scholarly journals Effects of Parental Education and Wealth on Early Childhood Stunting in Bangladesh

2021 ◽  
Author(s):  
Tuhinur Rahman Chowdhury ◽  
Sayan Chakrabarty ◽  
Muntaha Rakib ◽  
Stephen Winn ◽  
Jason Bennie
Keyword(s):  
Lower Risk ◽  
Parental Education ◽  
Wealth Index ◽  
Health Issues ◽  
Cross Sectional ◽  
Severe Stunting ◽  
Child Stunting ◽  
Using Data ◽  
Socioeconomic And Demographic Factors ◽  
Childhood Stunting

Abstract Background Malnutrition is considered to be a major public health challenge, which is associated with a range of health issues, including childhood stunting. Stunting is a reliable and well-recognized indicator of chronic childhood malnutrition. The objective of this study is to determine the effects of parental education and wealth on different specification of stunting among 17490 children below five years of age in Bangladesh. Methods Correlates of child stunting were examined using data generated by a cross-sectional cluster survey conducted in Bangladesh in 2019. The data includes a total of 17490 children (aged < 5 years) from 64400 households. Multiple logistic regressions were used to determine the risk factors associated with child stunting and severe stunting. Results The prevalence of stunting and severe stunting for children was 25.96% and 7.97%, respectively. Children aged 24 to <36 months [Odds Ratio (OR) = 2.65, 95% CI: 2.30, 3.05] and aged 36 to <48 months [OR = 2.33, 95% CI: 2.02, 2.69] had more risk of stunting compared to the children aged <6 months. Children from Sylhet division had the greatest risk of stunting of all the eight divisions [OR = 1.26, 95% CI: 1.09, 1.46]. Children of secondary complete or higher educated mothers were less likely to develop stunting [OR = 0.66, 95% CI: 0.56, 0.79] compared with children of mothers having no education at all. Similarly, children of secondary complete or higher educated father [OR = 0.74, 95% CI: 0.63, 0.87] were found to have lower risk of stunting compared with children whose father hadn’t any education. Substantially lower risk of stunting was observed among children whose mother and father both completed secondary education or above [OR = 0.59, 95% CI: 0.52, 0.69]. Children from richest households [OR = 0.49, 95% CI: 0.41, 0.58] had 51 % smaller odds on stunting compared to children from poorest families. Conclusions After controlling for socioeconomic and demographic factors, parental education and household position in wealth index were found as to be the most important determinants of child stunting in Bangladesh.

scholarly journals Alcohol-related harm to others in England: a cross-sectional analysis of national survey data

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e021046 ◽  
Author(s):  
Caryl Beynon ◽  
David Bayliss ◽  
Jenny Mason ◽  
Kate Sweeney ◽  
Clare Perkins ◽  
...  
Keyword(s):  
Negative Impact ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Harm To Others ◽  
Using Data ◽  
Socioeconomic And Demographic Factors ◽  
The Impact ◽  
Alcohol Related Harm ◽  
Related Harm

ObjectivesTo estimate the prevalence, the frequency and the perpetrators of alcohol-related harm to others (AHTO) and identify factors associated with experiencing harm and aggressive harm.DesignCross-sectional survey.SettingEngland.ParticipantsAdults (general population) aged 16 and over.Outcome measuresPercentage of respondents who experienced harm. Socioeconomic and demographic factors associated with the outcomes. Outcomes were (1) experienced harm/did not experience harm and (2) experienced aggressive harm (physically threatened, physically hurt and forced/pressured into something sexual)/did not experience an aggressive harm (no aggressive harm plus no harm at all).ResultsData to support a response rate calculation were not collected; 96.3% of people surveyed completed the AHTO questions. The weighted sample was 4874; 20.1% (95% CI 18.9 to 21.4, N=980) reported experiencing harm in the previous 12 months and 4.6% (95% CI 4.0 to 5.4, N=225) reported experiencing an aggressive harm. Friends and strangers were the dominant perpetrators. Most harms (74.8%) occurred less than monthly. Factors associated with experiencing harm were: younger age (p<0.001), drinking harmfully/hazardously (p<0.001), white British (p<0.001 compared to other white groups and Asian groups and p=0.017 compared to black groups), having a disability (p<0.001), being educated (p<0.001 compared to no education) and living in private rented accommodation (p=0.004 compared with owned outright). Being in the family stage of life (defined as having children in the household) had significantly lower odds of harm (p=0.006 compared to being single), as did being retired (p<0.001 compared to being employed). Factors associated with experiencing an aggressive harm were similar.ConclusionsThis exploratory study, using data collected through the Alcohol Toolkit Survey, shows that AHTO affects 20.1% of the population of England. Even apparently minor harms, like being kept awake, can have a negative impact on health, while aggressive harms are clearly of concern. Using a standard methodology to measure harm across studies would be advantageous. Policies that focus on alcohol must take into consideration the impact of drinking on those other than the drinker.

