Paediatric nutrition directly influences survival, clinical outcomes, and long-term health, and is particularly of significance in India with one of the world's largest child populations. This symposium, hosted by St. John's National Academy of Health Sciences as part of an ICMR-funded Centre for Advanced Research initiative, convened national and international experts spanning from clinical nutrition and public health. Day 1 focused on the management of intestinal failure and the life-saving role of parenteral and enteral nutrition, highlighting global best practices, surgical advances, and the need to strengthen multidisciplinary nutrition support teams in India. Day 2 shifted to maternal and child nutrition at the community level, addressing breastfeeding challenges, complementary feeding, stunting, and government program strategies. Together, the sessions underscored that nutrition for vulnerable children requires continuous care supported by technology, coordinated systems, and policy. The symposium laid the foundation for sustained annual engagement to strengthen paediatric nutrition systems in India.
Shalini Gajanan Hegde, Greeshma Mulakatte, Alekia Uscoicar et al.
Somalia records one of the highest global burdens of child wasting and stunting, with approximately 1.7–1.85 million children under five estimated to be affected by acute malnutrition annually during 2022–2025, including approximately 421,000–513,550 children with severe acute malnutrition. For over two decades, the dominant policy response has been community-based management of acute malnutrition (CMAM), a curative intervention that treats clinical endpoints rather than underlying drivers. Despite meeting international cure-rate standards, CMAM alone cannot address the food insecurity, water, sanitation and hygiene (WASH), microbial and parasitic infectious diseases, health-system, and climatic drivers that perpetuate malnutrition. This paper integrates recent Somali survey, programme-evaluation, and administrative data to show that the national burden of acute malnutrition has remained high despite continued treatment scale-up, with stunting falling only 9.7 percentage points over 24 years, relapse after discharge remaining a documented challenge, and nationally representative Somalia-specific estimates of CMAM treatment coverage remaining unavailable. Diagnostic discordance between screening tools leaves an unknown share of wasted children undetected, and persistent sex- and region-based disparities highlight structural gaps. Ending child malnutrition in Somalia requires rebalancing investment from an emergency, treatment-centred paradigm toward integrated, multisectoral strategies combining therapeutic feeding with WASH investment, maternal and infant feeding support, primary health-care strengthening, climate-resilient livelihoods, and shock-responsive social protection. We propose four policy shifts: sustaining CMAM while addressing diagnostic gaps, mandating nutrition-sensitive financing, institutionalizing relapse prevention, and expanding anticipatory financing. These shifts require governance reforms and multi-year donor commitment to address the determinants of child nutrition in Somalia comprehensively.
Background Anemia and malnutrition are major contributors to child morbidity and mortality in Sub-Saharan Africa, particularly in West Africa where their prevalence remains high due to multifaceted socio-economic and environmental factors. Malnutrition, as defined by WHO, includes both undernutrition and overnutrition and is linked to increased risk of non-communicable diseases. Anemia, characterized by low hemoglobin levels, impairs oxygen transport and is associated with developmental delays and increased mortality in children. Given their interrelated nature, a joint modeling approach is essential to understand shared risk factors and inform targeted interventions. Methods This study analyses pooled DHS data from Gabon, Gambia, Liberia, Mauritania, and Nigeria to identify determinants of anemia and malnutrition. Malnutrition is measured using the Composite Index of Anthropometric Failure (CIAF), which integrates stunting, underweight, and wasting for a comprehensive assessment. A copula-based geo-additive joint model is employed to simultaneously examine both conditions, accounting for spatial variation and interdependence. This approach offers a novel framework for informing policy and improving child health outcomes in West Africa. Results Key predictors of malnutrition and anemia were identified across five West African countries. Malnutrition risk was significantly associated with maternal education, water source, household wealth, child age, gender, and feeding practices. Notably, children from households using non-bottled water sources and those given milk were at higher risk. Several water-source categories were positively associated with malnutrition relative to bottled/sachet water; however, these associations may reflect socioeconomic and residential differences in the reference group and warrant cautious, non-causal interpretation. Anemia risk was significantly lower among urban children and those whose mothers had higher education. Fortified food and egg consumption were protective against anemia, while poverty and poor water sources increased risk. These findings highlight distinct and overlapping determinants of both conditions. Conclusion This study highlights the complex interplay of socioeconomic, environmental, and dietary factors influencing malnutrition and anemia among children in West Africa. Key predictors include maternal education, household wealth, water source, and feeding practices, with notable geographic variation. Addressing these challenges requires integrated, multisectoral strategies focused on improving maternal education, access to safe water, dietary diversity, and poverty reduction. Geographically targeted interventions and strengthened health systems are essential.
