Dataset Information

Levels and trends of adolescent girl's undernutrition and anemia in West and Central Africa from 1998 to 2017.

ABSTRACT:

Background

Adolescence is a highly vulnerable period of human life characterized by substantial physiological and cognitive changes for which adequate nutrition is crucial. To date, evidence on determinants, prevalence, and trends of undernutrition and anemia for the entire West and Central African region is missing. This paper provides evidence on trends and levels of adolescent anemia and undernutrition in West and Central Africa.

Methods

We pooled all Demographic and Health Surveys (DHS) for West and Central African countries that were conducted between 1986 and 2017 to analyze levels and trends of adolescent anemia and undernutrition. We investigated the association of adolescent undernutrition and anemia within this region with World Bank income level classification of the country.

Results

Our findings suggest that the regional prevalence of adolescent anemia and undernutrition remained high at 45% and 19% respectively over the last 20 years. Anemia increased in about one third of countries and undernutrition in about two thirds over the studied period. On the aggregated level, these trends are largely masked and both levels remained stable in the entire region between the years 1998 and 2017. The results of the multivariable regression analysis indicate an association of adolescence with undernutrition and anemia, which was independent of socio-economic factors such as income, education, and place of residence.

Conclusion

We conclude that levels of adolescent undernutrition and anemia remain high with little progress over the last 20 years and that adolescence is a significant correlate of both anemia and undernutrition. Given the recognition of the international community that adolescent nutrition is an important public health concern in resource-poor settings, there is an urgent need to improve data availability, quality, and use for decision-making and to design successful high-impact interventions to combat adolescent malnutrition in low- and middle-income countries.

SUBMITTER: Le Dain AS

PROVIDER: S-EPMC8397282 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe world has made considerable progress in the reduction of adolescent maternity and early marriage. However, this progress has been uneven, with many countries finding themselves far from achieving the Sustainable Development Goals in this dimension. We assessed levels and trends over time in adolescent marriage and maternity prevalence within the West and Central African region as well as their correlation with select macro-level indicators for income and social institutions.MethodsWe estimated country-specific prevalence rates using survey data (pooled cross-sectional) conducted between 1986 and 2017. The pooled sample provides information on 262 721 adolescent girls between the ages of 15 and 19. We assessed the relative country-level trends by comparing prevalence rates from the first and latest available survey in each country. We further analyzed regional trends by country income group (low- and middle-income) and examined the association of prevalence rates with measurements of gender discrimination and social institutions at the country-level. Estimations were conducted using survey weights and country-specific weights for population shares in the pooled sample.ResultsPrevalence of adolescent maternity declined from 30.1 percent (95% confidence interval (CI) = 29.6%-32.2%) in the 1990s, to 28.7 percent (95% CI = 27.9%-29.6%) in the 2000s and 26.2 percent (95% CI = 25.4%-27.1%) in the 2010s. Adolescent marriage rates decreased from 37.3 percent (95% CI = 35.5%-39.1%) in the 1990s to 27.5 percent (95% CI = 26.5%-28.6%) in the 2000s, and to 24.9 percent (95% CI = 24.1%-25.7%) in the 2010s. Between 1986 and 2017, adolescent marriage decreased in all countries except for the Central African Republic (with a rise from 39% to 55%) and Niger (56% to 61%). The prevalence of adolescent maternity decreased in all but three countries: Congo, Dem. Rep. (25% to 37%), Niger (36% to 40%), and the Central African Republic (36% to 49%). When grouped by income level, the prevalence was 8 percentage points higher in low-income countries than in middle-income countries in both outcomes. We did not establish any statisticly significant association between adolescent marriage and maternity with country-level measures of discrimination against women. However, we found evidence of an association between specific legal measures of protection against early marriage and lower prevalence rates for both early marriage and maternity.ConclusionsDespite considerable progress in the reduction of adolescent maternity and marriage over the last 30 years, current levels of both indicators remain overall high in the WCA region, with high heterogeneity across individual countries. Countries with higher income level and higher standard in legal protection of young girls perform consistently better on both indicators. The prevalence rates of adolescent marriage and maternity reversed over the course of three decades, so that nowadays adolescent maternity rates exceed adolescent marriage rates in most countries. Further research is needed to understand the weak or non-existent association between adolescent marriage and maternity with gender discrimination and social institutions.

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