Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa?
Abstract Objective: We investigated the relationship between socio-economic status and child undernutrition in West Africa (WA), and further examined the mediating role of dietary practices (measured as minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-05-01
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| Series: | Public Health Nutrition |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S1368980022002269/type/journal_article |
| _version_ | 1797742006175268864 |
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| author | Duah Dwomoh Christian Sewor Samuel K Annim Saverio Stranges Ngianga-Bakwin Kandala A Kofi Amegah |
| author_facet | Duah Dwomoh Christian Sewor Samuel K Annim Saverio Stranges Ngianga-Bakwin Kandala A Kofi Amegah |
| author_sort | Duah Dwomoh |
| collection | DOAJ |
| description |
Abstract
Objective:
We investigated the relationship between socio-economic status and child undernutrition in West Africa (WA), and further examined the mediating role of dietary practices (measured as minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)) and household environmental quality (HEQ) in the observed relationship.
Design:
Thirteen countries were included in the study. We leveraged the most recent Demographic and Health Surveys datasets ranging from 2010 to 2019. Poisson regression model with robust standard errors was used to estimate prevalence ratios and their corresponding 95 % CI. Structural equation modelling was used to conduct the mediation analysis.
Setting:
West Africa.
Participants:
132 448 under-five children born within 5 years preceding the survey were included.
Results:
Overall, 32·5 %, 8·2 %, 20·1 % and 71·7 % of WA children were stunted, wasted, underweight and anaemic, respectively. Prevalence of undernutrition decreased with increasing maternal education and household wealth (Trend P-values < 0·001). Secondary or higher maternal education and residence in rich households were associated with statistically significant decrease in the prevalence of stunting, wasting, underweight and anaemia among children in WA. MAD was found to mediate the association of low maternal education and poor household wealth with childhood stunting and underweight by 35·9 % to 44·5 %. MDD, MMF and HEQ did not mediate the observed relationship.
Conclusions:
The study findings enables an evaluation and improvement of existing intervention strategies through a socio-economic lens to help address the high burden of child undernutrition in WA and other developing regions.
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| first_indexed | 2024-03-12T14:34:49Z |
| format | Article |
| id | doaj.art-f6321e57fa484a1a8bf9e98535a832b4 |
| institution | Directory Open Access Journal |
| issn | 1368-9800 1475-2727 |
| language | English |
| last_indexed | 2024-03-12T14:34:49Z |
| publishDate | 2023-05-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Public Health Nutrition |
| spelling | doaj.art-f6321e57fa484a1a8bf9e98535a832b42023-08-17T10:00:50ZengCambridge University PressPublic Health Nutrition1368-98001475-27272023-05-01261022103310.1017/S1368980022002269Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa?Duah Dwomoh0Christian Sewor1https://orcid.org/0000-0003-1155-4730Samuel K Annim2Saverio Stranges3Ngianga-Bakwin Kandala4A Kofi Amegah5https://orcid.org/0000-0001-5868-6402Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, GhanaPublic Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, GhanaDepartment of Applied Economics, School of Economics, University of Cape Coast, Cape Coast, Ghana Ghana Statistical Service, Accra, GhanaDepartment of Epidemiology and Biostatistics and Africa Institute, Western University, London, ON, Canada Department of Precision Health, Luxembourg Institute of Health, Strassen, LuxembourgDepartment of Epidemiology and Biostatistics and Africa Institute, Western University, London, ON, Canada University of Warwick, Division of Health Sciences, Warwick Medical School, Coventry, UK University of the Witwatersrand, Division of Epidemiology and Biostatistics, School of Public Health, Johannesburg, South AfricaPublic Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana Abstract Objective: We investigated the relationship between socio-economic status and child undernutrition in West Africa (WA), and further examined the mediating role of dietary practices (measured as minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD)) and household environmental quality (HEQ) in the observed relationship. Design: Thirteen countries were included in the study. We leveraged the most recent Demographic and Health Surveys datasets ranging from 2010 to 2019. Poisson regression model with robust standard errors was used to estimate prevalence ratios and their corresponding 95 % CI. Structural equation modelling was used to conduct the mediation analysis. Setting: West Africa. Participants: 132 448 under-five children born within 5 years preceding the survey were included. Results: Overall, 32·5 %, 8·2 %, 20·1 % and 71·7 % of WA children were stunted, wasted, underweight and anaemic, respectively. Prevalence of undernutrition decreased with increasing maternal education and household wealth (Trend P-values < 0·001). Secondary or higher maternal education and residence in rich households were associated with statistically significant decrease in the prevalence of stunting, wasting, underweight and anaemia among children in WA. MAD was found to mediate the association of low maternal education and poor household wealth with childhood stunting and underweight by 35·9 % to 44·5 %. MDD, MMF and HEQ did not mediate the observed relationship. Conclusions: The study findings enables an evaluation and improvement of existing intervention strategies through a socio-economic lens to help address the high burden of child undernutrition in WA and other developing regions. https://www.cambridge.org/core/product/identifier/S1368980022002269/type/journal_articleMaternal educationHousehold wealthUndernutritionIYCFHousehold environmental qualityWest Africa |
| spellingShingle | Duah Dwomoh Christian Sewor Samuel K Annim Saverio Stranges Ngianga-Bakwin Kandala A Kofi Amegah Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa? Public Health Nutrition Maternal education Household wealth Undernutrition IYCF Household environmental quality West Africa |
| title | Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa? |
| title_full | Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa? |
| title_fullStr | Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa? |
| title_full_unstemmed | Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa? |
| title_short | Do dietary practices and household environmental quality mediate socio-economic inequalities in child undernutrition risk in West Africa? |
| title_sort | do dietary practices and household environmental quality mediate socio economic inequalities in child undernutrition risk in west africa |
| topic | Maternal education Household wealth Undernutrition IYCF Household environmental quality West Africa |
| url | https://www.cambridge.org/core/product/identifier/S1368980022002269/type/journal_article |
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