scholarly journals Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in Bangladesh (2000-2018)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hayman Win ◽  
Jordyn Wallenborn ◽  
Nicole Probst-Hensch ◽  
Günther Fink
Keyword(s):  
Urban Poor ◽  
Maternal Education ◽  
Linear Growth ◽  
Household Wealth ◽  
Household Food Security ◽  
Maternal Body Mass Index ◽  
Growth Status ◽  
Child Stunting ◽  
Growth Difference ◽  
Poor Children

Abstract Background Despite significant progress in reducing child undernutrition, Bangladesh remains among the top six countries globally with the largest burden of child stunting and has disproportionately high stunting prevalence among the urban poor. We use population representative data to identify key predictors of child stunting in Bangladesh and assess their contributions to linear growth differences observed between urban poor and non-poor children. Methods We combined six rounds of Demographic and Health Survey data spanning 2000-2018 and used official poverty rates to classify the urban population into poor and non-poor households. We identified key stunting determinants using stepwise selection method. Regression-decomposition was used to quantify contributions of these key determinants to poverty-based intra-urban differences in child linear growth status. Results Key stunting determinants identified in our study predicted 84% of the linear growth difference between urban poor and non-poor children. Child’s place of birth (27%), household wealth (22%), maternal education (18%), and maternal body mass index (11%) were the largest contributors to the intra-urban child linear growth gap. Difference in average height-for-age z score between urban poor and non-poor children declined by 0.31 standard deviations between 2000 and 2018. About one quarter of this observed decrease was explained by reduced differentials between urban poor and non-poor in levels of maternal education and maternal underweight status. Conclusions Although the intra-urban disparity in child linear growth status declined over the 2000-2018 period, socioeconomic gaps remain significant. Increased nutrition-sensitive programs and investments targeting the urban poor to improve girls’ education, household food security, and maternal and child health services could aid in further narrowing the remaining linear growth gap.

scholarly journals How countries can reduce child stunting at scale: lessons from exemplar countries

2020 ◽  
Vol 112 (Supplement_2) ◽  
pp. 894S-904S ◽  
Author(s):  
Zulfiqar A Bhutta ◽  
Nadia Akseer ◽  
Emily C Keats ◽  
Tyler Vaivada ◽  
Shawn Baker ◽  
...  
Keyword(s):  
Maternal Education ◽  
Linear Growth ◽  
Multivariable Analysis ◽  
Health Sector ◽  
Demographic And Health Surveys ◽  
Significant Heterogeneity ◽  
Nutrition Interventions ◽  
Child Stunting ◽  
Causal Pathways ◽  
Research Activities

ABSTRACT Background Child stunting and linear growth faltering have declined over the past few decades and several countries have made exemplary progress. Objectives To synthesize findings from mixed methods studies of exemplar countries to provide guidance on how to accelerate reduction in child stunting. Methods We did a qualitative and quantitative synthesis of findings from existing literature and 5 exemplar country studies (Nepal, Ethiopia, Peru, Kyrgyz Republic, Senegal). Methodology included 4 broad research activities: 1) a series of descriptive analyses of cross-sectional data from demographic and health surveys and multiple indicator cluster surveys; 2) multivariable analysis of quantitative drivers of change in linear growth; 3) interviews and focus groups with national experts and community stakeholders and mothers; and 4) a review of policy and program evolution related to nutrition. Results Several countries have dramatically reduced child stunting prevalence, with or without closing geographical, economic, and other population inequalities. Countries made progress through interventions from within and outside the health sector, and despite significant heterogeneity and differences in context, contributions were comparable from health and nutrition sectors (40% of change) and other sectors (50%), previously called nutrition-specific and -sensitive strategies. Improvements in maternal education, maternal nutrition, maternal and newborn care, and reductions in fertility/reduced interpregnancy intervals were strong contributors to change. A roadmap to reducing child stunting at scale includes several steps related to diagnostics, stakeholder consultations, and implementing direct and indirect nutrition interventions related to the health sector and nonhealth sector . Conclusions Our results show that child stunting reduction is possible even in diverse and challenging contexts. We propose that our framework of organizing nutrition interventions as direct/indirect and inside/outside the health sector should be considered when mapping causal pathways of child stunting and planning interventions and strategies to accelerate stunting reduction to achieve the 2030 Sustainable Development Goals.

