It is claimed that improving the education of women may be the most efficient way for Melanesian countries to attain economic development goals but the necessary empirical evidence has been lacking. This paper uses nationally representative household survey data to compare the effect of mother?s and father?s education on the risk of child stunting. Stunting is the major nutritional problem in Papua New Guinea and contributes to inferior health and labour productivity. The results show that mother?s education is at least three times more productive than father?s education. Thus, under-investment in women?s education appears to contribute to the problems of poor health and economic performance in Papua New Guinea.
Rural Guatemala has one of the highest rates of chronic child malnutrition (stunting) in the world, with little progress despite considerable efforts to scale up evidence-based nutrition interventions. Recent literature suggests that one factor limiting impact is inadequate supervisory support for frontline workers. Here we describe a community-based quality improvement intervention in a region with a high rate of stunting. The intervention provided audit and feedback support to frontline nutrition workers through electronic worklists, performance dashboards, and one-on-one feedback sessions. We visualized performance indicators and child nutrition outcomes during the improvement intervention using run charts and control charts. In this small community-based sample (125 households at program initiation), over the two-year improvement period, there were marked improvements in the delivery of program components, such as growth monitoring services and micronutrient supplements. The prevalence of child stunting fell from 42.4 to 30.6%, meeting criteria for special cause variation. The mean length/height-for-age Z-score rose from -1.77 to -1.47, also meeting criteria for special cause variation. In conclusion, the addition of structured performance visualization and audit and feedback components to an existing community-based nutrition program improved child health indicators significantly through improving the fidelity of an existing evidence-based nutrition package.
Michel Juarez, Carlos Dionicio, Neftali Sacuj et al.
Stunting is a condition where the growth of children under five is hampered due to chronic malnutrition. One of the causes of Stunting is the mother's lack of understanding regarding the nutritional needs of children, which can inhibit brain growth and development and reduce the body's immunity. One of the efforts to prevent Stunting is to increase the quality of mother and child care, improve pattern foster care in practice feeding, and enhance maternal nutritional self-care management to prevent Stunting. This research aims to determine the relationship between self-care management and mothers' attitudes towards fulfilment in toddler nutrition to prevent Stunting. The research design uses a correlation with a cross-sectional approach to the design survey analytics. The population of this study was comprised of all mothers who had toddlers under 5 years, with 87 respondents and techniques. The sample uses purposive sampling with criteria for inclusion and exclusion. Data was collected using a questionnaire, and the research results were analyzed using the Spearman rho test. The research results show a significant relationship between self-care management and the mother's attitude towards fulfilling nutrition in toddlers for stunting prevention , with a value significance variable of 0.001. The better self-management you have, the better influence the mother's attitude towards fulfilling nutrition for children to prevent stunting.
Milasari, Nugraha Putra Perdana Arriadie, Yenny Okvitasari
Although recommended infant and young child feeding (IYCF) practices have been found to be protective against undernutrition in some settings, there is no finality yet due to inconsistencies in the literature. A cross-sectional survey of 581 mother-child pairs was conducted in northern Ghana in June 2018. The association between IYCF indicators and child undernutrition (stunting and wasting) were assessed. The descriptive analysis showed that 66.4% of the children (6-23 months) were introduced to complementary feeding in a timely manner, 69.4% met the minimum meal frequency, and 38.9% met the minimum acceptable diet daily. The prevalence of stunting, wasting, underweight and overweight was 33.2%, 14.1%, 27% and 2.6%, respectively. From the multivariable binary logistic regression, child gender, child age group and source of power for lighting the household were significantly associated with wasting. Intake of iron-rich foods, child age group, and maternal height were significantly associated with stunting after adjusting for confounders. The prevalence of the compliance with IYCF indicators was relatively high. None of the individual IYCF indicators showed significant association with undernutrition, except intake of iron-rich foods for stunting. Nutrition-specific interventions targeted at improving IYCF practices, dietary diversification and intake of nutrient-rich meals, should be adopted and scaled up to address undernutrition in northern Ghana.
Stephen Kofi Anin, Mahama Saaka, Florian Fischer et al.
