The Interrelationships of Child Under-Nutrition, Ecological and Maternal Factors: A Case Study of Pakistan by Using Composite Index of Anthropometric Failure

Abstract

Under-nutrition is a serious health problem of developing countries, including Pakistan. Despite the implementation of a number of health strategies for the vulnerable population (especially children), the issue is still emerging and needs further investigation. The aim of this study was to investigate the role of various ecological and maternal factors responsible of children's nutritional health variations. By using Pakistan Demographic and Health Survey (PDHS) data, maternal factors were assessed as important factors of child under-nutrition. Multinomial nested logit regression and classification tree analysis were performed. A total of 1870 children of age < 5 years were included in the analysis and out of these 50.1% fall in the composite index of anthropometric failure (CIAF). Maternal education, mother's body mass index (BMI) and working status were among the significant factors while decision making autonomy remain insignificant. Maternal factors have significant impact on child health and use of CIAF as a measure of nutritional status is recommended for policy makers because of its capability to estimate the overall burden of under-nutrition.

Prevalence and associated factors of stunting, wasting and underweight of children below five using quintile regression analysis (PDHS 2017–2018)

“…Quantile Regression results suggest that the most important factors for the improvement of child health are maternal factors and published literature emphasized the positive impact of improved maternal education on child’s health 4 , 25 , 26 . Smoker and older mothers are observed at higher risk of having stunting or underweight children.…”

Decomposing socio‐economic inequality in vaccination coverage among Pakistani children: A population‐based cross‐sectional study

“…(KPK), Balochistan, Gilgit Baltistan (GB), Islamabad Capital Territory (ICT), Azad Jammu Kashmir (AJK) and Federally Administrative Tribal Areas (FATA). Based on the framework adopted by Rehman, Saima, &Goni, 2015 andAsif, Akbar, Noor, Sherwani, &Farooq, 2019, given wealth index (used as a proxy measure for household wealth status) was re-categorised by merging poorest and poor as poor and similarly by merging rich and richest as rich only. In this way, wealth index comprises only three categories, that is, poor, middle and rich.…”

“…Types of water and sanitation facility were categorised as improved and unimproved following WHO guidelines (WHO, 2006). Following Rehman et al, 2015, Ghose et al, 2017and Asif, Akbar, Noor, et al, 2019, we constructed a proxy measure of ME using composite score based on four questions asked to the respondent regarding who take the decisions in the household, about her own healthcare, large purchase, visit to family/relatives and the consumption of husband earnings. The possible answers were as follows: (i) respondent alone, (ii) respondent and husband/partner, (iii) husband/partner alone, (iv) family elders and (v) others.…”

Does maternal empowerment improve dietary diversity of children? Evidence from Pakistan demographic and health survey 2017–18

“…According to the extended UNICEF framework, 12 childcare is an important factor among the underlying factors which affects child nutrient adequacy through diet diversity. Maternal factors including their own health, maternal empowerment (ME) and social support, are considered as the most important components of childcare practices 13–15 . Since the Beijing conference on women in 1995, women empowerment has become policy goal in developing countries and large literature is available while linking it with a number of other goals.…”

“…Maternal factors including their own health, maternal empowerment (ME) and social support, are considered as the most important components of childcare practices. [13][14][15] Since the Beijing conference on women in 1995, women empowerment has become policy goal in developing • Acceptance of productive and allocative efficiency points of health economics due to significant positive association of maternal higher education level and child dietary diversity (CDD).…”