Correction: The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar

Remonja, Chitale Rabaoarisoa; Rakotoarison, Rado; Rakotonirainy, Nivo Heritiana; Mangahasimbola, Reziky Tiandraza; Randrianarisoa, Alain Berthin; Jambou, Ronan; Vigan-Womas, Inès; Piola, Patrice; Randremanana, Rindra Vatosoa

doi:10.1371/journal.pone.0189747

Cited by 6 publications

(7 citation statements)

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“…As dietary diversity is an indicator of the micronutrient density of children’s diets in Madagascar [ 42 ] – and a key to reduce stunting is to increase the consumption of nutrient-rich food [ 43 ] –a high rate of children in the study region may therefore suffer from micronutrient deficiencies, which leads to chronic malnutrition and stunting. Another study conducted by Remonja et al (2017) in Madagascar illustrated that stunting was associated with the specific age range of 12–35 months and was possibly linked to weaning [ 12 ]. Rakotonirainy et al (2018) investigated the WHO IYCF indicators for children of 6–59 months.…”

Section: Discussionmentioning

confidence: 99%

“…These assess the nutritional quality of diets for children between the ages of 6–23 months [ 25 , 26 ]. In this study, they were also used for older children (24–59 months), as this age group is at a high risk for stunting in Madagascar [ 12 ] and micronutrient malnutrition due to low dietary diversity is common in this age group in Sub-Saharan Africa (e.g. [ 27 , 28 ]).…”

Section: Methodsmentioning

confidence: 99%

“…Low maternal height is an underlying predictor of child stunting [ 10 ]; around 45% of mothers are shorter than 150 cm in the region [ 11 ]. In Malagasy studies, children perceived by their mothers to be small at birth were shown to be at increased risk of becoming stunted [ 10 , 12 , 13 ]. Rakotomanana et al (2017) examined which infant and young child feeding practices indicators were associated with stunting in Madagascar.…”

Section: Introductionmentioning

confidence: 99%

“…Poor nutritional quality was mainly due to a carbohydrate-rich diet containing inadequate amounts of animal products [ 16 ]. The risk of stunting increased with age [ 10 , 13 ] being particularly associated with the 12–35 months age range [ 12 ]. Furthermore, the risk of stunting increased in the presence of severe or moderate anemia in children below the age of two, whereas in the older group of 24–59 months of age, a mild to moderate anemia sufficed to increase the risk [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6–59 months

Ribeli

Pfister

2022

BMC Nutr

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Background More than 1.7 million children in Madagascar are stunted, with low dietary diversity being a determinant. Although diverse crops are produced in the Vakinankaratra region, it registers the highest stunting prevalence rate nationally. While children’s diets may be influenced by region-specific cultural factors, little is known about this link so far. The aim of this study was to determine the influence of cultural habits on dietary diversity in children between 6 to 59 months in the Vakinankaratra region. Methods A mixed method design with a qualitative lead approach was used, including three transect walks, six focus group discussions and 51 semi-structured interviews with caregivers. The interviews contained a quantitative part to assess the four feeding indicators: ‘minimum meal frequency’, ‘minimum dietary diversity’, ‘minimum acceptable diet’ and the consumption of iron-rich foods. Participants were selected by convenience sampling. Data was collected in November 2019 in three communities displaying maximal possible variation. Results Subsistence farming with diverse crops and livestock was found to be a common practice. Minimum meal frequency was achieved by 78% of the sixty included children. In total, 45% attained minimum dietary diversity and 40% consumed a minimum acceptable diet. Across the three communities, the range of children attaining a minimum acceptable diet was 25–60%. Older, no longer breastfed children were prone to not achieving a minimum acceptable diet. Although caregivers had a basic idea of important foods for child development, these were often not available to or affordable for them. An effect of cultural events on diet, especially diversity, was found. Whilst for annual events this effect was short-term, the region-specific ceremony of reburying the dead (Famadihana) was found to have a long-term influence on the diet of certain families. Conclusions The dietary diversity of children under five in the Vakinankaratra region is influenced by cultural factors like agricultural practices, caregivers’ knowledge of child nutrition, food taboos and a region-specific cultural event. Cultural determinants, especially important traditions that result in significant expenditures, may thus influence the quality of children’s diet and should therefore be considered in future nutrition programmes and research on child malnutrition and stunting.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6–59 months

Ribeli

Pfister

2022

BMC Nutr

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“…Low income families tend to have reduced quality, quantity, and variety of food, as reported in Ethiopia and Madagascar studies that showed a relationship between stunting and poverty. 40,41 An Indonesian study conducted in North Maluku Province study reported that children in low income families had 43.1 times higher risk of stunting than children in middle income families. 42 We also noted that subjects whose parents' total income was below the minimum monthly wage set by the Aceh District had a 2.49 (95%CI 1.38 to 4.49) times higher risk of stunting than a children whose parents' total income was above minimum wage.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of stunting in Indonesian children aged 1 to 60 months

Wicaksono

Arto

Mutiara

et al. 2021

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Background The Indonesian province of Aceh has a high prevalence of stunting. Identifying risk factors for stunting may help prevention efforts. The Growth Diagrams of Indonesian Children are a specific tool to diagnose stunting in Indonesian pediatric populations. Objective To determine the risk factors of stunting in children aged 1-60 months using the Growth Diagrams of Indonesian Children. Methods This observational, analytic study with case-control design was conducted in the Lawe Alas District, Southeast Aceh, Indonesia to compare prior risk factors exposure between stunted children (cases) and non-stunted children (controls) from January-April 2018. Subjects were children aged 1-60 months and recruited by consecutive sampling. Results The subjects comprised 97 cases and 97 controls, totaling 194 subjects, internal risk factors of stunting were short birth length (OR 2.87; 95%CI 1.24 to 6.61; P=0.011), inadequate calorie intake (OR 2.37; 95%CI 1.32 to 4.27; P=0.004), non-exclusive breastfeeding (OR 3.64; 95%CI 2.01 to 6.61; P<0.001), chronic diarrhea (OR 6.56; 95%CI 3.33 to 13.01; P<0.001) and upper respiratory tract infections (OR 3.47; 95%CI 1.89 to 6.35; P<0.001). External risk factors of stunting were unimproved sanitation (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), unimproved water sources (OR 2.71; 95%CI 1.50 to 4.88; P=0.001), low family income (OR 2.49; 95%CI 1.38 to 4.49; P=0.002), low paternal educational level (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), low maternal educational level (OR 2.64; 95%CI 1.38 to 5.04; P=0.003), and living in households with >4 family members (OR 1.23; 95%CI 0.69 to 2.17; P=0.469). Regression analysis showed that the dominant risk factor of stunting was chronic diarrhea (OR 5.41; 95%CI 2.20 to 13.29; P<0.001). Conclusion The history of chronic diarrhea and non-exclusive breastfeeding are the main risk factors of childhood stunting.

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Cohort Profile: Moramanga health survey in urban and rural areas in Madagascar (MHURAM project)

Ratovoson

Randremanana

Rakotomanana

et al. 2019

International Journal of Epidemiology

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Correction: The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar

Cited by 6 publications

References 1 publication

An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6–59 months

An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6–59 months

Risk factors of stunting in Indonesian children aged 1 to 60 months

Cohort Profile: Moramanga health survey in urban and rural areas in Madagascar (MHURAM project)

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