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Background and aim: Despite adequate food production and nutrition intervention coverage, stunting remains an enduring problem in Ntchisi, Malawi. Globally, gender and social norms are known to influence nutritional outcomes in children. This study explores how gender norms contribute to child stunting, in Ntchisi district, Central Malawi. Research methods: Informed by the UNICEF Framework for Malnutrition, nine focus group discussions were conducted with a target population of mothers (n = 24), fathers (n = 23) purposively targeted through growth monitoring sessions, and members of policy and health treatment committees (n = 21), spanning three different areas of Ntchisi district. Data were analysed through inductive thematic analysis, guided by the framework for Research in Gender and Ethics (RinGs). Results: Three primary themes were identified: 1) gender unequal decision making on the consumption, sale and distribution of food; 2) enshrined community norms influence feeding practices underpinned by gender-based violence; and 3) policy disconnections and gaps that reinforce gender norms regarding nutrition. Themes encompassed practices across household, health treatment, and policy level. Conclusion: Gender norms that underpin inequalities in decision making for production and consumption of food undermine children's nourishment and contributes towards sustained child malnutrition in Ntchisi. Existing policy documents should revise their guidelines to incorporate gender norms as key determinants of malnutrition. [ABSTRACT FROM AUTHOR]

This commentary explores the intersection between climate, conflict, and child nutrition, highlighting the severe child nutrition crisis in Sub-Saharan Africa exacerbated by climate change and ongoing conflicts. Shifting climate patterns disrupt agricultural productivity and food security, while persistent conflicts displace populations and destroy infrastructure, significantly increasing food insecurity and malnutrition among children. Recent UNICEF data indicates that 1 in 4 children globally live in severe food poverty, with those affected up to 50% more likely to suffer from life-threatening malnutrition. Over half a billion children reside in areas prone to climate-related extreme weather events, challenging food production, distribution, and access. Extreme weather events have led to crop failures, food shortages, and price spikes, disproportionately affecting vulnerable populations. Changes in temperature and precipitation patterns also alter the nutritional content of crops, worsening nutritional challenges. Conflicts in SSA have led to a food crisis of unprecedented scale, with over 80% of the 137 million Africans facing acute food insecurity located in conflict-affected countries. The conflict between Russia and Ukraine has further disrupted global food and fertilizer supply chains, exacerbating food shortages and inflation in many African countries. Addressing this crisis requires a multifaceted approach integrating evidence-based, cost-effective strategies. This commentary advocates for the adoption of the 3 C approach—climate-smart school feeding programs, cultivation of edible insects, and community-based food hubs—as solutions to enhance child nutrition and build climate resilience. [ABSTRACT FROM AUTHOR]

Purpose: Child malnutrition is a grave concern for Pakistan, as the country has one of the highest incidences of child stunting in the developing world. The present study examines the relative significance of parents' education on a child's nutritional status in Pakistan. Design/methodology/approach: For analysis, the study has used data from Phase 7 of the Pakistan Demographic and Health Survey (PDHS) (2017–2018). Since the dependent variable ranges from 0 to 1 (1 indicates not a stunted child, while 0 represents a stunted child), binary logistic regressions are used for the analysis. Findings: The results show that mothers' and fathers' education positively contributes to a child's nutrition. However, mothers' education is considered more significant, especially in the long run. The mother's education categories are positive and significant in the long run, while only their higher education is positive and significant for the father's. Moreover, the magnitude of the effect also shows that the probability of stunting is less if the mothers are educated. The long-run coefficient for mothers' higher education is 0.752, while that of fathers' higher education is only 0.232. Originality/value: The present study compares the importance of mothers' and fathers' education in child nutrition and concludes that the role of the mother is more crucial for child upbringing. There are rarely any studies that focus on the role of fathers' education in child nutrition and compare whose role, mothers' or fathers,' is more important for child well-being. Peer review: The peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-06-2023-0483 [ABSTRACT FROM AUTHOR]

Child malnutrition is one of the major causes of child morbidity and mortality around the globe especially in developing countries. The current study attempts to investigate the factors that contribute to malnutrition captured through WAZ (weight for age) among children in the Cholistan desert area of Punjab, Pakistan. Out of 900 households surveyed, 584 households were identified, having a sample of 1059 children aged between 0 and 59 months. The logit, multilevel logit, generalized linear mixed model, and generalized linear latent and mixed model approaches were employed to analyze the collected data. The findings reveal that the wealth index of households, mother's age at birth of a child, birth order of the child, duration of breastfeeding, distance to the basic health unit, and use of protected/clean water significantly affect children for being underweight. The policy recommendations are made in line with the study findings to suggest ways that can reduce prevalance of underweight children in the area. [ABSTRACT FROM AUTHOR]

The objective of the present study is to address child and maternal malnutrition in nine African countries located in the Western sub-region of Sub-Saharan Africa (SSA) by incorporating three types of agricultural financing (domestic and external) along with energy poverty, human capital and corruption on malnutrition for the 1990–2019 period and present implications for Sustainable development goals (SDGs). This objective is realized by employing recently advanced panel techniques such as the second-generation panel econometrics techniques and the method of moments quantile regression (MMQR) approach. The estimated results reveal that agricultural credit and foreign aid in the agriculture sector significantly and negatively affect the malnutrition of children and mothers, while research spending in agriculture positively influences malnutrition. Energy poverty and human capital exert a negative and significant influence on child and maternal malnutrition, while corruption induces it. The study finally recommends several policy insights for the governments across the SSA region for tackling child and maternal malnutrition and advancing towards the achievement of SDG 3 through investment in SDG 4, SDG 7 and SDG 17. [ABSTRACT FROM AUTHOR]

Background: Anaemia is a global public health problem associated with early childhood adverse effects on mental, physical, and social development. Sierra Leone had made progress in reducing the prevalence of anaemia pre-Ebola period however this was affected by the Ebola epidemic which further strained an already struggling health system. Therefore, this study aimed to assess the prevalence and factors associated with anaemia during post-Ebola period among children aged 6–59 months in Sierra Leone. Methods: We analyzed data from the 2019 Sierra Leone demographic and health survey (SLDHS), a nationally representative cross-sectional study. We used data collected using a stratified two-stage cluster sampling design that resulted in the random selection of a representative sample of 13,872 households. A total sample of 3,459 children aged 6–59 months were included in the study. Multivariable logistic regression was used to calculate the adjusted odds ratios and corresponding 95% confidence intervals. Results: The prevalence of anaemia was 68.9%, that of mild anaemia was 35.8%, moderate anaemia was 30.3% and for severe anaemia was 2.8%. Children aged 6–36 months were 1.83 times more likely to have anaemia compared to those above 36 months, while boys 1.33 times more likely to be anaemic compared to girls. Children born in poor households, to mothers who had anaemia and had a history of fever had 65%, 85% and 38% increase in likelihood of childhood anaemia respectively. In addition, children living in rural areas and stunted were 1.55 and 1.38 times more likely to be anaemic respectively compared to those living in urban areas and not stunted. Children born to younger mothers (15–24 years) were 1.45 times more likely to be anaemic compared to older mother (35–49 years. Conclusion: The current study demonstrated the predominant existence of anaemia among children aged 6–59 months in Sierra Leone. Owing to the adverse effects of anaemia on the development of children in the future, there is an urgent need for effective and efficient remedial public health interventions to prevent further complications. [ABSTRACT FROM AUTHOR]

