scholarly journals Political Economy, Capability Development, and Fundamental Cause: Integrating Perspectives on Child Health in Developing Countries

2017 ◽  
Vol 23 (1) ◽  
pp. 62-92 ◽  
Author(s):  
Rebekah Burroway
Keyword(s):  
Political Economy ◽  
Developing Countries ◽  
Child Health ◽  
Maternal Education ◽  
Well Being ◽  
Household Wealth ◽  
Child Malnutrition ◽  
Demographic And Health Surveys ◽  
Individual Level ◽  
Fundamental Cause

Several dominant theoretical perspectives attempt to account for health disparities in developing countries, including political economy, the capability approach, and fundamental cause. This study combines the perspectives in a multi-level analysis of child malnutrition and diarrhea in order to gain a more comprehensive understanding of who faces increased health risks and who is shielded from them. Using the Demographic and Health Surveys and World Bank data, I estimate a series of models that predict the likelihood of child malnutrition and diarrhea, based on a set of country- and individual-level explanatory variables. Results suggest that at the individual-level, household wealth and maternal education are the most robust predictors of child health. These social factors are even more important than more proximate factors like clean water or sanitation. At the country-level, gross domestic product (GDP) per capita reduces malnutrition, but does not significantly affect incidence of diarrhea. Contrary to the predominant economic development paradigm, health care and education are more important in accounting for the prevalence of diarrhea than GDP. Finally, trade in and of itself is not harmful to well-being in developing countries. It is when countries become too dependent on one or a few commodities that trade starts to have detrimental costs. Thus, a synthesis of theoretical frameworks best illustrates the complex web of social structural factors that manifest as unequal life chances for children.

scholarly journals SickKids Centre for Global Child Health - Chronic Child Malnutrition Project Placement

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Zahra Hussain
Keyword(s):  
Child Health ◽  
Motor Development ◽  
Maternal Education ◽  
Multivariable Analysis ◽  
Household Wealth ◽  
Acute Malnutrition ◽  
Child Malnutrition ◽  
Global Health Research ◽  
Access To Health Services ◽  
Mortality And Morbidity

I completed a 16-week practicum at the SickKids Centre for Global Child Health where I was a part of the stunting team led by Dr. Nadia Akseer under the research portfolio of Dr. Zulfiqar A. Bhutta. Linear growth stunting, or low height-for-age, is a visible and easily measurable physical manifestation of chronic malnutrition. Children who are stunted have higher rates of mortality and morbidity, as well as experience suboptimal cognitive and motor development. At the time of my placement, one of the team's main projects was a mixed-methods study involving an in-depth evaluation of policies, programs, and factors that have contributed to the decline of under-5 stunting in Ethiopia from 2000-2016. I worked on a variety of components of the manuscript for this study. These included narratives for country demographics, background statistics as well as migration and remittance trends. I also contributed to a literature review on factors that have contributed to a reduction in stunting in Ethiopia in relation to an adapted version of UNICEF's conceptual framework for malnutrition. In addition to the manuscript, I conducted a multivariable analysis of the 2016 determinants of under-5 wasting in Ethiopia. Wasting, or low weight for height, is a form of acute malnutrition and is also a risk factor for mortality. I applied a hierarchical analysis to wasting indicators such as disease, household wealth, maternal education and access to health services. I used Ethiopia's 2016 Demographic and Health Survey data and additional data sources provided through various Ethiopian government ministries. Overall my practicum was a rich interdisciplinary learning experience which allowed me to develop my quantitative and qualitative research skills. I also gained a deeper understanding of global health research processes and the multi-sectoral nature of combating child malnutrition.

