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1 – 10 of 257Collins Afriyie Appiah, Faustina O. Mensah, Frank E. A. Hayford, Vincent A. Awuuh and Daniel Edem Kpewou
The purpose of this study was to identify the predictors of child undernutrition and anemia among children 6–24 months old in the East Mamprusi district, Northern region, Ghana.
Abstract
Purpose
The purpose of this study was to identify the predictors of child undernutrition and anemia among children 6–24 months old in the East Mamprusi district, Northern region, Ghana.
Design/methodology/approach
This cross-sectional study recruited 153 children and their mothers. Weight, height and hemoglobin levels of the children were measured. A structured questionnaire based on the World Health Organization's indicators for assessing infant and young child feeding practices was used to collect data on parents' socioeconomic status, household characteristics, hygiene and sanitation practices, mothers' knowledge on feeding practices such as child's meal frequency and dietary diversity and child morbidity within the past two weeks. Predictors of child nutritional status were determined using multinomial logistic regression analysis.
Findings
Underweight in the children was significantly predicted by maternal knowledge on protein foods (AOR = 0.045, p = 0.008), time of initiation of complementary feeding (AOR = 0.222, p = 0.032) and maternal age (AOR = 9.455, p = 0.017). Feeding child from separate bowls (AOR = 0.239, p = 0.005), minimum meal frequency per child's age (AOR = 0.189, p = 0.007) and time of initiation of complementary feeding (AOR = 0.144, p = 0.009) were significant determinants of stunting among the children. Exclusive breast feeding (AOR = 7.975, p = 0.012) and child's past morbidity (AOR = 0.014, p = 0.001) significantly contributed to anemia among the children.
Research limitations/implications
This is a cross-sectional study and cannot establish causality. The small sample size also limits the generalizability of study findings. However, findings of the study highlight factors which could potentially influence the high rate of child undernutrition in the study setting.
Practical implications
This study identifies determinants of undernutrition in the East Mamprusi district, an underresourced area in Ghana. This information could inform the development/reformulation of locally sensitive key messages and targeted intervention strategies to curb the high levels of child undernutrition in the East Mamprusi district of Ghana.
Originality/value
This study identifies maternal care practices as key potential drivers of undernutrition in a low-resource setting known for high prevalence of child undernutrition. It suggests insight for large-scale studies on the predictors of child undernutrition in Northern Ghana and other resource-poor settings.
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Humphery Garti, Anthony Wemakor, Alexander Badu and Mohammed Bukari
This study aims to estimate the magnitude of undernutrition and its associated factors [especially child health interventions at Child Welfare Clinics (CWCs)] among children in…
Abstract
Purpose
This study aims to estimate the magnitude of undernutrition and its associated factors [especially child health interventions at Child Welfare Clinics (CWCs)] among children in Techiman Municipality, Ghana.
Design/methodology/approach
A facility-based analytical cross-sectional design involving 403 mothers/caregivers with children. Simple random sampling was used to sample study sites and participants. Child health interventions were assessed by adapting items used in the Ghana Demographics and Health Survey. Weight and length of children were measured and used to calculate anthropometric z-scores based on World Health Organization guidelines. Test for associations was performed using bivariate analysis and multivariate logistic regression. Statistical significance was considered at p < 0.05.
Findings
The magnitudes of stunting, wasting and underweight were 20.6% [95% confidence interval (CI): 17–25], 11.4% (95% CI: 9–15), and 9.7% (95% CI: 7–13) respectively. Children aged 12–17 months [odds ratio (OR) = 3.1; CI: 1.3–7.5], male children (OR = 5.2; CI: 2.7–10.0) and children attending CWC 19–22 times (OR = 28.8; CI: 6.6–125) had increased odds of stunting. Additionally, belonging to households with one child under 5 (OR = 2.7; CI: 1.4–5.1) and using borehole/well water (OR = 2.7; CI: 1.4–5.3) were associated with increased odds of stunting. Similarly, being a female (OR = 3.5; CI: 1.6–8.0) and using borehole/well water (OR = 2.1; CI: 1.0–4.2) were associated with increased odds of underweight.
Originality/value
The magnitude of malnutrition, specifically stunting and wasting, exceeds the threshold for public health significance. CWC attendance frequency, age and sex of the child, number of children under five years old in households and water source were significantly associated with undernutrition.
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Gopal Chandra Mandal, Kaushik Bose and Slawomir Koziel
Developing countries like India, accounts for about 40 percent of undernourished children in the World and it is largely due to the result of dietary inadequacy in relation to…
Abstract
Purpose
Developing countries like India, accounts for about 40 percent of undernourished children in the World and it is largely due to the result of dietary inadequacy in relation to their needs. The purpose of this paper was to evaluate the changes in the nutritional status of the children, from their preschool days to the present primary school days.
