Association between economic growth and early childhood undernutrition: evidence from 121 Demographic and Health Surveys from 36 low-income and middle-income countries. Lancet Global Health, Apr 2014.

Authors: Sebastian Vollmer, et al.

Background - Economic growth is widely regarded as a necessary, and often sufficient, condition for the improvement of population health. We aimed to assess whether macroeconomic growth was associated with reductions in early childhood undernutrition in low-income and middle-income countries.

Methods - We analysed data from 121 Demographic and Health Surveys from 36 countries done between Jan 1, 1990, and Dec 31, 2011. The sample consisted of nationally representative cross-sectional surveys of children aged 0—35 months, and the outcome variables were stunting, underweight, and wasting. The main independent variable was per-head gross domestic product (GDP) in constant prices and adjusted for purchasing power parity. We used logistic regression models to estimate the association between changes in per-head GDP and changes in child undernutrition outcomes. Models were adjusted for country fixed effects, survey-year fixed effects, clustering, and demographic and socioeconomic covariates for the child, mother, and household.

Findings - Sample sizes were 462 854 for stunting, 485 152 for underweight, and 459 538 for wasting. Overall, 35·6% (95% CI 35·4—35·9) of young children were stunted (ranging from 8·7% [7·6—9·7] in Jordan to 51·1% [49·1—53·1] in Niger), 22·7% (22·5—22·9) were underweight (ranging from 1·8% [1·3—2·3] in Jordan to 41·7% [41·1—42·3] in India), and 12·8% (12·6—12·9) were wasted (ranging from 1·2% [0·6—1·8] in Peru to 28·8% [27·5—30·0] in Burkina Faso). At the country level, no association was seen between average changes in the prevalence of child undernutrition outcomes and average growth of per-head GDP. In models adjusted only for country and survey-year fixed effects, a 5% increase in per-head GDP was associated with an odds ratio (OR) of 0·993 (95% CI 0·989—0·995) for stunting, 0·986 (0·982—0·990) for underweight, and 0·984 (0·981—0·986) for wasting. ORs after adjustment for the full set of covariates were 0·996 (0·993—1·000) for stunting, 0·989 (0·985—0·992) for underweight, and 0·983 (0·979—0·986) for wasting. These findings were consistent across various subsamples and for alternative variable specifications. Notably, no association was seen between per-head GDP and undernutrition in young children from the poorest household wealth quintile. ORs for the poorest wealth quintile were 0·997 (0·990—1·004) for stunting, 0·999 (0·991—1·008) for underweight, and 0·991 (0·978—1·004) for wasting.

Interpretation - A quantitatively very small to null association was seen between increases in per-head GDP and reductions in early childhood undernutrition, emphasising the need for direct health investments to improve the nutritional status of children in low-income and middle-income countries.

Childhood malnutrition and parasitic helminth interactions. Clin Infect Dis. 2014 Apr 4.

Papier K, et al

Background. There is evidence to support that nutritional deficiency can reduce the body’s immune function thereby decreasing resistance to disease and increasing susceptibility to intestinal parasites.

Methods. A cross-sectional survey was carried out on 693 school-aged children from five schistosomiasis endemic villages in Northern Samar, The Philippines. Information on dietary intake, nutritional status, and intestinal parasitic infection were collected.

Results. The prevalence of stunting, thinness and wasting was 49.21%, 27.85% and 59.72% of all children. The proportion of children infected with S. japonicum (15.64%, p=0.03) and hookworm (20.99%, p=0.05) were significantly lower among children who met the recommended energy and nutrient intake (RENI) for total calories. The percentage of children infected with T. trichiura was highest among children who did not meet the RENI for energy (74.06%, p=0.04), iron (73.40%, p=0.01), thiamine (74.05%, p=0.00) and riboflavin (73.29%, p 0.01). Susceptibility to having one or more parasitic infections was significantly associated with poor intake of energy (p=0.04), thiamine (p=0.02) and riboflavin (p=0.01).The proportion of stunted children was significantly higher among children who did not meet the RENI for energy (68.91%, p=0.002), protein (53.96%, p=0.004) and niacin (30.79%, p=0.02) and for those infected with hookworm (31.80%, p= 0.0002). After adjusting for potential confounders, protein intake below the RENI (OR 1.48; 95% CI: 1.03-2.14) and hookworm infection (OR 1.77; 95% CI: 1.22-2.55) were the major predictors of stunting.

