Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study

Semba, Richard D.; Pee, Saskia de; Sun, Kai; Sari, Mayang; Akhter, Nasima; Bloem, Martin W.

doi:10.1016/s0140-6736(08)60169-5

Cited by 316 publications

(353 citation statements)

References 15 publications

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“…Mothers' education has been shown to be important for child development in other LMICs 1,6,10,31,32 and developed countries 33 ; however, fathers' education is usually less important than maternal education. 32 Fathers' education also has a strong effect on child growth in Bangladesh 34 and may represent economic input not captured by the wealth index. We showed that much (60%) of the effect of maternal education on child' s IQ and somewhat less (40%) of paternal education was mediated by the quality of home stimulation and growth.…”

Section: Parental Educationmentioning

confidence: 99%

Cognitive Deficit and Poverty in the First 5 Years of Childhood in Bangladesh

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: More than 200 million children ,5 years old in low-and middle-income countries are not reaching their potential in cognitive development because of factors associated with poverty. WHAT THIS STUDY ADDS:Poverty affects children' s cognition as early as 7 months and continues to increase until 5 years of age. It is mainly mediated by parental education, birth weight, home stimulation throughout the 5 years, and growth in the first 24 months. abstract OBJECTIVE: We aimed to determine the timing and size of the cognitive deficit associated with poverty in the first 5 years of life and to examine the role of parental characteristics, pre-and postnatal growth, and stimulation in the home in Bangladeshi children. We hypothesized that the effect of poverty on cognition begins in infancy and is mainly mediated by these factors. METHODS:We enrolled 2853 singletons, a subsample from a pregnancy supplementation trial in a poor rural area. We assessed mental development at 7, 18, and 64 months; anthropometry at birth, 12, 24, and 64 months; home stimulation at 18 and 64 months; and family' s socioeconomic background. In multiple regression analyses, we examined the effect of poverty at birth on IQ at 64 months and the extent that other factors mediated the effect.RESULTS: A mean cognitive deficit of 0.2 (95% confidence interval -0.4 to -0.02) z scores between the first and fifth wealth quintiles was apparent at 7 months and increased to 1.2 (95% confidence interval -1.3 to -1.0) z scores of IQ by 64 months. Parental education, preand postnatal growth in length, and home stimulation mediated 86% of the effects of poverty on IQ and had independent effects. Growth in the first 2 years had larger effects than later growth. Home stimulation had effects throughout the period.CONCLUSIONS: Effects of poverty on children' s cognition are mostly mediated through parental education, birth size, growth in the first 24 months, and home stimulation in the first 5 years. Pediatrics

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Section: Parental Educationmentioning

confidence: 99%

Cognitive Deficit and Poverty in the First 5 Years of Childhood in Bangladesh

et al. 2014

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“…A second control variable is female education. There is strong empirical evidence that the role of women in general, and maternal education in particular, are important factors in explaining child malnutrition (Desai & Alva, 1998;Semba et al, 2008;Aslam & Kingdon, 2012;Smith & Haddad, 2014). We use female literacy rates from DHS, referring to women of child-bearing age (ICF International, 2013).…”

Section: (C) Control Variablesmentioning

confidence: 99%

The nutrition transition and indicators of child malnutrition

Kimenju

Qaim

2016

Food Sec.

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Abstract. We analyze how the nutrition transition affects child malnutrition in developing countries. It is often assumed that the nutrition transition affects child weight but not child growth, which could be one reason why child underweight decreases faster than child stunting.But these effects have hardly been analyzed empirically. Our cross-country panel regressions show that the nutrition transition reduces child underweight, while no consistent effect on child overweight is found. Against common views, our results also suggest that the nutrition transition reduces child stunting. Further research is required to confirm these findings.Keywords: Nutrition transition, malnutrition, stunting, underweight, obesity JEL codes: I15, O10, O13 AcknowledgementThis research was financially supported by the German Research Foundation (DFG). 1 The Nutrition Transition and Indicators of Child MalnutritionAbstract. We analyze how the nutrition transition affects child malnutrition in developing countries. It is often assumed that the nutrition transition affects child weight but not child growth, which could be one reason why child underweight decreases faster than child stunting.But these effects have hardly been analyzed empirically. Our cross-country panel regressionsshow that the nutrition transition reduces child underweight, while no consistent effect on child overweight is found. Against common views, our results also suggest that the nutrition transition reduces child stunting. Further research is required to confirm these findings.