Design/methodology/approach
The present investigation was conducted at 20 Integrated Child Development Service (ICDS) centers (Center-A) and 15 primary schools (Center-B) in Bali Gram Panchayat, Arambag, Hooghly District of West Bengal, India, at an interval of three to four years. A total of 1,012 children (boys=498; girls=514) aged two to six years old enrolled in these ICDS centers and a total of 603 children (boys=300, girls=303), aged five to ten years were studied from the 15 primary schools who were the beneficiaries of ICDS centers. Underweight (weight-for-age Z-score (WAZ)) and wasting (weight-for height Z-score (WHZ)) were used to assess the nutritional status.
Findings
The nutritional situation (both in case of underweight and wasting) was better in Center B as compared with Center A. In general, the nutritional condition of boys was better than girls. Center had a very significant effect on both WAZ as well as WHZ, irrespective of age and sex. Sex has a significant impact only on WAZ. Interestingly, there was no significant sex-center interaction for both WAZ as well as WHZ. The children of the area were getting Mid Day Meal supplied through the school authorities which was comparatively better than the ICDS centers’ food supplementation. Better monitoring of nutritional supplementation at primary schools may be an important factor.
Practical implications
In ICDS centers, only the Anganwari worker is responsible in running and implementing the programs offered by the Government. However, at primary schools, the active involvement of all the teachers to run the program may have effectively led to have better results. Furthermore, the Government's focus should not be only on the increase the area covered by the ICDS program, but focus should be to increase the quality of food supplied, proper monitoring of the implementation and increase the allocation of funds. Appropriate measures may be taken by the authorities regarding this.
Originality/value
The results of the study will help in policy making in reducing the prevalence of undernutrition.
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Vincent Adocta Awuuh, Collins Afriyie Appiah and Faustina O. Mensah
This study aims to determine the impact of nutrition education intervention on nutritional status of undernourished children aged 6-24 months in the East Mamprusi district of…
Abstract
Purpose
This study aims to determine the impact of nutrition education intervention on nutritional status of undernourished children aged 6-24 months in the East Mamprusi district of Ghana.
Design/methodology/approach
This was a pre-post interventional study. In all, 153 undernourished children of age 6-24 months and their mothers were recruited from five communities. Underweight, stunting, wasting, mid upper arm circumference (MUAC) and haemoglobin (Hb) levels were determined at baseline and after intervention. Nutrition education was given to the mothers for three months based on the nutrition problems identified at baseline assessment.
Findings
There were improvements in underweight, wasting, MUAC and Hb levels among the children after the nutrition education intervention. The level of improvement at post-intervention differed significantly for underweight (−2.4 ± 0.4, −2.2 ± 0.4; p = 0. 001), wasting (−2.2 ± 0.6, −1.9 ± 0.6; p = 0. 001), MUAC (12.3 ± 0.5, 12.9 ± 0.6; p = 0. 001) and Hb level (10.0 ± 1.4, 10.5 ± 1.4; p = 0. 001) of the children compared to pre-intervention (−1.4 ± 1.8, −1.3 ± 1.7; p = 0.314).
Practical implications
There was significant improvement in the nutritional status of the undernourished children after the nutrition education intervention. Community nutritionists and stakeholders involved in nutrition and health issues concerning infants and young children should consider nutrition education, as it could be an inexpensive and effective strategy in combating childhood undernutrition in resource-poor settings.
Originality/value
Findings of this study provide evidence, suggesting nutrition education as a potential strategy to curb the high rates of child undernutrition in resource-poor communities in Ghana. This study provides insight for larger studies on the effectiveness of nutrition education in curbing child malnutrition in deprived communities in Ghana.
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Elina Maseta, T.C. Mosha, Cornelio Nyaruhucha and Henry Laswai
Child undernutrition is a persistent problem in Africa, especially in areas where the poor largely depend on starchy staples with limited access to diverse diets. The purpose of…
Abstract
Purpose
Child undernutrition is a persistent problem in Africa, especially in areas where the poor largely depend on starchy staples with limited access to diverse diets. The purpose of this study was to determine the protein quality, growth and rehabilitating potential of composite foods made from quality protein maize.
Design/methodology/approach
Four composite diets were prepared from quality protein maize, namely quality protein maize-soybeans; quality protein maize-soybeans-cowpeas; quality protein maize-soybeans-common beans and quality protein maize alone. A fifth diet was prepared from common maize alone. The control diet (Chesta®) was made from maize, soybeans, fish, bone and blood meal. The formulations were made to meet the greatest amino acid score and the desired amount of energy and fat according to the FAO/WHO (1985) recommendation for pre-school children. Albino rats were used in evaluating the protein quality of the formulations.
