Association between Maternal and Child Dietary Diversity: An Analysis of the Ghana Demographic and Health Survey.
ABSTRACT: This study examined the association between maternal and child dietary diversity in a population-based national sample in Ghana.The data for this analysis are from the 2008 Ghana Demographic and Health Survey. We used data obtained from 1187 dyads comprised of mothers' ages 15-49 and their youngest child (ages 6-36 months). Maternal and child dietary diversity scores (DDS) were created based on the mother's recall of her own and her child's consumption of 15 food groups, during the 24 hours prior to the in-home survey. The same food groups were used to compose both maternal and child DDS. Linear regression was used to assess the relationship between the predicted outcome--child DDS--and maternal DDS, taking into account child age and sex, maternal factors (age, education, occupation, literacy, empowerment, number of antenatal visits as an indicator of health care use), household Wealth Index, and urban/rural place of residence.There was a statistically significant positive association between child and maternal DDS, after adjusting for all other variables. A difference of one food group in mother's consumption was associated with a difference of 0.72 food groups in the child's food consumption (95% CI: 0.63, 0.82). Also, statistically significant positive associations were observed such that higher child DDS was associated with older child age, and with greater women's empowerment.The results show a significant positive association between child and maternal DD, after accounting for the influence of child, maternal and household level factors. Since the likely path of influence is that maternal DDS impacts child DDS, public health efforts to improve child health may be strengthened by promoting maternal DDS due to its potential for a widened effect on the entire family.
Project description:Guided by the UNICEF framework for childcare, this study examined the association of childcare practices (CCP) with infant and young children's growth (height-for-age Z-scores, HAZ), and investigated whether care practices are more important to growth in some sociodemographic subgroups of children.Cross-sectional survey.Urban and rural Ghana.The study sample comprised 1187 dyads of mothers aged 15-49 years and their youngest child (aged 6-36 months).The results showed that CCP was a significant predictor of HAZ, after controlling for covariates/confounders at child, maternal and household levels. Children with higher CCP scores had higher HAZ. A 1-unit increase in the CCP score was associated with a 0.17-unit increase in HAZ. Child's and mother's age, number of children under 5 years, place of residence, maternal weight and wealth index were also significantly associated with HAZ. Statistical interaction analyses revealed no subgroup differences in the CCP/HAZ relationship.This study found a significant, positive association between CCP and child growth, after accounting for other important determinants of child growth at maternal and household levels. This calls for research into the effects on growth of various CCP components, with longitudinal cohort study designs that can disentangle causal relationships.
Project description:Background:Dietary diversity (DD) is among the core infant and young child feeding (IYCF) indicators. However, in many developing countries, meeting the minimum standards of DD is challenging and information concerning its determinants is limited. Objective:To assess the level and predictors of DD among children aged 6-23 months in rural communities of Aleta Wondo district, Sidama zone, Southern Ethiopia. Method:A community-based cross-sectional study was conducted in rural Aleta Wondo in February 2016. Multistage sampling was employed to recruit 502 children aged 6-23 months. DD was assessed by asking the mother whether the index child had received food from the standard seven food groups in the previous day, without setting minimum intake restrictions. Ultimately, the dietary diversity score (DDS) was rated on a 7-point scale, and it was modeled using linear regression analysis. The outputs are presented using adjusted regression coefficients (?). Results:Only 12.0% (95% confidence interval: 9.0-15.0%) of the children met the minimum recommended DD, receiving from four or more from seven food groups. The analysis identified eleven significant predictors of DDS. As the maternal knowledge of IYCF increases by a unit, DDS raised by 0.21 units (p = 0.004). Unit increment in the husband's involvement in the IYCF score was linked with 0.32 units improvement in DDS (p = 0.016). One unit change in the ordinal category of household food insecurity was associated with 0.13 reduction in DDS (p = 0.001). Similarly, household wealth index (??=?0.54, p = 0.041), father's literacy (??=?0.48, p = 0.002), ownership of home garden (??=?0.38, p = 0.01), mother's participation in cooking demonstrations (??=?0.19, p = 0.036), and child age in months (??=?0.04, p = 0.001) were all positively associated with DDS. Furthermore, receiving IYCF information via mass media (??=?0.04, p = 0.001) and during antenatal (??=?0.91, p = 0.022) and postnatal checkups (??=?0.21, p = 0.043) were positive predictors of DDS. Conclusions:Promoting the socioeconomic status of the community, strengthening of home gardening, involving husbands in IYCF, and enhancing maternal knowledge of IYCF may advance DD.
