Distance to Healthcare Facility and Lady Health Workers’ Visits Reduce Malnutrition in under Five Children: A Case Study of a Disadvantaged Rural District in Pakistan

Abstract

This study accesses the impact of lady health worker (LHWs) visits in the community and distance to a healthcare facility on the nutritional status of under-five children. Additionally, it explores the perceptions and attitudes of the community about the performance of LHWs. A self-administered instrument was applied to gather data on different parameters, such as children’s height, age, weight, and socioeconomic status from 384 rural households in a marginalized district of Punjab province with the help of a purposive random sampling technique. The binary logistic regression model was employed for the computation of the probability of malnutrition. The prevalences of stunting, underweight children, and wasting in the district were 34.8%, 46.1%, and 15.5%, respectively. The logistic results illustrate that those households in which LHW visits occur regularly within 15 days (OR = 0.28 with 95% CI: 0.09–0.82) have a lower probability of malnutrition prevalence among their children. The distance to the health facility shows that the odds of malnutrition were higher from 3–4 Kilometers (Km) (OR = 2.61, 95% CI: 0.85–8.14), and odds were also higher for the ≥5 km category (OR = 2.88, 95% CI: 0.94–8.82). Children from richer families had lower chances of being malnourished (OR = 0.28, 95% CI: 0.07–1.14). Furthermore, the respondents show a positive attitude towards LHWs. They have given the first rank to their performance being beneficial to mothers and childcare, especially on checkups and safe deliveries, while they have shown negative responses and given lower ranks to their performance due to irregular visits (6th rank) and poor community awareness (7th rank). We conclude that LHWs’ regular visits to targeted households and less distance to healthcare facilities reduce the malnutrition risk in under-five children.

Epidemiological profile of malnutrition status and spatial distribution of children and adolescents living with HIV/AIDS in Tanzania

“…There is conflicting evidence for significant association between malnutrition status and health facility type and ownership. The difference in proportion among categories may be due to limited access to certain health services offered at the facility level, shortages in medical supplies [43] or distance to healthcare facilities, which increase the risk of child malnutrition [44]. A study in Haiti demonstrated that an integrated facility‐based intervention involving the micronutrient and HIV programme improved BMI, food security, clinic attendance [23] and promotion of health facilities against anthropometric failure [45].…”

Associated factors of malnutrition status among children and adolescents living with HIV in Tanzania: Individual-level analysis and marginal effect estimation

“…35 Furthermore, participants who received CTC services at clinics and hospitals had lower marginal estimation compared to those attending at dispensaries and health centers. This could be explained by limited access to specific healthcare provided at the facility level, as some studies reported shortage in medicine supply 36 and an increased distance to healthcare facilities has been shown to increase the risk of child malnutrition. 37 Additionally, imbalances in supportive supervision, training, mentorship, financial capacity and reliance on donors, can significantly affect the provision of comprehensive CTC services to participants across facilities under public, private, or FBO ownership.…”

Comparison of Different Nutritional Screening Approaches and the Determinants of Malnutrition in Under-Five Children in a Marginalized District of Punjab Province, Pakistan

“…Due to the lack of family socioeconomics in India, the greater part of the poor families had at least one weak or underweight child compared to non-poor families [ 49 ]. In Pakistan, a review of past studies showed that families with poor financial status were the foremost factor contributing to the malnourishment of the children [ 14 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ]. By enhancing economic and social status, households have additional resources to afford food and nutrition for their children.…”