Rural Transformation and the Double Burden of Malnutrition Among Rural Youth in Developing Countries

Kadiyala, Suneetha; Aurino, Elisabetta; Cirillo, Cristina; Srinivasan, C. S.; Zanello, Giacomo

doi:10.2139/ssrn.3523118

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…WHZ was overall higher than reference data for all children across the DHS and, although WHZ and overweight did not increase over time in DHS children under 5 years, we have seen increasing levels of overweight and obesity at older ages in Peru and across the Latin America region [28,37,38]. Furthermore, there appeared to be a mean shift towards positive WAZ for urban children over time.…”

Section: Changes Over Timecontrasting

confidence: 60%

“…The positive WHZ trend may reflect historically low WHZ which could have slowed linear growth, subsequently allowing for recovery of WHZ using energy saved by slowing linear growth [10]. However, as Peru continues through its nutrition transition and food environments and behaviours change in the region [6,37,38], the prevalence of overweight will likely increase as the children increase in age. Indeed, previous findings in the Young Lives Peru cohort study of children indicate that this will likely happen both as the individual children grow older and across birth cohorts over time, particularly for those in living in urban areas [37].…”

Section: Changes Over Timementioning

confidence: 99%

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Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

et al. 2022

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Background Peru has historically experienced high rural-to-urban migration. Despite large reductions in undernutrition, overweight is increasing. Elsewhere, internal migration has been associated with differences in children’s growth and nutritional health. We investigated how child growth and nutritional status in Peru varied over time and in association with maternal internal migration. Methods Using data from Demographic & Health Surveys from 1991 to 2017, we assessed trends in child growth (height-for-age [HAZ], weight-for-age [WAZ], weight-for-height [WHZ] z scores) and nutritional health (stunting, underweight, overweight) by maternal adult internal migration (urban [UNM] or rural non-migrant [RNM], or urban-urban [UUM], rural-urban [RUM], rural-rural [RRM], or urban-rural migrant [URM]). Using 2017 data, we ran regression analyses, adjusting for confounders, to investigate associations of maternal migration with child outcomes and the maternal and child double burden of malnutrition. We further stratified by timing of migration, child timing of birth and, for urban residents, type of area of residence. Results are given as adjusted predictive margins (mean z score or %) and associated regression p-values [p]. Results In 1991–2017, child growth improved, and undernutrition decreased, but large differences by maternal migration persisted. In 2017, within urban areas, being the child of a migrant woman was associated with lower WHZ (UUM = 0.6/RUM = 0.5 vs UNM = 0.7; p = 0.009 and p < 0.001 respectively) and overweight prevalence ((RUM 7% vs UNM = 11% [p = 0.002]). Results however varied both by child timing of birth (birth after migration meant greater overweight prevalence) and type of area of residence (better linear growth in children of migrants [vs non-migrants] in capital/large cities and towns but not small cities). In rural areas, compared to RNM, children of URM had higher HAZ (− 1.0 vs − 1.2; p < 0.001) and WAZ (− 0.3 vs − 0.4; p = 0.001) and lower stunting (14% vs 21%; [p < 0.001]). There were no differences by timing of birth in rural children, nor by time since migration across all children. The mother and child double burden of malnutrition was higher in rural than urban areas but no differences were found by maternal internal migration. Conclusions Migration creates a unique profile of child nutritional health that is not explained by maternal ethnic and early life factors, but which varies depending on the pathway of migration, the child timing of birth in relation to migration and, for urban dwellers, the size of the place of destination. Interventions to improve child nutritional health should take into consideration maternal health and migration history.

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Section: Changes Over Timecontrasting

confidence: 60%

Section: Changes Over Timementioning

confidence: 99%

Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

et al. 2022

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“…TBM is a relatively new topic of constructive debate, and it has received limited attention from academics. In the developing world, there has been a great deal of research on the double burden of malnutrition [16,17], including Indonesia [18,19], but TBM has yet to be thoroughly explored due to a lack of data on the determinants of child and maternal malnutrition. In this study, multilevel modeling improved estimation methodologies by allowing us to analyze individual heterogeneities as well as heterogeneities between clusters.…”

