kenya, a series of independent HIV indicator household-based surveys of similar design can be used to assess trends in key indicators relevant to HIV prevention and control and to describe geographic and sociodemographic disparities, assess the impact of interventions, and develop strategies. We developed methods and tools to facilitate a robust analysis of trends across three national household-based surveys conducted in Kenya in 2007, 2012, and 2018. MethodsWe used data from the 2007 and 2012 Kenya AIDS Indicator surveys (KAIS 2007 and KAIS 2012) and the 2018 Kenya Population-based HIV Impact Assessment (KENPHIA 2018). To assess the design and other variables of interest from each study, variables were recoded to ensure that they had equivalent meanings across the three surveys. After assessing weighting procedures for comparability, we used the KAIS 2012 nonresponse weighting procedure to revise normalized KENPHIA weights. Analyses were restricted to geographic areas covered by all three surveys. The revised analysis files were then merged into a single file for pooled analysis. We assessed distributions of age, sex, household wealth, and urban/rural status to identify unexpected changes between surveys. To demonstrate how a trend analysis can be carried out, we used continuous, binary, and time-to-event variables as examples. Specifically, temporal trends in age at first sex and having received an HIV test in the last 12 months were used to demonstrate the proposed analytical approach. These were assessed with respondent-specific variables (age, sex, level of education, and marital status) and household variables (place of residence and wealth index). All analyses were conducted in SAS 9.4, but analysis files were created in Stata and R format to support additional analyses.ResultsThis study demonstrates trends in selected indicators to illustrate the approach that can be used in similar settings. The incidence of early sexual debut decreased from 7.99 (95% CI: 7.67–8.33) per 1,000 person-years at risk in 2007 to 6.68 (95% CI: 6.35–7.02) per 1,000 person-years at risk in 2012 and to 6.62 (95% CI: 6.4–6.85) per 1,000 person-years at risk in 2018. HIV-testing rates increased from 12.6% (95% CI: 11.6%–13.6%) in 2007 to 56.1% (95% CI: 54.6%–57.6%) in 2012 but decreased slightly to 55.6% [95% CI: 54.6%–56.6%) in 2018.ConclusionsOur approach can be used to support trend comparisons for variables in HIV surveys in low-income settings. Independent national household surveys can be assessed for comparability, adjusted as appropriate, and used to estimate trends in key indicators. Analyzing trends over time can not only provide insights into Kenya’s progress toward HIV epidemic control but also identify gaps.

scholarly journals Impact of the Liberian National Community Health Assistant Program on Childhood Illness Treatment in Grand Bassa County, Liberia: A Difference-in-Differences Analysis of Population-Based Data

2021 ◽  
Author(s):  
Emily White ◽  
Savior Mendin ◽  
Featha R. Kolubah ◽  
Robert Karlay ◽  
Ben Grant ◽  
...  
Keyword(s):  
Community Health ◽  
Maternal Education ◽  
Oral Rehydration Therapy ◽  
Household Wealth ◽  
Population Based ◽  
Difference In Differences ◽  
Oral Rehydration ◽  
National Community ◽  
Malaria Rapid Diagnostic Tests ◽  
Health Assistant

Liberia launched its National Community Health Assistant Program in 2016, which seeks to ensure that all people living 5 kilometers or farther from a health facility have access to trained, supplied, supervised, and paid community health workers (CHWs). This study aims to evaluate the impact of the national program following implementation in Grand Bassa County in 2018 using data from population-based surveys. We measured before-to-after changes in childhood treatment from qualified providers in a portion of the county that implemented in a first phase compared to those which had not yet implemented. We also assessed changes in whether children received oral rehydration therapy for diarrhea and malaria rapid diagnostic tests if they had a fever by a qualified provider (facility based or CHW). For these analyses, we used a difference-in-differences approach and adjusted for potential confounding using inverse probability of treatment weighting. We also assessed changes in the source from which care was received and examined changes by key dimensions of equity (distance from health facilities, maternal education, and household wealth). We found that treatment of childhood illness by a qualified provider increased by 60.3 percentage points (95%CI 44.7-76.0) more in intervention than comparison areas. Difference-in-differences for oral rehydration therapy and malaria rapid diagnostic tests were 37.6 (95%CI 19.5-55.8) and 38.5 (95%CI 19.9-57.0) percentage points, respectively. In intervention areas, treatment by a CHW increased from 0 to 81.6% and care from unqualified providers dropped. Increases in treatment by a qualified provider did not vary significantly by household wealth, remoteness, or maternal education. This evaluation found evidence that the Liberian National Community Health Assistant Program has increased access to effective treatment in rural Grand Bassa County. Improvements were approximately equal across three measured dimensions of marginalization.  

scholarly journals Household Poverty, Women Fertility and Child Nutritional Status in Tehsil Jahanian, Pakistan

2020 ◽  
Vol V (III) ◽  
pp. 97-117
Author(s):  
Muhammad Ramzan Sheikh ◽  
Muhammad Tariq ◽  
Maryam Ghafoor
Keyword(s):  
Nutritional Status ◽  
Z Score ◽  
Poverty Level ◽  
Number Of Children ◽  
Household Poverty ◽  
Per Capita ◽  
Nutritional Status Of Children ◽  
Child Nutritional Status ◽  
The Impact ◽  
Height For Age