Findings
The food intake was significantly different (p < 0.05) among diets; with a trend of intake decreasing from quality protein maize-based to conventional maize alone diets (apart from the control diet). Protein efficiency ratio and net protein ratio varied significantly (p < 0.05) across the experimental diets. Protein digestibility-corrected amino acid score (PDCAAS) was 80 per cent (quality protein maize-soybeans-cowpeas), 87 per cent (quality protein maize-soybeans), 103 per cent (common maize alone), 98 per cent (quality protein maize), 80 per cent (quality protein maize-soybeans-common beans) and 53 per cent (control).
Research limitations/implications
Two diets, namely quality protein maize-soybeans-common beans and quality protein maize-soybeans-cowpeas, showed the greatest potential to support growth and rehabilitation of undernourished rats. Human trial is proposed to validate the findings.
Originality/value
Despite adoption of quality protein maize in several parts of the country, there are no studies that have been done to determine the potential of quality protein maize to support optimal growth and rehabilitation of undernourished children. The objective of this study was, therefore, to evaluate the protein quality, growth and rehabilitating potential of composite foods made from quality protein maize.
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This paper aims to evaluate the progress made in achieving sustainable development goal-2 (SDG 2) in India, with a focus on ending hunger, ensuring food security, improving…
Abstract
Purpose
This paper aims to evaluate the progress made in achieving sustainable development goal-2 (SDG 2) in India, with a focus on ending hunger, ensuring food security, improving nutrition and promoting sustainable agriculture. The assessment uses data from SDG Index reports, which offer a comprehensive overview of the advancements made by 28 states and 8 union territories (UTs) in India.
Design/methodology/approach
The evaluation is based on information derived from three editions of the SDG Index reports, initially published in 2018 and subsequently in 2019 and 2020. These reports provide a detailed analysis of the status and achievements of different states and UTs in relation to SDG 2. The categorization of states and UTs into aspirant, performer, front runner and achiever categories serves as a crucial framework for assessing the progress.
Findings
Despite concerted efforts by India, the majority of states and UTs are positioned in the aspirant and performer categories, suggesting that significant challenges persist in achieving SDG 2 targets. The results emphasize the necessity for stronger measures to elevate states and UTs to the categories of front-runners and achievers. The persistent challenges of malnutrition, hunger and their economic ramifications require immediate and strategic interventions to address these pressing concerns.
Originality/value
This paper contributes to the existing literature by providing a comprehensive analysis of the progress towards SDG 2 in India, using the insights from the SDG Index reports. The categorization framework used in this assessment offers a nuanced understanding of the challenges faced by different regions, highlighting the original contribution of this study. The findings underscore the urgency of targeted efforts to address malnutrition, hunger and related issues, emphasizing the importance of sustained commitment to achieving SDG 2 for the overall well-being of vulnerable populations.
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Anuska Kalita and Shinjini Mondal
The aim of this paper is to highlight the significance of integrated governance in bringing about community participation, improved service delivery, accountability of public…
Abstract
Purpose
The aim of this paper is to highlight the significance of integrated governance in bringing about community participation, improved service delivery, accountability of public systems and human resource rationalisation. It discusses the strategies of innovative institutional structures in translating such integration in the areas of public health and nutrition for poor communities.
Design/methodology/approach
The paper draws on experience of initiating integrated governance through innovations in health and nutrition programming in the resource‐poor state of Chhattisgarh, India, at different levels of governance structures – hamlets, villages, clusters, blocks, districts and at the state. The study uses mixed methods – i.e. document analysis, interviews, discussions and quantitative data from facilities surveys – to present a case study analyzing the process and outcome of integration.
Findings
The data indicate that integrated governance initiatives improved convergence between health and nutrition departments of the state at all levels. Also, innovative structures are important to implement the idea of integration, especially in contexts that do not have historical experience of such partnerships. Integration also contributed towards improved participation of communities in self‐governance, community monitoring of government programs, and therefore, better services.
Practical implications
As governments across the world, especially in developing countries, struggle towards achieving better governance, integration can serve as a desirable process to address this. Integration can affect the decentralisation of power, inclusion, efficiency, accountability and improved service quality in government programs. The institutional structures detailed in this paper can provide models for replication in other similar contexts for translating and sustaining the idea of integrated governance.
Originality/value
This paper is one of the few to investigate innovative public institutions of a particularly vulnerable and poor region in India, and is unique in that it uses the lenses of governance and community mobilisation to explore this important, and under‐researched, topic.
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Iqramul Haq, Md. Ismail Hossain, Mst. Moushumi Parvin, Ahmed Abdus Saleh Saleheen, Md. Jakaria Habib and Imru- Al-Quais Chowdhury
Malnutrition is one of the serious public health problems especially for children and pregnant women in developing countries such as Bangladesh. This study aims to identify the…
Abstract
Purpose
Malnutrition is one of the serious public health problems especially for children and pregnant women in developing countries such as Bangladesh. This study aims to identify the risk factors associated with child nutrition for both male and female children in Bangladesh.