BACKGROUND: Child undernutrition is a global health issue that is associated with poor sanitation and an altered intestinal microbiota. Immunoglobulin (Ig) A mediates host-microbial homeostasis in the intestine, and acutely undernourished children have been shown to have altered IgA recognition of the fecal microbiota. We sought to determine whether chronic undernutrition (stunting) or intestinal inflammation were associated with antibody recognition of the microbiota using two geographically distinct populations from the Afribiota project. Fecal bacteria from 200 children between 2 and 5 years old in Antananarivo, Madagascar, and Bangui, Central African Republic (CAR), were sorted into IgA-positive (IgA+) and IgA-negative (IgA-) populations by flow cytometry and subsequently characterized by 16S rRNA gene sequencing to determine IgA-bacterial targeting. We additionally measured IgG+ fecal bacteria by flow cytometry in a subset of 75 children. RESULTS: Stunted children (height-for-age z-score ≤ -2) had a greater proportion of IgA+ bacteria in the fecal microbiota compared to non-stunted controls. This trend was consistent in both countries, despite the higher overall IgA-targeting of the microbiota in Madagascar, but lost significance in each country individually. Two of the most highly IgA-recognized bacteria regardless of nutritional status were Campylobacter (in CAR) and Haemophilus (in both countries), both of which were previously shown to be more abundant in stunted children; however, there was no association between IgA-targeting of these bacteria and either stunting or inflammatory markers. IgG-bound intestinal bacteria were rare in both stunted and non-stunted children, similar to levels observed in healthy populations. CONCLUSIONS: Undernourished children carry a high load of intestinal pathogens and pathobionts. Our data suggest that stunted children have a greater proportion of IgA-recognized fecal bacteria. We moreover identify two putative pathobionts, Haemophilus and Campylobacter, that are broadly targeted by intestinal IgA. This study furthers our understanding of host-microbiota interactions in undernutrition and identifies immune-recognized microbes for future study.
Kelsey E. Huus, André Rodriguez Pozo, Nathalie Kapel et al.
Climatic change threatens agricultural productivity and food security of smallholders in sub-Saharan Africa, yet evidence on how climate-induced declines in agricultural productivity affect child nutrition remains limited. By merging nationally representative household-level panel data with long-term changes in temperate and precipitation, and using two-stage fixed effects econometric models, we examined the effect of climate-induced agricultural productivity shocks on child nutritional indicators – (height-for-age (HAZ), weight-for-age (WAZ), and stunting. We exploit exogenous variation in rainfall and temperature to address potential endogeneity. The results show that climate-induced agricultural productivity shocks significantly reduce HAZ and WAZ and increase stunting. Households with limited market access and lower education levels experience larger negative effects. The main pathway operates through reductions in household food production for own consumption, a mechanism particularly relevant in low- and middle-income households. These findings underscore the need for targeted interventions including climate-smart agriculture to enhance smallholder resilience. Complementary investments in market infrastructure and human capital can help mitigate the adverse effects of climatic shocks. This study contributes to the literature by linking climate-induced productivity shocks to child nutrition, identifying plausible pathways, and providing recommendations on building resilient food systems to address the vulnerability of smallholders to the adverse effects of climate shocks.
Covid-19 around the world, including in Indonesia, has harmed the community's economic system, including the decline in people's income. This has an impact on people's purchasing power which leads to a lack of food availability in the family, causing reduced food intake, poor nutrition, and health problems. The purpose of the study was to determine the impact of the Covid-19 pandemic on the increase in the number of stunting cases due to food insecurity and malnutrition in toddlers. The results of a literature review, it shows that the Covid-19 pandemic has an impact on parents' income and has an impact on meeting family needs, especially the fulfillment of nutrition for toddlers. Children who are malnourished from an early age can affect their physical and psychological growth and development, decrease neurodevelopmental and cognitive functions, and increase the risk of chronic diseases in adulthood. The disruption of growth and physical and psychological development of these children affects the number of stunting cases. Covid-19 not only has an impact on social, economic, and cultural conditions but also has an impact on food sovereignty. Food security as the basis for realizing a prosperous society requires maximum contribution from all stakeholders and the community. Efforts to achieve food security and nutrition improvement are encouraged, among others, by food diversification, supplementary feeding for children under five years old, nutrition education efforts to increase exclusive breastfeeding, baby and child feeding, and promotion of balanced nutrition guidelines.