The Sahel is a region particularly characterized by undernutrition in several forms. In Burkina Faso, where several interventions have been carried out across the past several years, the nutritional situation of children under five years of age is still characterized by persistent stunting in the Est, Sahel, and Cascades regions. This study aims to understand the factors associated with the high prevalence of chronic malnutrition in these regions. National nutrition survey data as well as data from the Ministry of Water and Sanitation were used for bivariate and multivariate statistical analyses to identify factors statistically associated with stunting in children aged 0–59 months who participated in the national nutritional surveys from 2009 to 2019. Around one in ten mothers in all regions had no schooling at all. The improving of IYCF practice has a positive impact on the reduction of the prevalence of chronic malnutrition among children in the Cascades, Est and Sahel regions. In the three target regions, gender and province were significantly associated with stunting. Fever, diarrhea, vitamin A supplementation, household size, and maternal education level were also associated with stunting but only in the Sahel and Cascades regions. Overall, the results of the study show that the fight against stunting must be carried out in a multisectoral approach and target certain provinces particularly because stunting is not uniformly present in all provinces. [ABSTRACT FROM AUTHOR]

The Indian enigma, the prevalence of higher chronic undernutrition among Indian children compared to poorer countries, is driven by stunted children from the so-called lower caste. Based on this background, the study measures the extent of the inequities contributed by the caste system to the availability of minimum nutrition among children aged 2 years and less in the country. We use the third and fifth rounds of the National Family Health Survey (NFHS) and employ the Human Opportunity Index (HOI) for the analysis. HOI is the technique that measures the inequality of opportunity experienced by children. The study controls for other social, family, regional and child-level circumstances. Findings reveal that the success story of the economic growth of the country has not contributed to an equal allocation of minimum nutrition availability, where the absolute difference of the HOI index between children belonging to the low caste subgroups and others is high. On the other hand, considering the account of HOI across the two NFHS rounds for each subgroup, the improvement rate depicts an optimistic future. [ABSTRACT FROM AUTHOR]

Grand challenges are system-wide problems. While top-down approaches to mitigating grand challenges may have potentially far-reaching impact, such initiatives from the higher scales can fail because of limited knowledge of ground realities. At the same time, resilient local efforts to address societal challenges can have limited reach. How can a grassroots organization work across locations and scales to address a grand challenge? We report the findings of a longitudinal case study of the Child In Need Institute, a nonprofit organization that successfully scaled its impact to reach over seven million beneficiaries. Based on 40 years of archival data and four years of intensive fieldwork, our findings reveal "double weaving" as a recursive process of diagnosing and addressing problems by connecting actors and resources across locations and scales. The double weaving process gives researchers a framework to explore the complex interplay between locations and scales that is necessary to address grand challenges. Our study contributes to research on grand challenges and scaling, advancing the spatial turn in organizational studies by developing the scalar dimension, and expanding research that has primarily focused on locations. [ABSTRACT FROM AUTHOR]

This study investigates the trends in chronic malnutrition (stunting) among young children across Bangladesh's 64 districts and 544 sub-districts from 2000 to 2018. We utilized remote-sensed data–nighttime light intensity to indicate urbanization, and environmental factors like precipitation and vegetation levels–to examine patterns of stunting. Our primary data source was the Bangladesh Demographic and Health Survey, conducted six times within the study period. Using Bayesian multilevel time-series models, we integrated cross-sectional, temporal, and spatial data to estimate stunting rates for years not covered by the direct survey information. This approach, enhanced by remote-sensed data, allowed for greater prediction accuracy by incorporating information from neighboring areas. Our findings show a significant reduction in national stunting rates, from nearly 50% in 2000 to about 30% in 2018. Despite this overall progress, some districts have consistently high levels of stunting, while others show fluctuating levels. Our model gives more precise sub-district estimates than previous methods, which were limited by data gaps. The study highlights Bangladesh's advancements in reducing child stunting, highlighting the value of integrating remote-sensed data for more precise and credible analysis. [ABSTRACT FROM AUTHOR]

Bangladesh continues to face the persistent issue of child malnutrition. This study aims to investigate the influence of parental characteristics on undernutrition among children under the age of five in both urban and rural areas of Bangladesh. This study utilizes data from the Bangladesh Demographic and Health Survey (BDHS) 2017–18, which includes 7806 children under the age of five and their parents. The effects of parental education and occupation on undernutrition (e.g., stunting, underweight, and wasting) are examined using the binary probit regression technique. Among rural children, 32.6% are stunted, 22.5% are underweight, and 8.1% are wasted. The corresponding figures for urban children are 25.3%, 18.9%, and 8.9%, respectively. In all forms of undernutrition, children living in rural areas face greater challenges than those living in urban areas. The prevalence of stunting and underweight is low among children, irrespective of their rural or urban background, when both parents have the same level of education. The prevalence is also low when fathers are employers or traders and mothers are homemakers, or when highly educated fathers are employers or traders and highly educated mothers are homemakers. In both rural and urban areas, the risk of stunting, underweight and all forms of malnutrition among children decreases as parents' education levels increase. Children whose fathers work in service or business activities are less likely to experience stunting, being underweight, or wasting compared to children whose fathers work in agriculture or other professions in both areas. In urban areas, children born to mothers with lower levels of education are more vulnerable to wasting than children whose mothers have at least secondary education. To reduce child undernutrition nationwide, it is recommended that both parents have at least a secondary school education and that the father has a stable and sufficient income. [ABSTRACT FROM AUTHOR]

Background: Severe acute malnutrition (SAM) poses a significant threat to child health globally, particularly in low- and middle-income countries. Zambia, like many Sub-Saharan African nations, faces high rates of child malnutrition, with SAM contributing significantly to under-five mortality. Therefore, this study aimed to determine the prevalence and factors associated with SAM. Methods: This retrospective cross-sectional study was conducted at Livingstone University Teaching Hospital in Zambia (LUTH). SAM was defined according to the World Health Organization (WHO) criteria as either weight-for-height less than -3 standard deviations, mid-upper arm circumference (MUAC) less than 115 mm, or presence of bilateral pitting edema in children between 6 months and 5 years old who were attended to between 2020 and 2022. Data abstraction from pediatric patient records was conducted between August 2023 and January 2024. The records without the age and outcome variable were excluded. A total of 429 participants between 6 months and 5 years old were included, with demographic, clinical, and hematological parameters analyzed. Univariable and multivariable logistic regression were employed to investigate factors associated with SAM. Results: Overall, 429 medical records were included in the study and the prevalence of SAM was 27.0% (n = 116). Age group 6–24 months (Adjusted Odds Ratio [AOR]: 11.60; 95% Confidence Interval [CI]: 3.34–40.89, p<0.001), living with HIV (AOR:3.90; 95% CI: 1.14–13.70, p = 0.034), Tuberculosis (TB) (AOR:22.30, 95% CI: 4.53, 110.3, p < 0.001), comorbidities (AOR: 2.50; 95% CI 1.13, 5.88, p = 0.024) and platelet count (AOR: 1.00; 95% CI 1.00, 1.00, p = 0.027) were positively associated with SAM. Conclusions: This study found a high prevalence of SAM, exceeding the WHO target of reducing SAM to 5% by 2025. SAM was associated with younger age (6–24 months), HIV infection, TB, comorbidities and platelet count. Therefore, there is need to enhance strategies aimed at reducing SAM among young children, children living with HIV, TB and comorbidities, particularly by intensive treatment, continuing and strengthening nutrition services. [ABSTRACT FROM AUTHOR]

In this research, I examined the role of socioeconomic variations in the prevalence of stunting and underweight among children in Ethiopia. The study aimed to identify key health factors contributing to these disparities in child malnutrition by utilizing concentration indices, concentration curves, and regression-based decomposition analysis. Despite a notable decline in the average rates of stunting and underweight prevalence, the relative and absolute gaps between different demographic and socioeconomic groups have widened in Ethiopia. The empirical analysis revealed that higher levels of maternal education and household wealth significantly benefited children from better socioeconomic backgrounds, making them less likely to experience malnutrition. The disparity in socioeconomic status is the primary driver of inequalities in child malnutrition. The findings suggest that to reduce these disparities, national health policies should focus on promoting maternal literacy and targeting interventions for underprivileged groups. Key messages: Children from higher socioeconomic backgrounds and mothers' educational levels were less likely to suffer from malnutrition. The disparity in socioeconomic positions is the major cause behind child malnutrition inequities. [ABSTRACT FROM AUTHOR]

