Decomposing the educational inequalities in the factors associated with severe acute malnutrition among under-five children in low- and middle-income countries

Fagbamigbe, Adeniyi Francis; Kandala, Ngianga‐Bakwin; Uthman, Olalekan A.

doi:10.1186/s12889-020-08635-3

Cited by 11 publications

(5 citation statements)

References 28 publications

(35 reference statements)

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“…In Niger, there were 86.1% of children whose mothers did not have a high school diploma, compared to 0.1% in Armenia and the Kyrgyz Republic. The overall prevalence of SAM varied by country but was 5.8% in the group of children whose mothers had no education and 4.2% in the group of children whose mothers had some education 14 . According to research from Quetta, Pakistan, 295 out of 500 mothers were found to be illiterate, making up around 59% of the population.…”

Section: Discussionmentioning

confidence: 95%

Various Risk Factors of Severe Acute Malnutrition in Children Under 5 Years of Age Presenting at a Secondary Care Hospital

Ahmed,

Mahar

et al. 2023

PJMHS

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Aim: To assess the various risk factors of severe acute malnutrition in children under 5 years of age presenting at a secondary care hospital Study design: A cross-sectional study Place and duration: Nutritional stabilization centre, Pediatric department, civil hospital Mirpur Khas from January to June 2022 Methodology: A total of 321 children (both males and females) below the age of 5 years were enrolled in this study. Severe acute malnutrition was diagnosed on the basis of weight for height/length Z score criteria. (ie < - 3 SD). Children were managed at a nutritional stabilization centre according to WHO management criteria. History was taken regarding breastfeeding, age of complementary feeding, immunization, maternal education level and repeated diarrhea. Counts with percentages were reported on age group, sex, mother education, lack of breastfeeding, delayed weaning, lack of immunization, and diarrhea. Association was tested with sex and mother education status using the Pearson Chi-Square test. P-values less than 0.05 were considered statistically significant. The bar chart also reported the study outcomes with gender. Results: In the present study, there were three hundred twenty children with mean age 17.9 of (SD=±10.3) months, 30.6% were aged 9 – 12 months, 55.9% were male gender, and 65.6% of mothers were uneducated. Lack of breastfeeding was observed in 10.3% of children, delayed weaning was 12.5%, lack of immunization was 14.1%, and diarrhea was found in 20.6% of children. Children with uneducated mothers 11% were found to have a lack of breastfeeding, 84.2% with delayed complementary feeding, 81% with a lack of immunization and 26.2% with diarrhea. Conclusion: According to our study lack of breast feeding, delayed weaning, lack of immunization, recurrent diarrhea and maternal education are strongly associated with severe acute malnutrition in children. Uneducated women breastfeed their children more, but they start complementary feeding late and their children are more unvaccinated and had more frequent diarrhea which leads to severe acute malnutrition. Keywords: severe acute malnutrition, breastfeeding, diarrhea, complementary feeding

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Section: Discussionmentioning

confidence: 95%

Various Risk Factors of Severe Acute Malnutrition in Children Under 5 Years of Age Presenting at a Secondary Care Hospital

Ahmed,

Mahar

et al. 2023

PJMHS

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“…As the education level of mothers increased, the chances of their children being at risk of having SAM decreased. The past literature has also highlighted the importance of a mother's education for the occurrence of SAM [32][33][34][35] . Mothers' education appears to be so impactful for children's nutrition as an educated mother is better equipped with knowledge and awareness regarding child care.…”

Section: Discussionmentioning

confidence: 99%

Changing Patterns of Severe Acute Malnutrition and Associated Socio-Demographic Factors Among Under-Five Children in Maharashtra

