scholarly journals Midday meals as an early childhood nutrition intervention: evidence from plantation communities in Sri Lanka

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Udeni De Silva Perera ◽  
Brett A. Inder

Abstract Background High rates of child malnutrition are a major public health concern in developing countries, particularly among vulnerable communities. Midday meals programs can be effective for combatting childhood malnutrition among older children. However, their use in early childhood is not well documented, particularly within South Asia. Anthropometric measures and other socioeconomic data were collected for children below the age of 5 years living in selected Sri Lankan tea plantations, to assess the effectiveness of midday meals as a nutrition intervention for improving growth among young children. Methods The study exploits a natural experiment whereby the provision of the midday meals program is exogenously determined at the plantation level, resulting in comparable treatment and control groups. Longitudinal data was collected on heights and weights of children, between 2013 and 2015. Standardized weight-for-age, height-for-age and weight-for-height, and binary variables for stunting, wasting and underweight are constructed, following WHO guidelines. All modelling uses STATA SE 15. Random-effects regression with instrumental variables is used for modelling standardized growth while random-effects logistic regression is used for the binary outcomes. Robustness analysis involves different estimation methods and subsamples. Results The dataset comprises of longitudinal data from a total of 1279 children across three tea plantations in Sri Lanka, with 799 children in the treatment group and 480 in the control group. Results show significant positive effects of access to the midday meals program, on the growth of children. A child with access to the midday meals intervention reports an average standardized weight-for-age 0.03 (±0.01) and height-for-age 0.05 (±0.01) units higher than a similar child without access to the intervention. Importantly, access to the intervention reduces the likelihood of being underweight by 0.45 and the likelihood of wasting by 0.47. The results are robust to different model specifications and across different subsamples by gender, birthweight and birth-year cohort. Conclusions Midday meals programs targeting early childhood can be an effective intervention to address high rates of child malnutrition, particularly among vulnerable communities in developing countries like Sri Lanka.

2020 ◽  
Author(s):  
Udeni De Silva Perera ◽  
Brett A. Inder

Abstract Background: High rates of child malnutrition are a major public health concern in developing countries, particularly among vulnerable communities. Midday meals programs can be effective for combatting childhood malnutrition among older children. However, their use in early childhood is not well documented, particularly within South Asia. Anthropometric measures and other socioeconomic data were collected for children below the age of five years living in selected Sri Lankan tea plantations, to assess the effectiveness of midday meals as a nutrition intervention for improving growth among young children.Methods: The study exploits a natural experiment whereby the provision of the midday meals program is exogenously determined at the plantation level, resulting in comparable treatment and control groups. Longitudinal data is regularly collected on heights and weights of children, between 2013-2015. Standardized weight-for-age, height-for-age, BMI-for-age and weight-for-height are calculated following WHO guidelines, and binary variables for stunting, wasting and underweight are constructed. All modelling uses STATA SE 15. Random-effects regression with instrumental variables is used for modelling standardized growth variables whilst random-effects logistic regression is used for binary outcome variables. Robustness analysis involves different estimation methods and subsamples. Results: The dataset consists of longitudinal data from a total of 1279 children across three tea plantations in Sri Lanka, with 799 children in the treatment group and 480 in the control group. Results show significant positive effects of access to the midday meals program, on the growth of children. A child with access to the midday meals intervention reports an average standardized weight-for-age 0.03 (±0.01) and height-for-age 0.05 (±0.01) units higher than a similar child without access to the intervention. Importantly, access to the intervention reduces the likelihood of being underweight by 0.45 and the likelihood of wasting by 0.47. The results are robust to different model estimations and across different subsamples by gender, birthweight and birth-year cohort. Qualitative data analysis suggests a high viability of implementing similar programs within tea plantations in Sri Lanka.Conclusions: Midday meals programs targeting early childhood can be an effective intervention to address high rates of child malnutrition, particularly among vulnerable communities in developing countries like Sri Lanka.


2018 ◽  
Vol 66 (1) ◽  
pp. 1-7
Author(s):  
Halima Akhter ◽  
M Ershadul Haque

Malnutrition is the burning question all over the world’s public health. Bangladesh is one of those countries where level of malnutrition of infant and child is very serious and many problems that results from malnutrition in Bangladesh. The aim of this study is to substantiate whether there exists any influence of parents’ education for child nutrition as well as to find out the potential effects of non-parental household member’s literacy level on child malnutrition. In this study we have found that parents’ education is an important factor for child nutrition. Also other household members’ education has significant impact on stunting (height for age) and underweight (weight for age). The results of this study focus the policies that encourage participation in schools and higher education program as well as improve economic condition of the households to dilute child malnutrition in Bangladesh. Dhaka Univ. J. Sci. 66(1): 1-7, 2018 (January)


2020 ◽  
Vol 3 ◽  
Author(s):  
Lucy Brown ◽  
Katrina Co ◽  
Robert Opoka ◽  
Dibyadyuti Datta ◽  
Chandy John

