scholarly journals Why under five children are stunted in Pakistan? Multilevel analysis of Punjab Multiple Indicator Cluster Survey (MICS-2014)

2019 ◽  
Author(s):  
Tahir Mahmood ◽  
Faisal Abbas ◽  
Ramesh Kumar ◽  
Ratana Somrongthong
Keyword(s):  
Gender Bias ◽  
Rural Areas ◽  
Multilevel Models ◽  
National Level ◽  
Cluster Sampling ◽  
Severe Stunting ◽  
Under Five ◽  
Cluster Survey ◽  
Multiple Indicators ◽  
Punjab Province

Abstract Background : Pakistan is facing an acute problem of child under-nutrition as about 38 percent of children in Pakistan are stunted. Punjab, the largest province by population and GDP share having stunting prevalence of about 33.5 percent moderately and 13.3 percent severely stunted children of less than five years. Thus, this study aims at examining empirically the determinants of stunting (moderate and severe) at different level of hierarchy. Methodology : Data for this study is coming from Punjab Multiple Indicators Cluster Survey (MICS-2014). MICS uses two-stage, stratified cluster sampling approach. MICS is sub national level (Punjab province) data covering urban and rural areas. The data consists of 25,067 children under five, for 9 administrative divisions and 36 districts of Punjab province of Pakistan. Descriptive statistics and multilevel hierarchical models were estimated. Multilevel data analyses has advantage because it provides robust standard error estimates and helps in finding variation in the data at various levels. Results : Punjab has stunting prevalence of about 27 percent moderately and 10 percent severely stunted children of less than five years. The results depict that increasing age of child, increasing birth order, illiterate mothers and fathers, lack of sanitation facilities and being poor are associated significantly with the likelihood of moderate and sever stunting. Surprisingly, there is a gender bias in stunting in Punjab, Pakistan and being girl child is more likely associated with moderate and severe stunting which depicts the patriarchal nature of the society and a strong prevalence of gender bias in household resource allocations. Conclusion : This outcome of our analysis points towards targeting not only households (focus on girls) but also their families and communities. Keywords: Undernutrition; Stunting; Child Health; Pakistan; Punjab; Multilevel Models; Multiple Indicators Cluster Survey.

scholarly journals Why under five children are stunted in Pakistan? A Multilevel analysis of Punjab Multiple Indicator Cluster Survey (MICS-2014)

2020 ◽  
Author(s):  
Tahir Mahmood ◽  
Faisal Abbas ◽  
Ramesh Kumar ◽  
Ratana Somrongthong
Keyword(s):  
Gender Bias ◽  
Rural Areas ◽  
National Level ◽  
Cluster Sampling ◽  
Severe Stunting ◽  
Under Five ◽  
Cluster Survey ◽  
Punjab Province ◽  
Multilevel Hierarchical Models ◽  
Urban And Rural Areas

Abstract Background: Pakistan is facing an acute problem of child under-nutrition as about 38% of children in Pakistan are stunted. Punjab, the largest province by population and GDP share having a stunting prevalence of about 33.5% moderately and 13.3%severely stunted children of less than five years. Thus, this study aims at examining the determinants of stunting (moderate and severe) at different level of hierarchy empirically.Methodology: Data for this study is coming from Punjab Multiple Indicators Cluster Survey (MICS-2014). MICS uses a two-stage, stratified cluster sampling approach. MICS is sub-national level (Punjab province) data covering urban and rural areas. The data consists of 25,067 children under five, for 9 administrative divisions and 36 districts of Punjab province of Pakistan. Descriptive statistics and multilevel hierarchical models were estimated. Multilevel data analyses have an advantage because it provides robust standard error estimates and helps in finding variation in the data at various levels. Results: Punjab has a stunting prevalence of about 27% moderately and 10% severely stunted children of less than five years. The results depict that increasing the age of the child, increasing birth order, illiterate mothers and fathers, lack of sanitation facilities and being poor are associated significantly with the likelihood of moderate and severe stunting. Surprisingly, there is a gender bias in stunting in Punjab, Pakistan and being a girl child is more likely associated with moderate and severe stunting, which depicts the patriarchal nature of the society and a substantial prevalence of gender bias in household resource allocations.Conclusion: This outcome of our analysis points towards targeting not only households (focus on girls) but also their families and communities.