Project description:OBJECTIVE(S):Using nationally representative surveys conducted in Kenya, this study examined optimal health promoting childcare practices in 2003, 2008-9 and 2014. This was undertaken in the context of continuous child health promotion activities conducted by government and non-government organizations throughout Kenya. It was the aim of such activities to increase the prevalence of health promoting childcare practices; to what extent have there been changes in optimal childcare practices in Kenya during the 11-year period under study? METHODS:Cross-sectional data were obtained from the Kenya Demographic and Health Surveys conducted in 2003, 2008-9 and 2014. Women 15-49 years old with children 0-59 months were interviewed about a range of childcare practices. Logistic regression analysis was used to examine changes in, and correlates of, optimal childcare practices using the 2003, 2008-9 and 2014 data. Samples of 5949, 6079 and 20964 women interviewed in 2003, 2008-9 and 2014 respectively were used in the analysis. RESULTS:Between 2003 and 2014, there were increases in all health facility-based childcare practices with major increases observed in seeking medical treatment for diarrhoea and complete child vaccination. Mixed results were observed in home-based care where increases were noted in the use of insecticide treated bed nets, sanitary stool disposal and use of oral rehydration solutions, while decreases were observed in the prevalence of urging more fluid/food during diarrhoea and consumption of a minimum acceptable diet. Logit models showed that area of residence (region), household wealth, maternal education, parity, mother's age, child's age and pregnancy history were significant determinants of optimal childcare practices across the three surveys. CONCLUSIONS:The study observed variation in the uptake of the recommended optimal childcare practices in Kenya. National, regional and local child health promotion activities, coupled with changes in society and in living conditions between 2003 and 2014, could have influenced uptake of certain recommended childcare practices in Kenya. Decreases in the prevalence of children who were offered same/more fluid/food when they had diarrhea and children who consumed the minimum acceptable diet is alarming and perhaps a red flag to stakeholders who may have focused more on health facility-based care at the expense of home-based care. Concerted efforts are needed to address the consistent inequities in the uptake of the recommended childcare practices. Such efforts should be cognizant of the underlying factors that affect childcare in Kenya, herein defined as region, household wealth, maternal education, parity, mother's age, child's age and pregnancy history.
Project description:Mother's body mass index (BMI) is a strong predictor of child BMI. Whether mother's BMI correlates with child's food intake is unclear. We investigated associations between mother's BMI/overweight and child's food intake using data from two German birth cohorts.Food intakes from 3230 participants were derived from parent-completed food frequency questionnaires. Intakes of 11 food groups were categorized into three levels using group- and sex-specific tertile cutoffs. Mother's BMI and overweight were calculated on the basis of questionnaire data. Multinomial regression models assessed associations between a child's food intake and mother's BMI/overweight. Linear regression models assessed associations between a child's total energy intake and mother's BMI. Models were adjusted for study region, maternal education, child's age, sex, pubertal status and energy intake and the BMIs of the child and father.Mothers' BMI was associated with high meat intake in children (adjusted relative risk ratio (RRR (95% confidence interval))=1.06 (1.03; 1.09)). Mothers' overweight was associated with the meat intake (medium versus low RRR=1.30 (1.07; 1.59); high versus low RRR=1.50 (1.19; 1.89)) and egg intake (medium versus low RRR=1.24 (1.02; 1.50); high versus low RRR=1.30 (1.07; 1.60)) of children. There were no consistent associations for rest of the food groups. For every one-unit increase in mothers' BMI, the total energy intake in children increased by 9.2 kcal (3.7; 14.7). However, this effect was not significant after adjusting for children's BMI.Our results suggest that mother's BMI and mother's overweight are important correlates of a child's intake of energy, meat and eggs.
Project description:We investigated the prevalence of maternal dissatisfaction with their child's body size and its associated factors among mothers of first- to third-grade elementary school students in private schools in the Federal District, Brazil. This is a cross-sectional study with 548 mother-schoolchildren pairs. We measured children's weight and height, and collected their mother's sociodemographic data and Body Mass Index using an online questionnaire. We also verified maternal body dissatisfaction and maternal dissatisfaction with their child's body size using Shape Scales. Most mothers (50.5%) were dissatisfied with their child's body size. Mothers of boys (Adjusted OR = 2.85) were more likely to want a larger silhouette for their child, while mothers of girls (Adjusted OR = 3.18), overweight (Adjusted OR = 24.83) and obese (Adjusted OR = 189.86) children were more likely to want a thinner silhouette for their child. A positive correlation was observed between maternal dissatisfaction with their own body and maternal dissatisfaction with their children's body size (rs = 0.178). There was a high prevalence of maternal dissatisfaction with their child's body size, particularly among mothers of overweight and obese children. Additional studies should be conducted to better understand the influence of this dissatisfaction on maternal practices and attitudes related to their child's body, food consumption, and lifestyle.
Project description:The term malnutrition generally refers to both under-nutrition and over-nutrition, but this study uses the term to refer solely to a deficiency of nutrition. In Ethiopia, child malnutrition is one of the most serious public health problem and the highest in the world. The purpose of the present study was to identify the high risk factors of malnutrition and test different statistical models for childhood malnutrition and, thereafter weighing the preferable model through model comparison criteria.Bayesian Gaussian regression model was used to analyze the effect of selected socioeconomic, demographic, health and environmental covariates on malnutrition under five years old child's. Inference was made using Bayesian approach based on Markov Chain Monte Carlo (MCMC) simulation techniques in BayesX.The study found that the variables such as sex of a child, preceding birth interval, age of the child, father's education level, source of water, mother's body mass index, head of household sex, mother's age at birth, wealth index, birth order, diarrhea, child's size at birth and duration of breast feeding showed significant effects on children's malnutrition in Ethiopia. The age of child, mother's age at birth and mother's body mass index could also be important factors with a non linear effect for the child's malnutrition in Ethiopia.Thus, the present study emphasizes a special care on variables such as sex of child, preceding birth interval, father's education level, source of water, sex of head of household, wealth index, birth order, diarrhea, child's size at birth, duration of breast feeding, age of child, mother's age at birth and mother's body mass index to combat childhood malnutrition in developing countries.