Zinc (Zn) is an essential micronutrient that is found in almost all classes of enzymes. Its deficiency is a well-documented problem among cereal crops that causes decreased crop yields and nutritional quality. Therefore, an experiment was implemented in a randomized block design which included the treatments of bacterial inoculation consisting of T1 (Control), T2 (100% RDF;100:40:20), T3(100% RDF + 25 kg ZnSO4.7 H2O), T4(100%RDF+ ZnSB1– Bacillus sp. strain BAU_A2 @750 ml ha−1), T5 (100%RDF+ ZnSB2– Priestia megaterium strain BAU_A3 @750 ml ha−1), T6 (100%RDF+ ZnSB3-Bacillus subtilis strain BAU_A5@750 ml ha−1). The mineral NPK was applied as per treatments. The results indicated the maximum values of water soluble exchangeable Zn and organically bounded Zn in treatments consisting ZnSB1, ZnSB2 and ZnSB3, respectively. The WS+EXCH-Zn was significantly increased by 68.57%, 28.26%, 18%, 98.14%, 41.30%, 30.00% and 128.12%, 55.55%, 37.25%, 43%, 62.22% and 43.13% in first year (2018–19) and second year (2019–2020) under the soil treated with ZnSB1-Peribacillus simplex strain BAU_A1, ZnSB2-Bacillus sp. strain BAU__A2 and ZnSB3-Bacillus subtilis strain BAU_A5 along with 100%RDF over control, application of recommended dose of fertilizer with and without application of 25 kg ZnSO4 ha−1, respectively. However, the maximum decrement in Mn-oxide-bounded zinc (1.12 mg kg−1 soil) was observed with T6 which was significantly higher by 158%, 194.4%, 185.71% over control, 100% RDF with and without application of 25 kg ZnSO4 ha−1, which showed the solubilization of zinc with the activity of ZnSB in soil. The study may be beneficial to mitigate the zinc deficiency in soil and malnutrition in children. [ABSTRACT FROM AUTHOR]

Plasmodium falciparum malaria remains a dominant infectious disease that affects Africa than the rest of the world, considering its associated cases and death rates. It's a febrile illness that produces several reliable biomarkers, for example, P. falciparum lactate dehydrogenase (PfLDH), P. falciparum Plasmodium glutamate dehydrogenase (PfGDH), and P. falciparum histidine‐rich proteins (HRP‐II) in blood circulatory system that can easily be employed as targets in rapid diagnostic tests (RDTs). In recent times, several DNA aptamers have been developed via SELEX technology to detect some specific malaria biomarkers (PfLDH, PvLDH, HRP‐II, PfGDH) in a biosensor mode with good binding affinity properties to overcome the trend of cross‐reactivity, limited sensitivity and stability problems that have been observed with immunodiagnostics. In this review, we summarized existing diagnostic methods and relevant biomarkers to suggest promising approaches to develop sensitive and species‐specific multiplexed diagnostic devices enabling effective detection of malaria in complex biological matrices and surveillance in the endemic region. Significance statement: The focus of this review was to summarize research findings on the existing diagnostics approaches for malaria infection and the necessity for multiplex malaria detection using aptamer agents, biomarkers, and microfluidic technology. The World Health Organization had shown that malaria infection does not only lead to death, there are other complications such as low birthweight, growth retardation, poor cognitive function, and malnutrition in underage children (0−5 years). However, due to the lack of adequate medical facilities in the low‐middle income countries (LMIC) and low analytical performance of the existing biomedical devices, there is a need for medium to high throughput point‐of‐care devices to conduct routine surveillance by testing. Microfluidic technology is a facile and versatile approach to diagnostics that can be trialed to multiplex assay for malaria in the LMIC. [ABSTRACT FROM AUTHOR]

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Background/Objectives: Failure to thrive (FTT) is mostly caused by insufficient consumption of nutrient-rich food, recurrent infections like diarrhea and intestinal worms, substandard caregiving practices, and limited availability of health and other vital services. Furthermore, there was a correlation between the educational level of mothers and the occurrence of FTT in children aged 6–12 months. Thus, the objective of the current research is twofold: (i) to investigate other factors related to FTT and (ii) to evaluate the impact of them on FTT in Sub-Saharan African countries and their urban areas. Methods: We used weight entropy and TOPSIS methods to approach the research question. In particular, the entropy-weight method is effective for precisely evaluating the relative significance of the selected criteria for TOPSIS computation. Thus, data were retrieved from the database of UNICEF for the year 2019 for nine Sub-Saharan countries, and based on the methods used, five criteria have been selected for consideration. Those of mothers in higher education were identified as having a higher weight, which means that this can affect positively the ability of mothers to mitigate the situation of FTT and protect their children. Results: The findings of the study highlight the factors of maternal education at a higher level and unhealthy habits as those with the greatest weight and impact on the FTT. Moreover, the results indicate that the association between maternal education, and especially higher education, and FTT is stronger in Ethiopia. Despite the limited amount of research on the specified relationship in Sub-Saharan countries, this study is among the initial ones to examine it. Conclusions: The current study can aid policymakers in devising appropriate policies and implementing effective measures to tackle FTT in Sub-Saharan Africa, like enhancing the number of mothers in these countries to be integrated into the educational system to help both themselves and their children mitigate or avoid the symptoms of FTT. [ABSTRACT FROM AUTHOR]

Treating children with acute malnutrition can be challenging, particularly regarding access to healthcare facilities during treatment. Task shifting, a strategy of transferring specific tasks to health workers with shorter training and fewer qualifications, is being considered as an effective approach to enhancing health outcomes in primary healthcare. This study aimed to assess the effectiveness of integrating the treatment of acute malnutrition by community health volunteers into integrated community case management in two sub-counties in northern Kenya (Loima and Isiolo). We conducted a two-arm non-inferiority cluster-randomized controlled trial across 20 community health units. Participants were children aged 6–59 months with uncomplicated acute malnutrition. In the intervention group, community health volunteers used simplified tools and protocols to identify and treat eligible children at home and provided the usual integrated community case management package. In the control group, community health volunteers provided the usual integrated community case management package only (screening and referral of the malnourished children to the health facilities). The primary outcome was recovery (MUAC ≥12.5 cm for 2 consecutive weeks). Results show that children in the intervention group were more likely to recover than those in the control group [73 vs 50; risk difference (RD) = 26% (95% CI 12 to 40) and risk ratio (RR) = 2 (95% CI 1.2 to 1.9)]. The probability of defaulting was lower in the intervention group than in the control group: RD = −21% (95% CI −31 to −10) and RR = 0.3 (95% CI 0.2 to 0.5). The intervention reduced the length of stay by about 13 days, although this was not statistically significant and varied substantially by sub-county. Integrating the treatment of acute malnutrition by community health volunteers into the integrated community case management programme led to better malnutrition treatment outcomes. There is a need to integrate acute malnutrition treatment into integrated community case management and review policies to allow community health volunteers to treat uncomplicated acute malnutrition. [ABSTRACT FROM AUTHOR]