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 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 Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008–2009

2012 ◽  
Vol 15 (9) ◽  
pp. 1715-1727 ◽  
Author(s):  
Peninah K Masibo ◽  
Donald Makoka
Keyword(s):  
Health Survey ◽  
Urban Areas ◽  
Child Nutrition ◽  
Maternal Education ◽  
Sampling Technique ◽  
Household Wealth ◽  
Demographic And Health Survey ◽  
Demographic And Health Surveys ◽  
Double Burden ◽  
Percentage Points

AbstractObjectiveTo report on the trends and determinants of undernutrition among children <5 years old in Kenya.DesignData from four nationwide Kenya Demographic and Health Surveys, conducted in 1993, 1998, 2003 and 2008–2009, were analysed. The Demographic and Health Survey utilizes a multistage stratified sampling technique.SettingNationwide covering rural and urban areas in Kenya.SubjectsThe analysis included 4757, 4433, 4892 and 4958 Kenyan children aged <5 years in 1993, 1998, 2003 and 2009–2009, respectively.ResultsThe prevalence of stunting decreased by 4·6 percentage points from 39·9 % in 1993 to 35·3 % in 2008–2009, while underweight decreased by 2·7 percentage points from 18·7 % in 1993 to 16·0 % in 2008–2009. The effects of household wealth, maternal education and current maternal nutritional status on child nutrition outcomes have changed dynamically in more recent years in Kenya. Inadequate hygiene facilities increased the likelihood of chronic undernutrition in at least three of the surveys. Small size of the child at birth, childhood diarrhoea and male gender increased the likelihood of undernutrition in at least three of the surveys. Childhood undernutrition occurred concurrently with maternal overnutrition in some households.ConclusionsThe analysis reveals a slow decline of undernutrition among young children in Kenya over the last three decades. However, stunting and underweight still remain of public health significance. There is evidence of an emerging trend of a malnutrition double burden demonstrated by stunted and underweight children whose mothers are overweight.

scholarly journals Racial and Ethnic Disparities in Health

2019 ◽  
Author(s):  
Samia Tasmim ◽  
Sarah Collins
Keyword(s):  
Health Disparities ◽  
Healthcare Access ◽  
Ethnic Disparities ◽  
Well Being ◽  
Racial And Ethnic Disparities ◽  
Individual Level ◽  
Fundamental Cause ◽  
Race Ethnicity ◽  
Unequal Opportunities ◽  
Racial Ethnic

Racial and ethnic disparities in health stem from the historical legacy and continued patterns of unequal resources and treatment on the basis of race/ethnicity in society (Hummer and Hamilton 2019; Williams and Sternthal 2010). Health disparities encompass differences in physical health, mental health, all-cause and cause-specific mortality risk, activity limitations, healthcare access and utilization, and other metrics of well-being. Researchers have identified a variety of explanations for racial/ethnic health disparities, including socioeconomic inequality, institutional- and individual-level discrimination, residential segregation, early-life circumstances, and health behaviors, among others. However, unequal opportunities on the basis of race/ethnicity remain the fundamental cause of health disparities (Hummer 1996; Phelan and Link 2015).

scholarly journals Using National Survey Data From Nigeria to Assess Maternal-Child Dietary Concordance and Inform Nutrition Program Strategy

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 389-389
Author(s):  
Nadia Akseer ◽  
Rebecca A Heidkamp ◽  
Andrew Thorne-Lyman
Keyword(s):  
Maternal Education ◽  
Fruits And Vegetables ◽  
Dietary Diversity ◽  
Maternal Diet ◽  
Food Group ◽  
Household Wealth ◽  
Demographic And Health Surveys ◽  
Food Groups ◽  
Diet Diversity ◽  
Maternal Child

