Social and environmental determinants of child health in Mongolia across years of rapid economic growth: 2000-2010

Joshi, Nehal; Bolorhon, Bolormaa; Narula, Indermohan; Zhu, Shihua; Manaseki-Hollan, Semira

doi:10.1186/s12939-017-0684-x

Cited by 9 publications

(22 citation statements)

References 42 publications

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“…A total of 40 included studies explored the association between childhood stunting and improved water sources ( 15 , 21 , 28–30 , 33 , 37 , 39–41 , 43 , 46–51 , 54 , 55 , 58 , 59 , 62 , 66 , 68–70 , 74 , 76 , 77 , 79 , 83 , 87 , 89 , 90 , 93 , 96 , 98 , 99 , 101 , 102 ). These studies used a variety of methods and examined associations with several indicators measuring access to clean water, including presence of improved sources, unimproved sources, and physical distance to water sources.…”

Section: Resultsmentioning

confidence: 99%

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Vaivada

Akseer

et al. 2020

The American Journal of Clinical Nutrition

195

149

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Background Progress has been made worldwide in reducing chronic undernutrition and rates of linear growth stunting in children under 5 y of age, although rates still remain high in many regions. Policies, programs, and interventions supporting maternal and child health and nutrition have the potential to improve child growth and development. Objective This article synthesizes the available global evidence on the drivers of national declines in stunting prevalence and compares the relative effect of major drivers of stunting decline between countries. Methods We conducted a systematic review of published peer-reviewed and gray literature analyzing the relation between changes in key determinants of child linear growth and contemporaneous changes in linear growth outcomes over time. Results Among the basic determinants of stunting assessed within regression-decomposition analyses, improvement in asset index score was a consistent and strong driver of improved linear growth outcomes. Increased parental education was also a strong predictor of improved child growth. Of the underlying determinants of stunting, reduced rates of open defecation, improved sanitation infrastructure, and improved access to key maternal health services, including optimal antenatal care and delivery in a health facility or with a skilled birth attendant, all accounted for substantially improved child growth, although the magnitude of variation explained by each differed substantially between countries. At the immediate level, changes in several maternal characteristics predicted modest stunting reductions, including parity, interpregnancy interval, and maternal height. Conclusions Unique sets of stunting determinants predicted stunting reduction within countries that have reduced stunting. Several common drivers emerge at the basic, underlying, and immediate levels, including improvements in maternal and paternal education, household socioeconomic status, sanitation conditions, maternal health services access, and family planning. Further data collection and in-depth mixed-methods research are required to strengthen recommendations for those countries where the stunting burden remains unacceptably high.

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Section: Resultsmentioning

confidence: 99%

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Vaivada

Akseer

et al. 2020

The American Journal of Clinical Nutrition

195

149

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…The low prevalence of child underweight, wasting, and stunting reflects the substantial improvements in child growth achieved by the government of Mongolia in recent years (Joshi, Bolorhon, Narula, Zhu, & Manaseki‐Hollan, ; Mongolia Ministry of Health, ). These are laudable successes and provide compelling evidence that a sizable reduction in child stunting is within reach in low‐income countries.…”

Section: Discussionmentioning

confidence: 99%

Complementary feeding practices and associated factors among Mongolian children 6–23 months of age

Janmohamed

Luvsanjamba²,

Норов

et al. 2020

Maternal & Child Nutrition

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Little is known about factors influencing children's dietary intake in Mongolia, a country undergoing rapid nutrition transition. Using nationally representative data from the 2017 Mongolia National Nutrition Survey, we assessed the nutritional status of children aged <2 years and examined household, maternal, and child factors associated with feeding practices among children aged 6–23 months ( n = 938). Multivariable logistic regression models were used to identify predictors of minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). The prevalence of child stunting (length/height‐for‐age Z ‐score < −2 SD ) was 6.3%, and the prevalence of overweight (weight‐for‐height Z ‐score > +2 SD) was 16.8%. The prevalence of anaemia and iron deficiency was 39.0% and 32.2%, respectively, and 73.5% and 85.5% of children had inadequate vitamin A and vitamin D status, respectively. Of children aged 6‐23 months, 92.1% ( n = 864) had MMF, 49.6% ( n = 465) had MDD, and 43.8% ( n = 411) achieved MAD. Increased household wealth was positively associated with all three indicators, whereas severe food insecurity was not associated with MMF, MDD, or MAD. Older child age (odds ratio, 95% CI: 1.09 [1.06, 1.12]; p < .001) and maternal dietary diversity (odds ratio, 95% CI: 2.36 [1.67, 3.34]; p < .001) were positively associated with child MDD. Nutrition‐specific and nutrition‐sensitive efforts are needed to improve the dietary quality of infants and young children in Mongolia and reduce the high burdens of child micronutrient deficiency and overweight in the country.

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“…The subject is essentially qualitative in nature, hence the difficulty in understanding the precise mechanisms of having varying degrees of vulnerability to child mortality and fertility preference among different ethnic groups. A possible mechanism for this variation might be linked with socioeconomic characteristics such as living environment, educational attainment, types of profession, which are some of the crucial proximate determinants of maternal and child health [23][24][25]. Differences in health outcomes among ethnically diverse populations may reflect the interplay of genetic/biological factors with those surrounding environmental, lifestyle behaviour, and culture [26,27].…”

Section: General Discussion and Policy Recommendationmentioning

confidence: 99%

Ethnic disparities in parity and child mortality in Nigeria: a multiple indicator cluster survey

Bishwajit¹,

Yaya²

2020

jhi

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Introduction: Women's reproductive or fertility behaviour and overall maternal and child health outcomes are greatly influenced by various biological and psychosocial factors, which themselves seem to vary substantially among different ethnic backgrounds. This study was undertaken on a representative sample of Nigerian women to assess whether: 1) the ethnic disparities in fertility and child mortality rates are significant even after controlling for potential confounders, 2) women who experience higher child mortality have higher fertility rates. Methods: Cross-sectional data on 34,139 women aged between 15 and 49 years were extracted from a multiple indicator cluster survey conducted in 2017. The total number of children ever born and self-reported events of child health were used as outcome variables. Ethnic differences in parity and child mortality were analysed using multivariable regression techniques. Results: Significant ethnic variation was found across fertility and under-five mortality rates. These variations persisted even after adjusting for several potential risk factors. There was an inverse relationship between under-five mortality and fertility. The prevalence of having > 6 children was highest among women who reported > 2 child deaths. In the regression analysis, high-parity women were found to have experienced higher child mortalities. Conclusions: Significant ethnic differences exist in fertility and under-five mortality, which might be indicative of ethnic inequalities in health determinants and access to healthcare resources. The findings also support the view that women who experience child death are more likely to have higher fertilities than those who do not. Future studies should explore the underlying disparities in child mortality and fertility rates in Nigeria.

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Social and environmental determinants of child health in Mongolia across years of rapid economic growth: 2000-2010

Cited by 9 publications

References 42 publications

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Complementary feeding practices and associated factors among Mongolian children 6–23 months of age

Ethnic disparities in parity and child mortality in Nigeria: a multiple indicator cluster survey

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