Afghanistan in transition: call for investment in nutrition

Varkey, Sherin; Higgins-Steele, Ariel; Mashal, Taufiq; Hamid, Bashir Ahmad; Bhutta, Zulfiqar A

doi:10.1016/s2214-109x(14)70362-6

Cited by 16 publications

(20 citation statements)

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“…One previous study in Afghanistan also found high levels of recent diarrhea (26.4 % of children in the previous 2 weeks) [13]. Although very few studies have examined sanitation in Afghanistan specifically, the role of hygienic practices, potable water and sanitation in prevention of diarrhea is well established [15, 19–21].…”

Section: Discussionmentioning

confidence: 99%

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Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study

et al. 2016

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BackgroundSustained civil and military conflict, resulting in large numbers of internally displaced persons (IDP), in combination with rapid urbanization has strained public health and sanitation within cities in Afghanistan. In order to examine the association between preventive sanitary behaviors and diarrhea within two high risk settings located within Kabul, Afghanistan, this study aimed to evaluate the prevalence of hygienic practices and diarrheal illness in an IDP camp and an urban slum.MethodsIn this cross sectional study, a convenience sample of residents of an IDP camp and an urban slum in Kabul, Afghanistan, was used. Participants were asked to describe their hygienic practices and interviewers independently documented household sanitation. The knowledge and attitudes about and practice of hygienic activities to prevent diarrhea were compared between the two settings.ResultsTwo hundred participants, 100 from each setting, were enrolled. Knowledge, attitudes, and practices regarding hygienic activities to prevent diarrhea were greater among the slum dwellers than the IDP. Fewer than half of participants washed their hands with soap before eating or after eating: 31 % of slum dwellers washed before eating compared to 11 % of IDPs (P = 0.0050), and 25 % of slum dwellers washed after defecating compared to 4 % of IDPs (P = 0.0020). The IDPs were more likely to share a latrine (P = 0.0144) and less likely to disinfect their latrine than slum dwellers. Diarrhea in the household within the past 3 months was more common in the IDP camp (54 %) than the slum (20 %) (P = 0.0020).ConclusionsEven though certain sanitary and hygienic practices were more common among slum dwellers than IDPs, the lack of hygienic activities in both setting indicates that interventions to change behavior, like increasing the availability of soap and encouraging hand washing, are needed. Any initiative will have to be developed in the context of pervasive illiteracy among persons in both of these settings.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1789-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…The proportion of the population considered living at or below poverty line is 36.5 %, and only 31.4 % of adolescents and adults aged 15–24 are literate [13]. Infant mortality in Afghanistan is high with a rate of 71 per 1000 live births compared to 15 in Iran and 24 in Kyrgyzstan, two neighboring countries [14].…”

Section: Introductionmentioning

confidence: 99%

Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study

et al. 2016

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“…Though infant and young child nutrition was included in the national child health policy 2004 to 2006 and the national child and adolescent health policy and strategy 2009 to 2013, nutrition has not been sufficiently prioritized in recent national development agendas (Institute of Development Studies, Irish Aid,, & UK Aid, ) . Supporting a call for greater attention to and investment in nutrition (Varkey, Higgins‐Steele, Mashal, Hamid, & Bhutta, ), our study aims to discern the immediate and underlying predictors of complementary feeding of children aged 6–23 months in Afghanistan. We analysed data collected by the 2015 Afghanistan Demographic and Health Survey (AfDHS; CSO et al, ), which provided up to date information on child feeding practices from a large nationally representative sample of infants and young children aged 0–23 months.…”

Section: Introductionmentioning

confidence: 99%

“…, 2014). Supporting a call for greater attention to and investment in nutrition (Varkey, Higgins-Steele, Mashal, Hamid, & Bhutta, 2015), our study aims to discern the immediate and underlying predictors of complementary feeding of children aged 6-23 months in Afghanistan.…”

