Good Care Practices Can Mitigate the Negative Effects of Poverty and Low Maternal Schooling on Children’s Nutritional Status: Evidence from Accra

Ruel, Marie T.; Levin, Carol; Armar‐Klemesu, Margaret; Maxwell, Daniel; Morris, Saul S.

doi:10.1016/s0305-750x(99)00097-2

Cited by 178 publications

(105 citation statements)

References 21 publications

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“…In order to avoid an endogeneity bias, we employ an instrumental variable (IV) approach, using household assets, access to electricity, tapped water, tarred road, and distance to market as instruments. This is similar to approaches that have been used by Ruel et al (1999) and Ruben and van den Berg (2001) in different contexts. In terms of functional form, we tried different specifications, with a linear model showing the best statistical fit.…”

Section: Off-farm Income and Calorie Supplysupporting

confidence: 65%

Impact of off-farm income on food security and nutrition in Nigeria

2010

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Abstract: While the poverty implications of off-farm income have been analyzed in different developing countries, much less is known about the impact of off-farm income on household food security and nutrition. Here, this research gap is addressed by using farm survey data from Nigeria. Econometric analyses are employed to examine the mechanisms through which off-farm income affects household calorie and micronutrient supply, dietary quality, and child anthropometry. We find that off-farm income has a positive net effect on food security and nutrition. The prevalence of child stunting, underweight, and wasting is lower in households with off-farm income than in households without. Using a structural model, we also show that offfarm income contributes to higher food production and farm income by easing capital constraints, thus improving household welfare in multiple ways. Terms of use: Documents inKeywords: Farm households; food security; micronutrients; child anthropometry; off-farm income 1 Impact of off-farm income on food security and nutrition in Nigeria AbstractWhile the poverty implications of off-farm income have been analyzed in different developing countries, much less is known about the impact of off-farm income on household food security and nutrition. Here, this research gap is addressed by using farm survey data from Nigeria.Econometric analyses are employed to examine the mechanisms through which off-farm income affects household calorie and micronutrient supply, dietary quality, and child anthropometry. We find that off-farm income has a positive net effect on food security and nutrition. The prevalence of child stunting, underweight, and wasting is lower in households with off-farm income than in households without. Using a structural model, we also show that off-farm income contributes to higher food production and farm income by easing capital constraints, thus improving household welfare in multiple ways.

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Section: Off-farm Income and Calorie Supplysupporting

confidence: 65%

Impact of off-farm income on food security and nutrition in Nigeria

2010

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“…Current recommendations to practise exclusive breast-feeding to 6 months of age and continue breast-feeding to at least 2 years of age (25) informed the breast-feeding and bottle-feeding components of the ICFI. The responsive feeding and food consistency components of the index were based on current recommendations for complementary feeding of young children (14) and were adapted from similar components used in previously published studies using summary feeding and care indices (26,27) . The continuous ICFI score (0-11) was divided into age-specific feeding tertiles in models examining the association of the ICFI with child anthropometry and dietary adequacy.…”

Section: Data Collection and Samplingmentioning

confidence: 99%

The production diversity of subsistence farms in the Bolivian Andes is associated with the quality of child feeding practices as measured by a validated summary feeding index

Jones

2014

Public Health Nutr.