This study measures the impact of household poverty on women fertility and the nutritional status of children. In this study, the poverty level is computed by the per capita income, while women fertility is measured by the number of children in a household. The Height- for-age Z-score (HAZ) method has been used to measure the nutritional status of children. A survey has been conducted to collect household data. The study uses the OLS method and finds that household poverty is positively correlated to women fertility rate but negatively related to the nutritional status of children. The study has suggested various policies measures for poverty, women fertility and the nutritional status of children.

scholarly journals Nutrition Education of Mothers and Zinc Supplementation among Children in the Rural Community, Cameroon

2021 ◽  
pp. 59-69
Author(s):  
Nicolas Policarpe Nolla ◽  
Marie Modestine Kana Sop ◽  
Marlyne Joséphine Mananga ◽  
Inocent Gouado
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Rural Community ◽  
Maternal Education ◽  
Zinc Supplementation ◽  
Dietary Diversity ◽  
Public Health Problem ◽  
Baseline Survey ◽  
Control Group ◽  
The Impact

Aims: Malnutrition among children, especially stunting is a public health problem in Cameroon. This study assesses the impact of zinc supplementation of children and nutrition education of mothers on the nutritional status of the children in the Bangang rural community. Study Design: This was a descriptive and prospective study. Place and Duration of Study: The study took place in the Bangang community in the Region of West Cameroon, during the period from March to December 2015. Methodology: The children aged 6 to 48 months and mothers aged 20 to 34 years were selected after the baseline survey and enrolled. Dietary surveys were used to evaluate the frequency of foods consumed by 150 children. Zinc supplementation group of children (ZSG, n= 25) received 10 mg of zinc sulfate tablets per day for 14 days and control group (CG, n=25) was formed by children whose mothers received nutrition counseling. The nutrition education sessions organized into 4 modules were conducted quarterly for 9 months on a sample of 100 mothers. After interventions, impact of zinc supplementation and maternal education was assessed by determining height for age and weight for age indices, and biochemistry parameters. Results: The results showed that zincemia of ZSG varied significantly (P = .0001) and not significantly (P = .23) for CG. After nutrition education, dietary diversity was improved; reduction of chronic malnutrition (10.9%) and increasing number of children with good nutritional status (6.6%) were observed. Increased for phosphoremia (3.6 ± 2.4 to 5.7 ± 1.8 mg/dl; P = .001) and albuminemia (34.8 ± 15.5 to 46.9 ± 8.9 g/l; P = .002) were significant which was not the case of calcemia, zincemia, magnesemia and serum iron. Conclusion: This study showed positive impact of zinc supplementation and maternal education on the nutritional status of children.

scholarly journals Sociodemographic Differences in Prenatal Diagnosis of Chromosomal Anomalies: A Population-Based Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Michele Santoro ◽  
Lorena Mezzasalma ◽  
Alessio Coi ◽  
Silvia Baldacci ◽  
Lucia Pasquini ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Prenatal Diagnosis ◽  
Maternal Education ◽  
Geographic Origin ◽  
Population Based ◽  
Termination Of Pregnancy ◽  
Chromosomal Anomalies ◽  
Essential Information ◽  
Maternal Characteristics ◽  
The Impact

Background: In Europe, about 76% of cases of chromosomal anomalies are prenatally diagnosed. Prenatal diagnosis allows more efficient planning of postnatal treatment and helps parents for an informed decision about the continuation of pregnancy. The main aim of this study was to evaluate whether the sociodemographic maternal characteristics affect the probability of prenatal diagnosis of chromosomal anomalies.Methods: Cases of chromosomal anomalies in the period 2005–2017 came from the population-based registry of congenital anomalies of Tuscany (Italy). Differences in the proportion of cases prenatally diagnosed were investigated through the following maternal characteristics: education, geographic origin and occupation. The association between cases of termination of pregnancy after prenatal diagnosis and maternal characteristics was also analysed. Odds Ratios (OR) adjusted by maternal age were calculated using logistic regression models. Results were provided for all cases of chromosomal anomalies and for Down syndrome cases.Results: A total of 1,419 cases were included in the study. Cases prenatally diagnosed were 1,186 (83.6%). We observed a higher proportion of cases not prenatally diagnosed among cases with low maternal education compared to those with high maternal education (OR = 2.16, p &lt; 0.001) and in women from high migratory outflow countries, compared to the Italian ones (OR = 2.85, p &lt; 0.001). For prenatally diagnosed Down syndrome cases, we observed a higher proportion of termination of pregnancy for women with low education level (OR = 4.36, p = 0.023).Conclusions: In our study evidence of differences in the probability of prenatal diagnosis of chromosomal anomalies associated with maternal education and geographic origin was found. Population-based studies investigating sociodemographic disparities can provide essential information for targeted public health programs. Further studies are recommended to monitor the impact of the increasing availability of non-invasive screening tests.

