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Child stunting, or linear growth faltering, affects 1 in 5 children under the age of five years. These 151 million stunted children predominantly live in low- and middle-income countries. For decades, clinicians and researchers considered stunting a form of chronic malnutrition but modest gains were made in eliminating stunting through nutritional interventions. This dissertation explored emerging areas in child stunting. Chapters 1 and 2 introduced stunting and provided backgrounds, respectively. The research was guided by the Social Ecological Model and Life Course Perspective in approaching stunting as embedded in macro structures at multiple levels over the life course of women and children. Chapter 3 described theoretical frameworks and an integrated model. The analyses focused on Madagascar and Zambia, which were ranked among countries with the highest proportions of child stunting. We used health data from the Demographic and Health Surveys (DHS) and armed conflict data from the Armed Conflict Location and Event Data Project (ACLED) database in Madagascar and Zambia. Chapter 4 detailed the methodology, including multivariate logistic and linear regression models assessing child stunting and height-for-age z-score (HAZ) outcomes. Chapter 5 examined maternal anthropometry and child gender factors. Results indicated that short stature or underweight in mothers were associated with increased stunting odds while higher maternal height and BMI scores were associated with higher child HAZ. Chapter 6 investigated household water and sanitation measures. We found that households without piped water and finished flooring were associated with increased stunting odds. Stunting was associated with lack of an advanced flush toilet in Zambia but not in Madagascar. Chapter 7 explored proximity of armed conflict events during critical developmental periods with child stunting and height. Conflict exposure during pregnancy was associated with increased stunting odds and lower HAZ in Madagascar but decreased odds and higher HAZ in Zambia. This dissertation framed stunting as occurring over the life course and embedded in multiple external structures. These studies were among the first to examine population-level environmental enteric dysfunction risk factors and apply disaggregated conflict data to stunting. We also contributed stunting context in Madagascar and Zambia, which have been understudied.

Supplemental Material, sj-pdf-1-cpc-10.1177_10556656211018956 for The International Family Study of Nonsyndromic Orofacial Clefts: Design and Methods by Allyn Auslander, Roberta McKean-Cowdin, Devin Feigelson, Frederick Brindopke, Melissa DiBona, Kathy Magee, Lili Arakaki, Rijuta Kapoor, Stephanie Ly, David V. Conti, Sylvia Rakotoarison, Fouzia Mahmoudi, Albertina McGregor, Melissa Giron, Angela Rose Hernandez, Thi-Hai-Duc Nguyen, Anselme Mwepu, Pedro A. Sanchez-Lara and William Magee in The Cleft Palate-Craniofacial Journal

The study questionnaire in both English and Amharic languages. It consists of comprehensive information regarding the participantsâ socio-demographic characteristics, menopausal status, menopause knowledge and attitude, and an 11-item Menopause Rating Scale. (PDF 365Â kb)

Menopause is a phenomenon experienced by women as they approach middle age, marking the end of menstruation and reproduction. Throughout history, menopause has been classified in negative terms as a malady and decay of femininity necessitating a cure, which led to the controversial development of hormone replacement therapy. Feminists and activists challenged existing stereotypes and emphasized menopause as a natural transition. There is still little consensus on universal menopause symptoms since wide variations are reported across geographic regions and cultures. These differences can be better examined via individual menopausal experiences, which are unique and shaped by attitudes and expectations. Macro-level structures often place psychosocial constraints on individual women imposing roles after menopause or creating expectations of common symptoms. This chapter applies three theoretical frameworks to the menopausal experience. The biomedical model portrays menopause as a result of biological pathways with clear diagnoses of menopausal stages and is widely used by physicians. The life course perspective views menopause as a lifelong process that is shaped by the current time period with early life advantages or disadvantages that affect women as they enter their menopausal years. The biopsychosocial model integrates women's experiences of menopause into a hierarchy of structures. Each woman is shaped by microlevel factors like genetics and body functions while also influenced by macro-level structures within her family or society. As the number of women experiencing menopause rises with emerging demographic shifts, special consideration to individual and global experiences of menopause should be integrated to advance well-being.