Lifetime economic impact of the burden of childhood stunting attributable to maternal psychosocial risk factors in 137 low/middle-income countries

Abstract

IntroductionThe first 1000 days of life is a period of great potential and vulnerability. In particular, physical growth of children can be affected by the lack of access to basic needs as well as psychosocial factors, such as maternal depression. The objectives of the present study are to: (1) quantify the burden of childhood stunting in low/middle-income countries attributable to psychosocial risk factors; and (2) estimate the related lifetime economic costs.MethodsA comparative risk assessment analysis was performed with data from 137 low/middle-income countries throughout Asia, Latin America and the Caribbean, North Africa and the Middle East, and sub-Saharan Africa. The proportion of stunting prevalence, defined as <−2 SDs from the median height for age according to the WHO Child Growth Standards, and the number of cases attributable to low maternal education, intimate partner violence (IPV), maternal depression and orphanhood were calculated. The joint effect of psychosocial risk factors on stunting was estimated. The economic impact, as reflected in the total future income losses per birth cohort, was examined.ResultsApproximately 7.2 million cases of stunting in low/middle-income countries were attributable to psychosocial factors. The leading risk factor was maternal depression with 3.2 million cases attributable. Maternal depression also demonstrated the greatest economic cost at $14.5 billion, followed by low maternal education ($10.0 billion) and IPV ($8.5 billion). The joint cost of these risk factors was $29.3 billion per birth cohort.ConclusionThe cost of neglecting these psychosocial risk factors is significant. Improving access to formal secondary school education for girls may offset the risk of maternal depression, IPV and orphanhood. Focusing on maternal depression may play a key role in reducing the burden of stunting. Overall, addressing psychosocial factors among perinatal women can have a significant impact on child growth and well-being in the developing world.

Multidimensional predictors of common mental disorders among Indian mothers of 6- to 24-month-old children living in disadvantaged rural villages with women’s self-help groups: A cross-sectional analysis

“…4 The sample size with anthropometric measures was slightly smaller (n = 1,412 overall; n = 1,206 low CMD; n = 206 high CMD). 5 Coded as positive if mother reported that child suffered from cough, fever or diarrhea in the previous 2 weeks. 6 Ratio of individuals aged <15yrs or >55yrs to those aged 16-55yrs.…”

“…Common mental disorders (CMD) such as depression and anxiety are important yet often neglected issues in high poverty contexts, where problems that are easier to see, measure, or treat often draw public health investments. Depression is the leading cause of disability worldwide [1] and CMD have been linked to lost productivity [2], increased healthcare expenses [3], poor physical and cognitive development in children [4], and high long-term costs [5]. In India, a systematic review found that 20% of mothers suffer from postpartum depression [6], but little information is available on the prevalence of CMD in mothers beyond the postpartum period.…”

Nutrition, Hygiene and Stimulation Education for Impoverished Mothers in Rural Uganda: Effect on Maternal Depression Symptoms and Their Associations to Child Development Outcomes

“…Inadequate infant and young child feeding practices increase the risk of morbidity and mortality, especially in low resource settings. Moreover, childhood morbidity has been associated with maternal depression symptoms in such settings [4]. The prevalence of postnatal maternal depression symptoms in 2015 was 50% in South Africa [5] while in Zimbabwe the prevalence increased from 16 to 34% between 1995 and 2015 [6].…”

Malnutrition and poverty in India: does the use of public distribution system matter?

“…While the national and local government has been implementing many welfare schemes in the key domain of livelihood, health, nutrition, education for reduction of poverty, the effect of these schemes varied by type of services, outcome variable and country-specific [6][7][8][9]. Malnutrition among children is positively associated with poverty and has many adverse short and long term consequences; illhealth, cognitive impairment, childhood mortality in short term and the likelihood of developing the noncommunicable diseases in the long term [10][11][12][13][14][15]. Nutrition sensitive interventions for children are increasingly emphasized in the poverty reduction programme of developing countries.…”