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“…This contrasts with previous studies in Madagascar which have attributed malnutrition to behavioral factors, poor maternal education, and male sex [25,27–29], and to international literature emphasizing parental education and behaviors [13,19] and male sex [13,17,21] as risk factors for malnutrition. The lack of association with vaccination and supplementation in our study provides evidence that these factors, which may mediate the relationships between parental education, work, and nutrition [18,20], are less important in this population. Environmental factors such as rural location predispose to malnutrition in this population, similar to international ones [13,17].…”

Section: Discussionmentioning

confidence: 79%

“…Environmental factors such as rural residence [13,17], dry season, and local food shortages [18] all predict malnutrition in multiple studies. Maternal and paternal education have been associated with lower odds of malnutrition [13,19]; in one study in Indonesia, health-promoting parental behaviors such as vaccination and supplementation appeared to mediate this relationship [20], and in one study in Tanzania, maternal farming work appeared to worsen child nutritional status [18]. However across international literature, the strongest and most consistent risk factors for malnutrition are demographic: male sex [13,17,21], increasing child age [13,14,21], smaller birth size [13,14,19], and poor maternal nutritional status [13,14,17,19] all predicted malnutrition, particularly stunting, in multiple studies and reviews, leading some authors to conclude that many relevant determinants of growth faltering are already established at birth [19].…”

Section: Introductionmentioning

confidence: 99%

Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

McCuskee

Garchitorena

Miller

et al. 2018

Global Health Action

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Background: Child malnutrition, a leading cause of death and disability worldwide, is particularly severe in Madagascar, where 47% of children under 5 years are stunted (low height-for-age) and 8% are wasted (low weight-for-height). Widespread poverty and a weak health system have hindered attempts to implement life-saving malnutrition interventions in Madagascar during critical periods for growth faltering. Objective: This study aimed to shed light on the most important factors associated with child malnutrition, both acute and chronic, and the timing of growth faltering, in Ifanadiana, a rural district of Madagascar. Methods: We analyzed data from a 2014 district-representative cluster household survey, which had information on 1175 children ages 6 months to 5 years. We studied the effect of child health, birth history, maternal and paternal health and education, and household wealth and sanitation on child nutritional status. Variables associated with stunting and wasting were modeled separately in multivariate logistic regressions. Growth faltering was modeled by age range. All analyses were survey-adjusted. Results: Stunting was associated with increasing child age (OR = 1.03 (95%CI 1.02–1.04) for each additional month), very small birth size (OR = 2.32 (1.24–4.32)), low maternal weight (OR = 0.94 (0.91–0.97) for each kilogram, kg) and height (OR = 0.95 (0.92–0.99) for each centimeter), and low paternal height (OR = 0.95 (0.92–0.98)). Wasting was associated with younger child age (OR = 0.98 (0.97–0.99)), very small birth size (OR = 2.48 (1.23–4.99)), and low maternal BMI (OR = 0.84 (0.75–0.94) for each kg/m2). Height-for-age faltered rapidly before 24 months, then slowly until age 5 years, whereas weight-for-height faltered rapidly before 12 months, then recovered gradually until age 5 years but did not reach the median. Conclusion: Intergenerational transmission of growth faltering and early life exposures may be important determinants of malnutrition in Ifanadiana. Timing of growth faltering, in the first 1000 days, is similar to international populations; however, child growth does not recover to the median.

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Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study

Cited by 316 publications

References 15 publications

Cognitive Deficit and Poverty in the First 5 Years of Childhood in Bangladesh

Cognitive Deficit and Poverty in the First 5 Years of Childhood in Bangladesh

The nutrition transition and indicators of child malnutrition

Child malnutrition in Ifanadiana district, Madagascar: associated factors and timing of growth faltering ahead of a health system strengthening intervention

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