Prevalence and predictors of growth stunting in children within 1,000 days in dry zone, Pakokku Township, Myanmar
Keywords:
Stunting, 1,000 days children, dry zone, MyanmarAbstract
Background : Under - nutrition is leading to a global public health problem associated with child morbidity and mortality especially low and middle income countries, Myanmar was also still facing under nutrition especially growth stunting is the highest rate compared with others.
Objective : To explore the prevalence and predictors of growth stunting in children among 1,000 days in Dry Zone, Pakokku Township, Myanmar.
Methods : A cross-sectional and community based study was conducted with 393 participants. Multi-stage sampling technique was drawn to select these respondents at Pakokku Township in Myanmar. Data were collected from mothers with children under 2 years of age. Using 6 parts of structured questionnaires by face - to - face interview. Emergency Nutrition Assessment (ENA) smart software was used for nutritional status assessment based on WHO’s references to calculate child’s height to get Z score (standard deviation score). Stunting was assessed by comparing the body length with age. It could be categorized as stunting when the body length is less than -2 compared to standard deviation. Chi-square and multiple logistic regression were performed to examine factors associated with stunting.
Results : The prevalence of stunting was 14.8 %. The following factors were significantly associated with stunting: children in large family size (more than 2 children) (AOR=2.13, 95% CI 1.05 - 4.31), children aged 13 to 24 months (AOR = 4.52, 95% CI 1.20 - 16.9), children were born with low birth weight and small gestation period (AOR = 3.26, 95% CI 1.34 - 7.95 and AOR = 2.67, 95% CI 1.33 - 5.43), mothers with shorter height (< 145 cm) (AOR = 3.84, 95% CI 1.29 - 11.48) (P <0.05).
Conclusion : Maternal factors were mainly associated with child’s stunting. Nutrition investments should be added for the young especially those under two years old. Nutrition promotion should be focused for both mother and child since the mother is pregnant. Family planning service should be provided and promoted to mothers in this area.
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References
World Food Program. WFP in Myanmar: Looking forward 2013 - 2017. Yangon, Myanmar: World Food Program Myanmar; 2012.
Shetty P. Malnutrition and undernutrition. Medicine 2003;31:18-22.
https://doi.org/10.1383/medc.31.4.18.27958
World Health Organization. Malnutrition [Internet]. 2017 [cited 2017 Jan 4]. Available from: http://www.who.int/mediacentre/factsheets/ malnutrition/en/.
Save the Children. Nutrition in the first 1,000 days: State of the world's mothers 2012. New Hampshire, United States: Johnson & Johnson, Mattel Brookstone; 2012.
International Food Policy Research Institute. Global nutrition report 2016: From promise to impact: Ending malnutrition by 2030 [Internet]. Washington, DC: International Food Policy Research Institute; 2016 [cited 2016 Nov 2]. Available from: http://dx.doi.org/10.2499/ 9780896295841.
https://doi.org/10.2499/9780896295841
Victora CG, de Onis M, Hallal PC, Bl๖ssner M, Shrimpton R. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 2010;125:e473-8.
https://doi.org/10.1542/peds.2009-1519
Chaparro C, Oot L, Sethuraman K. Overview of the nutrition situation in seven countries in Southeast Asia. Washington, DC: Food And Nutrition Technological Assistance III project and FHI 360; 2014.
United Nations Children's Fund. Monitoring the situation of women and children, Multiple Indicator Cluster Survey 2009 - 2010. New York: UNICEF; 2011.
Sport MoHa. Myanmar demographic and health survey (2016-2017) [Internet]. 2017 [cited 2016 Dec 12]. Available from: http://mohs. gov.mm/cat/MDHS%20(2015-16).
Sibson V. A Nutrition and food security assessment of the dry zone of Myanmar. Save the Children, World Food Program and the Ministry of Livestock, Fisheries and Rural Development [Internet]. 2014 [cited 2017 Jan 3]. Available from: http://reliefweb.int/ report/myanmar/nutrition-and-food-securityassessment-dry-zone-myanmar-june-andjuly-2013.
Christian P, Lee SE, Donahue Angel M, Adair LS, Arifeen SE, Ashorn P, et al. Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middleincome countries. Int J Epidemiol 2013;42: 1340-55. https://doi.org/10.1093/ije/dyt109
Chatterjee K, Sinha RK, Kundu AK, Shankar D, Gope R, Nair N, et al. Social determinants of inequities in under-nutrition (weight-for-age) among under-5 children: a cross sectional study in Gumla district of Jharkhand, India. Int J Equity Health 2016;15:104. https://doi.org/10.1186/s12939-016-0392-y
Phyo SW, Keiwkarnka B, Mongkolchati A. Factors related to stunting status of children aged under two years in Magway township, Myanmar. J Public Health Dev 2014;12:3-15.
Undernutrition in Myanmar. Part 1: A critical review of literature. Yangon, Myanmar: Livelihoods and Food Security Trust Fund (LIFT); 2016.
Win Z, Cashin J. Undernutrition in Myanmar: Part 2: A secondary analysis of LIFT 2013 household survey data. Yangon, Myanmar: Leveraging Essential Nutrition Actions to Reduce Malnutrition (LEARN) programme and Livelihoods and Food Security Trust Fund; 2016.
United Nations Children's Fund (UNICEF). The achievable imperative for global progress. Improving Child Nutrition. New York: UNICEF; 2013.
United Nations Children's Fund (UNICEF), World Health Organization, World Bank. Joint child malnutrition estimates -levels and trends. New York: United Nations International Children's Emergency Fund; 2016.
Beniko M, Mongkolchati A, Chompikul J, Phuphaibul R. Relationship between child rearing and child nutritional status during the first year of life in Thailand. J Pub Health Dev 2016; 14:3-19.
Alemu ZA, Ahmed AA, Yalew AW, Birhanu BS, Zaitchik BF. Individual and community level factors with a significant role in determining child height-for-age Z score in East Gojjam Zone, Amhara Regional State, Ethiopia: a multilevel analysis. Arch Public Health 2017; 75:27.
https://doi.org/10.1186/s13690-017-0193-9
Cruz LMG, Azpeitia GG, Súarez DR, Rodriguez AS, Ferrer JFL, Serra-Majem L. Factors associated with stunting among children aged 0 to 59 months from the Central Region of Mozambique. Nutrients 2017;9:E491. https://doi.org/10.3390/nu9050491
Mutua RN, Keriko J, Mutai J. Factors associated with stunting, wasting and underweight among children aged 2-5 years in early childhood 22. Strauss RS, Dietz WH. Growth and development of term children born with low birth weight: effects of genetic and environmental factors. J Pediatr 1998;133:67-72. https://doi.org/10.1016/S0022-3476(98)70180-5
Subramanian S, Acherson LK, Smith GD, John NA. Association of maternal height with child mortality, anthropometric failure, and anemia in India. JAMA 2009;301:1691-701.
https://doi.org/10.1001/jama.2009.548
Mongkolchati A, Thinkhamrop B, Mo-Suwan L, Chittchang U, Choprapawon C. Prevalence and incidence of child stunting from birth to two years of life in Thai children: based on the Prospective Cohort Study of Thai Children (PCTC). J Med Assoc Thai 2010; 93:1368-78.
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