Nutritional status as a central determinant of child mortality in sub‐Saharan Africa: A quantitative conceptual framework

Abstract

Child mortality is a major public health problem in sub-Saharan Africa and is influenced by nutritional status. A conceptual framework was proposed to explain factors related to undernutrition. Previously proposed conceptual frameworks for undernutrition do not consider child mortality and describe factors related to undernutrition from a qualitative viewpoint only. A structural equation modelling approach was applied to the data from World Bank and FAO databases collected from over 37 sub-Saharan countries from 2000 to the most recent update. Ten food groups, exclusive breastfeeding, poverty and illiteracy rates, and environmental hygiene were investigated in relation to underweight, stunting, low birthweight, and child mortality.Standardized beta coefficient was reported, and graphical models were used to depict the relations among factors related to under-five mortality in sub-Saharan Africa.Child mortality in sub-Saharan Africa ranged between 76 and 127 × 1,000. In the same period, low birthweight rate was about 14%. Poverty and illiteracy are confirmed to affect health resources, which in turn influenced nutritional status and child mortality. Among nutritional factors, exclusive breastfeeding had a greater influence than food availability. Low birthweight, more than underweight and stunting, influenced child mortality.Structural equation modelling is a suitable way to disentangle the complex quantitative framework among factors determining child mortality in sub-Saharan Africa.Acting on poverty at the base appear to be the more effective strategy along with improvement of breastfeeding practice and improvement of hygiene conditions.

Child Electronic Growth Monitoring System: An innovative and sustainable approach for establishing the Kaduna Infant Development (KID) Study in Nigeria

“…1 Globally, the developing countries, including sub-Saharan Africa (SSA), disproportionally bear the burden of childhood stunting and its sequelae. [2][3][4][5] Childhood stunting is a risk factor for adverse health outcomes in adults such as obesity, signifying the need for growth monitoring of children to identify stunting early in life. 6 Contemporary evidence indicates a rising trend of childhood overweight and obesity in developing countries.…”

Mortality in relation to profiles of clinical features in Ghanaian severely undernourished children aged 0–59 months: an observational study

“…Despite attempts to control malaria infection, it remains endemic in Ghana and a leading cause for hospital admission and death (23) . The first sub-cluster is common in Africa due to poor hygiene conditions (24,25) .…”

“…In addition to the typical features of malnutrition, children often present with an array of complications and infections. Respiratory, urinary and gastrointestinal infections are common in children requiring admission for SAM (6)(7)(8)(9) . Infectious diseases such as HIV, malaria and tuberculosis are very common in Africa and worsen the already compromised clinical condition (10)(11)(12)(13)(14) .…”

Trends in the association between educational assortative mating, infant and child mortality in Nigeria

“…When under-5 mortality is decomposed, the findings from the 21-cross-country study may not be a complete reflection of infant mortality in particular. While morbidities of preventable diseases such as malaria, diarrhea, chronic malnutrition, and so on are common causes of child deaths [24,25], deaths within the first 11 months of life (including neonates) have been linked to preterm births, short birth intervals, fertility behavior, household wealth, and environmental factors among other things [26][27][28][29][30]. Many of these factors concern decisions relating to health, fertility, or the household.…”