Stunting and severe stunting among infants in India: the role of delayed introduction of complementary foods and community and household factors

Dhami, Mansi Vijaybhai; Ogbo, Felix Akpojene; Osuagwu, Uchechukwu L.; Ugboma, Zino; Agho, Kingsley

doi:10.1080/16549716.2019.1638020

Cited by 45 publications

(58 citation statements)

References 49 publications

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“…This low rate of EBF indicates that a substantial proportion of newborns in ECOWAS countries are fed with water and/or prelacteal foods before the age of at least six months. This will, in turn, predispose the infant to gastrointestinal infections due to intake of contaminated prelacteal [18] or complementary foods [1,3,19]. In a recent study conducted in Nigeria, one of the ECOWAS countries with the largest population and economy [10], an estimated 22,371 diarrhoea-related deaths among children under five years could have been averted in 2016 if nursing mothers had strictly adhered to appropriate breastfeeding practices, particularly EBF [20].…”

Section: Introductionmentioning

confidence: 99%

Exclusive Breastfeeding Rates and Associated Factors in 13 “Economic Community of West African States” (ECOWAS) Countries

et al. 2019

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Exclusive breastfeeding (EBF) has important protective effects on child survival and also increases the growth and development of infants. This paper examined EBF rates and associated factors in 13 “Economic Community of West African States” (ECOWAS) countries. A weighted sample of 19,735 infants from the recent Demographic and Health Survey dataset in ECOWAS countries for the period of 2010–2018 was used. Survey logistic regression analyses that adjusted for clustering and sampling weights were used to determine the factors associated with EBF. In ECOWAS countries, EBF rates for infants 6 months or younger ranged from 13.0% in Côte d’Ivoire to 58.0% in Togo. EBF decreased significantly by 33% as the infant age (in months) increased. Multivariate analyses revealed that mothers with at least primary education, older mothers (35–49 years), and those who lived in rural areas were significantly more likely to engage in EBF. Mothers who made four or more antenatal visits (ANC) were significantly more likely to exclusively breastfeed their babies compared to those who had no ANC visits. Our study shows that EBF rates are still suboptimal in most ECOWAS countries. EBF policy interventions in ECOWAS countries should target mothers with no schooling and those who do not attend ANC. Higher rates of EBF are likely to decrease the burden of infant morbidity and mortality in ECOWAS countries due to non-exposure to contaminated water or other liquids.

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Section: Introductionmentioning

confidence: 99%

Exclusive Breastfeeding Rates and Associated Factors in 13 “Economic Community of West African States” (ECOWAS) Countries

et al. 2019

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“…Study based in India showed that maternal age is positively associated with stunting among children (58), while some studies showed that stunting is inversely related with maternal age (63,64). Many studies have documented that with the increase of maternal education, the chances of stunting decrease among children (44,54,(65)(66)(67)(68). Mother's body mass index that is negatively associated with stunting among children, also another important risk factor of stunting among children as evidenced by the previous studies (28,44,67).…”

Section: Review Of the Literaturementioning

confidence: 95%

“…It has also been observed that household characteristics, e.g. religion, caste or social groups (44,65), wealth index and the place of residence (72,73) are also associated factors of stunting among children. Besides these, studies evaluated the effects of ICDS at the national level in India shows that there are no signi cant effects on reducing stunting among children who are accessing the services from ICDS (74-76).…”

Section: Review Of the Literaturementioning

confidence: 99%

Nutritional status and its concomitant factors among pre-school children in Malda, India: A micro-level study using a multilevel approach