Children account for over one-third of Indonesia's poor demographic. This situation linked to the social and demograhic situation of the family ecosystem, forming experiences of deprivation that can harm their growth. As sporadic aid fails to transform deprivative home environments, the government introduced the Sekolah Rakyat Program, an institutional intervention aimed to break the cycle of poverty. This study aims to deconstruct the experiences of deprivation among underprivileged children and how the presence of Sekolah Rakyat reconstruct their lived experiences differently. This qualitative phenomenological study examines the lived experiences of 10 impoverished children aged 15 – 17 who are enrolled in the program. Data were collected through in-depth interview, observation, and documentation. The findings reveal diverse forms of material deprivations (housing, education, health, nutrition, information, and leisure) and psychosocial deprivations at home. Furthermore, the study identifies significant shifts in both material and psychosocial experiences following the intervention of Sekolah Rakyat. This research serves as a valuable reference for a new model in child poverty alleviation initiatives.
Five waves of the Young Lives Indian survey are analysed using sequence and regression analysis. Four clusters of individuals sharing similar life histories are identified,reflecting childhood and family circumstances measured by living conditions, health and exposure to family and economic shocks. Regression analysis examines how life histories and gender shape employment outcomes at age 22. The results show that accumulation of (dis)advantages across childhood helps explain inequalities in employment and earnings. Those who have led wealthier, healthier, more stable lives have higher earnings but are less likely to be employed. Those from the poorest but most stable cluster are the most likely to be employed, but among women, this group earns the least. For young men, earnings are lowest for those exposed to the most shocks. Policy to equalise employment opportunities in India should therefore aim to improve the living conditions, health and security of disadvantaged young children.
Fiona Carmichael, Christian; id_orcid 0000-0002-1665-2594 Darko, Nicholas V. Vasilakos
Background Child undernutrition remains a major public health concern and creates health-related inequalities in developing countries, with long-term consequences for human development deficits. Most of these early studies were conducted using conventional econometric techniques; however, understanding the complex, multi-level determinants of undernutrition may require more advanced analytical methods. Methods This study, PC algorithm is used for Structural Learning-Based Bayesian Networks [SL-BN] (a graphical model based on directed acyclic graph with joint and conditional associations)—which is conceptually different than the weight-based networks, to examine the macro- and micro-level determinants of child undernutrition in Pakistan. Macro-level analysis combines historical nutrition policy evaluation (critical discourse) with WDI and UNDP data (2000–2022), spanning the MDG and SDG eras. Micro-level analysis draws on the Pakistan Demographic and Health Survey (PDHS 2017–18) to identify socioeconomic drivers of child malnutrition and nutritional inequalities. Results In micro analysis, the SL-BN network structure identifies household-level determinants—such as poor wealth status, rural residence, poor environmental conditions, low maternal education, and diarrhea—as key drivers of child undernutrition. Inequality is stark, with malnutrition disproportionately concentrated among the poorest. However, the SL-BN findings and critical assessment of nutritional policies and programs found that low investment in human development, foreign dependency on health, poverty, inflation, and a history of inconsistent nutritional policies to combat hunger and undernutrition are the fundamental issues at the macro level in Pakistan. Conclusion The study concluded that the underlying micro level determinants of child undernutrition in Pakistan cannot overcome without long-term targeted policies at macro level.
Introduction: Low birth weight, defined as a weight below 2500 grams in live newborns, is a fundamental indicator of maternal and child health and a predictor of neonatal morbidity and mortality with consequences throughout the entire life course. Objective: To comprehensively describe the current state of knowledge on low birth weight, covering its epidemiology, pathophysiological mechanisms, maternal risk factors, and strategies for detection, management, and prevention. Methods: A narrative literature review was conducted through searches in PubMed/MEDLINE, SciELO, LILACS, and Google Scholar, using the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) “low birth weight infant,” “premature birth,” “fetal growth retardation,” and “risk factors,” complemented with clinical practice guidelines and technical documents from the World Health Organization. Development: Low birth weight affects 14.7% of live births worldwide and arises from two pathophysiological pathways—prematurity and intrauterine growth restriction—driven by largely modifiable maternal nutritional, metabolic, toxic, and infectious determinants. Antenatal ultrasound and Doppler surveillance, together with standardized neonatal care protocols, help mitigate its immediate and long-term complications. Conclusions: Low birth weight is a critical factor for neonatal survival and human development. Translating the accumulated scientific knowledge into scalable preventive strategies is necessary to achieve the reduction targets set by the World Health Organization.
Maikro Osvaldo Chávez Moya, Leodanis Hernández Cabrera, Laura Beatriz Fernández Feitó et al.
