Peer-reviewed article
Mitigating the Impact of Intergenerational Risk Factors on Stunting: Insights From Seven of the Most Food Insecure Districts in South Africa
Kate Rich, Liezel Engelbrecht, Gabrielle Wills, Edzani Mphaphuli ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5The study uses data from the 2022 Grow Great Community Stunting Survey to look at which factors best predict stunting and height-for-age in children under 5 in seven of South Africa's most food-insecure districts. Maternal height, birth weight and household wealth (assets) were the most important predictors. The authors then tested whether other factors could weaken the link between these intergenerational factors and child height. Being on track for vitamin A and deworming, adequate sanitation, a diverse diet and good maternal mental health appeared to do so. The authors expect these effects to be small compared with the intergenerational risk factors.
Key points
- Maternal height, birth weight and asset-based socioeconomic status were the most important predictors of height-for-age z-scores and stunting.
- Maternal height: HAZ coefficient 0.02 (95% CI 0.01–0.03); stunting OR 0.96 (95% CI 0.94–0.98).
- Birth weight: HAZ coefficient 0.3 (95% CI 0.16–0.43); stunting OR 0.5 (95% CI 0.35–0.72).
- Asset-based socioeconomic status: HAZ coefficient 0.17 (95% CI 0.10–0.24); stunting OR 0.77 (95% CI 0.67–0.89).
- Vitamin A and deworming status, adequate sanitation, a diverse diet and good maternal mental health moderated the effect of birth weight or maternal height.
Limitations
The abstract describes an analysis of survey data from seven districts, so it shows associations rather than the effect of any programme, and the findings may not apply to other parts of South Africa. The moderating effects are described as likely small, and the abstract gives no figures for them.
Abstract
ABSTRACTA large body of research investigates the determinants of stunting in young children, but few studies have considered which factors are the most important predictors of stunting. We examined the relative importance of predictors of height‐for‐age z‐scores (HAZ) and stunting among children under 5 years of age in seven of the most food‐insecure districts in South Africa using data from the Grow Great Community Stunting Survey of 2022. We used dominance analysis and variable importance measures from conditional random forest models to assess the relative importance of predictors. We found that intergenerational and socioeconomic factors—specifically maternal height (HAZ: Coef. 0.02, 95% CI 0.01–0.03; stunting: OR 0.96, 95% CI 0.94–0.98), birth weight (HAZ: Coef. 0.3, 95% CI 0.16–0.43; stunting: OR 0.5, 95% CI 0.35–0.72) and asset‐based measures of socioeconomic status (HAZ: Coef. 0.17, 95% CI 0.10–0.24; stunting: OR 0.77, 95% CI 0.67–0.89)—were the most important predictors of HAZ and stunting in these districts. We explored whether any other factors moderated (weakened) the relationship between these intergenerational factors and child height using conditional inference trees and moderation analysis. We found that being on track for vitamin A and deworming, adequate sanitation, a diverse diet and good maternal mental health moderated the effect of birth weight or mother's height. Though impacts are likely to be small relative to the impact of intergenerational risk factors, these moderating factors may provide promising avenues for helping to mitigate the intergenerational transmission of stunting risk in South Africa.