Tonpe,

Mankar

2024

Preprint

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Background: Malnutrition poses a significant health concern, particularly among children under the age of five, on a global scale. Among the various forms of malnutrition, Severe Acute Malnutrition (SAM) stands out as one of the most devastating conditions, contributing to an 11-fold greater risk of mortality and morbidity in affected children than in well-nourished children. Despite being regarded as one of India's most economically developed states, Maharashtra continues to experience a persistently high prevalence of SAM. Recognizing this, there is a necessity to delve into the evolving trends of SAM in Maharashtra and explore the factors influencing its prevalence. Materials and Methods: In this study, the focus was on children aged 6 to 59 months who were residents of the state of Maharashtra. The information was obtained from the National Family Health Survey-4 (NFHS-4, 2015-16) and NFHS-5 (2019-21) databases. Bivariate analysis was conducted to determine the association between socio-demographic variables and SAM between NFHS-4 and NFHS-5 in Maharashtra. The multivariable binary logistic regression analysis was used to study the significant factors associated with the rising trend in SAM between the two survey periods. Results: The analysis showed that the SAM prevalence in Maharashtra has increased from 9.4% to 10.9% since NFHS-4. Bivariate analysis revealed that factors such as the wealth index, total number of children, media exposure of mothers, birth order, birthplace, and birth weight of the child were significant factors during NFHS-4, whereas, during NFHS-5, birth order and child age were the only factors that were found to be significant. The multivariable logistic regression model showed that maternal education and birth weight were the only factors that had a consistently significant association with SAM between the two survey periods (p<0.05). Conclusion: This study showed that despite the nutrition-sensitive policies and efforts of the Maharashtra government, the level of SAM among children is increasing. The observations from the study underscore the necessity of implementing nutrition-specific measures that target the underlying social issues in the state. Addressing these social determinants is crucial to overcoming the challenges associated with SAM effectively.

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“…Several studies on the understanding of factors associated with inequalities in a wide range of health outcomes have adopted the technique of multivariable decomposition analysis [ 24 , 26 , 38 – 40 ]. Multivariable decomposition analysis is ideal for the quantifications of the contributions of different factors to gaps in an outcome of interest between two groups [ 41 ].…”

Section: Methodsmentioning

confidence: 99%

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis

2022

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Background The burden of under-5 deaths is disproportionately high among poor households relative to economically viable ones in developing countries. Despite this, the factors driving this inequality has not been well explored. This study decomposed the contributions of the factors associated with wealth inequalities in under-5 deaths in low- and middle-income countries (LMICs). Methods We analysed data of 856,987 children from 66,495 neighbourhoods across 59 LMICs spanning recent Demographic and Health Surveys (2010-2018). Under-5 mortality was described as deaths among live births within 0 to 59 months of birth and it was treated as a dichotomous variable (dead or alive). The prevalence of under-five deaths was stratified using household wealth status. A Fairlie decomposition analysis was utilized to investigate the relative contribution of the factors associated with household wealth inequality in under-5 deaths at p<0.05. The WHO health equity assessment toolkit Plus was used to assess the differences (D) ratios (R), population attributable risk (PAR), and population attributable fraction (PAF) in household wealth inequalities across the countries. Results The proportion of children from poor households was 45%. The prevalence of under-5 deaths in all samples was 51 per 1000 children, with 60 per 1000 and 44 per 1000 among children from poor and non-poor households (p<0.001). The prevalence of under-5 deaths was higher among children from poor households than those from non-poor households in all countries except in Ethiopia, Tanzania, Zambia, Lesotho, Gambia and Sierra Leone, and in the Maldives. Thirty-four of the 59 countries showed significantly higher under-5 deaths in poor households than in non-poor households (pro-non-poor inequality) and no significant pro-poor inequality. Rural-urban contexts, maternal education, neighborhood socioeconomic status, sex of the child, toilet kinds, birth weight and preceding birth intervals, and sources of drinking water are the most significant drivers of pro-poor inequities in under-5 deaths in these countries. Conclusions Individual-level and neighbourhood-level factors were associated with a high prevalence of under-5 deaths among poor households in LMICs. Interventions in countries should focus on reducing the gap between the poor and the rich as well as improve the education and livelihood of disadvantaged people.

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Decomposing the educational inequalities in the factors associated with severe acute malnutrition among under-five children in low- and middle-income countries

Cited by 11 publications

References 28 publications

Various Risk Factors of Severe Acute Malnutrition in Children Under 5 Years of Age Presenting at a Secondary Care Hospital

Various Risk Factors of Severe Acute Malnutrition in Children Under 5 Years of Age Presenting at a Secondary Care Hospital

Changing Patterns of Severe Acute Malnutrition and Associated Socio-Demographic Factors Among Under-Five Children in Maharashtra

Factors contributing to household wealth inequality in under-five deaths in low- and middle-income countries: decomposition analysis

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