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Food transfers, electronic food vouchers and child nutritional status among Rohingya children living in Bangladesh.

ABSTRACT: OBJECTIVE:To examine associations between receipt of an electronic food voucher (e-voucher) compared to food rations on the nutritional status of Rohingya children living in refugee camps in Bangladesh. METHODS:This is an associational study using cross-sectional data. We measured heights and weights of 523 children aged between 6 and 23 months in households receiving either a food ration consisting of rice, pulses, vegetable oil (362 children) or an e-voucher (161 children) that could be used to purchase 19 different foods. Data were also collected on the characteristics of their mothers and the households in which they lived, including household demographics, consumption and expenditure, coping strategies, livelihoods and income profiles, and access to assistance. Associations between measures of anthropometric status (height-for-age z scores, stunting, weight-for-height z scores, wasting, weight-for-age z scores and mid-upper arm circumference) and household receipt of the e-voucher were estimated using ordinary least squares regressions. Control variables included child, maternal, household and locality characteristics. The study received ethical approval from the Institutional Review Board of the International Food Policy Research Institute, Washington DC. RESULTS:Household receipt of an e-voucher was associated with improved linear growth in children. This association is robust to the inclusion of maternal, household and location characteristics. The magnitude of the association is 0.38 SD (CI: 0.01, 0.74), and statistically significant at the five percent level. We cannot reject the null hypothesis that these associations differ by child sex. Receipt of an e-voucher is not associated with stunting when a full set of control variables are included. There is no association between receipt of e-vouchers and weight-for-length, weight-for-age or mid-upper arm circumference. We cannot reject the null hypothesis that these associations differ by child sex. CONCLUSIONS:In a humanitarian assistance setting, Rohingya refugee camps in Bangladesh, household receipt of an electronic food voucher instead of a food ration is associated with improvements in the linear growth of children between 6 and 23 months but not in measures of acute undernutrition or other anthropometric outcomes. Our associational evidence indicates that transitioning from food rations to electronic food vouchers does not adversely affect child nutritional status.

SUBMITTER: Hoddinott J

PROVIDER: S-EPMC7190090 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Food transfers, electronic food vouchers and child nutritional status among Rohingya children living in Bangladesh.

Hoddinott John J Dorosh Paul P Filipski Mateusz M Rosenbach Gracie G Tiburcio Ernesto E

PloS one 20200429 4

<h4>Objective</h4>To examine associations between receipt of an electronic food voucher (e-voucher) compared to food rations on the nutritional status of Rohingya children living in refugee camps in Bangladesh.<h4>Methods</h4>This is an associational study using cross-sectional data. We measured heights and weights of 523 children aged between 6 and 23 months in households receiving either a food ration consisting of rice, pulses, vegetable oil (362 children) or an e-voucher (161 children) that ...[more]

PMID: 32348313

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Project description:Background:The Rohingyas are an ethnic minority group from Myanmar who have experienced severe forms of violence such as murder, rape, humanitarian defilement and forcible expellation from their motherland. Exposure to trauma has a long-lasting impact on psychological well-being and Health-related Quality of Life (HRQoL). Objective:The purpose of this study was to examine the prevalence of depression and association with HRQoL for Rohingya displaced persons. Methodology:This was a prospective, cross-sectional study in two refugee camps in Southern Bangladesh, with a structured and language validated questionnaire. Results:The study indicates the prevalence of depression was 70% (n=150 respondents), with 8.7% reporting "severe depression" in PHQ-9. WHOQOL-BREF scores were inversely associated with symptoms on the depression scale with a strong and significant correlation (r= 0.652; p<0.01) in total and physical health; psychological (r= 0.757, p<0.01), social relationship (r= 0.479, p<0.01), environment (r= 0.443, p<0.01), increasing age (r= 0.272, p<0.01), severity of depression (r= 0.489, p<0.01). Furthermore, there was a statistically significant correlation with overall quality of life with same variables subsequently (r =0.600, 0.309, 0.482, 0.170, 0.103, 0.272, 0.339; p<0.01), also correlation was observed between married individuals and severity of depression in PHQ (r= 0.346), physical state (r= 0.353), psychological state (r= 0.358), and with social relationship (r= 0.435), with statistical significance (p= <0.01). Conclusion:There are higher incidence rates of moderate to severe depression than the population norms and low health-related quality of life than published population norms for Rohingya displaced persons living in refugee camps. Depression rates were inversely associated with HRQoL for Rohingya displaced persons living in refugee camps. Future research may consider the prevention of related medical issues for long term program implementation.

