Environmental predictors of stunting among children under-five in Somalia: cross-sectional studies from 2007 to 2010

Abstract

BackgroundStunting among children under five years old is associated with long-term effects on cognitive development, school achievement, economic productivity in adulthood and maternal reproductive outcomes. Accurate estimation of stunting and tools to forecast risk are key to planning interventions. We estimated the prevalence and distribution of stunting among children under five years in Somalia from 2007 to 2010 and explored the role of environmental covariates in its forecasting.MethodsData from household nutritional surveys in Somalia from 2007 to 2010 with a total of 1,066 clusters covering 73,778 children were included. We developed a Bayesian hierarchical space-time model to forecast stunting by using the relationship between observed stunting and environmental covariates in the preceding years. We then applied the model coefficients to environmental covariates in subsequent years. To determine the accuracy of the forecasting, we compared this model with a model that used data from all the years with the corresponding environmental covariates.ResultsRainfall (OR = 0.994, 95 % Credible interval (CrI): 0.993, 0.995) and vegetation cover (OR = 0.719, 95 % CrI: 0.603, 0.858) were significant in forecasting stunting. The difference in estimates of stunting using the two approaches was less than 3 % in all the regions for all forecast years.ConclusionStunting in Somalia is spatially and temporally heterogeneous. Rainfall and vegetation are major drivers of these variations. The use of environmental covariates for forecasting of stunting is a potentially useful and affordable tool for planning interventions to reduce the high burden of malnutrition in Somalia.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3320-6) contains supplementary material, which is available to authorized users.

Infant and young child nutritional status and their caregivers’ feeding knowledge and hygiene practices in internally displaced person camps, Somalia

“…Another key predictor of malnutrition was the lack of close monitoring of drought forecasts. The study showed that closer monitoring of climatic trends could provide valuable information for nutritional intervention planning [5]. In 2017, when our study was Never (n and %) 0 0 0 carried out, a nationwide famine was making assistance necessary to IDPs both in the camps and outside of them.…”

“…Sustainable humanitarian assistance in terms of counselling or education in care practices may enhance caregivers' resilience in the long-term [31] when combined with other emergency efforts from time to time [4,5]. The distress caused by long term insecurity, lack of income and drought and the effect of recurrent emergencies on the emotional well-being and mental health of caregivers and children was not investigated in this study although it needs further attention.…”

“…In Kenya, following post-election violence in 2007/2008, HIV infection and other chronic conditions were identified as significant causes of morbidity and mortality among their IDP population [3]. In a crosssectional nutritional assessment survey from 2007 to 2010, with the aim of informing the better targeting of nutritional interventions, two of the predictors of malnutrition risk among children under the age of 5 in Somalia were the presence of infectious diseases and the likelihood of drought [5]. Somalia is a country with frequent humanitarian crises due to droughts and civil war.…”

Development and Application of Novel Caregiver Hygiene Behavior Measures Relating to Food Preparation, Handwashing, and Play Environments in Rural Kenya

“…A mother’s behavior during her pregnancy and the caregiver’s behavior in early childhood can either mitigate or exacerbate the impact of modifiable environmental conditions on growth outcomes. Caregivers dictate or influence many exposures to a child in the first 1000 days of life [ 14 ], and while research has explored the biological and environmental factors that contribute to stunting [ 5 , 7 , 15 , 16 , 17 , 18 , 19 ], there is limited evidence on how caregiver behaviors may impact the outcome of stunting in their children in low income settings.…”

Malnutrition and morbidity trends in Somalia between 2007 and 2016: results from 291 cross-sectional surveys

“…On top of the two mentioned famines, the rates of acute malnutrition have remained at very high levels since the start of the conflict, and they are among the highest in the world today. The causes of different forms of malnutrition in Somalia are multifactorial and linked to food insecurity and to morbidity and inadequate caring practices, all of them related to the disruption of peoples livelihood, destitution, large-scale population displacement and the limited access to basic services 2–4…”