scholarly journals What Drives Outpatient Care Costs in Kenya? An Analysis With Generalized Estimating Equations

2021 ◽  
Vol 9 ◽  
Author(s):  
Ngugi Mwenda ◽  
Ruth Nduati ◽  
Mathew Kosgei ◽  
Gregory Kerich
Keyword(s):  
Outpatient Care ◽  
Generalized Estimating Equations ◽  
Household Head ◽  
Estimating Equations ◽  
Wealth Index ◽  
Education Level ◽  
Cross Sectional ◽  
Household Spending ◽  
Using Data ◽  
Generalized Estimating

Objective: This study aimed to identify the factors associated with outpatient expenses incurred by households in Kenya.Background: The problem of outpatient healthcare expenses incurred by citizens in countries with limited resources has received little attention. Thus, this study aimed to determine the predictors of household spending on outpatient expenses in Kenya.Method: We conducted a cross-sectional analysis on households in Kenya using data from the 2018 Kenya Household Health Expenditure and Utilization Survey. We applied the generalized estimating equations method to determine the best subset of predictors of outpatient care cost.Findings: The best predictors of outpatient care expenses in Kenya are age, wealth index, and education level of the household head.Conclusions: There were no differences regarding age in the mean spending on outpatient care. Moreover, we found that the cost of outpatient care changes with age in a sinusoidal manner. We observed that rich households spent more on outpatient care, mostly owing to their financial ability. Households whose heads reported primary or secondary school education level spent less on outpatient costs than households headed by those who never went to school.

scholarly journals Caesarian section (CS) delivery in Bangladesh: A nationally representative cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254777
Author(s):  
Foyez Ahmmed ◽  
Muhammad Mahabub Rahaman Manik ◽  
Md. Jamal Hossain
Keyword(s):  
Private Hospital ◽  
Wealth Index ◽  
Cross Sectional Study ◽  
Caesarian Section ◽  
Antenatal Visit ◽  
Clinical Practices ◽  
Cross Sectional ◽  
Nationally Representative ◽  
Mother’S Age ◽  
Socioeconomic And Demographic Factors

A growing trend in the caesarian section (CS) for delivery is a threat to child health as well as maternal health. This study was conducted to identify the potential socioeconomic and demographic factors associated with CS delivery in Bangladesh. Data obtained from the Bangladesh Demographic and Health Survey (BDHS) 2014 has been used for this study. The prevalence of CS delivery among Bangladeshi mothers was 24% (Urban: 36.9%, Rural: 17.9%). A two-level logistic regression showed that mothers having delivery in the private sector or private hospital (adjusted odds ratio [AOR] = 38.70, 95% confidence interval [CI] = 29.58 to 50.62), mother’s age 25–35 years (AOR = 1.73, 95% CI = 1.26 to 2.37), wealth index average (AOR = 1.61, 95% CI = 1.15 to 2.27) and rich (AOR = 1.80, 95% CI = 1.29 to 2.51), antenatal visit 1–2 (AOR = 2.31, 95% CI = 1.47 to 3.64) and ≥ 3 (AOR = 3.68, 95% CI = 2.35 to 5.76), overweight mothers (AOR = 1.44, 95% CI = 1.09 to 1.90), multiple births (AOR = 3.87, 95% CI = 1.15 to 12.58), husband’s occupation professional/technical/managerial (AOR = 1.68, 95% CI = 1.15 to 2.47) were significantly more prone to CS delivery. Also, place of residence, number of family members, birth order, child’s size during birth, and divisions of Bangladesh, were potentially associated with CS delivery. The current epidemiological findings and evidence suggest adopting and implementing some urgent clinical practices and strict guidelines in the healthcare system to avoid unnecessary CS delivery in Bangladesh.

scholarly journals Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville

2020 ◽  
Vol 5 (8) ◽  
pp. e002478
Author(s):  
Jessica Hall ◽  
Merrilyn Walton ◽  
Floris Van Ogtrop ◽  
David Guest ◽  
Kirsten Black ◽  
...  
Keyword(s):  
Rural Areas ◽  
Cross Sectional ◽  
Household Level ◽  
Individual Level ◽  
Explanatory Variables ◽  
Child Stunting ◽  
Mixed Regression ◽  
Women And Children ◽  
Using Data ◽  
The Individual

