Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville

Abstract

Half the children under the age of 5 years in Papua New Guinea (PNG) are undernourished, more than double the global average with rural areas disproportionately affected. This study examines factors associated with stunting, wasting and underweight in cocoa growers’ children (<5 years) in the Autonomous Region of Bougainville (ARoB), using data from a comprehensive 2017 cross-sectional livelihoods survey. Sixteen independent predictors for stunting, wasting and underweight were selected based on the UNICEF Conceptual Framework of Determinants of Undernutrition. We used multilevel logistic mixed regression models to measure the association of the explanatory variables with stunting, wasting and underweight. At the household level, the adjusted OR (aOR) of stunting (aOR=1.71,95% CI 1.14 to 2.55) and underweight (aOR=2.11, 95% CI 1.16 to 3.82) increased significantly among children from households with unimproved toilet facilities. The aOR for underweight also increased among children from households without access to clean drinking water (aOR=1.97, 95% CI 1.19 to 3.29). Short maternal stature was significantly associated with child stunting, the odds increased as maternal height decreased (from 150 to <155 cm, aOR=1.52, 95% CI 1.02 to 2.26) (<150 cm, aOR=2.37, 95% CI 1.29 to 4.35). At the individual level, the odds of a child being underweight increased with birth order (second born, aOR=1.92, 95% CI 1.09 to 3.36; third born, aOR=6.77, 95% CI 2.00 to 22.82). Compared with children less than 6 months, children aged 6–23 months and 24–59 months had a higher odds of being stunted (aOR=3.27, 95% CI 1.57 to 6.78 and aOR=2.82, 95% CI 1.40 to 5.67) and underweight (aOR=4.83, 95% CI 1.36 to 17.24 and aOR=4.59, 95% CI 1.29 to 16.26). No variables were found to be significant for wasting. Interventions that simultaneously target key life stages for women and children and the underlying social and environmental determinants are required for sustained improvements to undernutrition.

Co-existence of Overweight/obesity and Stunting: It’s Prevalence and Associated Factors Among Under - Five Children in Addis Ababa, Ethiopia

“…The odd of the co-existence of overweight/obesity and stunting among children aged 6-23 months was 2.86 times higher than that of children aged 24-59 months. This nding is in line with a study conducted in Indonesia and Papua New Guinea (31,40).…”

Factors associated with adverse nutritional status of children in sub‐Saharan Africa: Evidence from the Demographic and Health Surveys from 31 countries

“…This may be premised on the assumption that the conditions of the average-sized and small-sized children did not improve as they grew older probably due to the lack of nutritious diet. Toilet facility and child's stool disposal system exert influence on adverse nutritional outcomes of children as children from households with nonimproved toilet facility and those from households with poor child's disposal system are more exposed to the risk of wasting and underweight (Hall et al, 2020;Rahman et al, 2020;van Cooten et al, 2018). Nonimproved toilet facility together with poor stool disposal system may predispose children to infections, which could eventually lead to morbidity.…”

Predictors of Nutritional Status and Academic Performance of Under-Five Early Childhood Development Children in Zimbabwe

“…According to Smith and Haddad (2000), malnutrition at an early age could result in irreversible damage and other far-reaching consequences such as diminished learning and school performance and reduced future earnings. Literature proclaims important synergies between malnutrition and cognitive development (Martorell, 1999 andHall et al, 2020). Studies on growth rate and nutritional status have been well documented in developed countries but not in developing countries where not much work has been documented on anthropometric evaluations (Onimawo & Cole 2010;Srivastava et al, 2012).…”

“…The responses to the challenge of malnutrition has a long history, globally and this is well documented in literature (Hall et al, 2020). The WHO, in response to global child malnutrition challenge, set goals to reduce the number of stunted children by 40% and to maintain childhood wasting to less than 5% by 2025 (Hall et al, 2020) and the second Sustainable Development Goal reinforces the need to fight child malnutrition.…”

“…The responses to the challenge of malnutrition has a long history, globally and this is well documented in literature (Hall et al, 2020). The WHO, in response to global child malnutrition challenge, set goals to reduce the number of stunted children by 40% and to maintain childhood wasting to less than 5% by 2025 (Hall et al, 2020) and the second Sustainable Development Goal reinforces the need to fight child malnutrition. The evolving nature of global child malnutrition demands a deeper understanding of both the socioeconomics drivers of malnutrition and an assessment of the factors affecting the nutritional status and academic performance of under-five Early Childhood Development children.…”