Determinants of Growth Retardation in Pakistani Children under Five Years of Age

Abstract

Ensuring the survival and well being of children is a concern of families, communities, and nations throughout the world. Since the turn of the 20th century infant and child mortality in more developed countries has steadily declined and, currently, has been reduced to almost minimal levels. In contrast, although infant and child mortality has declined in the past three decades in most less developed countries, the pace of change and the magnitude of improvement vary considerably from one country to another. Children are at risk of both mortality and morbidity. The problem of malnutrition is widespread in developing countries and particularly severe in South Asian countries, where almost fifty percent of the undernourished children of the world live [Carlson and Wardlaw (1990)]. Rural populations are especially prone to malnutrition because they are more likely to be poor [Tinger (1998)]. The analysis of Demographic and Health Surveys (DHS) in 19 developing countries shows that children living in rural areas are more likely to be malnourished [Sommerfelt and Stewart (1994)].

Water, Sanitation, and Hygiene: Linkages with Stunting in Rural Ethiopia

“…Of the demographic and descriptive determinants, child gender is found to be a non-significant predictor of stunting for this study group. The literature on this is mixed, with some studies indicating that child gender has a role to play [21,41], although these studies are not specific to Ethiopia or Africa more broadly, as both studies emerge from the South Asian context. For Ethiopia, there are studies indicating the significance of gender of child for stunting [25,35] versus studies placing more prominence on livelihood and access to farming opportunities in rural communities [42].…”

“…Population density and the density of open defecation are factors that were identified to be strongly associated with stunting in a comparative analysis of 130 Demographic & Health Surveys (DHS) cross-sectional surveys [19]. There are several studies that report stunting as significantly less prevalent in families with higher socioeconomic status and increases with poverty, environmental factors, a non-utilization of health services, and lack of parental education [20,21,22,23]. Levels of parental education, and in particular maternal education, inversely affect stunting, as demonstrated through a cross-sectional analysis of the Demographic and Health Surveys for low and middle-income countries [24].…”

Child Undernutrition in Pakistan: What Do We Know?

“…Measured in percentage point terms, Pakistan's rural-urban difference with respect to the stunting rate is on the higher end of the distribution for South Asia, and in the middle with respect to wasting and underweight rates. Mahmood (2001), Hazarika (2000), and Ibrahim (1999) find that the national urban-rural difference in nutrition status becomes insignificant after controlling for other factors. Likewise, the World Bank provincial nutrition status notes do not find that the urban-rural difference in stunting status is significant in any of the provinces, based on either a bivariate or a multivariate test depending on the province.…”

Child Health and Poverty in Pakistan

“…This scarcity of income/consumption data has hampered inclusion of poverty in the health and demographic research in Pakistan. This is one reason that earlier studies have used indirect measures of poverty such as 'wealth index', constructed from the data on the household ownership of different assets [Mahmood (2001); Sathar, et al (2003); Ibrahim (2004)]. The PSES had a household expenditure module which collected data in detail on food and non-food items.…”

“…Child morbidity and malnutrition have also been the subject of several recent studies. Like the studies in other developing countries, most of these studies have focused on diarrheal diseases, the most important cause of child morbidity and malnutrition [Arif and Ibrahim (1998); Mahmood (2001); PIDE (2004)]. Significant negative association has also been noted between growth retardation and communicable and other diseases.…”