Objective: Indonesia has quite a serious nutritional problem which is characterized by the large number of cases of malnutrition in children under five, as a result this problem has become the attention of the Indonesian government so that it has become a national protas called stunting, so it must be resolved in an integrated manner across sectors. Unfortunately, this problem has not been resolved so stunting cases are still very high, one of which is Maros district which has the eighth number of stunting cases based on SSGI data for 2022. Method: Qualitative research is carried out in natural settings to seek information from executive and legislative experience based on knowledge, attitudes, actions and interests. We used indepth interviews, assisted by interview guides, and reviewed the rules to answer the research objectives. The researchers carried out a review of the regulations in the form of basic reading of the recommendations and outreach carried out by the relevant government. Results: Interestingly, government planning uses new methods, namely bottom up, participatory and top down. The reason given by the executive is that this method is the most effective method in government organizations because planning is made based on the Maros district government budget calendar. Conclusion: In analyzing the behavior of the Executive and the legislature, not all of them understand stunting program planning so their involvement is lacking and not all of them play an active role in the stunting program, even though they have an interest in improving the level of health in the people of Maros district by trying to achieve zero stunting for the sustainability of regional development in Maros district. Recommendation: Continuing research on the theme of Analysis of Community Behavior towards the Implementation of Stunting Program Planning in Maros Regency, we suggest to the regional government to accelerate the realization of community welfare through improving human resource services and health levels, overcoming poverty. [ABSTRACT FROM AUTHOR]

This paper describes a novel method for detecting child malnutrition based on artificial intelligence and facial photography. Estimates of severe and moderate acute malnutrition in children are critical for rapid emergency responses. However, the two traditional measurement methods, mid‐upper arm circumference (MUAC) and weight‐for‐height (WFH), are impractical in conflict and catastrophic disaster situations. They require well‐trained enumerators, cumbersome equipment, and close supervision. The Method for Extremely Rapid Observation of Nutritional Status (MERON) addresses the problem, using simple facial photographs. Facial features are extracted to predict Body Mass Index (BMI) in adults and Weight for Height Z Score (WFHZ) in children under five. MERON correctly predicts adult BMI classification with 78% accuracy. A variant of the model, trained on a sample of 3167 children in Kenya, successfully classified 60% of cases. On most measures, MERON was easier and more culturally acceptable to use than the traditional measurement methods. If MERON were to be trained and validated on a larger sample, with more extreme cases, it would provide a practical solution to a recurrent humanitarian problem. [ABSTRACT FROM AUTHOR]

The first thousand days, from conception to two years of age, are a critical period for the development and prevention of malnutrition in all its forms, and a window of opportunity for the implementation of interventions that ensure optimal development and improve human capital. This special article aims to present the main challenges for health and nutrition care in the first thousand days, the progress in the development and implementation of a strategy for this purpose, and to formulate priority recommendations for public policy for the next administration. [ABSTRACT FROM AUTHOR]

Objective. To analyze the trends of malnutrition in children under five years of age in Mexico from 1988 to 2023 and to discuss the possible causes of the observed trends. Materials and methods. Information about nutritional status and sociodemographic variables from 5 987 children under five years of age from the National Health and Nutrition Surveys during the period 2020-2023 was analyzed and compared with the results of previous surveys. Results. The prevalence of underweight, stunting, wasting, and overweight was 3.9%, 13.9%, 1.2%, and 7.7% in 2020-2023. The highest percentages of stunting were observed in indigenous vs. non-indigenous households (27.4%) (p>0.10), with severe food insecurity vs. food security (20.7%) (p=0.079), quintiles of very low vs. high well-being conditions (20.8%), and rural vs. urban areas (16.9%) (p>0.10). Only 37.4% of households with children under five years of age are beneficiaries of one or more social programs. Conclusions. Malnutrition plateaued in 2012 and overweight has increased. The situation of poverty in households with children under five years old, the increase in the complexity of Prospera and the reduction in funding per beneficiary between 2012-2018, and since 2018 the lack of targeted programs and specific transfers to households with children under five years old, and the increase in the absence of basic health services, among others, could explain this situation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: With this study, we aimed to estimate the disease burden attributable to child and maternal malnutrition (CMM) throughout the world between 1990 and 2019. METHODS: The number, age-standardized rate, population attributable fraction of deaths, disabilityadjusted life-years, years of life lost, and years lived with disability associated with CMM were estimated using the Global Burden of Disease Study 2019 by age, sex, year, location, and sociodemographic index at the global level. The slope index of inequality and concentration index were employed to measure socioeconomic-related health inequalities across countries. RESULTS: The number (million) of global deaths, disability-adjusted life-years, and years of life lost related to CMM were 2.9, 294.8, and 250.5 in 2019, showing decreases of 60.8, 57.4, and 60.7% since 1990. However, the number of years lived with CMM-related disability increased from 36.0 in 1990 to 44.3 in 2019. Additionally, the age-standardized rates of these 4 indicators showed varying degrees of decline. The global burden of CMM-related conditions differed with age and sex. The burden was the heaviest in western sub-Saharan Africa, especially in Chad. In terms of diseases, neonatal disorders represented the most significant burden attributed to CMM. Additionally, the CMM burden was more concentrated in regions with low sociodemographic indices, shown by the slope index of inequality and concentration index. CONCLUSIONS: The findings of this study highlight the ongoing global burden of CMM, particularly in terms of years lived with disability. Population-wide actions targeting the effective treatment and relief of CMM may reduce the CMM-related disease burden. [ABSTRACT FROM AUTHOR]

Child malnutrition remains a significant concern in the Asia‐Pacific region, with short birth intervals recognised as a potential risk factor. However, evidence of this association is inconclusive. This study aimed to systematically review the existing evidence and assess the summary effects of short birth interval on child malnutrition in the Asia‐Pacific region. Five electronic databases were searched in May 2023 to identify relevant studies reporting the association between short birth interval and child malnutrition, including stunting, wasting, underweight, anaemia and overall malnutrition, in Asia‐Pacific region between September 2000 and May 2023. Fixed‐effects or random‐effects meta‐analysis was performed to estimate the summary effects of short birth interval on child malnutrition. Out of 56 studies meeting the inclusion criteria, 48 were included in quantitative synthesis through meta‐analysis. We found a slightly higher likelihood of stunting (n = 25, odds ratio [OR] = 1.13; 95% confidence interval [CI]: 0.97–1.32) and overall malnutrition (n = 3, OR = 2.42; 95% CI: 0.88–6.65) among children born in short birth intervals compared to those with nonshort intervals, although the effect was not statistically significant. However, caution is warranted due to identified heterogeneity across studies. Subgroup analysis demonstrated significant effects of short birth intervals on child malnutrition in national‐level studies and studies with larger sample sizes. These findings underscore short birth intervals as a significant contributor to child malnutrition in the Asia‐Pacific region. Implementing effective policies and programs is vital to alleviate this burden, ultimately reducing child malnutrition and associated adverse outcomes, including child mortality. Key messages: Short interval pregnancies pose a persistent public health threat in the South Asian region.While a potential link with child malnutrition exists, reported associations often conflict.Our findings suggest that short interval births slightly increase the risk of child malnutrition.Addressing short interval pregnancies is crucial to mitigate the ongoing nutritional burden in South Asian countries. [ABSTRACT FROM AUTHOR]

Background: Stunting, indicating chronic malnutrition in children, remains a pressing concern globally, especially in low- and middle-income countries. India, despite substantial efforts, continues to grapple with high rates of stunting, impacting child development and health outcomes. Understanding the multifaceted factors contributing to stunting is crucial for targeted interventions and policy formulation. Methods: This descriptive cross-sectional study was conducted in Balipatana, Khordha district, Odisha, India among 400 children. A survey employing structured questionnaires and WHO Anthropometric guidelines for data collection was used. Statistical analyses including Chi-square tests and logistic regression models were used to uncover significant associations. Results: The study revealed a stunting prevalence of 28% among children under five, with 7% severe and 21% moderate stunting. Regression analysis revealed key risk factors included low birth weight (1.5-2.5 kg), parental illiteracy, lower household income (Rs. 1000-15000), inadequate toilet facilities, and specific drinking water sources. Conclusion: The findings align with global concerns about stunting, emphasizing the complex interplay of socioeconomic and environmental factors. Interventions targeting parental education, household economic status, and improving sanitation and drinking water facilities are imperative. By addressing these factors, focused efforts can be made to reduce childhood stunting, ensuring a healthier future for the nation's children. [ABSTRACT FROM AUTHOR]