Sk¹,

Banerjee²,

Mj³

2020

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BackgroundMalnutrition was the main cause of death among children below five years in every Indian state in 2017. Despite several flagship programmes and schemes implemented by the Indian Government, the latest edition of the Global Nutrition Report 2018 addressed that India tops in the number of stunted children, that is a matter of concern. Thus, a micro-level study was designed to know the level of nutritional status and to study this by various disaggregate levels, as well as to examine the risk factors of stunting among pre-school children aged 36-59 months in Malda. MethodA primary quantitative survey was conducted using structured questionnaires following a multi-stage, stratified simple random sampling procedure. A sum of 731 samples collected. Anthropometric measures of children were collected following the WHO child growth standard. Children were classified as stunted, wasted and underweight if their HAZ, WHZ and WAZ scores, respectively were less than −2SD. Univariate descriptive statistics have been carried out to describe the sample characteristics and random intercept multilevel logistic regression model has been employed to estimate the effects of possible risk factors on childhood stunting. ResultsThe prevalence of stunting in the study area is 40 per cent among children aged 36-59 months which is very high prevalence as per the WHO’s cut-off values (≥40 per cent) for public health significance. Results of the multilevel analysis revealed that preceding birth interval, low birth weight, duration of breastfeeding, mother’s age at birth, mother’s education and occupation are the associated risk factors of stunting. Among them, low birth weight (OR 2.22, 95%CI: 1.44-3.41) and bidi worker as mothers’ occupation (OR 1.92, 95%CI: 1.18-3.12) are the most influencing factors of stunting. Further, about 14 per cent and 86 per cent variation in stunting lies at community and child/household level respectively.ConclusionSpecial attention needs to be placed for the modifiable risk factors of childhood stunting. Policy interventions should direct community health workers to encourage women as well as their male partner to increase birth interval using various family planning practices, provide extra care for low birth weight baby that can help to reduce childhood stunting.

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“…Birth weight and household wealth index are reported to be negatively related to both stunting and wasting. Other common predictors for stunting were low maternal height, low maternal BMI, low frequency of antenatal care visits, higher birth order, low maternal educational level, children of mothers without decision making power regarding food, lack of minimum meal frequency, no feeding of eggs, dairy products, fruits and/or vegetables, or the delayed introduction of complementary foods, increasing age of child, and households without access to improved sanitation [139], [143], [144], [145], [146]. Acute respiratory infection was predictive for underweight, whereas diarrhea was a major driver for stunting among Indian children below five years [147].…”

Section: Relationship Between Linear Growth and Wasting As Well As Imentioning

confidence: 99%

Effect of diversified meals only, or either enriched with Amaranthus tricolor and Moringa oleifera leaf powder or commercial micronutrient powder on prevention/treatment of anemia in Adivasi children, West Bengal, India

Stiller

Golembiewski

Stuetz

et al. 2020

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Background and objectives: Malnutrition associated with anemia remains a leading cause of morbidity and mortality among Adivasi children in India. The present trial aimed to test three possible ways of designing improved supplementary meals and to define their role in decreasing rates of anemia, thus increasing hemoglobin (Hb) concentrations as primary health objective: diversified meals only (intervention group 1 (IG 1)), with the addition of locally producible Amaranthus tricolor/Moringa oleifera leaf powders (ALP/MLP) in the ratio 2:1 (IG2) or with an adjusted amount of commercially produced micronutrient powder TopNutri (IG3). Methods: Cluster-randomization of 21 villages resulted in the inclusion of n=293 children aged 6-39 months after baseline assessment. The trial duration was 18 months, beginning in February 2015 (baseline assessment), with application of study meals three times a week at community level. Anthropometric, Hb (HemoCue201+) and morbidity data were collected in a total of four assessment points. At baseline a socio-economic questionnaire was performed. Results: Adjusted for age and Hb concentrations at baseline, time between assessment points, and gender; IG1 showed significant higher Hb concentrations as compared to the control group (CG) throughout the intervention period. The Hb of the remaining intervention groups IG2 or IG3, remained comparable to the CG at all assessment points. The effect on growth indices was less consistent, however most positive tendencies related to nutrition status (stunting, underweight, wasting) and morbidity reduction were attributable to IG3, indicating the beneficial role of a holistic nutrient composition in addressing undernutrition and infectious diseases. Conclusion: This low-dose intervention trial proofed the feeding of diversified diets alone (IG1) to be sufficient to significantly increase Hb concentrations of study children. On the way of achieving diversified diets for Santal children the promotion of kitchen garden programs combined with interactive awareness trainings may be a key measure. Trial registration: the trial was retrospectively registered at the German Clinical Trials Register on the 1 st July 2019 (DRKS00017388). URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017388

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Stunting and severe stunting among infants in India: the role of delayed introduction of complementary foods and community and household factors

Cited by 45 publications

References 49 publications

Exclusive Breastfeeding Rates and Associated Factors in 13 “Economic Community of West African States” (ECOWAS) Countries

Exclusive Breastfeeding Rates and Associated Factors in 13 “Economic Community of West African States” (ECOWAS) Countries

Nutritional status and its concomitant factors among pre-school children in Malda, India: A micro-level study using a multilevel approach

Effect of diversified meals only, or either enriched with Amaranthus tricolor and Moringa oleifera leaf powder or commercial micronutrient powder on prevention/treatment of anemia in Adivasi children, West Bengal, India

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