Background: In 2018, malaria produced an estimated 272,000 deaths in children <5 years of age, accounting for 67% of all malaria deaths worldwide, with a majority in the WHO African Region. Malnutrition is an important risk factor for malaria. Wasting, Stunting and Underweight are crucial indicators of malnutrition. Annually, 14 million children <5 are classified as wasted and 59 million children are classified as stunted.   Objective: The objective of this study is to determine the association between each of the major manifestations of severe malaria (SM) and nutritional parameters – weight-for-age (WAZ), height-for-age (HAZ), and weight-for-height (WHZ) – in children from the Ugandan cities Mulago and Jinja.   Methods: To assess differences in WAZ, HAZ, and WHZ by the five types of SM and community controls (CC), we evaluated Z-scores from children <5 years old enrolled in a prospective cohort study (NDI, Neurodevelopmental Impairment in Children with Severe Malaria) at enrollment and 12-month follow-up.   Results: WAZ and WHZ at baseline were significantly lower among SM groups than in CC (p<0.001), but there were no significant differences observed at 12-month follow-up. There were no major differences in HAZ between the SM and CC groups. WAZ and HAZ at baseline were significantly lower among High Mortality (HM) versus Low Mortality (LM) groups (p<0.01). At 12-month follow-up, HAZ remained significantly lower in HM versus LM (p<0.01). There were no major differences in WHZ between the HM and LM groups. Compared to those who survived, the 27 children who died had significantly lower WAZ (p<0.05), but no major differences in HAZ or WHZ.  Conclusion: Underweight, stunting, and wasting may be risk factors for SM. Overall, a more comprehensive understanding of how SM elicits adverse effects in children is necessary. Nutrition intervention programs must be implemented to prevent child stunting, wasting, underweight, and mortality. 


2010 ◽  
Vol 44 (2) ◽  
pp. 249-260 ◽  
Author(s):  
Jeovany Martínez ◽  
Cora Araújo ◽  
Bernardo Lessa Horta ◽  
Denise Petrucci Gigante

OBJECTIVE: To examine the relationship between growth patterns in early childhood and the onset of menarche before age 12. METHODS: The study included 2,083 women from a birth cohort study conducted in the city of Pelotas, Southern Brazil, starting in 1982. Anthropometric, behavioral, and pregnancy-related variables were collected through home interviews. Statistical analyses were performed using Pearson's chi-square and chi-square test for linear trends. A multivariable analysis was carried out using Poisson regression based on a hierarchical model. RESULTS: Mean age of menarche was 12.4 years old and the prevalence of menarche before age 12 was 24.3%. Higher weight-for-age, height-for-age, and weight-for-height z-scores at 19.4 and 43.1 months of age were associated with linear tendencies of increased prevalence and relative risks of the onset of menarche before age 12. Girls who experienced rapid growth in weight-for-age z-score from birth to 19.4 months of age and in weight-for-age or height-for-age z-scores from 19.4 to 43.1 months of age also showed higher risk of menarche before age 12. Higher risk was seen when rapid growth in weight-for-age z-score was seen during these age intervals and the highest risk was found among those in the first tertile of Williams' curve at birth. Rapid growth in weight-for-height z-score was not associated with menarche before age 12. CONCLUSIONS: Menarche is affected by nutritional status and growth patterns during early childhood. Preventing overweight and obesity during early childhood and keeping a "normal" growth pattern seem crucial for the prevention of health conditions during adulthood.


2021 ◽  
Vol 4 (2) ◽  
pp. 40
Author(s):  
Vaibhav Keshav

This paper explores the effect of birth weight on a series of anthropometric outcomes among children. We use a panel of individual-level data from 39 developing countries covering the years 1999-2018 and attempt to solve the Endogeneity using mother fixed effect and twin fixed-effect strategies. The results suggest that improvements in birth weight result in statistically and economically significant improvements in children's anthropometric outcomes. An additional 100 grams birth weight is associated with a 0.43 and 0.25 units increase in weight for age percentile and height for age percentile, respectively. The links are stronger among low educated mothers and poorer households. The observed protective effect of birth weight on infant mortality suggests that the true effects of birth weight on children’s outcomes are larger and that the estimated effects probably understate the true effects.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Mashkoor Ahmad Lone ◽  
Dr. P. Ganesan

The practice of placing deprived children having least or no emotional and material resources, in orphanages has since long been prevailing in socio -economically poor Asian countries. A sample of 30 children residing in orphanage in district Anantnag in the age group of 13-18 years was selected for the present study. Most of the children were found socially and psychologically disturbed. As per Indian Academy Paediatrics (IAP) classification with respect to weight for age the condition was not bad that as approximately 67% percent of the children were found to be normal. In the same way height for age as per Waterloo’s classification shown that more than half of the children were normal. On clinical examination approximately 47% of children were normal, while as rest were suffering from dispigmentation of hair, moon face, xerosis of skin cheilosis, magenta tongue, spongy bleeding gums, oedema, conjuctival xerosis, and mottled dental enamel. The findings indicated that nutritional intake was deficient for all nutrients when compared to, Recommended Daily Allowances Chart (RDA) for all age groups which may be linked to poor planning of menus in orphanages.