Design/methodology/approach
This study was conducted among 23,099 mothers or caretakers of children under five years of age from a nationally representative survey named Bangladesh Multiple Indicator Cluster Survey, 2019. This study used chi-square test statistic for bivariate analysis and multinomial logistic regression was used to evaluate the adjusted effects of those covariates on child nutritional status.
Findings
The prevalence of severely malnourished, nourishment was higher for males than females (5.3% vs 5.1%, 77.4% vs 76.8%) while moderately malnourished were higher for females (18.1% vs 17.4%). The findings from the multinomial model insinuated that the mother’s education level, wealth index, region, early child development, mother’s functional difficulties, child disability, reading children's books and diarrhea had a highly significant effect on moderate and severe malnutrition for male children. For the female children model, factors such as mother’s education level, wealth index, fever, child disability, rural, diarrhea, early child development and reading less than three books were significant for moderate and severe malnutrition.
Originality/value
There is a solution to any kind of problem and malnutrition is not an exceptional health problem. So, to overcome this problem, policymakers should take effective measures to improve maternal education level, wealth status, child health.
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Bunga Astria Paramashanti, Yhona Paratmanitya, Ignasia Ika Kusumaningtyas, Tri Mei Khasana, Anafrin Yugistyowati and Tri Siswati
This study aims to examine the association between minimum dietary diversity (MDD) and the concurrence of stunting and overweight (CSO) among children aged 6–23 months.
Abstract
Purpose
This study aims to examine the association between minimum dietary diversity (MDD) and the concurrence of stunting and overweight (CSO) among children aged 6–23 months.
Design/methodology/approach
A cross-sectional study was conducted in Sedayu Subdistrict, Bantul District, Daerah Istimewa Yogyakarta. The authors assessed the concurrence of stunting (height-for-age Z-score below −2 standard deviations SD) and overweight/obesity (Body mass index BMI-for-age Z-score above +2 SD) among a total of 189 children aged 6–23 months as the primary outcome. The authors defined MDD as consuming at least four out of seven food groups using a single 24-h recall. The authors also included other covariates, including sociodemographic characteristics, exclusive breastfeeding history and complementary feeding practices. To identify the factors associated with CSO, this study conducted multiple logistic regression across the study variables using STATA 16.1.
Findings
In the adjusted model, children who met the MDD criterion were associated with a reduced risk of CSO (adjusted odds ratios [OR]: 0.14; 95%confidence interval CI: 0.03–2.43). Compared to boys, girls were more likely to experience CSO (adjusted OR: 5.23; 95%CI: 1.02–26.9). Middle economic status was a protective factor for CSO (adjusted OR: 0.10; 95%CI: 0.01–0.98). This study did not find a significant relationship between CSO and the child’s age, low birth weight, exclusive breastfeeding, energy intake, protein intake, parental education and parental occupation.
Practical implications
This study suggests future programs and policies that promote dietary diversity to reduce the risk of CSO.
Originality/value
This study reveals the association between MDD and the coexistence of stunting and overweight.
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Children in Malaysia, just as children in many other countries, are vulnerable to poverty. They are exposed to different forms of deprivation and the COVID-19 pandemic exacerbated…
Abstract
Children in Malaysia, just as children in many other countries, are vulnerable to poverty. They are exposed to different forms of deprivation and the COVID-19 pandemic exacerbated their predicament. Concerns have been raised about the impact of the pandemic on children’s well-being, as this health crisis had intensified the educational and economic disparities among children in Malaysia, and for some children the impact will be lifelong. It is important to recognise the multidimensionality of poverty in regard to deprivation among poor children; however, such concerns are less pronounced in public policy discussions. Demands for greater policy attention intensified following the increasing number of unemployed parents and bereaved children who lost their parents due to the pandemic. The scope of poverty alleviation policies failed to consider the varying poverty gaps between recipients and the various forms of deprivation experienced by children in poor and larger sized households. As a result, the allocation of funds for the improvement of children’s well-being has been insignificant. The aim of this chapter is to provide a thorough overview of child poverty in developed and developing countries and how child poverty has changed in Malaysia. The analysis in this chapter seeks to provide deep insights on the development of policies that address poverty among children in Malaysia. An analysis on budget appropriations reveals that efforts to address other dimensions of child development were steadily improved, but policy commitments for such purposes need to be intensified in the post-pandemic era when hundreds of thousands of families and children have been plunged into poverty. It is timely for policymakers to acknowledge the need for separate policy considerations for children since they experience poverty differently from adults. The fulfilment of their needs should be prioritised, and the recognition of this fact would produce desirable plans of action for children living in poverty.
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