Undernutrition among children under 5 years of age in Yemen: Role of adequate childcare provided by adults under conditions of food insecurity

Abstract

Objective: This study examined the associations between the adequacy of childcare provided by adult caretakers and childhood undernutrition in rural Yemen, independent of household wealth and food consumption.Methods: We analyzed data of 3,549 children under the age of 5 years living in rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and Child Health. Nutritional status was evaluated by the presence of underweight, stunting, and wasting according to the World Health Organization child growth standards. The impact of childcare including leaving children alone, putting older children into labor force, and the use of antenatal care while pregnant on child undernutrition was assessed and adjusted for food consumption by children, household composition, demographic and educational background of caretakers, and household wealth.Results: The prevalence of underweight, stunting, and wasting was 46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of the labor force, and use of antenatal care were associated with a lower risk of underweight (odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). After further adjustment for food consumption, the associations between adequate childcare indicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR = 0.72, P = 0.046; and OR = 0.76, P = 0.038).Conclusions: A marked prevalence of stunting among rural children in Yemen was observed. Adequate childcare by adult caretakers in families is associated with a lower incidence of underweight and stunting among children under 5 years of age. Promoting adequate childcare by adult household members is a feasible option for reducing undernutrition among children in rural Yemen.

Prevalence and associated factors of underweight among children 6–59 months of age in Takusa district, Northwest Ethiopia

“…This might be due to the fact that mothers in food insecure areas were at a high risk of getting underweight babies [ 7 ], while participants in this study lived in a food secure area that maximized the frequency of feeding, and making it possible for providing diversified food provision. Similarly, the finding was lower than findings overseas, for example, Bangladesh 43% [ 31 ], Yemen 46.2% [ 17 ], and Nepal 27.4% [ 32 ]. The possible justification for this could be variations among participants in wealth, access to health care, and differences in socio-demographic characteristics [ 17 , 33 ].…”

“…Lack of dietary diversity and micronutrient-dense food consumption and poor child feeding practices contribute to the high rate of child under nutrition. Various reports also indicate that underweight in children is mainly caused by inadequate food intake [ 7 , 8 ], repeated infections [ 9 – 11 ], low parental education [ 12 – 14 ], lack of sanitation [ 15 ], poor feeding practices [ 16 ], no ANC [ 17 – 19 ], residence [ 20 ], child rearing practices [ 21 ], economic [ 21 , 22 ], social, and cultural factors [ 23 ].…”

Factors affecting stunting among under-five children in Bangladesh

“…Whether antenatal care is being made use of or not has been an important factor on determining the stunting status of children. Literature exhibits the idea that non-use of antenatal care is associated with a prevalence of stunting [45], and children whose mother received antenatal care are less likely to be stunted [46,47]. From this perspective, a key policy suggestion for the government would be expansion of antenatal care services to the far-reaching corners of the country.…”

Prevalence of underweight and it’s associated factors among children aged 6-59 months in Angolalla Tera district, Northeast Ethiopia

“…Calibration was done before weighing every child by setting it to zero. In the case of children age below two years, the scale was allowed weighing of very young children through an automatic mother-child adjustment that used to eliminate the mother's weight while she standing on the scale with her baby (17).…”

“…Though childhood underweight continues to be the leading public health problem in developing countries, it can occur as a result of a wide range of factors. Various reports have been indicated that underweight in children is mainly caused by inadequate food intake (13,14), repeated infections (15,16), poor feeding practices (16), lack of ANC follow up (17,18), rural residence (19), child-rearing practices (20), low economic status (20,21), social, and cultural factors (22) In Ethiopia, the magnitude of underweight was still high. Evidences claimed that according to the 2016 EDHS report underweight was 41% in 2000, 33% in 2005, and 29% in 2011, and24 in 2016 (23).…”