Conclusions. The results support the hypothesis that poor nutrient intake may increase susceptibility to parasitic diseases and together they negatively affect childhood nutritional status.

Catch-Up Growth Occurs after Diarrhea in Early Childhood

April 8, 2014

Catch-Up Growth Occurs after Diarrhea in Early Childhood. Jnl of Nutrition, April 2014. Order info Stephanie A. Richard, et al. To whom correspondence should be addressed. E-mail: wcheckl1@jhmi.edu. Diarrhea and linear growth faltering continue to burden low-income countries and are among the most important contributors to poor health during early childhood. Diarrhea is thought to […]

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Prevalence of Anemia and Its Risk Factors Among Lactating Mothers in Myanmar

April 8, 2014

Prevalence of Anemia and Its Risk Factors Among Lactating Mothers in Myanmar. Am J Trop Med Hyg, Mar 2014. A Zhao. (Abstract) In Myanmar, 60 percent of the population consists of mothers and children, and they are the groups most vulnerable to anemia. The objectives of this study are to determine:  the anemia prevalence among lactating […]

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Extra Food Means Nothing to Stunted Kids With Bad Water: Health

April 2, 2014

Extra Food Means Nothing to Stunted Kids With Bad Water:  Health | Source: by Adi Narayan, Bloomberg, June 2013. Excerpts – Aameena Mohammed gives her 20-month-old daughter Daslim Banu plenty to eat. The girl’s mother supplements breast milk with eggs, soup and rice to help her grow. The extra food doesn’t help. Daslim still weighs […]

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Francis Ngure – The WASH and Nutrition Nexus Current Operational Approaches, Lessons Learned and Practical Considerations for Future Programming

April 2, 2014

This presentation was made at a meeting at USAID on April 1, 2014. The WASH and Nutrition Nexus Current Operational Approaches, Lessons Learned and Practical Considerations for Future Programming, by Francis M. Ngure, Water and Sanitation Program. Presentation, pdf Excerpts from the presentation – There is enough evidence to support integration of  WASH and nutrition […]

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WASH/Nutrition Literature Update – March 2014

April 2, 2014

WASH/Nutrition Literature Update – March 2014 The March 2014 literature update includes details on an upcoming USAID-sponsored WASH nutrition presentation on April 1, 2014, and the March 2014 issue of USAID’s Global Waters magazine with descriptions of USAID WASH and nutrition efforts in Liberia and other countries. Other resources include a 2014 WHO report on […]

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Interventions to Address Maternal and Childhood Undernutrition: Current Evidence

March 12, 2014

Interventions to Address Maternal and Childhood Undernutrition: Current Evidence Order info Bhutta Z.A. · Das J.K. Black RE, Singhal A, Uauy R (eds): International Nutrition: Achieving Millennium Goals and Beyond. Nestlé Nutr Inst Workshop Ser. Nestec Ltd. Vevey/S. Karger AG Basel, © 2014, vol 78, pp 59-69 The global burden of undernutrition remains high with […]

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Can an Integrated Approach Reduce Child Vulnerability to Anaemia?

March 12, 2014

Can an Integrated Approach Reduce Child Vulnerability to Anaemia? Evidence from Three African Countries. PLoS One, March 2014. Full text Authors: Kendra Siekmans, et al. Addressing the complex, multi-factorial causes of childhood anaemia is best done through integrated packages of interventions. We hypothesized that due to reduced child vulnerability, a “buffering” of risk associated with […]

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Systematic review and meta-analysis: association between WASH and maternal mortality

March 12, 2014

Systematic review and meta-analysis: association between water and sanitation environment and maternal mortality. Trop Med Intl Health, Feb 2014. Full text, pdf Authors: Lenka Benova, Oliver Cumming and Oona M. R. Campbell Objective – To assess whether the lack of water or the lack of sanitation facilities in either the home or in health facilities is […]

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