scholarly journals Association Between Household Air Pollution and Infant and Child Mortality in Myanmar: Evidence From The First Demographic and Health Survey

2021 ◽  
Author(s):  
Juwel Rana ◽  
Md Nuruzzaman Khan ◽  
Rakibul M Islam ◽  
Razia Aliani ◽  
Youssef Oulhote
Keyword(s):  
Air Pollution ◽  
Child Mortality ◽  
Health Survey ◽  
Rural Areas ◽  
Demographic And Health Survey ◽  
Household Air Pollution ◽  
Cluster Sampling ◽  
High Exposure ◽  
Under Five ◽  
Under Five Children

Abstract Background: Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. This study was undertaken to investigate the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods: This cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. Data were collected from MDHS based on stratified two-stage cluster sampling design applied in urban and rural areas. The sample consists of 3249 under-five children in the household with a 98% response rate. Exposure measures were HAP (coal and biomass) and level of exposure to HAP (no exposure, moderate and high exposure). The main outcomes were neonatal, infant, and under-five child mortality reported by mothers presented in rates and risk ratios with 95% confidence intervals, accounting for survey weight and cluster variation. Results: The prevalence of SFU was 79.0%. The neonatal, infant and under-five child mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The risks of infant (aRR 2.02; 95% CI: 1.01-4.05) and under-five mortality (aRR 2.16; 95% CI: 1.07-4.36) mortality were higher among children from households with SFU compared to children from households using clean fuel. When applying an augmented measure of exposure to HAP by incorporating SFU and the kitchen's location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children than unexposed children with similar trends. Neonatal mortality was not associated with either HAP exposure or levels of exposure to HAP.Conclusion: Infants and under-five children are at higher risk of mortality from exposure to HAP. Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infant and under-five child mortality in LMICs, including Myanmar.

scholarly journals Prevalence and Determinants of Malaria Infection Among Children of local farmers in Central Malawi

2019 ◽  
Author(s):  
Emmanuel Chilanga ◽  
Delphine Collin-Vezina ◽  
Heather MacIntosh ◽  
Claudia Mitchel ◽  
Katrina Cherney
Keyword(s):  
Rural Areas ◽  
Partner Violence ◽  
Malaria Infection ◽  
Formal Education ◽  
National Level ◽  
Health Assessment ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Age Range

Abstract BackgroundMalaria is a leading cause of morbidity and mortality among children under five in Malawi. Children from rural areas of central Malawi have high burden of malaria morbidity compared to other regions. The goals of this study were to examine the prevalence and determinants of malaria infection among children in rural areas of Dowa district in central Malawi.Methods A multistage cross-sectional study design was used to systematically sample 523 child-mother dyads from postnatal clinics. The main outcome was child positive malaria diagnostic test during postnatal clinic health assessment. Logistic regressions were used to determine risk factors associated with malaria among children aged 2 to 59 months.Results The prevalence of malaria amongst children under five years was 35.4%. The results of multivariable analyses show that children of mothers who experienced recent intimate partner violence (IPV) were more likely to be diagnosed with malaria ( AOR : 1.88, 95% CI : 1.19-2.97; P = 0.007) than children of mothers who did not. Children of mothers who had no formal education were more likely to be diagnosed with malaria ( AOR : 2.77, 95% CI : 1.24-6.19; P = 0.013) than children of mothers who attained secondary education. In addition, children in the age range of 2 to 5 months, and 6 to 11 months were less likely to be diagnosed with malaria ( AOR :0.21, 95% CI: 0.10-0.46; P = 0.000 and AOR :0.43; 95% CI: 0.22-0.85; P = 0.016, respectively) than children in the age range of 24 to 59 months.Conclusion The study found that the prevalence of malaria infection among children in the study area was comparable to that of national level. We propose that malaria control programs among children should also take into account mothers without formal education, mothers with children aged 24 to 59 months, and mothers that are experiencing IPV in the area.

scholarly journals Nutritional status and its corelates in under five slum children of Kanpur Nagar, India