Context: Worldwide malnutrition is identified as a major health and nutrition problem. Undernutrition contributes to an estimated 45% of child deaths globally. The prevalence of underweight among children in India is among the highest in the world. Our children also bear a tremendous double burden of malnutrition. Aims: To find out the prevalence and determinants of malnutrition among six months to three-year-old children in the rural community of Northern India. Settings and Design: A community-based cross-sectional study conducted among children aged six months to three years in a rural area of Ludhiana district, Methods and Material: A total of 662 children in the age group of six months to three years from a population of 30,000 were identified and included in the study. All the relevant information regarding these children was collected from family folders. Socioeconomic status was assessed using the modified Udai Pareek scale (MUP). Statistical analysis used: The data collected was entered in MS Excel and was analyzed using SPSS version 26 and WHO Anthro Survey Analyzer. Results: Out of 662 children, 16% were underweight. Almost 50% of the children in the two--three years category were underweight. The prevalence of stunting in the study population was 20.7% and that of overweight was 4.8%. The prevalence of underweight was higher in children of low socioeconomic status than in children from upper socioeconomic status (P = 0.000). There was a significant association between birth order and increasing cases of underweight (P = 0.000). Conclusions: The causes of malnutrition in children are complex and involve multiple factors. There is a need for vigorous monitoring for early detection of malnutrition for children aged two--three years. The improvement of maternal education will improve the nutritional status of the child. [ABSTRACT FROM AUTHOR]

Background: chronic iron-deficiency anaemia in children has a negative impact on neuronal and cognitive development. Despite current knowledge on this subject, in Bolivia iron intake along the psychomotor development stimulation as part of a comprehensive rehabilitation process for children with severe chronic malnutrition is not yet used. Objective: to evaluate the effect of a neurorestorative diet, consisting of iron supplements and other micronutrients, along with psychomotor stimulation in preschool children with chronic malnutrition, iron-deficiency anaemia and severe psychomotor delay. Patients and methods: twenty-four children between 1 and 56 months of age admitted to the integral nutritional recovery centre (INRC), Paediatric Hospital of Cochabamba, Bolivia were included. A strategy of intervention was applied consisting of nutritional replenishment through the administration of elaborated meals prepared from local foods with high heme and non-heme iron concentration, added with vegetables plus the administration of micronutrient's supplementation and the psychomotor stimulation. Anthropometric indices, psychomotor and biochemical parameters were measured at four times points, during the hospitalisation period. Results: at the beginning, the anthropometric and psychomotor parameters were decreased (between -2 and -3 z score and below 50 % respectively). Combined strategy intervention with iron and other micronutrients together photons produced significant changes between the evaluated time points, both in anthropometric and psychomotor parameters, although these changes were less than expected. Conclusions: the combined strategy used in this study allowed recovery from the anaemia and minimal growth due to the low birth weight or chronic malnutrition. However, the intervention was insufficient to achieve a complete recovery. [ABSTRACT FROM AUTHOR]

This study examines the effects of the Strengthening Partnership, Results, and Innovations in Nutrition Globally (SPRING) project on malnutrition (stunting, acute malnutrition, and underweight) among children under five years of age. We employed the Difference-In-Difference (DID) estimation approach and the Ghana Multiple Indicator Cluster Survey data (MICS) to analyze the project's impact. Our analysis showed a strong positive association between the project's effect on the probability of stunting and underweight by 11% (p=0.01) and 9% (p=0.003), respectively, in the treated regions compared with the untreated regions. However, we found no evidence of the project's effect on acute malnutrition. We also provide suggestive evidence that the project may have influenced child nutrition status through antenatal care attendance. This study demonstrated that tackling child nutrition deficiencies through an integrated holistic approach, such as early Antenatal Care (ANC) attendance, increased access to high-quality foods, improving women's nutrition knowledge, and improving agricultural practices, can significantly reduce childhood stunting and underweight. [ABSTRACT FROM AUTHOR]

Undernutrition occurs when there are deficiencies in essential vitamins, while overnutrition refers to consuming an excessive amount of nutrients, leading to issues such as obesity, diabetes, and related health problems. Malnutrition often stems from the economic and social status of parents. In children, malnutrition can significantly result in physical and mental growth issues. Therefore, there is a need for early prediction of malnutrition in children to mitigate its adverse effects. Children image comprises great amount of information which can be analyzed for distinguishing between a nourished or malnourished children. The success stories of convolutional neural networks in image classification are the motivation to develop a deep learning model for the classification. In this work a custom designed convolutional neural network model is proposed for classification of children into category nourished or malnourished. The dataset consists of 630 and 1530 nourished and malnutrition children’s images respectively. The model is trained on children’s images database that includes both web scraped images and synthetic images. The convolutional neural network model is optimized by selecting optimal activation function through experimentation. The model is trained for 100 epochs with Adam optimizer and various activation functions. CNN with Relu with weight decay activation function obtained considerably good results with accuracy of 93.44%, precision 0.89, 0.85 recall, 0.87 F1 score for nourished class; and precision 0.95, 0.96 recall, and 0.96 F1 score for malnourished category. The model obtained a good accuracy of 92.83% for Leaky ReLu with precision 0.8, 0.9 recall, 0.85 F1 score for nourished and precision 0.97, 0.94 recall and 0.95 F1 score malnourished. Further, to develop trust in the model visualization of activation maps, convolutional layers and filters are implemented. [ABSTRACT FROM AUTHOR]

Objective: To determine the most appropriate cut-off values of Waist Circumference (WC) and Waist-to-Height Ratio (WHtR) for diagnosing moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) in under-five children. Methods: This cross-sectional diagnostic accuracy study was conducted between January 2021 and August 2022 in the Department of Pediatrics of a tertiary hospital in Delhi. Children aged 6 months to 5 years attending the outpatient or emergency services were included in the study. Detailed clinical evaluation and anthropometry including measurement of WC were done at enrollment. Body mass index (BMI) and WHtR were calculated. Malnutrition was classified as per the WHO criteria. Receiver operating characteristic curves (sensitivity, specificity) for WC and WHtR (absolute values) were drawn against the standard test of WHO definitions for MAM and SAM to determine the most appropriate cut-offs for diagnosing MAM and SAM. Results: 1500 children with a median (IQR) age of29 (14, 43) months were enrolled; 21% children had MAM and 11% had SAM as per the WHO criteria. WC < 44.5 cm (sensitivity 74.1%, specificity 71.1%) and WHtR < 0.565 (sensitivity 75.6%, specificity 33.7%) were the best cut-offs to identify MAM, whereas WC < 42.3 cm (sensitivity 67.5%, specificity 81.3%) and WHtR < 0.563 (sensitivity 81.3%, specificity 33.4%) were the best cut-offs to diagnose SAM. Conclusion: Waist circumference (< 44.5 cm for MAM; < 42.3 cm for SAM) had a reasonably good sensitivity and specificity for diagnosing MAM and SAM, but the same was not true for WHtR. [ABSTRACT FROM AUTHOR]

