Elucidating the sustained decline in under‐three child linear growth faltering in Nepal, 1996–2016

Hanley-Cook, Giles; Argaw, Alemayehu; Dahal, Pradiumna; Chitekwe, Stanley; Rijal, Sanjay; Bichha, Ram Padarath; Parajuli, Kedar Raj; Kolsteren, Patrick

doi:10.1111/mcn.12982

Cited by 7 publications

(13 citation statements)

References 64 publications

(113 reference statements)

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“…These results underscore the importance of maternal education and socioeconomic status in improving nutritional outcomes. This is consistent with recent work on nutrition in Nepal that included direct measures of healthcare access (Dorsey et al 2017;Nepali et al 2019;Budhathoki et al 2020;Hanley-Cook et al 2020). These studies, which did not account for elevation, nevertheless found strong negative associations between stunting and both maternal education and socioeconomic status.…”

Section: Discussionsupporting

confidence: 89%

“…These studies, which did not account for elevation, nevertheless found strong negative associations between stunting and both maternal education and socioeconomic status. The results on vaccination and breastfeeding are unexpected and at odds with the study of Hanley-Cook et al (2020). The negative correlation observed here between vaccination and linear growth could be a selection problem, wherein children who consume more healthcare do so because they are sicker, but we do not have any evidence from field-level institutional details to say this with confidence.…”

Section: Discussioncontrasting

confidence: 82%

“…Recent work from Nepal supports this conjecture. As a number of studies have noted that while nutrition data, measured using HAZ, stunting rates, or other measures have improved for children below age 5 since 2000, gains have been largest for children from wealthier and better educated households (Dorsey et al 2017;Nepali et al 2019;Budhathoki et al 2020;Hanley-Cook et al 2020). In a recent study from Nepal, characteristics of children and households were found to explain most of the variance in height for age and weight for height, with relatively smaller but statistically significant contributions from communitylevel factors (Smith and Shively 2019).…”

Section: Related Researchmentioning

confidence: 99%

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Elevation and Child Linear Growth in Nepal

Shively

Smith

Paskey

2020

Mountain Research and Development

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The relationship between elevation of residence and a child's linear growth was studied using data for 8824 children below the age of 5 years born between 2001 and 2016 at elevations ranging from 50 to 3200 m above sea level in Nepal. Multiple regression was used to measure the role of a variety of household and community factors in explaining the observed elevation effect. A negative association was found between elevation and linear growth that varied substantially across the sample but retained a significant marginal effect across model specifications. Controlling for household wealth, access to markets, indoor air quality, and a range of other factors associated with elevation, for each 1000 m gain in elevation, height for age z score (HAZ) declined by between 0.10 and 0.20 points for an average child, and by between 0.35 and 0.42 points for a child with the characteristics of those living at the highest elevations. Results underscore the potential developmental risks for children living at high elevations and call attention to factors that help to mitigate these risks.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 82%

Section: Related Researchmentioning

confidence: 99%

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Elevation and Child Linear Growth in Nepal

Shively

Smith

Paskey

2020

Mountain Research and Development

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“…Over the past 20 years, several South Asian countries have achieved a rapid decline in child stunting (Headey et al, 2016 , 2017 ; Torlesse & Aguayo, 2018 ). In this issue, Hanley‐Cook et al ( 2022b ) examine trends in linear growth in children under 3 years in Nepal using data from five national surveys conducted between 1996 and 2016. They find that Nepal achieved a 38.5% increase in height‐for‐age z ‐score (HAZ) and 24 percentage point (pp) decrease in stunting (57% to 33%) over the two decades, despite periods of socio‐economic and political instability, including a 10‐year armed conflict, and natural disasters, including the 2015 earthquakes.…”

Section: Early Childhood Nutritionmentioning

confidence: 99%

Nutrition in Nepal: Three decades of commitment to children and women

Chitekwe¹,

Torlesse²,

Aguayo

2021

Maternal & Child Nutrition

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South Asia has made significant progress in reducing child undernutrition. The prevalence of stunting declined by one third between 2000 and 2019; as a result, in 2019, there were 34 million fewer stunted children than in 2000, indicating that progress for child nutrition is possible and is happening at scale. However, no country in South Asia is on track for all nutrition targets of Sustainable Development Goal 2, and the region has the highest prevalence of stunting (33.2%) and wasting (14.8%) in the world. Nepal, the best performing country in the region, narrowly missed the Millennium Development Goal (MDG) target to half the prevalence of child underweight between 1990 and 2015 and achieved the fastest recorded reduction in stunting prevalence in the world between 2001 and 2011. In 2019, UNICEF Nepal completed a series of papers to examine Nepal's progress on maternal and child nutrition during the MDG era. The series explores the trends, distribution and disparities in stunting, micronutrient deficiencies and feeding practices in children under 5 years and anaemia in adolescents and women. Besides, it reviews national micronutrient programmes (vitamin A supplementation, iron and folic acid supplementation and universal salt iodization) and Nepal's first Multi-Sector Nutrition Plan, to illuminate the success factors and enduring challenges in the policy and programme landscape for nutrition. This overview paper summarizes the evidence from these analyses and examines the implications for the direction of future advocacy, policy and programme actions to improve maternal and child nutrition in Nepal and other similar contexts.

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“…Work from Nepal supports this conjecture. A number of studies find that height for age z scores (HAZ) and stunting rates have improved for children below age 5 since 2000, but gains have been largest for children from wealthier and more educated households (Budhathoki et al, 2020;Dorsey et al, 2018;Hanley-Cook et al, 2020;Nepali et al, 2019;Shively, et al, 2020). Characteristics of children and households explain most of the variance in HAZ and weight for height z scores (WHZ) in Nepal, with relatively smaller but statistically significant contributions from community-level factors (Smith & Shively, 2019).…”

Section: Background and Motivationmentioning

confidence: 99%

Altitude and early child growth in 47 countries

Shively

Schmiess

2021

Popul Environ

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The relationship between altitude of residence and child linear growth is studied using data for 630,499 children below age 5 years born between 1992 and 2016, as recorded in 47 countries at elevations ranging from − 377 to 4498 m above sea level. Regressions are used to measure the role of household, community, and environmental factors in explaining an observed altitude effect on linear growth. Controlling for birth year and country effects, and a range of factors correlated with altitude and associated with nutrition outcomes, for each 1000 m gain in elevation, height for age z score (HAZ) declines by 0.195 points on average. Country-specific estimates of the association vary and include positive associations. Results highlight the potential links between developmental risks for children and features of their physical environment.

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Elucidating the sustained decline in under‐three child linear growth faltering in Nepal, 1996–2016

Cited by 7 publications

References 64 publications

Elevation and Child Linear Growth in Nepal

Elevation and Child Linear Growth in Nepal

Nutrition in Nepal: Three decades of commitment to children and women

Altitude and early child growth in 47 countries

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