scholarly journals Faktor Risiko Stunting pada anak di Negara Berkembang

2019 ◽  
Vol 3 (3) ◽  
pp. 122
Author(s):  
Indah Budiastutik ◽  
Muhammad Zen Rahfiludin
Keyword(s):  
Developing Countries ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Exclusive Breastfeeding ◽  
Maternal Education ◽  
Linear Growth ◽  
Sub Saharan Africa ◽  
Child Stunting ◽  
Sub Saharan ◽  
Health Organization

Background: The problem of stunting occurs in developing countries including Indonesia. In Indonesia the prevalence of child stunting is 30.8%, still above the world prevalence, which is 22.2%. The prevalence of stunting in sub-Saharan Africa is 34.5%, in Ethiopia is 52.4%, and the prevalence of stunting in Congo is 40%. While WHO stipulates that nutrition problems should not exceed 20%. Stunting could inhibit linear growth, development and degenerative diseases later in adulthood.Objective: This review discussed the risk factors of child stunting in developing countries.Discusion: One of the causes of increased stunting in children was due to inadequate nutritional intake in a long period. Stunting was often not realized by parents and only visible after the age of 2 due to low stature. Based on the results of the literature review the likelihood of stunting in developing country were: 16.43 times morelikely due to low birth length, 3.27 times higher due to maternal education, 2.45 times higher if the children were living in rural area, 4.5 times higher due to low birth weight, no risk Antenatal Care increase the risk 3.4 times, 6.38 times higher due to no immunization, and no exclusive breastfeeding increase the risk of stunting 4.0 times.Conclusion: The risk factor for child stunting in developing countries are exclusive breastfeeding, socioeconomic, low birth weight, length of birth, low maternal education, infectious disease.ABSTRAKLatar Belakang: Masalah stunting (stunting) yang terjadi di Negara Berkembang seperti Indonesia masih tinggi yaitu 30,8% masih  di atas dunia yaitu 22,2%.  Stunting di sub sahara Afrika 34,5%, di Ethiopia  52,4%, prevalensi stunting di Congo 40%. Word Health Organization sudah menentukan bahwa terjadinya masalah gizi suatu negara sebaiknya kurang dari 20%. Stunting memiliki risiko gangguan pertumbuhan, perkembangan dan penyakit degeneratif pada usia dewasa nanti.Tujuan: Review ini bertujuan untuk mengidentifikasi faktor risikos apa saja yang dapat menentukan terjadinya stunting anak di Negara berkembang.Ulasan: Berdasarkan dari beberapa hasil penelitian menyebutkan bahwa salah satu penyebab stunting pada anak adalah karena tidak terpenuhinya gizi yang baik pada kurun waktu yang panjang dan sering kali tidak disadari oleh orang tuanya sehingga setelah anak usia di atas 2 tahun baru terlihat bahwa anaknya mengalami stunting. Berdasarkan hasil literatur review menunjukkan bahwa faktor risiko terjadinya stunting adalah panjang lahir berisiko 16,43 kali, pendidikan ibu yang rendah berisiko 3,27 kali, serta anak yang tinggal di desa berisiko 2,45 kali,  BBLR berisiko 4,5 kali, tidak ANC berisiko 3,4 kali, tidak imunisasi berisiko 6,38 kali, dan tidak ASI Eksklusif berisiko 4,0 kali  adalah merupakan faktor risiko  stunting anak di negara berkembang.Kesimpulan: Hasil sintesis ini secara konsisten yang menjadi faktor risikos terjadinya stunting pada anak di negara berkembang adalah tidak diberikan ASI eksklusif, sosial ekonomi, berat bayi lahir rendah, panjang lahir, pendidikan ibu rendah, penyakit infeksi.

scholarly journals Child stunting concurrent with wasting or overweight: A 6-year follow-up of a randomized maternal education trial in Uganda

Nutrition ◽  
2021 ◽  
pp. 111281
Author(s):  
Per O Iversen ◽  
Moses Ngari ◽  
Ane C Westerberg ◽  
Grace Muhoozi ◽  
Prudence Atukunda
Keyword(s):  
Maternal Education ◽  
Child Stunting

scholarly journals A Case Control Study on Risk Factors Associated with Low Birth Weight Babies in Eastern Nepal

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ravi Kumar Bhaskar ◽  
Krishna Kumar Deo ◽  
Uttam Neupane ◽  
Subhadra Chaudhary Bhaskar ◽  
Birendra Kumar Yadav ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Maternal Education ◽  
Case Control Study ◽  
Calcium Supplementation ◽  
Case Control ◽  
Maternal Body Mass Index ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Control Study