2018 ◽  
Vol 5 (2) ◽  
pp. 584 ◽  
Author(s):  
S. K. Gautam ◽  
Mahesh Verma ◽  
S. K. Barman ◽  
A. K. Arya
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Maternal Education ◽  
Standard Technique ◽  
Sampling Technique ◽  
Severe Malnutrition ◽  
Cluster Sampling ◽  
Severe Stunting ◽  
Under Five ◽  
Under Five Children

Background: In Kanpur, overall there were an estimated 43.6% stunted, 24.1% wasted and 41.8% underweight under-five children. There is a critical window of opportunity to prevent undernutrition by taking care of the nutrition of children in the first two years of life. With this background the present study was undertaken with the aim to assess the nutritional status in under five children in the slum area of Kanpur Nagar.Methods: The present study was conducted in 30 slums of Kanpur Nagar selected through 30 cluster sampling technique. The sample size was calculated as 390. From each cluster, approximate 13 study subjects aged 0-60 months were studied. Mothers of study subjects were interviewed to illicit the requisite information, using a predesigned and pretested questionnaire. Anthropometric measurements were taken using standard technique for each study subject. Data collected was analyzed using statistical tool.Results: Based on WHO classification, the prevalence of stunting and severe stunting was observed to be 31.28% and 13.59%. 14.62% study subjects were wasted while 6.15% subjects had severe wasting. 40.51% had mild-moderate malnutrition and 7.95% had severe malnutrition as per the criteria of mid upper arm circumference. Malnutrition was significantly associated with the age of the study subjects (p <0.05). The prevalence of malnutrition decreased significantly with higher maternal education and among those whose mother’s were housewives (p <0.05). Lower birth order and middle socio-economic class was associated with decreased prevalence of malnutrition (p <0.05). Conclusions: The nutritional status of children is dependent on maternal education and occupation and socioeconomic status. Nutrition education can have a significant effect in its reduction.

scholarly journals Prevalence and Determinants of Malaria Infection Among Children of local farmers in Central Malawi

2020 ◽  
Author(s):  
Emmanuel Chilanga ◽  
Delphine Collin-Vezina ◽  
Heather MacIntosh ◽  
Claudia Mitchel ◽  
Katrina Cherney
Keyword(s):  
Rural Areas ◽  
Partner Violence ◽  
Diagnostic Tests ◽  
Malaria Infection ◽  
Formal Education ◽  
National Level ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five

Abstract Background: Malaria is a leading cause of morbidity and mortality among children under five in Malawi. Children from rural areas of central Malawi have a high burden of malaria morbidity compared to other regions. The goal of this study was to examine the prevalence and determinants of malaria infection among children in rural areas of the Dowa district in central Malawi.Methods: A multistage cross-sectional study design was used to systematically sample 523 child‑mother dyads from postnatal clinics. A survey was administered to mothers to collect quantitative data, and rapid diagnostic tests were used to test for malaria infection in children. The main outcome was positive malaria diagnostic tests in children. Logistic regressions were used to determine risk factors associated with malaria among children aged 2 to 59 months.Results: The prevalence of malaria among children under five years was 35.4%. The results of the multivariate analyses showed that children of mothers who experienced recent intimate partner violence (IPV) were more likely to be diagnosed with malaria (AOR: 1.88, 95% CI: 1.19–2.97; P = 0.007) than children of mothers who did not. Children of mothers who had no formal education were more likely to be diagnosed with malaria (AOR: 2.77, 95% CI: 1.24–6.19; P = 0.013) than children of mothers who had received secondary education. In addition, children in the age ranges of 2 to 5 months and 6 to 11 months were less likely to be diagnosed with malaria (AOR: 0.21, 95% CI: 0.10–0.46; P = 0.000 and AOR: 0.43; 95% CI: 0.22–0.85; P = 0.016, respectively) than children in the age range of 24 to 59 months. Conclusion: The study found that the prevalence of malaria infection among children in the study area was comparable to the national level. We propose that in addition to available malaria control programs, further attention should be paid to children whose mothers have no formal education, children aged 24 to 59 months and mothers that are exposed to IPV in the area.