2020 ◽  
Author(s):  
Cristhian David Morales-Plaza

Guarantee better clinical practices among clinicians who attend NTDs in developing countries as well as provide education in vector control in hotspot vulnerable communities


2021 ◽  
pp. 1-24
Author(s):  
Renuka Jayatissa ◽  
Himali Herath ◽  
Amila Gayan Perera ◽  
Thulasika Thejani Dayaratne ◽  
Nawmali Dhanuska De Alwis ◽  
...  

Abstract Objectives: To determine changes and factors associated with child malnutrition, obesity in women and household food insecurity before and after the first wave of COVID-19 pandemic. Design: A prospective follow up study. Setting: In 2019, the baseline Urban Health and Nutrition Study (UHNS-2019) was conducted in 603 households, which were selected randomly from 30 clusters to represent underserved urban settlements in Colombo. In the present study, 35% of households from the UHNS-2019 cohort were randomly selected for repeat interviews, one year after the baseline study and 6 months after COVID-19 pandemic in Sri Lanka. Height/length and weight of children and women were re-measured, household food insecurity was reassessed, and associated factors were gathered through interviewer administered questionnaires. Differences in measurements at baseline and follow-up studies were compared. Participants: A total of 207 households, comprising 127 women and 109 children were included. Results: The current prevalence of children with wasting and overweight was higher in the follow-up study than at baseline UHNS-2019 (18.3%vs13.7%;p=0.26 and 8.3%vs3.7%;p=0.12 respectively). There was a decrease in prevalence of child stunting (14.7%vs11.9%;p=0.37). A change was not observed in overall obesity in women, which was around 30.7%. Repeated lockdown was associated with a significant reduction in food security from 57% in UHNS-2019 to 30% in the current study (p<0.001). Conclusions: There was an increase in wasting and overweight among children while women had a persistent high prevalence of obesity. This population needs suitable interventions to improve nutrition status of children and women to minimise susceptibility to COVID-19.


Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 223
Author(s):  
Wajiha Anzar ◽  
Ambrina Qureshi ◽  
Ashar Afaq ◽  
Hiba F. Kattan ◽  
Basil Almutairi ◽  
...  

Aim: This study aimed to investigate an association between dental caries status and anthropometric measures in primary school children. Methods and Materials: An analytical cross-sectional study (n = 376) was conducted among primary school children (age range = 6–9 years) registered in private schools. Non-clinical data was gathered from parents of participating children through a self-administered structured questionnaire as well as from the children through an interviewer-administered questionnaire. Clinical data included the examination of dental caries using dmft/DMFT index and anthropometric measures including calculated z-scores of height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BAZ), and physical examination. Inferential statistics included Kruskal Wallis and linear regression for univariate and multivariate analysis respectively. Results: The proportion of dental caries in primary and secondary dentition was 67.6% and 8.2% respectively. A significant association was observed between dental caries status and HAZ, WAZ, and BAZ (p < 0.001). An inverse relation was found between low, medium, and high dental caries categories and anthropometric measures. Conclusions: In the primary dentition, dental caries were significantly and inversely related to weight-for-age, height-for-age, and BMI-for-age. Hence, it can be concluded that among the low-income population dental caries is associated with lower anthropometric outcomes in children and therefore caries management should be considered an approach impacting overall health and quality of life.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. G. Sathiadas ◽  
Annieston Antonyraja ◽  
Arunath Viswalingam ◽  
Kasthuri Thangaraja ◽  
V. P. Wickramasinghe

Abstract Background Nutritional status is an important indicator for measuring quality of life in children. A region that is recovering from war will face many problems related to nutrition. Very few studies have addressed the nutritional problems in school children. This study was undertaken to identify the prevalence of wasting, stunting and obesity among school children from Northern Sri Lanka and associated socio-demographic factors. Methods A community based cross-sectional study was carried out using multistage stratified proportionate cluster among healthy children attending schools in the Northern part of the country. Height and weight were measured, and Body Mass Index (BMI) calculated [weight (kg)/Height (m) 2]. BMI-for-age z-score (BAZ) and Height for age Z (HAZ) scores were determined and WHO growth references were used to categorise the nutritional status. Correlation between various nutritional problems with Maternal education, household income, number of family members and the residential area was assessed. Results A total of 1012 children were recruited, and the mean age and standard deviation were 11.12±1.77 yrs. Girls in the age ranges of 9–14 were heavier and taller when compared to the boys compatible with the pubertal growth spurt. Stunting based on the height for age was seen in 10.9% of boys and 11.8% of girls. Wasting based on BMI for age WHO standard (WHO 2007) was seen in 30.6% of boys and 29.1% of the girls. The prevalence of overweight was 11% and Obesity was 6.3% of the population. Obesity was predominantly seen in boys (4.2%) and it was significantly higher when compared to the girls (2.1%) (p < 0.001). Obesity in older boys (> 10 years) was significantly more than the younger ones (p < 0.01). Maternal education and family income had a significant impact on the prevalence of wasting, stunting and obesity whereas the family size contributed to the wasting and obesity (p< 0.001). Conclusion Findings suggest that stunting, wasting, overweight and obesity are prevalent among 6–16-year-old leading to concerns in public health. The nutritional status significantly varies according to the geographical location, maternal education and the household income.


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