Background. This study was done to assess the maternal and sociodemographic factors associated with low birth weight (LBW) babies.Methods. An unmatched case control study was done involving 159 cases (mothers having LBW singleton babies) and 159 controls (mothers having normal birth weight singleton babies).Results. More than 50% of LBW babies were from the mothers with height ≤145 cm while only 9.43% of NBW babies were from the mothers with that height. Finally, after multivariate logistic regression analysis, maternal height, time of first antenatal care (ANC) visit, number of ANC visits, iron supplementation, calcium supplementation, maternal education, any illness during pregnancy, and hypertension were found as the significant predictors of LBW. However, maternal blood group AB, normal maternal Body Mass Index (BMI), mother’s age of 30 or more years, and starting ANC visit earlier were found to be protective for LBW.Conclusion. Study findings suggest that selectively targeted interventions such as delay age at first pregnancy, improving maternal education and nutrition, and iron and calcium supplementation can prevent LBW in Nepal.

scholarly journals Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys

2014 ◽  
Vol 17 (11) ◽  
pp. 2407-2418 ◽  
Author(s):  
Helga Bjørnøy Urke ◽  
Maurice B Mittelmark ◽  
Martín Valdivia
Keyword(s):  
Urban Areas ◽  
Health Surveys ◽  
Maternal Education ◽  
Wealth Quintile ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Sampling Weights ◽  
Cross Sectional ◽  
Growth Standards ◽  
Low Educated

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.

scholarly journals Urban-Rural Gaps in Breastfeeding Practices: Evidence From Lao People’s Democratic Republic

2021 ◽  
Vol 66 ◽  
Author(s):  
Jordyn T. Wallenborn ◽  
Camille B. Valera ◽  
Sengchanh Kounnavong ◽  
Somphou Sayasone ◽  
Peter Odermatt ◽  
...  
Keyword(s):  
Confidence Intervals ◽  
Maternal Education ◽  
Democratic Republic ◽  
Household Wealth ◽  
World Health ◽  
Lao People’S Democratic Republic ◽  
Lao People's Democratic Republic ◽  
Breastfeeding Practices ◽  
Urban Rural ◽  
Rural Residences

Objectives: Breastfeeding rates are decreasing rapidly in many low and middle-income countries, disproportionately affecting urban residences. We use data from Lao People’s Democratic Republic to identify primary mechanisms underlying the urban-rural gap in breastfeeding practices.Methods: We used data from the 2017 Lao Social Indicator Survey II. Residence was categorized as large-urban (>1 million), small-urban (<1 Million), and rural. Multivariable logistic regression provided odds ratios and 95% confidence intervals (CI) to identify factors attributing to the urban-rural differences in complying with World Health Organization’s breastfeeding recommendations for children <24 months.Results: Mothers in large-urban residences had 3.78 (95% confidence intervals: 1.19, 11.95) and 4.67 (95% CI: 2.30, 9.46) higher odds of non-compliance with exclusive and complementary breastfeeding recommendations, respectively, than mothers living in rural areas in bivariate models. Breastfeeding differentials between small urban and rural residences were largely explained by differences in maternal education and household wealth.Conclusion: Results of our paper suggest large disparities in breastfeeding practices between large-urban, small-urban, and rural residences.

scholarly journals Associations between maternal BMI, breastfeeding practices and infant anthropometric status in Colombia; secondary analysis of ENSIN 2010.

2020 ◽  
Author(s):  
Fanny Aldana-Parra ◽  
Gilma Olaya ◽  
Mary Fewtrell
Keyword(s):  
Birth Weight ◽  
Infant Feeding ◽  
Maternal Education ◽  
Secondary Analysis ◽  
Maternal Body Mass Index ◽  
Term Infants ◽  
Feeding Mode ◽  
Breastfeeding Practices ◽  
Maternal Bmi ◽  
Anthropometric Status