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Introduction: This study, of significant importance to healthcare professionals, policymakers, researchers, and organizations involved in child healthcare and malnutrition in Afghanistan, aimed to estimate the out‐of‐pocket expenditure (OOPE) in patients under 5 years old with severe malnutrition in a children's hospital in Herat Province, Afghanistan. Method: This study employed a meticulously designed cross‐sectional descriptive‐analytical approach with practical results. The research population consisted of families with malnourished children under 5 who were referred to Herat Children's Hospital. Data was collected using a comprehensive standard World Health Organization questionnaire to gather demographic information from children in Herat. A carefully selected convenience sampling method was used, with 300 referring patients participating in face‐to‐face interviews with the supervisors of these children. After obtaining personal consent and coordinating with health officials, interviews were conducted with the caregivers of children under 5 who suffered from severe malnutrition. The data was then analyzed using robust descriptive statistics, quantitative variables, mean and standard deviation, frequency, and relative frequency. Multiple regression analysis was used to determine the factors that most influenced direct payments from patients' pockets, ensuring the reliability and validity of the findings. Results: The results showed that OOPE in both households with seven and less than seven people and more than seven people was 68%. The findings indicated that among the residents of Herat referred to the studied hospital, these people spent 54% of the treatment costs directly out of pocket. In contrast, people in the rural areas of Herat pay 69% of the treatment costs to receive medical services straight out of pocket. The critical point is that 93% of the families have incurred catastrophic expenses to treat their children suffering from severe malnutrition. The research revealed that the patient's location and the education level of the head of the household were the most significant factors affecting out‐of‐pocket payments by patients. Conclusion: Increasing OOPE in rural Afghanistan poses a significant obstacle to equitable healthcare services and access to appropriate medicines. To support the goal of universal healthcare coverage, geographic imbalances, and broad health financing options must be addressed. Strengthening insurance coverage and more government assistance can significantly reduce these patients' out‐of‐pocket payments. [ABSTRACT FROM AUTHOR]

The most dramatic outcomes of protracted civil conflict include increased malnutrition among children and the resulting consequences for lifelong health and prosperity. Little is known about how to mitigate the nutritional impact of conflict. Understanding the potential of social-protection measures is particularly important when the risk of intense armed conflict is high. We use quarterly panel data from Yemen to estimate the impact of civil conflict on child nutrition and the effect of unconditional cash transfers in mitigating the adverse nutritional impact. The results show that a 1 standard deviation increase in armed conflict intensity reduces children's weight-for-height z -scores by 9.6% on average. We also find that the studied cash transfer program mitigates the estimated nutritional impact by 42.4%. Our analysis suggests that unconditional cash transfers can be an effective development-policy tool to curb rising acute child malnutrition in Yemen. [ABSTRACT FROM AUTHOR]

Introduction: Malaysia faces the threat of a double burden of malnutrition where undernutrition and overweight (including obesity) coexist in the same population. This study aimed to determine the anthropometric assessment among children and adolescents aged 5 to 17 years and its association with socio-demographic factors. Methods: Data were extracted from the National Health and Morbidity Survey conducted in 2019. This cross-sectional survey applied a two-stage stratified sampling design. Socio-demographic characteristics were obtained. Weight and height were measured, age- and sex-specific standard scores for height and BMI were calculated to establish individual's anthropometric assessment. Having either stunting or thinness was considered undernutrition, while being overweight (including obesity) was considered overnutrition. If someone had undernutrition and/or overnutrition, they were classified as having malnutrition. The prevalence was determined using complex sampling analysis, while the association was assessed through logistic regression. The analysis included a total of 3,185 respondents. Results: The prevalence of stunting, thinness, overweight and obesity among the respondents aged 5 to 17 years was 12.7%, 10.0%, 15.0% and 14.8%, respectively. The overall prevalence of malnutrition was 48.3%. Respondents residing in rural had 1.35 times more likelihood of experiencing undernutrition [AOR = 1.35, 95% CI (1.04, 1.77)] compared to their urban counterparts. Boys exhibited a greater likelihood of being overweight and obese than girls [AOR = 1.40, 95% CI (1.13, 1.73)]. Respondents aged 10 to 14 years were 1.37 times more likely to be overnutrition than those aged 5 to 9 years old [AOR = 1.37, 95% CI (1.09, 1.73)]. Conclusion: There is growing evidence of the increasing prevalence of coexistence of undernutrition along with overweight and obesity among children and adolescents in Malaysia. Moving forward, greater initiatives and efforts are required to formulate strategies for planning and implementing programs and policies to expedite progress in improving nutrition. [ABSTRACT FROM AUTHOR]

Background: Malnutrition of children under 5 years of age is persistent in Cameroon principally in rural areas. Moreover, there is limited knowledge of coexisting forms of malnutrition (CFM) among children of this age. Therefore, the aim of this study was to assess the prevalence of CFM in a cohort of children under 5 years and to identify the associated factors. Methods: A cross-sectional study was conducted in the Health Districts of the locality of Dschang in the West region of Cameroon between June 2021 to November 2021. Data were collected from 200 under-five children of both sexes and an interviewer-administered questionnaire was administered to consented children's mothers/guardians. Malnutrition in children was assessed by WHO growth standards (weight-for-height, weight-for-age, height-for-age and body mass index-for-age). The different CFM were defined by the presence of two autonomous forms of malnutrition in the same child. Logistic regression analyses were done to identify factors associated to different coexisting forms of malnutrition. Results: The results obtained showed prevalences of 4.20% for the coexistence of underweight with wasting, 7.8% for the coexistence of underweight with stunting and 14.8% for the coexistence of stunting with overweight. Lower maternal age (15–24 years old; OR = 0.09; p = 0.05) and lower education level (primary education, OR = 23.33; p = 0.00) were associated with the coexistence of underweight with wasting. Marital status (single mother, OR = 0.28; p = 0.00) was associated to the coexistence of stunting with overweight/obesity. Conclusion: The findings of this study provide evidence on the coexistence of different forms of malnutrition among children below five years of age in rural area of Cameroon. These finding would guide future research, policies, and programs on the management of malnutrition in rural areas of Cameroon. [ABSTRACT FROM AUTHOR]

Introduction: Double malnutrition (co-existing overnutrition and undernutrition) is increasingly prevalent in sub-Saharan Africa due to rapid epidemiological and nutritional transitions. In this region, studies of double malnutrition have largely been conducted at country and household level, with individual-level studies primarily limited to children and women of reproductive age. We investigated the prevalence and determinants of individual-level double malnutrition in middle-aged and older adults who constitute an increasing proportion of the sub-Saharan African population. Methods: 250 individuals aged 40–70 years (50% women) and resident in the Agincourt Health and socio-Demographic Surveillance System in rural Mpumalanga province, South Africa, were randomly selected. Double malnutrition was defined as overweight/obesity and anaemia only, overweight/obesity and iodine insufficiency, or overweight/obesity and any micronutrient deficiency (anaemia and/or iodine insufficiency). The Chi-squared goodness of fit test was used to compare the expected and observed numbers of individuals with the type of double malnutrition. Logistic regression was used to investigate determinants of each type of double malnutrition. Results: Double malnutrition was present in 22–36% of participants, depending on the definition used. All types of double malnutrition were more common in women than in men (overweight/obesity and anaemia: 34% vs. 10.2%, p < 0.01; overweight/obesity and iodine insufficiency: 32% vs. 12.2%, p < 0.01 and overweight/obesity and any micronutrient deficiency: 50.5% vs. 20.4%, p < 0.01). There were no differences between the overall expected and observed numbers of individuals with combinations of overweight and micronutrient deficiencies [overweight/obesity and anaemia (p = 0.28), overweight/obesity and iodine insufficiency (p = 0.27) or overweight/obesity and any micronutrient deficiency (p = 0.99)]. In models adjusted for socio-demographic factors, HIV and antiretroviral drug status, and food security or dietary diversity, men were 84–85% less likely than women to have overweight/obesity and anaemia, 65% less likely to have overweight/obesity and iodine insufficiency and 74% less likely to have overweight/obesity and any micronutrient deficiency. Conclusions: Individual-level double malnutrition is prevalent in middle-aged and older adults in a rural sub-Saharan African community. Interventions to improve nutrition in similar settings should target individuals throughout the life course and a focus on women may be warranted. [ABSTRACT FROM AUTHOR]