Abstract Objectives Improving child diet diversity is a policy priority in many settings. Multiple factors influence complementary feeding practices in low-income countries including household food access, caregiver-level factors and cultural practices. Child's dietary data is often available in national surveys (i.e., Demographic and Health Surveys, DHS), but they typically lack diet data from adults. The 2018 Nigeria DHS was among the first to measure food group intake in both young children and women. We describe the relationship between child and maternal diet diversity in Nigeria and highlight implications for design of infant and young child feeding (IYCF) programs. Methods Using the Nigeria DHS 2018 dataset, we estimated consumption of individual food groups in the previous 24 hours as well as minimum dietary diversity for children 6–23 months (MDD-C) and their mothers, women 15–49 years (MDD-W) using WHO-UNICEF definitions. We compare rates of concordance and discordance between n = 8975 mother-child pairs for individual food groups and MDD using McNemar's tests. Probit regression was used to identify drivers of MDD-C. Results Nationally, 22% of children achieve MDD-C; 51% of mothers achieve MDD-W. For both populations, the most commonly consumed group is grains, roots and tubers (&gt;80%) Dairy and eggs are the least consumed. Maternal-child (age 12–23 months) discordance is highest for consumption of legumes and nuts (36%), vitamin A rich fruits and vegetables (39%) and other fruits and vegetables (57%); mothers consume these more frequently. Children are more likely than mothers to consume dairy (19% vs 8%) and eggs (8% vs 4%). Maternal-child food group discordance is consistently higher for children 6–11months than children 12–23 months. Results vary at state level and by maternal age group. Children's MDD probability is increased by MDD-W (27%, P &lt; 0.001), higher maternal education (8%, P &lt; 0.01) and household wealth (7%, P &lt; 0.01). Conclusions Maternal and child diet diversity is suboptimal in Nigeria. Maternal diet is a primary driver of child diet in Nigeria. Legumes and nuts and fruits and vegetables are available but not consistently fed to children; an important finding for IYCF program design. The forthcoming DHS-8 core questionnaire will provide child and maternal diet data for more than 90 countries. Funding Sources Bill & Melinda Gates Foundation.

scholarly journals 1498Community-level risk factors for birth size of child in selected developing countries (1992-2018): multilevel analysis

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rahul Bawankule ◽  
Abhishek Singh
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Significant Risk ◽  
Binary Logistic Regression ◽  
Community Level ◽  
Demographic And Health Surveys ◽  
Birth Size ◽  
Level Variation ◽  
Logistic Regression Models ◽  
Individual Level

Abstract Background We aimed to identify emerging community-level risk factors for birth size in the last two decades in developing countries, particularly in Bangladesh, India, Indonesia, and Nigeria, having the highest burden of low birth weight (LBW) births globally. Methods We used data from multiple rounds of the Demographic and Health Surveys (DHS) conducted throughout the last two decades in the selected countries. We applied multilevel binary logistic regression models and estimated the intra-correlation coefficient (ICC) and median odds ratio (MOR) with a 95% confidence interval (CI) to analyze community-level variation in the birth size of child. Results The odds of having a smaller than average size birth increased by 1.28 times (95% CI: 1.11-1.79) in Bangladesh (2014), 3.03 times (95% CI: 2.90-3.18) in India (2015-16), 1.40 times (95% CI: 1.28-1.58) in Indonesia (2017) and 2.32 times (95% CI: 2.15-2.53) in Nigeria (2018) when women moved from low-risk to high-risk communities. The children residing in communities with a higher level of female illiteracy, higher level of inadequate antenatal care visits (ANC), higher use of unimproved toilet facilities were more likely to born with smaller than average birth size during 1992-2018. Conclusions The study confirms a significant community-level variation in smaller than average birth size among all analysed countries. Community with higher levels of female illiteracy, inadequate ANC visits, use of unimproved toilet facilities emerged as significant risk factors throughout the last two decades. Key messages The community-level risk factors have an independent association with the birth size of child regardless of individual-level characteristics of women and children.

scholarly journals Two decades of regional trends in vaccination completion and coverage among children aged 12-23 months: an analysis of the Uganda Demographic Health Survey data from 1995 to 2016

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Gerald Okello ◽  
Jonathan Izudi ◽  
Immaculate Ampeire ◽  
Frehd Nghania ◽  
Carine Dochez ◽  
...  
Keyword(s):  
Child Health ◽  
Health Survey ◽  
Maternal Education ◽  
Statistical Significance ◽  
Public Health Intervention ◽  
Household Wealth ◽  
Childhood Vaccination ◽  
Demographic Health Survey ◽  
Health Card ◽  
Vaccination Completion