Abstract Background: Maternal malnutrition and infant feeding mode impact short and long term infant and child morbidity and mortality. The period of lactation may provide an opportunity to modulate the risk of disease later in life. Our aim was to estimate the effect of maternal body mass index (BMI) and infant feeding mode, particularly breastfeeding practices, on the anthropometric status of children under two years in Colombia. Methods: A secondary analysis was performed using the data from ENSIN 2010. Term infants under 2y, singleton, with a mother older than 18y, were included in the analysis. Outcomes were wasting (WLZ<-2SD), overweight (WLZ>+2SD) and stunting (LAZ<-2SD). Predictors were infant feeding (exclusive and predominant BF constructed from 24-hour recall, age at introduction of liquids, semisolids and solids) and maternal BMI. Socioeconomic variables, maternal education and age, conditions during pregnancy and birth weight were analyzed as covariates. Results: Mothers of overweight infants had higher BMI (Mean dif=1.47 kg/m2; 95% CI=2.1, 0.8) than those with normal weight infants. Stunting and wasting were not predicted by maternal anthropometry or infant feeding mode. Fewer maternal years of education were associated with wasting (OR=0.90; 95% CI=0.86, 0.97; p=0.003) and stunting (OR=0.92; 95% CI=0.89, 0.94; p<0.0001), while more maternal years of education were associated with overweight (OR=1.06; 95% CI=1.02, 1.01; p=0.001); higher birth weight was associated with overweight (OR=1.001; 95% CI=1.00, 1.001; p<0.0001) and lower birth was associated with stunting (OR=0.99; 95% CI=0.89; p<0.0001) in the final regression model. Conclusions: Maternal BMI is a modifiable target for public health policy to promote healthy infant growth. Infant nutritional status is affected by direct and indirect factors that need to be addressed in further studies.

scholarly journals The trend of full vaccination coverage in infants and inequalities by wealth quintile and maternal education: Analysis from four recent Demographic and Health Surveys in Nepal

2019 ◽  
Author(s):  
Kiran Acharya ◽  
Yuba Raj Paudel ◽  
Dinesh Dharel
Keyword(s):  
Vaccination Coverage ◽  
Maternal Education ◽  
Immunization Coverage ◽  
Wealth Quintile ◽  
Educational Status ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Relative Index ◽  
Index Of Inequality ◽  
Over Time

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.

scholarly journals Escherichia coli Colonization in Neonates: Prevalence, Perinatal Transmission, Antimicrobial Susceptibility, and Risk Factors

Medicina ◽  
2012 ◽  
Vol 48 (2) ◽  
pp. 13 ◽  
Author(s):  
Rasa Tamelienė ◽  
Eglė Barčaitė ◽  
Dalia Stonienė ◽  
Jūratė Buinauskienė ◽  
Eglė Markūnienė ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Maternal Education ◽  
Transmission Rate ◽  
Perinatal Transmission ◽  
Cross Sectional Study ◽  
Maternal Body Mass Index ◽  
Cross Sectional ◽  
E Coli

Escherichia coli is one of the leading causes of early-onset neonatal sepsis in many industrialized countries. However, there is a lack of studies on Escherichia coli colonization in women and neonates. The study aimed at determining the prevalence Escherichia coli among pregnant women and newborns, perinatal transmission, antimicrobial susceptibility, and risk factors for neonatal colonization. Material and Methods. In this prospective, cross-sectional study, 827 infants born to 808 mothers were enrolled. The study was carried out from October 1, 2006, to June 30, 2007. Women were screened for E. coli carriage at 35–37 weeks of gestation or on admission for premature rupture of membranes and delivery; neonates, within 15 minutes of their lives. Risk factors for colonization were collected by a questionnaire and were recorded during labor. Results. Maternal E. coli colonization rate was 19.9%; neonatal, 14.4%; and transmission rate, 21.4%. Less than one-fourth (22.7%) of neonatal E. coli strains were resistant to ampicillin. Logistic regression analysis revealed that anal sexual intercourse (OR, 3.91; 95% CI, 1.87–8.19), one sexual partner (OR, 2.01; 95% CI, 1.30–3.11), maternal vaginal Escherichia coli colonization (OR, 1.81; 95% CI, 1.12–2.93), maternal body mass index of ≤27 (OR, 1.77; 95% CI, 1.15–2.73), and maternal education lower than university level (OR, 1.70; 95% CI, 1.06–2.74) were associated with neonatal Escherichia coli colonization. Conclusions. The prevalence of maternal Escherichia coli colonization was higher in this study than other studies (19.9%). Neonatal Escherichia coli colonization was 14.4%. The resistance of Escherichia coli isolates to ampicillin was not high (22.7%). Improvement of maternal education and modification of mothers’ sexual habits need to be undertaken to prevent neonatal Escherichia coli colonization.

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