Geographic distribution and socio-economic determinants of women's nutritional status in Mali households

Abstract

Objective: Mali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1?00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali. Design: Demographic and Health Survey data, multistage-stratified cluster sampling methodology. Setting: Rural and urban areas of Mali. Subjects: Non-pregnant women (n 6015) between the ages of 19 and 44 years. Results: Nineteen per cent of the women were overweight or obese while 11 % were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households' use of adequately iodized salt. Conclusions: The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations. Keywords Non-pregnant women BMI Iodized salt utilization MaliMali is one of the poorest countries in Africa, with 72 % of its population surviving on less than $US 1?00 per day. Health and demographic indicators are bleak; life expectancy from birth is 49?8 years and maternal mortality is 580 per 100 000 people. Several studies including the most recent national analysis from the Demographic and Health Surveys (DHS) examining the nutritional situation of children throughout Mali have shown significant numbers of stunted and wasted children (1) . Further, the WHO reports that approximately 30 % of children under 5 years of age are underweight, 40 % are stunted and about 4 % are overweight (2) . Recent research has shown evidence of poor nutrition among adolescent girls in Mali, suggesting that poor nutritional status is not a risk limited to childhood but extends into adolescence (3,4) . Most of the studies concerning the nutritional situation in Mali have focused primarily on infants and children and have ignored adolescents and adults. With the exception of studies related to infant feeding, reproductive health and violence against women, studies related to the health of women in Mali have largely been under-represented. Other field studies in Mali are generally dated and focus on children and infant feeding (5,6)

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