Maternal nutrition status during pregnancy highly contributed to risk factors of stunting among children. Bone ossification approximately begins in the sixth weeks of embryonic development and continues to the end of pregnancy. However, inadequate nutrient supply in pregnant women harmed fetal growth. The study aimed to identify the association between pregnant women’s nutrition status and stunting. The case-control study using the retrospective design involved mothers with children aged 12-59 months. A proportional random sampling technique was applied to select participants. The sample was 80 toddlers, divided into 40 stunted, and 40 non-stunted toddlers. Data were taken from 27 April to 3 May 2019 through observations following the Mother and Child Health handbook and children's height. Weight gain calculation during pregnancy determined the maternal nutrition status, referred to as maternal pre-pregnancy body mass index. The univariate analysis used frequency distribution, while bivariate analysis used the chi-square test. This study obtained approval from The Health Research Ethics Committee of the Institute of Health Science of General Achmad Yani, Cimahi. The mothers' poor nutritional status caused as many as 85% of stunted toddlers' prevalence during pregnancy. Results showed that maternal nutritional status during pregnancy was significantly associated with stunting among children (p-value: 0.000). The OR value was 13,222, which means children born to mothers with inadequate nutrient supply during pregnancy were more likely to be stunted as much as 13,222 times, than children born to mothers who had good nutrient supply. It is recommended that health workers prevent stunting from pregnancy by providing supplementary food to pregnant women, and promoting the health of the maternal nutritional status during pregnancy. Suggestions for pregnant women is to increase nutrient intake and nutritional status during pregnancy to prevent stunting in children.
Stunting is a well-known child health indicator for chronic malnutrition.The nutritional status of children is a good gauge for the nutritional well-being of the population, and it is, nowadays, one of the key issues in interrupting generational poverty transmissions as they bear the brunt of poverty.There has been scarcity of disaggregated survey to explore covariates of child stunting.This study attempted to identify socio-economic, demographic and other proximate factors associated with stunting of children under the age of five in Fitche town.The survey was cross-sectional, conducted using multistage sampling procedures to collect information from 160 children and caregivers.The anthropometric, descriptive and logistic analyses to determine the prevalence and identify covariates of child stunting were applied using Epi info and STATA software.Logistic analysis of the effects of selected child and maternal characteristics, child caring practices, and environmental health conditions on child stunting was done.Therefore, birth order, family size, maternal education, remittances, farm income, income from women employment and size of cultivated land were found to be the strongest predictors.However, the estimated coefficients of vaccine status of the child, Low Birth Weight, latrine facility in the house, morbidity status of the child, child birth interval, distance to the nearest health center, antenatal care visit of the mother and household's source of water indicated theoretically inconsistent and statistically insignificant effect on the likelihood of child stunting.The prevalence of child stunting was 45%, which is significantly higher than the regional and national averages.Among children who were stunted, 11.9 % were moderately stunted compared to 33.1% who were severely stunted.The proportion of stunted children for male was greater than female.There is a need to increase maternity care and education as this would make them amenable to health interventions that help improve not only their nutritional status and that of their child but also improve their income earning potential and food purchasing power.Addressing poverty may lead to improvements in the nutrition status of children as household economic status significantly determines nutritional status in the town.
Abstract Stunting is a chronic malnutrition problem characterized by height for age which is <-2 SD according to the median standard of child growth. Stunting causes poor quality of human resources, which will reduce productivity. The factor causing the problem of stunting In Tools AtPagambiran Health Center, Padang City is the lack of clean water sanitation. The purpose of this study was to determine the relationship between the nutritional status of the mother, the height of the mother, and the mother's knowledge of the incidence of stunting in toddlers at the Pagambiran Health Center, Padang City.This research is an observational analytic study with a cross-sectional design. This research was conducted at the Pagambiran Health Center in Padang City with 3457 populations in November 2021-December 2022. The research sample was 174 mothers and children aged 24-59 months. Sampling using Stratified Random Sampling and Simple Random Sampling. Data collection used a questionnaire and the MCH handbook. The statistical tests used are Chi-square and Logistic Regression.The results of the univariate study found that 55 mothers (31.6%) had a history of chronic energy deficiency, and 12 mothers (6.9%) had a height < 150 cm. The results of the bivariate study using chi-square analysis obtained the p-value of each variable, namely the mother's nutritional status (p=0.005) and mother's height (p=0.018). The study concludes that there is a relationship between the mother's nutritional status and the mother's height in the incidence of stunting in toddlers at the Pagambiran Health Center, Padang City. Researchers suggest that counseling related to stunting can be carried out for pregnant women and prospective brides as an initial preventive measure. Keywords: Chronic Energy Deficiency, Mother's Height, Stunting.
Annisa Namirah Nasution, Vaulinne Basyir, Rinang Mariko et al.
