Modelling the impact of stunting on child survival in a rural Ugandan setting

Abstract

Background: Uganda ranks among the top 10 countries in the world for newborn and child mortality rates and among the top 34 for burden of stunting. This study was conducted to model the impact of stunting on child mortality in the southwest region of Uganda where the prevalence of stunting and child mortality are of great public health concern. Methods: The study was conducted in Buhweju district in the southwest region of Uganda. The study was cross-sectional involving use of a structured household questionnaire, focus group discussions and interviews with key informants in order to gather relevant information on infant and young child feeding (IYCF) and coverage of antenatal care (ANC) and vaccination programs. The survey of stunting, vaccination and ANC services covered 221 children aged 6-59 months while the assessment of IYCF practices covered 83 children aged 0-23. The Lives Saved Tool (LiST) was used to estimate the impact of stunting on child mortality and cases of stunting averted. Results: The study findings indicated that only 33% of the mothers had knowledge of optimal IYCF and 39% of the sampled children were exclusively breastfed. The majority of the mothers (57%) breastfed their children for less than 2 years and only 31% of the mothers practiced appropriate introduction of complementary foods at 6 months. Only 17% of the 0-23-month-olds received a good standard of IYCF. Only 37% of the mothers reportedly attended ANC 4 times or more during pregnancy and among children aged 6-59 months, only 28% were fully vaccinated. The high impact LiST model estimated that 1297 children under 5 years would be saved and 24,850 cases of stunting averted in the study district. Conclusions: The study concludes that IYCF practices and coverage of expanded programme on immunization (EPI) and ANC in the study population are sub-optimal thus the high prevalence of stunting and child mortality in the region. LiST demonstrated that prevention of stunting would reduce child mortality in rural Uganda. Therefore, increased investment in cost-effective child survival interventions targeting rural areas of Uganda would have a significant impact on stunting and child mortality.

The Effect of Risk Accumulation on Childhood Stunting: A Matched Case-Control Study in China

“…A cross-sectional study based on 42 rural counties in seven western provinces of China showed that 44.5% of children aged 6–23 months failed to reach the minimum dietary diversity criteria defined by the WHO ( 36 ). Many studies have shown that the early initiation of breastfeeding and exclusive breastfeeding are protective factors against stunting, which was also supported in this study ( 37 – 39 ). In addition, we focused on the effect of eating behaviors and children's appetites on stunting.…”

Magnitude of undernutrition and its associated factors in children attending Child Welfare Clinics in Techiman Municipal, Ghana

“…This study showed that the age of the child, sex of the children and number of children under five years in households were associated with stunting. The association of child age and sex with nutritional status has been reported by other authors (Bukusuba et al, 2018;Glover-Amengor et al, 2016;Akombi et al, 2017;Kebede et al, 2021;Verma and Prasad, 2021;Muche et al, 2021;Tandoh et al, 2019;Webb et al, 2021) and these findings could have been due to varying care and attention given to children as they grow and perhaps based on their sex. Following that the prevalence of child undernutrition remains high in the Bono and Ahafo regions; this study provides a clue to the factors that are associated to undernutrition.…”

“…According to the Ghana Health Service, the main reason for irregular attendance to CWC is a lack of maternal interest after the completion of childhood vaccinations (Ghana Statistical Service, 2014). Because vitamin A supplementation, growth monitoring and immunization services are provided at CWCs, children who do not attend CWC will miss the health benefits of these interventions and increase their risk of undernutrition, morbidity and mortality; sub-optimal immunization and micronutrient deficiency have been associated with poor nutritional status and mortality among children (Gebre et al , 2019; Bukusuba et al , 2018).…”

Analysis of Factors Associated with Stunted Growth in Children Aged 12-60 Months Living in Lenda Village, Manggarai Regency, NTT

“…Mothers in Lenda Village who have babies believe that the habits of their parents in caring for babies are the best way to care for babies, including providing additional food to babies other than breast milk before the age of 6 months. Some mothers say their babies have to be given water before the age of 6 months so that the baby grows into a strong child, some even have been given additional food before the age of 6 months.This practice leaves infants at high risk of infection, stunted growth and death as reported by other studies (Bukusuba, Kaaya, & Atukwase, 2018). Knowledge factors also contribute to exclusive breastfeeding.…”