Abstract Background Childhood vaccination is an important public health intervention but there is limited information on coverage, trends, and determinants of vaccination completion in Uganda at the regional level. We examined trends in regional vaccination coverage and established the determinants of vaccination completion among children aged 12-23 months in Uganda. Methods We analyzed data from the women’s questionnaire for the 1995-2016 Uganda Demographic Health Survey (UDHS). Vaccine completion was defined as having received a dose of Bacillus-Calmette Guerin (BCG) vaccine; three doses of diphtheria, pertussis, and tetanus (DPT) vaccine; three doses of oral polio vaccine (OPV) (excluding OPV given at birth); and one dose of measles vaccine. We performed Chi-square tests to compare vaccination completion by socio-demographic factors stratified by 10 sub-regions: Eastern, East Central, Central 1, Central 2, Kampala, Karamoja, North, Western, West Nile, and Southwest. We performed logistic regression analysis for each of the regions to identify factors associated with vaccination completion at 5% level of statistical significance. Results Overall vaccination completion was 48.6% (95%CI, 47.2, 50.1) and ranged from 17.3% in Central 1 to 65.9% in Southwest. Vaccination completion rates declined significantly by 10.4% (95% confidence interval (CI), − 16.1, − 4.6) between 1995 and 2000, and increased significantly by 10.0% (95% CI, 4.6, 15.4) between 2000 and 2006, and by 5.4% (95% CI, 0.2, 10.6) between 2006 and 2011. Maternal education (secondary or higher level), receipt of tetanus toxoid (TT) during pregnancy, and possession of a child health card were associated with vaccination completion across all the sub-regions. Other factors like place of residence, religious affiliation, household wealth, maternal age, childbirth order, size of child at birth, and place of delivery were associated with vaccination completion but differed between the 10 sub-regions. Conclusion Besides considerable regional variations, the vaccination completion rate among children aged 12-23 months in Uganda remains suboptimal despite the availability of vaccines. Maternal education, receipt of TT, and possession of a child health card are associated with a higher likelihood of vaccination completion among children aged 12-23 months in all the regions of Uganda. Interventions to improve the utilization of vaccination services in Uganda should consider these factors.

scholarly journals A Review on Antenatal Care in Developing Country Like India

2021 ◽  
Vol 8 (5) ◽  
pp. 397-403
Author(s):  
Irin Ephrem ◽  
Ateendra Jha ◽  
A. R Shabaraya
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Maternal Health ◽  
Antenatal Care ◽  
Rural Areas ◽  
Maternal Education ◽  
Health Centre ◽  
Well Being ◽  
Maternal Health Care ◽  
Urban And Rural Areas

Antenatal care is the ‘care before birth’ to promote the well-being of mother and fetus, and it is essential to reduce maternal morbidity and mortality, low-weight births and perinatal mortality. The care for the mother during pregnancy, during delivery, and after delivery is important for the wellbeing of the mother and the child. Maternal health-care vary within developing countries, which shows differences between affluent and poor women, and between women living in urban and rural areas. Health care service provision in India is very diverse, with rural services achieving considerably less coverage than their urban counterparts. It was found that following factors affects the antenatal care utilization maternal education, husband’s education, marital status, availability, cost, household income, women’s employment, media exposure and having a history of obstetric complications. If a woman visited health centre three or more than three times, her chances were 31 percent higher to deliver in an institution. Poorer women may prefer home-based delivery care. Lack of affordability might explain the large poor–rich inequalities in professional delivery attendance within urban and rural areas. Traditional beliefs and ideas about pregnancy also influence on antenatal care use. Older women would have accumulated knowledge on maternal health care and therefore would likely have more self-confidence on pregnancy and childbirth and thus, may give less importance to obtaining institutional care. Incomplete access and underutilization of modern healthcare services are major causes for poor health in the developing countries. There is a need of enhancing community awareness about the importance for educating women about early detection of complications during pregnancy and promptly seeking care, and about the importance of giving birth in a health facility. Keywords: Antenatal Care, Developing Countries.

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.

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