Project description:BACKGROUND: Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life. METHODS: We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors. RESULTS: Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19) holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality. CONCLUSION: Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.
Project description:Developmental delays affect between 150 and 200 million children <5 years of age worldwide. Outside of diet supplement studies, relatively little is known about the relationships between diet quality and developmental status in resource-poor settings. We examined associations between different aspects of dietary quality (dietary diversity score [DDS] and animal-source food [ASF] consumption) and child development (assessed using the Ages and Stages Questionnaire-3 [ASQ-3]) among children whose families were enrolled in a community development intervention trial (implemented by Heifer Nepal) in western Nepal. Two sets of analyses were performed: (a) cross-sectional Sample (N = 629) seen at the endline survey and (b) longitudinal sample (N = 269) with complete dietary records (six surveys over 48 months). In both samples, child development was significantly related to household wealth, maternal education, and especially home environmental quality. In the cross-sectional sample, greater consumption of eggs (adjusted odds ratio [aOR] 0.80, p = .04) or dairy products (aOR 0.95, p = .05) over the previous 7 days significantly reduced odds of low total ASQ score, by logistic regression analysis. In the longitudinal sample, only egg consumption and cumulative DDS and ASF scores were associated with significantly reduced odds of low total ASQ score (aORs 0.59-0.89). In adjusted linear regression analysis, both cumulative DDS (? [CI]: 1.92 [0.4, 3.5]) and ASF scores (2.46 [0.3, 4.7]) were significantly associated with greater continuous total child development. Programmes targeting child development must address home environmental quality as well as long-term diet quality.
Project description:The mechanisms through which livestock ownership is associated with childhood anaemia are contested. Using a cross-sectional, community-based survey of 300 households in southern Ghana, we determined the associations of household livestock ownership with anaemia among children aged 2-5 years. Potential mediating effects of animal-source food (ASF) consumption, microbial infections, and household food security were investigated. Data on each child's anaemia, malaria, and intestinal infections were collected for a subset of 221 households. Anaemia was defined as a haemoglobin (Hb) concentration <110 g/L. ASF consumption was measured as a count of the number of different ASF types consumed by each child in the week prior to the interview. Household food security was measured with a 15-item, pre-tested tool adapted from the USDA Household Food Security Core Module. The number of sheep and goats in aggregate was associated with higher odds of a child being anaemic (aOR (95% CI) = 1.10 (1.03, 1.17)). Households owning more free-range poultry had greater diversity of consumed ASFs among children (Coef. (95% C) = 0.02 (0.01, 0.03)). Owning more pigs was associated with higher odds that a household was food secure (1.05 (0.99, 1.12). We found no evidence that the child's ASF consumption mediated the association of livestock ownership with child anaemia, however,household food security mediated the association between household pig ownership and child anaemia. Overall, household ownership of livestock was associated with higher ASF consumption among children and improved household-level food security, yet also a higher odd of anaemia among those young children. The mechanisms leading to these seemingly counterintuitive relationships require further investigation.
Project description:The impact of low-to-moderate levels of alcohol consumption during pregnancy on child cognitive outcomes has been of recent concern. This study has tested the hypothesis that low-to-moderate maternal alcohol use in pregnancy is associated with lower school test scores at age 11 in the offspring via intrauterine mechanisms.We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort study based in the South West of England. Analyses were conducted on 7062 participants who had complete data on: maternal and paternal patterns of alcohol use in the first trimester and at 18 weeks' gestation, child's academic outcomes measured at age 11, gender, maternal age, parity, marital status, ethnicity, household crowding, home ownership status and parental education. We contrasted the association of mother's alcohol consumption during pregnancy with child's National Curriculum Key Stage 2 (KS2) test scores with the association for father's alcohol consumption (during the time the mother was pregnant) with child's National Curriculum Key Stage 2 (KS2) test scores. We used multivariate linear regression to estimate mean differences and 95% confidence intervals [CI] in KS2 scores across the exposure categories and computed f statistics to compare maternal and paternal associations.Drinking up to 1 unit of alcohol a day during pregnancy was not associated with lower test scores. However, frequent prenatal consumption of 4 units (equivalent to 32 grams of alcohol) on each single drinking occasion was associated with reduced educational attainment [Mean change in offspring KS2 score was -0.68 (-1.03, -0.33) for maternal alcohol categories compared to 0.27 (0.07, 0.46) for paternal alcohol categories]. Frequent consumption of 4 units of alcohol during pregnancy may adversely affect childhood academic outcomes via intrauterine mechanisms.