Half the children under the age of 5 years in Papua New Guinea (PNG) are undernourished, more than double the global average with rural areas disproportionately affected. This study examines factors associated with stunting, wasting and underweight in cocoa growers’ children (<5 years) in the Autonomous Region of Bougainville (ARoB), using data from a comprehensive 2017 cross-sectional livelihoods survey. Sixteen independent predictors for stunting, wasting and underweight were selected based on the UNICEF Conceptual Framework of Determinants of Undernutrition. We used multilevel logistic mixed regression models to measure the association of the explanatory variables with stunting, wasting and underweight. At the household level, the adjusted OR (aOR) of stunting (aOR=1.71,95% CI 1.14 to 2.55) and underweight (aOR=2.11, 95% CI 1.16 to 3.82) increased significantly among children from households with unimproved toilet facilities. The aOR for underweight also increased among children from households without access to clean drinking water (aOR=1.97, 95% CI 1.19 to 3.29). Short maternal stature was significantly associated with child stunting, the odds increased as maternal height decreased (from 150 to <155 cm, aOR=1.52, 95% CI 1.02 to 2.26) (<150 cm, aOR=2.37, 95% CI 1.29 to 4.35). At the individual level, the odds of a child being underweight increased with birth order (second born, aOR=1.92, 95% CI 1.09 to 3.36; third born, aOR=6.77, 95% CI 2.00 to 22.82). Compared with children less than 6 months, children aged 6–23 months and 24–59 months had a higher odds of being stunted (aOR=3.27, 95% CI 1.57 to 6.78 and aOR=2.82, 95% CI 1.40 to 5.67) and underweight (aOR=4.83, 95% CI 1.36 to 17.24 and aOR=4.59, 95% CI 1.29 to 16.26). No variables were found to be significant for wasting. Interventions that simultaneously target key life stages for women and children and the underlying social and environmental determinants are required for sustained improvements to undernutrition.

scholarly journals Is the lack of smartphone data skewing wealth indices in low-income settings?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mathieu J. P. Poirier ◽  
Till Bärnighausen ◽  
Guy Harling ◽  
Ali Sié ◽  
Karen A. Grépin
Keyword(s):  
Low Income ◽  
Wealth Index ◽  
Ordinary Least Squares ◽  
Household Surveys ◽  
Full Model ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Wald Tests ◽  
Using Data

Abstract Background Smartphones have rapidly become an important marker of wealth in low- and middle-income countries, but international household surveys do not regularly gather data on smartphone ownership and these data are rarely used to calculate wealth indices. Methods We developed a cross-sectional survey module delivered to 3028 households in rural northwest Burkina Faso to measure the effects of this absence. Wealth indices were calculated using both principal components analysis (PCA) and polychoric PCA for a base model using only ownership of any cell phone, and a full model using data on smartphone ownership, the number of cell phones, and the purchase of mobile data. Four outcomes (household expenditure, education level, and prevalence of frailty and diabetes) were used to evaluate changes in the composition of wealth index quintiles using ordinary least squares and logistic regressions and Wald tests. Results Households that own smartphones have higher monthly expenditures and own a greater quantity and quality of household assets. Expenditure and education levels are significantly higher at the fifth (richest) socioeconomic status (SES) quintile of full model wealth indices as compared to base models. Similarly, diabetes prevalence is significantly higher at the fifth SES quintile using PCA wealth index full models, but this is not observed for frailty prevalence, which is more prevalent among lower SES households. These effects are not present when using polychoric PCA, suggesting that this method provides additional robustness to missing asset data to measure underlying latent SES by proxy. Conclusions The lack of smartphone data can skew PCA-based wealth index performance in a low-income context for the top of the socioeconomic spectrum. While some PCA variants may be robust to the omission of smartphone ownership, eliciting smartphone ownership data in household surveys is likely to substantially improve the validity and utility of wealth estimates.

scholarly journals Parental Education and Parental Time with Children

2008 ◽  
Vol 22 (3) ◽  
pp. 23-46 ◽  
Author(s):  
Jonathan Guryan ◽  
Erik Hurst ◽  
Melissa Kearney
Keyword(s):  
Child Care ◽  
Parental Education ◽  
Leisure Activities ◽  
College Education ◽  
Home Production ◽  
Cross Sectional ◽  
High School Degree ◽  
Parental Time ◽  
Cost Of Time ◽  
Using Data