Section: Introductionmentioning

confidence: 99%

A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys

Andriani,

Friska,

Arsyi

et al. 2023

BMC Public Health

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Background Although child malnutrition has been reducing, the coexistence in mothers and children of various forms of malnutrition has continued to rise around the world. In the Indonesian context, a knowledge gap exists on the coexistence of multiple malnutrition burdens. This study examines trends in the coexistence of the triple burden of malnutrition (TBM) among mother–child pairs living in the same house and explores multilevel (individual, household, and community) factors associated with TBM in Indonesia. Methods We used data from the 2013 and 2018 Indonesia Basic Health Research, the nationally representative survey of the Indonesian population, as repeated cross-sectional surveys. Study samples were mothers and children (0–59 months old), who resided in the same household and indicated by the same identifier number. The anthropometric measurements of the mothers and children, and the hemoglobin levels of the children were collected. We employed a multilevel mixed-effects model to consider the hierarchical data structure. The model captured the role of cluster, district, provincial differences, and the individual, household, community-level, and TBM status characteristics. Results Of 3,891 mother–child pairs analyzed, 24.9% experienced TBM. Girls had 63% higher odds than boys of TBM (aOR: 1.63; 95% CI: 1.30 to 2.03). Significantly lower odds were found in children of mothers who had a gestational age lower than 37 weeks (aOR: 0.72; 95% CI: 0.55 to 0.94). At the household level, children with a father who had a high-school, primary-school, or no school education had significantly higher odds of TBM than children of fathers who had graduated from academy. Children of mothers who visited Antenatal Care (ANC) no more than 6 times had significantly lower odds (aOR: 0.65; 95% CI: 0.47 to 0.88). Children of mothers who consumed Iron and Folic Acid (IFA) supplements had significantly lower odds. Conclusion TBM is related to characteristics at not just the individual level but also the family and community levels. To achieve significant outcomes, integrated nutrition interventions in Indonesia should also consider family and community factors.

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“…The majority of people still suffering hunger, undernutrition and micronutrient deficiencies are rural (ibid). At the same time rural diets are changing towards higher consumption of highly processed low nutrient quality foods with rising levels of overweight and obesity, albeit still lower than in urban populations (Christian & Dake, 2021;Kadiyala et al, 2019;NCD-RisC, 2019;Popkin, 2015;Popkin et al, 2020). These trends indicate that the triple burden will become concentrated in rural populations, with increasing levels of non-communicable disease and reduced earning capacities for those who can least afford it.…”

Section: Nutritionmentioning

confidence: 99%

Food systems and rural wellbeing: challenges and opportunities

Woodhill

Kishore²,

Njuki³

et al. 2022

Food Sec.

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The future wellbeing of billions of rural people is interconnected with transforming food systems for equity, nutrition, environmental sustainability, and resilience. This article tackles three blind spots in the understanding of rural poverty and vulnerability: the narrow focus on extreme poverty and hunger that hides a much wider set of inequalities and vulnerabilities, insufficient recognition of the diversity of rural households, and an inadequate appreciation of the impact of rapid structural changes in markets, the physical environment, and the political economic context. A better understanding of these areas is necessary for imagining a new policy landscape that can align progress on rural poverty alleviation with a wider transformation of food systems. The article provides a framework for assessing the dynamics of rural wellbeing and food systems change. It looks at the viability of small-scale farming and the diversification of livelihood options needed to overcome rural poverty and inequality. The analysis suggests that the future prosperity of rural areas will depend on policy reforms to address market failures in the food system, which currently work against equity, good nutrition and sustainability. Investments will also be needed to enable rural economies to capture greater value from the food system, particularly in the midstream of food distribution, processing and services. The likely future scale and nature of rural poverty and inequality is such that improved social protection and humanitarian relief schemes that support those in crisis or being left behind will still be essential.

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Rural Transformation and the Double Burden of Malnutrition Among Rural Youth in Developing Countries

Cited by 8 publications

References 39 publications

Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

Maternal internal migration and child growth and nutritional health in Peru: an analysis of the demographic and health surveys from 1991 to 2017

A multilevel analysis of the triple burden of malnutrition in Indonesia: trends and determinants from repeated cross-sectional surveys

Food systems and rural wellbeing: challenges and opportunities

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