Project description:BackgroundThe health status of Rohingya refugees or Forcibly Displaced Myanmar Nationals (FDMNs), especially women and children, is a significant challenge for humanitarian workers in Bangladesh. Though the Government of Bangladesh, in partnership with other organizations, is offering health care services to FDMNs, a comprehensive understanding of the program implementation is required for continuation in the future. This study explores the challenges and potential solutions for effective implementation of maternal, newborn, and child health (MNCH) programs for FDMNs residing in camps of Cox's Bazar, Bangladesh.MethodsWe conducted a qualitative study conducted in Cox's Bazar district, Bangladesh, which involved 34 interviews (15 key informant interviews and 19 in-depth interviews) with relevant persons working in organizations responsible for MNCH services to FDMNs. We relied on both inductive and deductive coding and applied the Consolidated Framework for Implementation Research (CFIR) as a guide to our thematic analysis and presentation of qualitative data.ResultsOur study identified some key challenges hindering the effective implementation of MNCH service delivery for the FDMNs. High turnover and poor retention of staff, overlapping of service, weak referral mechanism, complex health information system, and lack of security of the front line health providers were some of the key challenges identified. Motivating the health workers, task shifting, capacity building on emergency obstetric care, training CHW & TBA on danger signs, and ensuring the security of the workers are the potential solutions suggested by the respondents. Selecting a few indicators and the introduction of E-tracker can harmonize the health information system.ConclusionProviding healthcare in an emergency setting has several associated challenges. Considering the CFIR as the base for identifying different challenges and their potential solutions at a different level of the program can prove to be an excellent asset for the program implementers in designing their plans. Two additional domains, context, and security should be included in the CFIR framework for any humanitarian settings.

Project description:ObjectiveTo examine the association between household food insecurity (HFI) and risk of childhood stunting and to determine whether this association is modified by maternal-child overweight/obesity.DesignObservational cross-sectional study.SettingData come from the Mexican National Health and Nutrition Survey (ENSANUT 2012 by its initials in Spanish), representative of rural and urban areas.ParticipantsOur study sample included 5087 mother-preschool child pairs and 7181 mother-schoolchild pairs.Main outcome measuresDifferences in the prevalence (95% CI) of each HFI category by socioeconomic characteristics and maternal-child nutritional status were estimated. A logistic regression model was conducted for stunting and overweight among preschool children and for stunting and overweight/obesity among schoolchildren, adjusting for pertinent covariates. HFI was measured according to the Latin American and Caribbean Food Security Scale (ELCSA by its initials in Spanish). Weight and recumbent lenght or height measures were obtained from children. Overweight and obesity in women were determined according to the WHO Growth Reference Charts. The following covariates were included: sex of the child. urbanicity (urban/rural), region of residence and maternal education. Benefiting from food assistance programmes and socioeconomic status index were also included. Results were expressed as adjusted ORs.ResultsStunting proved more prevalent in preschool children with moderate or severe HFI (16.2% and 16.8%, respectively) (p=0.036 and p=0.007, respectively) than in their counterparts with mild or no HFI (13.2% and 10.7%, respectively). Furthermore, the interaction between HFI and maternal obesity had a significant impact on stunting in preschool children (p<0.05). Severe HFI increased risk of stunting in children with non-obese mothers but not in those with obese mothers.ConclusionWe have discovered a new relationship between HFI and maternal obesity on the one hand and risk of childhood stunting on the other hand. This may reflect a shared mechanism involving dual forms of malnutrition.

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Food transfers, electronic food vouchers and child nutritional status among Rohingya children living in Bangladesh.

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Food transfers, electronic food vouchers and child nutritional status among Rohingya children living in Bangladesh.

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