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Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study.

ABSTRACT: Previous studies conducted in Nepal have not identified the potential maternal risk for underweight among children under-five years of age in resource-poor settings. Therefore, to identify these risk factors for being underweight among children under-five years old, a community-based case-control study was conducted in a rural village in the Chitwan District in Nepal. Cases were defined as children who were diagnosed as underweight based on low weight per age, whereas controls were the children with normal weight for their age. Mothers of 93 cases and 186 controls were invited for an interview to collect the data. More than half of underweight children were female (51.6%) and nearly one third of them (31.2%) were aged 13-24 months. Nearly, 30% of the cases belonged to families in the lowest wealth quintile and 82% of cases were from food insecure families. Logistic regression analysis showed that children of mothers who were illiterate had 1.48 times the odds of being underweight compared to whose mothers were not illiterate (95% Confidence Interval [CI]: 1.53-3.07)). Children whose mother had not completed their postnatal care (PNC) were 3.16 more times likely to be underweight compared to children of mothers who completed PNC (95% CI: 1.24-8.03). The children who received care from other family members besides their mothers were 6.05 times more likely to be underweight (95% CI: 1.44-25.42); the children having mothers who had no income at all had 5.13 times the odds of being underweight (95% CI: 1.27-20.71) and children with diarrhea episodes within one month were 2.09 times more likely to be underweight (95% CI:1.02-4.31) compared to those children without any diarrhea episodes within one month. Women should be encouraged to take care of their children themselves, seek PNC services and take precautions to protect their children from diarrhea. Also, enabling factors such as education and improved income for women can help to reduce malnutrition among children.

SUBMITTER: Sigdel A

PROVIDER: S-EPMC7241795 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study.

Sigdel Anil A Sapkota Hardik H Thapa Subash S Bista Anu A Rana Anil A

PloS one 20200521 5

Previous studies conducted in Nepal have not identified the potential maternal risk for underweight among children under-five years of age in resource-poor settings. Therefore, to identify these risk factors for being underweight among children under-five years old, a community-based case-control study was conducted in a rural village in the Chitwan District in Nepal. Cases were defined as children who were diagnosed as underweight based on low weight per age, whereas controls were the children ...[more]

PMID: 32437366

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Project description:BackgroundUnderweight prevalence continues to be major public health challenge worldwide, particularly in developing countries like Pakistan. This study is focused on socio-economic and demographic aspects of underweight prevalence among children under-five in Punjab.MethodsIn this study, several socioeconomic and demographic factors are considered using MICS-4 data-set. Only those variables which are usually described in the nutritional studies of children were picked. Covariates include: the age of children, sex of the children, age of mother, total number of children born to women, family wealth index quintile, source of drinking water, type of sanitation, place of residence, parents' education and occupation. All Categorical variables are effect coded. The child's age and the mother's age are assumed to be nonlinear, geographical region is spatial effect, while other variables are parametric in nature. Since, the response is binary, covariate comprises linear terms, nonlinear effects of continues covariates and geographic effects, so we have use Geo-additive models (based on Fully Bayesian approach) with binomial family under logit link. Statistical analysis is performed on Statistical package R using Bayes X and R2 Bayes X Libraries.ResultsUnderweight status of children was found to be positively associated with number of under-five children in household, total number of children ever born to women and age of mother when the child was born. Whereas, it negatively associated with place of residence, parent's education and family wealth index quintile. On the regional effect, the Southern Punjab has higher prevalence of underweight compared to Central and Northern Punjab.ConclusionSimilarity of our results with several other studies demonstrate that the Geo-additive models are an ideal substitute of other statistical models to analyze the underweight prevalence among children. Moreover, our findings suggest the Punjab Government, to introduce target-oriented programs such as poverty reduction and enhancement of education and health facilities for poor population and disadvantaged regions, especially Southern Punjab.

Project description:ObjectiveImplementing national-level vaccination programs involves long-term investment, which can be a significant financial burden, particularly in resource-limited settings. Although many studies have assessed the economic impacts of providing vaccinations, evidence on the positive and negative implications of human resources for health (HRH) is still lacking. Therefore, this study aims to estimate the HRH impact of introducing pneumococcal conjugate vaccine (PCV) using a model-based economic evaluation.MethodsThis study adapted a Markov model from a prior study that was conducted in the Philippines for assessing the cost-effectiveness of 10-valent and 13-valent PCV compared to no vaccination. The Markov model was used for estimating the number of cases of pneumococcal-related diseases, categorized by policy options. HRH-related parameters were obtained from document reviews and interviews using the quantity, task, and productivity model (QTP model).ResultsThe number of full-time equivalent (FTE) of general practitioners, nurses, and midwives increases significantly if the universal vaccine coverage policy is implemented. A universal coverage of PCV13 - which is considered to be the best value for money compared to other vaccination strategies - requires an additional 380 FTEs for general practitioners, 602 FTEs for nurses, and 205 FTEs for midwives; it can reduce the number of FTEs for medical social workers, paediatricians, infectious disease specialists, neurologists, anaesthesiologists, radiologists, ultrasonologists, medical technologists, radiologic technologists, and pharmacists by 7, 17.9, 9.7, 0.4, 0.1, 0.7, 0.1, 12.3, 2, and 9.7, respectively, when compared to the no vaccination policy.ConclusionThis is the first attempt to estimate the impact of HRH alongside a model-based economic evaluation study, which can be eventually applied to other vaccine studies, especially those which inform resource allocation in developing settings where not only financial resources but also HRH are constrained.

Dataset Information

Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study.

Publications

Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study.

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