Rural-Urban Disparity of Under-Five Mortality Rate in Iran from 1990 to 2015

2020 ◽  
Author(s):  
Younes MOHAMMADI ◽  
Manoochehr KARAMI ◽  
Nasrin DERAKHSHANZADEH
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Maternal Age ◽  
National Level ◽  
Demographic And Health Surveys ◽  
Live Births ◽  
Under Five ◽  
Rural And Urban Areas ◽  
Rural And Urban

Background: To estimate under-five mortality rate (U5MR), as one of the sustainable development goals, in rural and urban areas of Iran from 1990 to 2015. Methods: We used the data collected through two censuses and one Demographic and Health Surveys (DHS). We analyzed the Summary Birth History (SBH) data via 2 approaches including Maternal Age Cohort (MAC) and Maternal Age Period (MAP) methods, and then, Gaussian Process Regression (GPR) was used to combine the three trends and with 95% uncertainty. Finally, Ratio of U5MR in rural to urban was calculated. Results: At the national level and in urban areas, U5MR in 1990, 2000, 2010, and 2015 was 66, 34, 18, and 13 per 1000 live births, respectively. Corresponding values in rural areas in 1990, 2000, 2010, and 2015 was 129, 64, 31, and 21 per 1000 live births, respectively. Accordingly, the ratio of U5MR in rural to urban at the national level was 1.93, 1.86, 1.72 and 1.63 in the same years. At the sub-national level, U5MR in urban areas ranged from 11.2 per 1000 live births in Isfahan to 18.2 per 1000 live births in Hormuzagn. U5MR in rural areas ranged from 14.1 per 1000 live births in Isfahan to 29.5 per 1000 live births in Sistan and Baluchistan Conclusion: There is still a gap between rural and urban areas, although it has decreased during the 25 years of the study. To alleviate this gap, health system authorities are advised to plan appropriate actions using multisectoral capacities

scholarly journals Food Consumption And Energy Intake In Rural Areas of Bangladesh

KYAMC Journal ◽  
2017 ◽  
Vol 7 (1) ◽  
pp. 687-690
Author(s):  
Md Mostaque Hossain Ansari ◽  
Sailendra Nath Biswas ◽  
Md Zulfikar Ali
Keyword(s):  
Energy Intake ◽  
Rural Areas ◽  
Fruits And Vegetables ◽  
National Level ◽  
Sampling Technique ◽  
Animal Protein ◽  
Cluster Sampling ◽  
Daily Consumption ◽  
Food Diversity ◽  
Per Capita

Background: Food supply at national level is satisfactory in Bangladesh though per capita energy intake and diversity of food are important concerns with food security in rural areas. Objectives: This nutritional survey was carried out to observe the food diversity at household level and to estimate per capita energy intake in rural areas for assessing the existing situation.Methodology: A total 648 households were surveyed in three villages selected by cluster sampling technique. Informations were collected on the basis of 24 hours' recall of respondents about the food items and the amount consumed at the household on the previous day and eating occasions by structured partially close ended questionnaire.Results: Food diversity was on the 'Border line' (3-6 score) at 65.28% of the household. Rice and oil were consumed at every house but per capita intake of meat, fish, fruits and vegetables were 64.67, 62.07, 20.11 and 57.78 gram respectively where those were consumed. Per capita food energy intake per day was 2695 kcal from 150.45 gram (616.85 k cal) of protein, 397.50 gram (1590.01 k cal) of carbohydrate and 52.49 gram (488.13 k cal) of fat from all sources giving 22.89%, 59.00 % and 18.11% of the dietary energy respectively.Interpretation & Conclusion: Diversity of foods and consumption of animal protein, vegetables and fruits intake were lower in amount.Recommendation: Recommendation was made to initiate health education program for inclusion of varieties of food and increase daily consumption of animal protein, fruits and vegetables.KYAMC Journal Vol. 7, No.-1, Jul 2016, Page 687-690

scholarly journals Anemia Affects One in Four Indian Men and Has Not Decreased in the Last Decade: Trends, Geographic Variability and Predictors from Nationally Representative Data, 2005 to 2016

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1830-1830
Author(s):  
Anjali Pant ◽  
Samuel Scott ◽  
Phuong Nguyen ◽  
Kapil Yadav ◽  
Purnima Menon
Keyword(s):  
Rural Areas ◽  
Fixed Effects ◽  
National Level ◽  
Family Health ◽  
Wealth Quintile ◽  
Multivariate Logistic Regression Model ◽  
Public Health Issue ◽  
Cluster Sampling ◽  
Geographic Variability ◽  
Indian Men