This paper examines parental time allocated to the care of one's children. Using data from the recent American Time Use Surveys, we highlight some interesting cross-sectional patterns in time spent by American parents as they care for their children: we find that higher-educated parents spend more time with their children; for example, mothers with a college education or greater spend roughly 4.5 hours more per week in child care than mothers with a high school degree or less. This relationship is striking, given that higher-educated parents also spend more time working outside the home. This robust relationship holds across all subgroups examined, including both nonworking and working mothers and working fathers. It also holds across all four subcategories of child care: basic, educational, recreational, and travel related to child care. From an economic perspective, this positive education gradient in child care (and a similar positive gradient found for income) can be viewed as surprising, given that the opportunity cost of time is higher for higher-educated, high-wage adults. In sharp contrast, the amount of time allocated to home production and to leisure falls sharply as education and income rise. We conclude that child care is best modeled as being distinct from typical home production or leisure activities, and thinking about it differently suggests important questions for economists to explore. Finally, using data from a sample of 14 countries, we explore whether the same patterns holds across countries and within other countries.

scholarly journals Deficiência de ferro em obesos acompanhados ambulatorialmente no pré-operatório de cirurgia bariátrica

2020 ◽  
Vol 35 (1) ◽  
pp. 93-96
Author(s):  
Ítalo José Lemos de Oliveira ◽  
Raquel de Arruda Campos Benjamim ◽  
Thayanne Breckenfeld Meneses ◽  
Ana Jessyca da Silva Costa ◽  
Jarson Pedro da Costa Pereira ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Iron Deficiency ◽  
Serum Iron ◽  
University Hospital ◽  
Nutritional Deficiencies ◽  
Health Issues ◽  
Cross Sectional ◽  
Health Crisis ◽  
Study Population ◽  
Using Data

Introduction: Obesity is an internationally health crisis. The bariatric surgery offers treatment to reduce body weight, induce remission of obesity-related diseases and improve quality of life. Nutritional deficiencies may have been installed even before surgery, and preoperative anemia is an independent risk factor. Thus, the present study aims to evaluate iron deficiency in obese candidates for bariatric surgery, attending a nutrition ambulatory of a university hospital in Recife/Brazil. Methods: Cross-sectional, descriptive study. The patients were evaluated according to sex, age, weight, body mass index (BMI), iron and ferritin levels. Iron deficiency was classified by levels <50 Ug/dl and <65 Ug/dl for women and men, respectively. The ferritin levels classified as deficient were those below 15 ng/ml for both sexes. Data collection was performed from May 2017 to June 2018, using data from nutrition setting’s monitoring forms. Data were tabulated and analyzed using Microsoft Excel software version 10. Results: 75 patients were included, with prevalence of women (85.3%), mean BMI of 47.99 ± 7.56 kg/m2. The means of serum iron (n = 70) and ferritin (n = 60) were 76.33 ± 37.06 Ug/dl and 160.82 ± 159.43 ng/ml, respectively. There was a high prevalence of serum iron deficiency (62.9%); however, ferritin was deficient in only 1.7% of the study population. Conclusion: This study observed an important presence of iron deficiency in the group of obese patients evaluated, with the greatest sensitivity being detected by means of serum iron. The biochemical evaluation of the patient who will be submitted to the bariatric procedure is important, in order to avoid health issues and postoperative complications, thus helping in their recovery.

scholarly journals Maternal Perceptions of Child's Nutritional Status in Rural, Indigenous Ixil Women from Guatemala

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 879-879
Author(s):  
Ana Palacios ◽  
Jeanne Freeland-Graves
Keyword(s):  
Body Size ◽  
Nutritional Status ◽  
Actual Body ◽  
Short Stature ◽  
Healthy Children ◽  
Maternal Perceptions ◽  
Double Burden ◽  
Cross Sectional ◽  
Severe Stunting ◽  
Child Stunting

Abstract Objectives To describe maternal perceptions of child's body image in a sample of indigenous women and children from the Ixil ethnic group in Guatemala. Methods A cross-sectional, semi-structured survey was administered to a sample of 46 mothers of 2 to 6-year-old children. The survey included questions on maternal, child and sociodemographic factors and perceptions of the child's nutritional status, and a silhouette scale with differing body sizes. Anthropometry was measured for both mothers and children and used to calculate Body Mass Index (BMI) and anthropometric z-scores for the children, based on international protocols. Pearson and Spearman correlations were used to evaluate associations between mother and child's BMIs and maternal short stature with child stunting, respectively. Results Mean age of children was 45.9 ± 12.6 months; 57% exhibited moderate stunting [height-for-age z-score (zHAZ) ←2], 25% had severe stunting (zHAZ ←3) and 20% were at risk of overweight, or overweight (zBMI &gt; 1). In the mothers, 82% had short stature (&lt;150.3 cm), 25% were overweight (BMI = 25–30 kg/m2), and 20% obese (BMI &gt; 30 kg/m2). The 43.5% of mothers underestimated their child's actual body size; 54% accurately denoted it, and 2.2% overestimated their child's actual body size. When asked the question “which of these silhouettes are healthy children,” silhouettes representing overweight/obese children were interpreted as “healthy” by 28% of the mothers. In addition, 18% misclassified underweight children as “healthy.” Maternal and child BMIs were not significantly correlated (r = 0.3, P = 0.07), nor maternal short stature with child stunting, (r = 0.02, P = 0.86). Conclusions The double burden of malnutrition in this sample is clear and evident. Almost half of the women misclassified the nutritional status of their child. Further research is suggested to understand if the misconceptions of a child's nutritional status influence their feeding practices in this population. Funding Sources The Mathile Institute for the Advancement of Human Nutrition.