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Objective: To determine the validity of a summary infant and child feeding index (ICFI) and the association with the index of factors related to agricultural production. Design: A cross-sectional survey in eight health-post jurisdictions identified as priority nutrition regions. All households with children aged 6-23 months in eligible communities were administered an integrated survey on agricultural production and nutrition-related practices. Quantitative 24 h dietary recall, food frequency data and anthropometric measurements were collected for each child. Ninety-one per cent of eligible families participated. Setting: The northern region of the Potosí department in the Bolivian highlands. Subjects: Two hundred and fifty-one households with children aged 6-23 months. Results: In multiple regression models controlling for potential confounding variables, infant and young child feeding (IYCF) practices as measured by an ICFI showed positive associations with child length-for-age Z-score (mean difference of 0?47 in length-for-age Z-score between children in the high ICFI tertile compared with the low tertile), child energy intake (mean difference of 1500 kJ between tertiles) and the micronutrient adequacy of child diets (mean difference of 7?2 % in mean micronutrient density adequacy between tertiles; P , 0?05). Examining determinants of IYCF practices, mother's education, livestock ownership and the crop diversity of farms were positively associated with the ICFI, while amount of agricultural land cultivated was negatively associated with the ICFI. Crop diversity and IYCF practices were more strongly positively correlated among households at high elevations. Conclusions: Nutrition-sensitive investments in agriculture that aim to diversify subsistence agricultural production could plausibly benefit the adequacy of child diets. Keywords Infant and child feedingChild anthropometry Agriculture Crop diversity NutritionIn 2011, at least 165 million children under the age of 5 years suffered from linear growth faltering worldwide, a consequence of chronic undernutrition (1) . Chronic nutritional deficiencies in childhood can lead to an increased risk of morbidity and mortality (2,3) , as well as impaired growth and cognitive development, diminished reproductive and work capacity, poor school performance, lowered income-earning potential and an increased risk of several adult-onset chronic diseases (4,5) . The diets of children in their first years are predominantly determined by the decisions and behaviours of their mothers and other household members who feed and care for them. Caregivers' breast-feeding and complementary feeding practices then are essential to the healthy growth and development of children early in life.Providing education, counselling and complementary foods to caregivers has been shown to improve infant and young children feeding (IYCF) practices in many settings (6) . However, very little evidence is available to evaluate nutrition-sensitive approaches to improving these practices; that i...

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“…The effect of income, when controlling for maternal schooling and care practices, was insignificant. Ruel et al (1999) suggest that lessschooled mothers should be targeted for special messages about care.…”

Section: Quality Of Care Practices Scalementioning

confidence: 99%

The role of care in nutrition programmes: current research and a research agenda

2000

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The importance of cultural and behavioural factors in children's nutrition, particularly with regard to feeding, has been recognized only recently. The combination of evidence regarding the importance of caregiving behaviour for good nutrition, and improved strategies for measuring behaviour have led to a renewed interest in care. The UNICEF conceptual framework suggests that care, in addition to food security and health care services, are critical for children's survival, growth and development. The present paper focuses on the care practice of complementary feeding, specifically behavioural factors such as parental interaction patterns, feeding style and adaptation of feeding to the child's motor abilities (self-feeding or feeding by others). Three kinds of feeding styles (Birch & Fisher, 1995) are identified: controlling; laissez-faire; responsive. Probable effects of each feeding style on nutrient intake are described. A number of studies of feeding behaviour have suggested that the laissez-faire style is most frequently observed among families and communities with a higher prevalence of malnourished children. Nutrition interventions that have been able to show significant effects on outcomes, such as the Hearth Model in Vietnam (Sternin et al. 1997), have usually incorporated behavioural components in their intervention. At this time, there have been no tests of the efficacy of behavioural interventions to improve feeding practices. Research is needed to understand behavioural factors in complementary feeding, and to identify and test intervention strategies designed to improve nutrient intake of young children. Finally, the paper concludes with a discussion of how nutrition programmes might change if care were incorporated. Care and child nutrition: Complementary feeding: Child development: MalnutritionIt is well known that inadequate food intake in the first 2 years of life is responsible for stunting and underweight in millions of children around the world (United Nations Children's Fund, 1998). Poor breast-feeding patterns, low nutrient density and poor quality of the foods that complement breast-feeding accounts for much of the nutrient deficiency (Brown et al. 1998). These patterns of feeding are not simply the result of low food availability in the household. In the present paper we suggest that caregivers' behaviours during feeding of complementary foods (those foods ingested by the child while the child is still being breast-fed, theoretically between the ages of 6 months and 2 years. Even though many children are not still breast-fed at this time, the term continues to be useful to describe this transitional period of food consumption (Brown et al. 1998)) contribute significantly to the adequacy of children's nutrient intake, and therefore to their nutritional status. The present paper will discuss four issues: (1) why there is an interest in feeding practices and care for nutrition; (2) the definition of care and its conceptual framework; (3) examples of research that illustrate the importance o...

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Good Care Practices Can Mitigate the Negative Effects of Poverty and Low Maternal Schooling on Children’s Nutritional Status: Evidence from Accra

Cited by 178 publications

References 21 publications

Impact of off-farm income on food security and nutrition in Nigeria

Impact of off-farm income on food security and nutrition in Nigeria

The production diversity of subsistence farms in the Bolivian Andes is associated with the quality of child feeding practices as measured by a validated summary feeding index

The role of care in nutrition programmes: current research and a research agenda

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