Basic determinants of child growth in sub-Saharan Africa: cross-sectional survey analysis of positive deviants in poor households

作者: Dickson A. Amugsi , Zacharie T. Dimbuene , Elizabeth W. Kimani-Murage

DOI: 10.1101/19006759

关键词: Positive devianceDemographyOverweightOddsBreastfeedingCross-sectional studyPsychological interventionOdds ratioMedicinePoverty

摘要: Objectives: To examine the sociodemographic correlates associated with better linear growth among children under 5 years living in poor households Design: Cross-sectional Setting: Ghana, Kenya, Democratic Republic of Congo (DRC), Nigeria and Mozambique Participants: Singleton aged 0 to 59 months, born mothers 15 49 years. Information on was obtained through face-to-face interviews mothers. Primary outcome measure: Child height-for-age Z-scores (HAZ), categorised into HAZ≥-2 standard deviations (SD) (better growth/not stunted) HAZ≤-2 SD (stunted/poor growth). Results: A unit change maternal education increased odds DRC [adjusted ratio (aOR)= 1.03, 95% CI=1.01,1.07)], Ghana (aOR=1.06, CI=1.01,1.11), Kenya (aOR=1.03, CI= 1.01, 1.05) (aOR=1.08, 95%=1.06,1.10). Maternal antenatal attendance at least four visits positively child (aOR=1.32, CI=1.05, 1.67) (aOR=1.67, CI=1.19, 2.33). The association did not reach statistical significance remaining three countries. In Mozambique DRC, breastfeeding significantly likelihood when only socio-demographic were included models, but disappeared after inclusion level covariates. Nigeria, normal weight (aOR=1.24, CI=1.08, 1.43) households, so overweight (aOR=1.51, 1.24, 1.83). all countries except biological factors such as sex age reduced growth. Conclusions: this analysis have potential promote households. Interventions aimed promoting poverty should target enhancing these factors. Keywords: growth, sub-Saharan Africa, positive deviance, cross sectional survey

参考文章(50)
Susan Keino, Guy Plasqui, Grace Ettyang, Bart van den Borne, Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa Food and Nutrition Bulletin. ,vol. 35, pp. 167- 178 ,(2014) , 10.1177/156482651403500203
David R. Marsh, Dirk G. Schroeder, The Positive Deviance Approach to Improve Health Outcomes: Experience and Evidence from the Field—Preface Food and Nutrition Bulletin. ,vol. 23, pp. 3- 6 ,(2002) , 10.1177/15648265020234S201
M. Blössner, E. A. Frongillo, M. de Onis, Is malnutrition declining? An analysis of changes in levels of child malnutrition since 1980. Bulletin of The World Health Organization. ,vol. 78, pp. 1222- 1233 ,(2000) , 10.1590/S0042-96862000001000008
Jessica F. Lamontagne, Patrice L. Engle, Marian F. Zeitlin, Maternal Employment, Child Care, and Nutritional Status of 12-18-Month-Old Children in Managua, Nicaragua Social Science & Medicine. ,vol. 46, pp. 403- 414 ,(1998) , 10.1016/S0277-9536(97)00184-6
Robert E Black, Lindsay H Allen, Zulfiqar A Bhutta, Laura E Caulfield, Mercedes De Onis, Majid Ezzati, Colin Mathers, Juan Rivera, Maternal and Child Undernutrition Study Group, None, Maternal and child undernutrition: global and regional exposures and health consequences The Lancet. ,vol. 371, pp. 243- 260 ,(2008) , 10.1016/S0140-6736(07)61690-0
Narayan Sastry, What explains rural-urban differentials in child mortality in Brazil? Social Science & Medicine. ,vol. 44, pp. 989- 1002 ,(1997) , 10.1016/S0277-9536(96)00224-9