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confidence: 99%

Predictors of complementary feeding practices in Afghanistan: Analysis of the 2015 Demographic and Health Survey

Aguayo

Arimond

et al. 2018

Maternal & Child Nutrition

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Despite improvements over the past 20 years, high burdens of child mortality and undernutrition still coexist in Afghanistan. Global evidence indicates that complementary feeding (CF) practices predict child survival and nutritional status. Our study aims to describe CF practices in Afghanistan and to discern underlying predictors of CF by analysing data from Afghanistan's 2015 Demographic and Healthy Survey. Multilevel models were constructed comprising potential predictors at individual, household, and community levels and four CF indicators: timely introduction of solid, semi‐solid, or soft foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD) among breastfed children. INTRO prevalence among children aged 6–8 months was 56%, whereas the prevalence of MMF, MDD, and MAD among children aged 6–23 months was 55%, 23%, and 18%, respectively. Of the seven food groups considered, four were consumed by 20% or fewer children: eggs (20%), legumes and nuts (18%), fruits and vegetables (15%), and flesh foods (14%). Increasing child age and more antenatal care visits were significantly and positively associated with greater odds of meeting all CF indicators. Lower household wealth and lower community‐level access to health care services were associated with lower odds of MDD and MAD. Disparities in achieving recommended CF practices were observed by region. CF practices in Afghanistan are poor and significant socioeconomic inequities in CF are observed across the country. Our study calls for urgent policy and programme attention to improve complementary feeding practices as an intrinsic part of the national development agenda.

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“…Likely the effects of poor nutrition among children in Afghanistan are underestimated. Attention to nutrition in the context of pneumonia and diarrhoea includes awareness-raising and interventions to improve infant and young child feeding after common illnesses, which is not widely practised in the country [20, 21] and region [22]. A recent study in one province in Afghanistan showed that children who had diarrhoea in the last two weeks were about two times more likely to be acutely malnourished than children with no such illness [23].…”

Section: Discussionmentioning

confidence: 99%

Ending Preventable Child Deaths from Pneumonia and Diarrhoea in Afghanistan: An Analysis of Intervention Coverage Scenarios Using the Lives Saved Tool

Higgins-Steele

Yousufi

Sultana

et al. 2017

Journal of Tropical Medicine

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Background. Despite improvements in child health, Afghanistan still has a heavy burden of deaths due to preventable causes: 17% of under-5 deaths are due to pneumonia and 12% are due to diarrhoea. Objective. This article describes the situation of childhood pneumonia and diarrhoea in Afghanistan, including efforts to prevent, protect, and treat the two diseases. It estimates lives saved by scaling up interventions. Methods. A secondary analysis of data was conducted and future scenarios were modelled to estimate lives saved by scaling up a package of interventions. Results. The analysis reveals that 10,795 additional child deaths could be averted with a moderate scale-up of interventions, decreasing the under-five mortality rate in Afghanistan from 55 per 1,000 live births in 2015 to 40 per 1,000 in 2020. In an ambitious scale-up scenario, an additional 15,096 lives could be saved. There would be a 71% reduction in child deaths due to these two causes between 2016 and 2020 in the ambitious scenario compared to 47% reduction in the moderate scenario. Conclusion. Significant reductions in child mortality can be achieved through scale-up of essential interventions to prevent and treat pneumonia and diarrhoea. Strengthened primary health care functions and multisector collaboration on child health are suggested.

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Afghanistan in transition: call for investment in nutrition

Cited by 16 publications

References 2 publications

Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study

Hygienic practices and diarrheal illness among persons living in at-risk settings in Kabul, Afghanistan: a cross-sectional study

Predictors of complementary feeding practices in Afghanistan: Analysis of the 2015 Demographic and Health Survey

Ending Preventable Child Deaths from Pneumonia and Diarrhoea in Afghanistan: An Analysis of Intervention Coverage Scenarios Using the Lives Saved Tool

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