Fragile Environment, Seasonality and Maternal and Childhood Undernutrition in Bangladesh

Mohsena, Masuda; Hossain, Mahabub; Chakraborty, Barnali; Bayes, Abdul; Rahman, Ataur

doi:10.1017/s002193201700044x

Cited by 14 publications

(20 citation statements)

References 29 publications

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“…Our study suggested seasonal household food insecurity as an independent predictor of decreased WHZ (Table 5), which is in accordance with previous investigations 57, 58 . This could be attributable to seasonal fluctuations in household food consumption patterns 11, 59 , and some scholars describe seasonality as a grossly neglected dimension of poverty 11, 17, 60 .…”

Section: Discussionsupporting

confidence: 93%

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: A cohort study

Kabalo

Lindtjørn

2022

Preprint

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Background and objectives: Over centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas. Methods: This cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for one year (2017 - 2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (e.g., household participation in a social safety net program and water access) and some time-varying factors (e.g., household food insecurity). Results: Child wasting rates (i.e., low weight-for-heigh Z-scores) varied with seasonal household food insecurity (ᵪ2 trend = 15.9, p = 0.001), but stunting rates (i.e., low height-for-age Z-scores) did not. Household participation in a social safety net program was associated with decreased stunting (p = 0.001) and wasting (p = 0.002). In addition to its association with decreased wasting (p = 0.001), protected drinking water access enhanced the association between household participation in a social safety net program and decreased stunting (p = 0.009). Absence of a household latrine (p = 0.011), lower maternal education level (p = 0.001), larger family size (p = 0.004), and lack of non-farming income (p = 0.002) were associated with increased child stunting. Conclusions: Seasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programs, such as the Ethiopian social safety net program, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition. Key terms: Z-scores; Social safety net program; Water access

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Section: Discussionsupporting

confidence: 93%

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: A cohort study

Kabalo

Lindtjørn

2022

Preprint

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“…Even with the rapid social changes and economic development, the distribution of wealth is unequal within the population. This inequality explains the sizable proportion of undernourished women in this rural community and other parts of the country [ 31 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Body mass index in early-pregnancy and selected maternal health outcomes: Findings from two cohorts in Bangladesh

Rahman¹,

Rahman²,

Pervin³

et al. 2020

Journal of Global Health

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Background Maternal nutrition is one of the most influential factors that affect the health of the mother and her offspring and remains a significant public health challenge globally. There is a lack of studies evaluating the trends of maternal nutrition and its impact on the burden of pregnancy complications from low-income countries, including Bangladesh. We aimed to determine the burden of early-pregnancy nutrition status based on body mass index (BMI), and the associations of nutritional status with pregnancy-induced hypertension (PIH), cesarean section (CS) delivery, perineal tear and postpartum hemorrhage (PPH) in a rural area in Bangladesh. Methods This prospective study analyzed data from two cohorts: the Maternal, Neonatal, and Child Health (MNCH) project carried out from January 2008 to June 2010, and the Preterm and Stillbirth Study, Matlab (PreSSMat) conducted from October 2015 to March 2018. In total, information of 9287 women who gave birth from the two cohorts was available for analysis. Early-pregnancy BMI was categorized into underweight, normal-weight, and overweight groups. The change in the burden of malnutrition between two cohort periods and the associations between women’s BMI and maternal health outcomes were presented in odds ratios (ORs) with their 95% confidence interval (CI). Results Between the two cohort periods, the prevalence of underweight decreased from 17.5% to 15.4%, and overweight increased from 10.8% to 20.9%. The risk of being overweight in pregnant women was about two times (OR = 2.19; 95% CI = 1.94-2.46) higher in the PreSSMat cohort than in the MNCH cohort. After multivariate-adjustment for socio-demographic factors, the pooled ORs of PIH, CS delivery, perineal tear, and PPH were 2.41 (95% CI = 1.95-2.99), 2.12 (95% CI = 1.86-2.41), 2.46 (95% CI = 1.54-3.92), and 1.68 (95% CI = 1.12-2.53), respectively, in women with overweight compared to the normal-weight group. Conclusions The results confirmed the existence of a double burden of malnutrition in rural women in Bangladesh. Women with overweight had an increased risk of selected pregnancy complications. The findings call for the adoption of appropriate prenatal counseling and preparedness tailored to women’s nutritional status to prevent possible adverse health outcomes.

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“…56 Our study suggested seasonal HFI as an independent predictor of decreased WHZ (table 5), which is in accordance with previous investigations. 57 58 This could be attributable to seasonal fluctuations in household food consumption patterns, 11 59 and some scholars describe seasonality as a grossly neglected dimension of poverty. 11 17 60 Meanings and possible explanations Seasonal HFI could contribute to decreased WHZ indices in rural Ethiopia, suggesting that this population is vulnerable to food insecurity.…”

Section: Open Accessmentioning

confidence: 99%

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study

Kabalo

Lindtjørn

2022

BMJ Open

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Background and objectivesOver centuries, Ethiopia has experienced severe famines and periods of serious drought, and malnutrition remains a major public health problem. The aims of this study were to estimate seasonal variations in child stunting and wasting, and identify factors associated with both forms of child malnutrition in drought-prone areas.MethodsThis cohort study was conducted among a random sample of 909 children in rural southern Ethiopia. The same children were followed for 1 year (2017–2018) with quarterly repeated measurements of their outcomes: height-for-age and weight-for-height indices (Z-scores). Linear regression models were used to analyse the association between both outcomes and baseline factors (eg, household participation in a social safety net programme and water access) and some time-varying factors (eg, household food insecurity).ResultsChild wasting rates varied with seasonal household food insecurity (ᵪ2trend= 15.9, p=0.001), but stunting rates did not. Household participation in a social safety net programme was associated with decreased stunting (p=0.001) and wasting (p=0.002). In addition to its association with decreased wasting (p=0.001), protected drinking water access enhanced the association between household participation in a social safety net programme and decreased stunting (p=0.009). Absence of a household latrine (p=0.011), lower maternal education level (p=0.001), larger family size (p=0.004) and lack of non-farming income (p=0.002) were associated with increased child stunting.ConclusionsSeasonal household food insecurity was associated with child undernutrition in rural Ethiopia. Strengthening community-based food security programmes, such as the Ethiopian social safety net programme, could help to reduce child undernutrition in drought-prone areas. Improving clean water access and sanitation could also decrease child undernutrition.Key terms:Z-scores; Social safety net program; Water access

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Fragile Environment, Seasonality and Maternal and Childhood Undernutrition in Bangladesh

Cited by 14 publications

References 29 publications

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: A cohort study

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: A cohort study

Body mass index in early-pregnancy and selected maternal health outcomes: Findings from two cohorts in Bangladesh

Seasonality and predictors of childhood stunting and wasting in drought-prone areas in Ethiopia: a cohort study

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