scholarly journals Nutritional status of under-five children in rural Bangladesh

2020 ◽  
Vol 9 (3) ◽  
pp. 205
Author(s):  
Liton Chandra Sen ◽  
Md. Sabbir Ahmed ◽  
Abu Shoeb Md. Touhiduzzaman ◽  
Soumitra Mandal ◽  
AH Towfique Ahmed ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Cross Sectional Study ◽  
Z Score ◽  
Cross Sectional ◽  
Severe Stunting ◽  
Under Five ◽  
Under Five Children ◽  
Z Scores ◽  
Childhood Stunting ◽  
Height For Age

A cross-sectional study was carried out in Dumki Upazila of Patuakhali district in Bangladesh to assess the prevalence of stunting, wasting and underweight among the under-five children. Anthropometric measurements were taken from all children, aged 0-59 months in the studied area using wooden height board and digital weight machine. We used WHO Anthro software for analyzing the z scores of the children. A total of 4409 (2296 boys and 2113 girls) under five children were counted for anthropometric analysis.  Regarding the Height-for-age Z-score (HAZ), the study revealed that the prevalence of stunting was 27.10% (95% CI: 25.8-28.5) of the children while 7.80% (95% CI: 7-8.6) were severe stunting. By assessing the Weight-for-height Z-score (WHZ), the study showed that 11.20% (95% CI: 10.3-12.1) were wasting whereas 3% (95% CI 2.5-3.5) were severe wasting. According to Weight-for-age Z-score (WAZ), about 18.20% (95% CI: 17-19.3) were underweight and 4.1% (95% CI: 3.5-4.7) were underweight. The findings of the study show that prevalence of stunting is very high. Focusing on childhood stunting is a high priority, and there should be comprehensive efforts to increase the overall nutritional status of the under-five children in this area.

ADOLESCENT BEHAVIOR IN UNWANTED PREGNANCY PREVENTION

2019 ◽  
Vol 1 (1) ◽  
pp. 41-46
Author(s):  
Arip Ambulan Panjaitan
Keyword(s):  
Sexual Behavior ◽  
Reproductive Health ◽  
Risky Sexual Behavior ◽  
Parental Education ◽  
Unwanted Pregnancy ◽  
Sampling Technique ◽  
Adolescent Behavior ◽  
Cluster Sampling ◽  
Chi Square ◽  
Cross Sectional

Introduction: Adolescent are at high risk of unwanted pragnency, including abortion, STIs, HIV/AIDS. Risky sexual behavior is one of the entrance transmissions of unwanted pregnancy. Such behavior can be influenced by various factors, beyond and within the individual factors. Teens need the support and motivation in deciding not to do risky sexual behavior. The purpose of this study was to investigate the determinants of adolescent behavior in the prevention of unwanted pregnancy.Methods: This research used cross-sectional design. The populations were students of senior high school in District Sintang. The were 123 respondents chosen by cluster sampling technique for this study. All data were collected using questionnaires and then analysed using bivariate (chi square) and multivariate analysis (logistic regression).Results: The results showed that the majority of respondents did not have good knowledge about the prevention of unwanted pregnancy. Related variable is the level of parental education (p=0.001), the support of parents/guardians (p=0.009), support teachers (p=0.005), peer support (p=0.039), residency (p=0.009), a pastime activity (p=0.000), knowledge of adolescents about reproductive health (p=0.016), perception ability of adolescents (p=0.006) and attitude of adolescents (p=0.049). Adolescent self-perception abilities are variables that most influence on the behavior of adolescents in the prevention of unwanted pregnancy.Conclusions: Efforts to improve reproductive health programs should be early and adolescent have responsibilities as well as healthy behaviors.

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