AbstractSeveral strategies, programs and policies have long been developed and implemented to alleviate child malnutrition in sub-Saharan African countries. However, stunting and wasting still persist at an alarming rate, suggesting that alternative strategies are needed to induce faster progress toward the 2030 SDGs targets of reducing malnutrition. Gut microbiota-directed intervention is now being recognized as an unconventional powerful approach to mitigate malnutrition and improve overall child health. In an African setting, manufactured probiotic and synbiotic foods or supplements may not be successful owing to the non-affordability and high attachment of African populations to their food tradition. This review analyses the potential of indigenous fermented cereal-based products including porridges, doughs, beverages, bread- and yoghurt-like products, to be used as microbiota-directed foods for over 6 months children. The discussion includes relevant strategies to effectively enhance the beneficial effects of these products on gut microbiota composition for improved child health and nutrition in sub-Saharan Africa. Characterization of probiotic features and general safety of food processing in sub-Saharan Africa as well as randomized clinical studies are still lacking to fully ascertain the health effects and suitability of these fermented foods in preventing and treating child malnutrition and diarrhea. [ABSTRACT FROM AUTHOR]

We aimed to determine the variations in the prevalence of childhood anemia according to the ethnic group before and during the COVID-19 pandemic in Peru. Secondary analysis of the Demographic and Family Health Survey during 2016–2021. The outcome variable was anemia, and the exposure variable was maternal ethnicity. Also, we included sociodemographic and clinical confounding variables. We constructed generalized linear models of the Poisson family with a logarithmic link function. We evaluated 85,905 records; 30.34% had anemia, 50.83% were mestizo, 25.98% were Quechua, and 2% were Aymara. Compared with mestizos, Quechua children (PR: 1.11; 95% CI: 1.07–1.15; p < 0.001), Aymara (PR: 1.35; 95% CI: 1.27–1.44; p < 0.001), natives of the Amazon (PR: 1.20; 95% CI: 1.12–1.28; p < 0.001) and those who belonged to other indigenous peoples (PR: 1.29; 95% CI: 1.05–1.57; p = 0.013) had a higher prevalence of childhood anemia. On the contrary, compared to mestizos, white children had a lower prevalence of anemia (PR: 0.93; 95% CI: 0.89–0.99; p = 0.019). During the COVID-19 pandemic, compared to mestizos, only Quechua (PR: 1.15; 95% CI: 1.08–1.23; p < 0.001) and Aymara (PR: 1.38; 95% CI: 1.23–1.55; p < 0.001) had a higher prevalence of childhood anemia. Except for Afro-descendants, children from 6 to 59 months of age who belong to an ethnic minority had a higher probability of having childhood anemia than mestizos. However, only Quechua and Aymara children had higher odds of anemia during the COVID-19 pandemic than mestizos. [ABSTRACT FROM AUTHOR]

It is widely acknowledged that patients with cancer commonly experience malnutrition, and some individuals may adopt specific dietary trends. This study investigated the prevalence of malnutrition and dietary trends among Algerian cancer outpatients undergoing chemotherapy. This cross-sectional, descriptive study was conducted from January to October 2023 with 71 cancer outpatients undergoing chemotherapy. Malnutrition risk was evaluated using the Malnutrition Screening Tool (MST). The questionnaire also collected the occurrence of nutrition impact symptoms, the avoidance of specific food groups, and the use of oral nutritional supplements and dietary supplements. Malnutrition risk was identified in 57.7% (41 cases) of participants. Nutrition impact symptoms were reported by 59.2% (42 cases) of patients. A total of 36 of the patients (50.7%) altered their eating habits by avoiding at least one food group. Among malnourished cancer outpatients, only five used oral nutritional supplements. Dietary supplements were used by 23.9% (27/71) of the patients after cancer diagnosis. Our findings underscore the necessity for a systematic malnutrition assessment in cancer patients. Qualified clinicians should provide nutritional awareness to enhance the quality of life for these patients. [ABSTRACT FROM AUTHOR]

Stunting is a multi-cause growth failure affecting the growth and development of children. The Government of Indonesia is implementing a National Strategy to Accelerate Stunting Prevention in order to ensure that it targets all individuals including those in the critical period of "the first 1000 days of life" —those with pregnant women or children under the age of two —can access the full package program of services essential to stunting prevention. Indonesia has successfully reduced stunting prevalence, by about 6.4% during 5 years between 2013 and 2018. The present study focused on analyzing the pathway of possible factors affecting stunting, among children under five based on national data from the 2013 and 2018 Indonesia Basic Health Surveys (IBHS). The partial least squares structural equation modeling (PLS-SEM) was used to identify the different pathways affecting stunting in the two data sets. This study found the different pathway within the data from the 2013 and 2018 IBHS. Stunting was significantly affected by birth size (T value=9.78) (low weight and length birth), as well as, the disease factors (T=2.48) in 2013, but only birth size (T=8.75) in 2018. In 2013, socio-economic factors affected stunting indirectly (T=1.497) through maternal factors (T=13.86) that influence disease (T=5.235) via exclusive breastfeeding (T=3.531). This study found that, Low Birth Weight (LBW) babies were two to three times more likely to be stunted children. Click or tap here to enter text. Overall, the stunting prevalence across regions in Indonesia demonstrated a decreasing trend from 2013 (38.4%) and reached lower in 2018 (33.9%). The 2013 IBHS showed an indirect effect of socioeconomic factors on stunting through the pathways of maternal factors, breastfeeding practices, and disease. This indirect effect was not found in the 2018 IBHS. There were different pathways of factors affecting stunting between the two datasets of the 2013 and 2018 basic health survey, but the consistent factor is the birth size (birth weight and length). Birth size is the most important determinant of stunting in Indonesia and must be prioritized and addressed immediately. [ABSTRACT FROM AUTHOR]

The article explores the impact of maternal aflatoxin exposure on the health of infants aged 0 to 3 months. Aflatoxin exposure, commonly found in certain foods, has been linked to negative health outcomes, particularly in developing countries with high malnutrition rates. Infants can be exposed to aflatoxins through breast milk and early cereal-based complementary feeds. Studies suggest that aflatoxin exposure may lead to reduced growth and increased morbidity in young children. While the exact mechanism is not yet understood, aflatoxin exposure may compromise immune function and nutrient absorption, leading to diarrhea and other infections. It is crucial to address aflatoxin contamination in foods and ensure the quality of consumed foods to protect vulnerable populations, especially mothers and infants, from the harmful effects of aflatoxins. [Extracted from the article]

Malnutrition remains a major public health challenge among children in developing countries, especially those experiencing civil wars and political unrest. It is imperative to ascertain the level of malnutrition, particularly in displaced children, to develop and effectively implement interventions. This study was a cross‐sectional survey conducted to assess the nutritional status of 657 internally displaced school‐aged children (5–15 years) enrolled in primary schools in the West and Littoral Regions of Cameroon. The height, weight, and mid‐upper arm circumference of the children were measured using standard measurements. Clinical examinations were also made on the children. Other parameters that affect nutritional status, such as morbidity and health‐seeking practices, were assessed using pre‐tested, structured interviewer questionnaires. An analysis of the data revealed that stunting was the most prevalent form of malnutrition (27.1%), followed by wasting (23%), thinness (21.6%), and underweight (20.1%). About 44.5% of the children had low serum iron, and 35.7% of them had poor protein status. The prevalence of anemia was 30.0%. The most common signs of protein, vitamin A, and iron deficiencies observed were thin, dry, or sparse hair (5.2%), pallor (7.3%), and xerosis (3.3%), respectively. About 32% of the children had been sick within the previous month of the study, and the most common illness was the common cold (19.8%). Most of them (>60%) had good health‐seeking practices. The high prevalence of stunting, wasting, thinness, underweight, anemia, protein, and iron deficiency calls for interventions such as nutrition education and supplementation to prevent malnutrition and diet‐related diseases among children. [ABSTRACT FROM AUTHOR]