scholarly journals Maternal education and language development at 2 years corrected age in children born very preterm: results from a European population-based cohort study

2020 ◽  
Vol 74 (4) ◽  
pp. 346-353 ◽  
Author(s):  
Mariane Sentenac ◽  
Samantha Johnson ◽  
Marie-Laure Charkaluk ◽  
Anna-Veera Sëppanen ◽  
Ulrika Aden ◽  
...  
Keyword(s):  
Language Development ◽  
Maternal Education ◽  
Short Form ◽  
Population Based ◽  
Expressive Vocabulary ◽  
Perinatal Risk ◽  
Adjusted Risk ◽  
Very Preterm ◽  
Clinical Records ◽  
The Impact

BackgroundSocioeconomic factors influence language development in the general population, but the association remains poorly documented in children born very preterm (VPT). We assessed the impact of maternal education on language development in children born VPT and effect modification by perinatal risk.MethodsData were from the Effective Perinatal Intensive Care in Europe (EPICE) population-based cohort of children born <32 weeks’ gestational age (GA) in 2011/2012. Regions from six countries (Estonia, France, Germany, Italy, Sweden and UK) used a validated short form MacArthur Developmental Communicative Inventories Checklist to assess language at 2 years corrected age. Perinatal variables were collected from clinical records. We assessed expressive language delay (ELD), defined as (a) not combining words; and (b) expressive vocabulary <10th percentile of norms for age and sex. Perinatal risk (low, moderate and high) was determined using GA, small for GA and neonatal morbidities. We estimated adjusted risk ratios (aRR) of ELD by maternal education with inverse weighting to account for non-response bias.ResultsOf 2741 children, 24.6% were not combining words and 39.7% had a low expressive vocabulary. Low maternal education (lower secondary or less compared with a bachelor’s degree or more) increased risks of ELD: not combining words: aRR=1.52 (95% CI 1.36 to 1.69); low expressive vocabulary: aRR=1.25 (1.04 to 1.51). For children with low perinatal risk, the aRR were 1.88 (1.26 to 2.80) and 1.44 (1.06 to 1.95), respectively, compared with those with high perinatal risks: 1.36 (1.10 to 1.67) and 1.11 (0.97 to 1.27), respectively.ConclusionLow maternal education affects ELD for children born VPT, although the association appears attenuated among those with highest perinatal risk.

scholarly journals Disturbed Glucose Metabolism and Left Ventricular Geometry in the General Population

2021 ◽  
Vol 10 (17) ◽  
pp. 3851
Author(s):  
Volker H. Schmitt ◽  
Anna-Maria Billaudelle ◽  
Andreas Schulz ◽  
Karsten Keller ◽  
Omar Hahad ◽  
...  
Keyword(s):  
Glucose Metabolism ◽  
Clinical Outcome ◽  
Early Stage ◽  
Prevalence Ratio ◽  
Population Based ◽  
Left Ventricular ◽  
Health Study ◽  
Left Ventricular Geometry ◽  
Gutenberg Health Study ◽  
The Impact

Background: This study sought to investigate the prevalence and clinical outcome of left ventricular (LV) geometry in prediabetes and type 2 diabetes mellitus (T2DM) and the impact of glucose metabolism on the incidence of left ventricular hypertrophy (LVH). Methods: 15,010 subjects (35–74 years) of the population-based Gutenberg Health Study were categorized into euglycemia, prediabetes, and T2DM according to clinical and metabolic (HbA1c) information. Clinical outcome was assessed via structured follow-up. Results: The study comprised 12,121 individuals with euglycemia (81.6%), 1415 with prediabetes (9.5%), and 1316 with T2DM (8.9%). Prevalence of LVH increased from euglycemia (10.2%) over prediabetes (17.8%) to T2DM (23.8%). Prediabetes and T2DM were associated with increased LV mass index (prediabetes: β1.3 (95% CI 0.78–1.81), p < 0.0001; T2DM: β2.37 (95% CI 1.81; 2.92), p < 0.0001) independent of age, sex, and cardiovascular risk factors (CVRF). The frequency of LVH was related to the presence of T2DM (prevalence ratio (PR)T2DM 1.2 (95% CI 1.06–1.35), p = 0.0038). T2DM was related to mortality independent of age, sex, and CVRF regardless of LVH (hazard ratio (HR)T2DM-LVH 2.67 (95% CI 1.94–3.66), p < 0.0001; HRT2DM-noLVH 1.59 (95% CI 1.29–1.96), p < 0.0001), prediabetes was only associated with outcome in individuals with LVH independent of age and sex (HRprediabetes-LVH 1.51 (95% CI 1.01–2.25), p = 0.045). Neither T2DM nor prediabetes were predictors of incident LVH after adjustment for clinical covariates. Conclusions: Prediabetes and T2DM promote alterations of cardiac geometry. T2DM and particularly the coprevalence of T2DM with LVH substantially reduce life expectancy. These findings highlight the need for new therapeutic and screening approaches to prevent and detect cardiometabolic diseases at an early stage.

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