Abstract Objectives Men have largely been ignored in anemia-focused research and policies. We sought to examine trends, geographic variability, and predictors of anemia in Indian men between 2005 and 2016. Methods We used data for men aged 15–54 years (n = 172,717) from the 2005–2006 and 2015–2016 rounds of India's National Family Health Survey. To examine national and subnational anemia trends and variability, we computed survey-weighted prevalence at each timepoint for the full sample and by state. To examine factors associated with anemia, we used a multivariate logistic regression model adjusted for cluster sampling design, state fixed effects and survey year. Factors examined included age, marital status, education, residence type, employment type, wealth, diet, household characteristics, religion and caste. Results Anemia among Indian men remained unchanged (23%) between 2006 and 2016 at the national level but trends varied by state (−6 to + 13 percentage points). In 2016, anemia was highest in adolescents 15–19 years (29%) and adults 50–54 years (30%). Higher likelihood of anemia was predicted by residence in rural areas (adjusted odds ratio (AOR) 1.24, 95% CI 1.18–1.30), employment in more labor intensive activities (AOR 1.12, 95% CI 1.07–1.18), being in the lowest wealth quintile (AOR 1.36, 95% CI 1.26–1.46), lack of improved sanitation facilities (AOR 1.11, 95% CI 1.06–1.16), Hindu religion (AOR 1.14, 95% CI 1.08–1.20) and being from a disadvantaged caste (AOR 1.07, 95% CI 1.01–1.12). Completing higher education (AOR 0.62, 95% CI 0.58–0.67) and consumption of animal source food at least once per week (AOR 0.98, 95% CI 0.96–0.99) predicted lower anemia prevalence. Conclusions Anemia among men remains a moderate public health issue in India, thus men should be considered in anemia prevention policies. Improvements in diets, wealth, sanitation and education through family-targeted public programs may reduce anemia among men. Funding Sources Bill and Melinda Gates Foundation.

scholarly journals Prevalence and Determinants of Malaria Infection Among Children of local farmers in Central Malawi

2020 ◽  
Author(s):  
Emmanuel Chilanga ◽  
Delphine Collin-Vezina ◽  
Heather MacIntosh ◽  
Claudia Mitchel ◽  
Katrina Cherney
Keyword(s):  
Rural Areas ◽  
Partner Violence ◽  
Malaria Infection ◽  
Formal Education ◽  
National Level ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Children Under Five ◽  
Under Five ◽  
Control Programs

Abstract Background: Malaria is a leading cause of morbidity and mortality among children under five in Malawi, and especially among those from rural areas of central Malawi. The goal of this study was to examine the prevalence and determinants of malaria infection among children in rural areas of the Dowa district in central Malawi.Methods: A multistage cross-sectional study design was used to systematically sample 523 child‑mother dyads from postnatal clinics. A survey was administered to mothers and a rapid malaria infection diagnostic test was administered to children. The main outcome was positive malaria diagnostic tests in children. Logistic regressions were used to determine risk factors associated with malaria among children aged 2 to 59 months.Results: The prevalence of malaria among children under five years was 35.4%. Results suggest that children of mothers who experienced recent intimate partner violence were more likely to be diagnosed with malaria (AOR: 1.88, 95% CI: 1.19–2.97; P = 0.007) than children of mothers who did not. Children of mothers who had no formal education were more likely to be diagnosed with malaria (AOR: 2.77, 95% CI: 1.24–6.19; P = 0.013) than children of mothers who had received secondary education. Children aged 2 to 5 months and 6 to 11 months were less likely to be diagnosed with malaria (AOR: 0.21, 95% CI: 0.10–0.46; P = 0.000 and AOR: 0.43; 95% CI: 0.22–0.85; P = 0.016, respectively) than children aged 24 to 59 months. Conclusion: We found that the prevalence of malaria infection among children in the study area was comparable to the national level. In addition to available malaria control programs, further attention should be paid to children whose mothers have no formal education, children aged 24 to 59 months and children of mothers that are exposed to IPV in the area.

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