Early marriage is a social issue that can affect the continuity of education, psychological readiness, reproductive health, and the family's ability to carry out parenting functions. Therefore, educational efforts that involve teenagers and the social environment comprehensively are needed. This community service activity aims to increase the knowledge, understanding, and awareness of teenagers and the social environment about preventing early marriage in Ranokomea Village, West Poleang District, Bombana Regency. The activity implementation methods include observation and coordination with the village government, delivering material by two resource persons, interactive discussions, and evaluation through a Focus Group Discussion (FGD). The first resource person from the Poleang Barat District Office of Religious Affairs (KUA) provided education on laws, age limits, and marriage purposes based on regulations. The second speaker, an officer from the Poleang Barat District Family Planning (KB) office, gave a talk about couple’s mental readiness, women’s reproductive health, preparedness for parenthood, parenting, and preventing stunting in toddlers. The activity results showed that participants had a better understanding of the consequences of early marriage and the importance of being ready before starting a family. Participants also showed enthusiasm by actively joining in discussions and focus group discussions (FGDs), especially on topics like marriage laws, reproductive health, mental readiness, and child-rearing. This activity shows that preventing early marriage requires a multidimensional and collaborative approach that integrates legal, psychological, reproductive health, parenting, and social support aspects. Ongoing education and guidance are needed so that increased knowledge can turn into changes in people's attitudes and behavior when it comes to preventing early marriage.
Arafat Mallapiseng, Sismayani Sismayani, Rahmat Hidayat et al.
Abstrak: Stunting masih menjadi permasalahan gizi pada balita yang memerlukan penguatan intervensi berbasis masyarakat. Kader posyandu berperan strategis dalam mendukung pemenuhan gizi balita, namun keterbatasan pengetahuan tentang pola pangan Beragam, Bergizi Seimbang, dan Aman (B2SA) serta teknologi pengolahan pangan lokal dapat menghambat penyediaan Pemberian Makanan Tambahan (PMT). Kegiatan ini bertujuan meningkatkan pengetahuan kader Posyandu Matahari Desa Purwokerto Wetan mengenai stunting dan pencegahannya, B2SA, pemanfaatan pangan lokal, serta teknologi pengolahan pangan untuk PMT. Kegiatan menggunakan pendekatan Community-Based Participatory Research (CBPR) melalui sosialisasi, pelatihan, praktik, monitoring, dan evaluasi. Pengetahuan diukur menggunakan pre-test dan post-test. Hasil menunjukkan peningkatan pengetahuan tentang stunting dari 80% menjadi 90%, B2SA dari 60% menjadi 90%, pemanfaatan pangan lokal dari 78% menjadi 98%, dan teknologi pengolahan PMT dari 80% menjadi 92%. Rata-rata pengetahuan meningkat dari 74,5% menjadi 92,5%. Kegiatan ini meningkatkan kapasitas kader dalam mendukung pemanfaatan pangan lokal sebagai PMT untuk pencegahan stunting.Abstract: Stunting remains a major nutritional problem among children under five, requiring stronger community-based interventions. Posyandu cadres play a strategic role in supporting children's nutritional needs; however, limited knowledge of Diverse, Nutritious, Balanced, and Safe (B2SA) food patterns and local food processing technology may hinder the provision of supplementary food (PMT). This community service activity aimed to improve the knowledge of Posyandu Matahari cadres in Purwokerto Wetan Village regarding stunting prevention, B2SA, local food utilization, and food processing technology for PMT. The activity applied a Community-Based Participatory Research (CBPR) approach through socialization, training, hands-on practice, monitoring, and evaluation. Knowledge was assessed using pre- and post-tests. Results showed increased knowledge of stunting prevention from 80% to 90%, B2SA from 60% to 90%, local food utilization from 78% to 98%, and food processing technology for PMT from 80% to 92%. Overall knowledge increased from 74.5% to 92.5%. The activity strengthened cadres’ capacity to utilize local food as PMT to support stunting prevention.
Background & Objective: Children with a history of Low Birth Weight (LBW) are at greater risk of undernutrition compared to those without such a history. This vulnerability is associated with incomplete organ development and weakened immune systems, making them more susceptible to infectious diseases. The objective of this study was to evaluate the effectiveness of oral stimulation in improving the sucking reflex in LBW infants.Materials & Methods: A quasi-experimental design with pre-test and post-test control groups was conducted involving 25 infants diagnosed with LBW. The intervention consisted of oral stimulation with one finger for 5 minutes followed by 1 minute of breastfeeding in the intervention group, while the control group received standard Neonatal Intensive Care Unit (NICU) unit procedures. Oral stimulation was administered twice daily for 14 days, with permission to continue beyond this period. Reflex assessment was then performed. The Wilcoxon Signed Rank Test was used for statistical analysis.Results: Baseline characteristics indicated that most infants were preterm (66%), classified as LBW (72%), and male (62%). Statistical analysis revealed significant improvement in the sucking reflex in both the intervention group (P<0.001) and the control group (P=0.001). However, the intervention group demonstrated a higher post-test mean score (1.25) compared to the control group (0.73). Comparison of Post-Test Sucking Reflex Scores yielded a p-value of 0.002, indicating a significant difference between groups.Conclusion: Oral stimulation effectively enhances the rooting-sucking reflex in LBW infants. These findings suggest that periodic oral stimulation can be implemented to support the rooting-sucking reflex in this vulnerable population.
Parida Hanum, Siti Arofah Siregar, Debi Novita Siregar et al.