The timely detection of malnutrition in children is of paramount importance, as it allows for early intervention and treatment. This proactive approach not only prevents further health deterioration but also fosters proper growth, minimizing the long-term consequences of malnutrition, such as stunted growth, impaired cognitive development, and increased vulnerability to diseases. Our work encompasses the creation of a new dataset comprising images of children in Healthy, Undernourished, Stunting, and Wasting categories. The core objective is to assess the deep learning model performance in classifying these children images. The experimentation is carried out by varying epochs, batch size, optimizers AdamW, Adamax, and RMSprop; and different values of the learning rate 0.1, 0.01, 0.001, and 0.0001 during model training. The model is trained on image dataset constructed by cleaning images generated by the stable diffusion model. The model is tested on randomly selected child images from websites. The model successfully classified two classes with 95% accuracy, 97.6% F1 score, precision 97.6%, and 97.6% recall with Adam optimizers, 0.0001 learning rate, and Batch size 4. Additionally, for the four-class categorization scenario, the study broadens the classification. The model achieved 88.87% accuracy, 90.3% recall, 90.2% precision, and an F1 score of 90% for four-class categorization with AdamW optimization, 0.0001 learning rate, and batch size 6. These results are satisfactory for prediction of malnutrition category in children. [ABSTRACT FROM AUTHOR]

The efficacy of foreign aid, especially escalating Chinese aid, has been controversial. Considering the widespread malnutrition in Sub-Saharan Africa and the substantial concerns about Chinese aid, we investigate whether and how Chinese development assistance improves the nutrition of the African recipients, particularly children and women. We match Chinese aid projects and Demographic and Health Surveys (DHS) covering 24 SSA countries during 2000–2016. We address the causality by comparing the individuals who lived near a Chinese aid project that was effective at the time of the interview to those who were not exposed to Chinese aid projects while a nearby Chinese aid project would be initiated after the interview. We measure malnutrition by hemoglobin haemoglobin and anemia anaemia which are more relevant and reliable than other indicators. Our results show that Chinese aid significantly increased hemoglobin haemoglobin and decreased the likelihood of anemia anaemia, and the effects are more pronounced among children. In contrast to the popular expectation, health aid does not significantly improve nutrition conditions, at least in the short run. Instead, other aid projects that promote earnings and job opportunities substantially reduced malnutrition among children and women. Heterogeneity analysis further shows that Chinese aid strongly improved nutrition mainly among disadvantaged residents. [ABSTRACT FROM AUTHOR]

In Africa, the number of children under 5 years old who suffer from stunting and wasting are, respectively, 61.4 and 12.1 million, and to manage situations like these, emergency food products like RUTF and RUSF (ready-to-use therapeutic/supplementary food) are very useful. The aim of this study was to develop an RUSF biscuit using the low-cost food resources usually present in Sub-Saharan Africa (Burundi and the DRCongo in our case study); we conducted chemical characterization, nutritional evaluation, and a stability trial simulating the usual storage conditions in a rural context to demonstrate that RUSF can be functional also using low-cost ingredients and a simple method of production. The obtained recipes showed good potential in supplying protein integration—17.81% (BUR) and 16.77% (CON) (% as food) were the protein contents—and the protein digestibility values were very high (BUR: 91.72%; CON: 92.01%). Moreover, 30% of the daily requirement was achieved with less than 50 g of both recipes in all the considered ages. Finally, a good shelf-life was demonstrated during the 35-day testing period at 30 °C, considering moisture, texture, and lipid oxidation evolution. Recipes like these, with appropriate changes, could be very useful in all contexts where child malnutrition is a serious problem. [ABSTRACT FROM AUTHOR]

Child malnutrition remains a pervasive problem in India though there are significant improvements in several health indicators with country's consistent economic growth. Along with other factors, maternal autonomy is considered to be critical in influencing health outcome of a child. This paper attempts to examine the determinants of nutritional measures of children under age five with the focus to the role of mother's autonomy in India. There are studies which link characteristics of mother, like education, age, with nutrition of her children. But maternal autonomy is a complex subject as this variable is not tangible. Women's autonomy in daily life is more likely to result in their better healthcare which in turn influences children's birth weight and infant nutrition. We used nationally representative India Human Development Survey 2004–05 (IHDS- 1) and 2011–12 (IHDS 2) data for the analysis. This paper studies the association between maternal autonomy and childhood stunting, the indicator of chronic malnutrition, and the risk of having a stunted child. We have also used the panel data using both waves of IHDS and used mothers fixed effect model to evaluate the impact of maternal autonomy. The autonomy index is created using four dimensions-women's decision making, freedom of movement, financial autonomy and attitude toward domestic violence. The two dimensions of autonomy—physical autonomy, financial autonomy—remain significant determinants for childhood stunting. [ABSTRACT FROM AUTHOR]

This narrative review article aims to describe the issue of stunting in Indonesia, a condition from chronic malnutrition that impairs children’s growth and development. With a stunting prevalence of approximately 30% among children under five, this problem is a critical concern for policymakers and healthcare providers. The article also reviews various interventions, including programs to enhance nutrition, promote breastfeeding, and improve sanitation. By assessing these existing interventions, health policy strategies and service management enhancements are proposed to reduce stunting rates. It underlines the necessity of a comprehensive approach integrating cross-sector collaboration and community engagement to achieve lasting solutions. The insights provided are crucial for policymakers to refine and enhance intervention strategies, aiming to lessen the long-term health impacts and improve children’s well-being in Indonesia. [ABSTRACT FROM AUTHOR]

This study examines the impact of an integrated intervention programme on the linear growth and psycho-cognitive development of malnourished children aged 6-59 months in Kanam, Plateau State, Nigeria. The intervention employs a multifaceted approach, including nutritional supplementation, psychosocial stimulation, water, sanitation and hygiene. A mixed method approach that employed multi-stage cluster sampling technique to select malnourished children aged 6 to 59 months residing in the targeted communities was used. Quantitative assessments of anthropometric measurements height/length, weight and mid-upper arm conference were undertaken to assess nutritional status, and psycho-cognitive assessment along with qualitative data from caregiver interviews and community feedback, were utilized to evaluate the intervention's effectiveness. The findings of the study show that community whose children received the complete package recorded higher liner growth. This was followed by communities whose children received two packages of nutrition and psychosocial support, as well as nutrition and water, sanitation, hygiene respectively. The community whose children received only nutrition had the least liner growth. Furthermore, the study shows a greater improvement in psycho-cognitive development among children in two communities that had psychosocial support added to their packages compare to the children from the other two communities without psychosocial support been added. Recommendations made include the need to establish community food-based intervention programmes, create awareness among parents to be more involved in psychosocial activities with children, provision of age-appropriate stimulation materials, training of parents/caregivers on responsive caregiving practices, and the need to establish safe spaces for play and learning in schools and communities. [ABSTRACT FROM AUTHOR]

Background and Aims: With existing undernutrition in the developing world, the prevalence of obesity is increasing rapidly. Some studies reported an association of intestinal parasitic infection (IPIs) with undernutrition while few recent studies reported an inverse association of IPIs with overweight and obesity. This study evaluated the comparative risk and associated factors of IPIs among under (body mass index [BMI] < 18.5), normal (BMI: 18.5–24.9) and overweight (BMI > 24.9) school‐aged adolescents. Methods: A total of 105 fecal samples were collected, with 35 samples from each group. The collected samples were tested for the presence of intestinal parasites via concentration method, and the parasites were identified morphologically. Results: Overall prevalence of IPIs was 5.71% with 3 protozoa viz Giardia lamblia (2.86%), Entamoeba histolytica (1.90%) and Endolimax nana (0.95%). Univariate and multivariable regression analysis indicated none of the nutritional, socioeconomic status, demographic, lifestyle and behavioral characteristics were significantly associated with the prevalence of overall IPIs. Yet, significant numbers of male reported undernutrition and elevated risk of IPIs in this study population. Conclusion: Despite low prevalence of IPIs in this study, risk of IPIs is attributable to individual differences in behavior like "not using soap for hand washing". Relatively elevated malnutrition with risky hygiene behaviors, male adolescents appeared as risky cluster of school age population. [ABSTRACT FROM AUTHOR]