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When transforming from a traditional rural economy to a rapid marketization period, it is essential to consider the relationship between multiple shocks and household income in poor rural areas of China. Using two waves of a rural household surveys from six poor counties in China between 2015 and 2018, we examine the effect of multiple shocks on households' income and explore the heterogeneity of different shocks and households based on income. The multiple linear regression and quantile regression results demonstrate that multiple shocks negatively affect farm household income, and the range of impact is widening. Specifically, natural disaster shocks reduce the income of low-income households more, and unnatural disaster shocks reduce the income of middle–low-income farm households more. We conclude that illness within the family and lack of working household members are the primary shocks currently suffered by different types of farm households. In contrast to previous research, this study identifies middle–low-income farm households as most in need of attention and reveals that unnatural disaster shocks in poor rural areas of China are most in need of governance during recovery transitions. The findings enrich the existing theoretical system and provide policymakers with practical insights regarding differentiated and preemptive risk governance approaches. [ABSTRACT FROM AUTHOR]

A balanced and adequate diet is the key point to ensure healthy development of children's brains, physical health, and immunity in early life. Infant nutritional status is affected by many factors, among which complementary feeding is the most important. In this paper, we reviewed the definition and assessment method of complementary feeding patterns, the prevalence of Chinese complementary feeding patterns and existing problems, the research progress of the relationship between patterns of complementary feeding and nutritional status and the limitation and future study of complementary feeding. Previous studies showed that the malnutrition status and qualified complementary feeding patterns of infants and young children in poor areas need improvement. And there is almost no research focus on introducing different types of a specific food, the number of food types and the amount of feeding. There is still a lack of research on the patterns of complementary feeding and its effect on the nutritional status of infants. Few studies focus on the causes of the complementary feeding patterns, such as the patterns of complementary feeding and its associated factors for breastfed and non-breastfed infants, the relationship between the characteristics of complementary foods and nutritional status of infants, and the overall analysis of risk factors of complementary foods.

This study aimed to estimate the status of complementary feeding (CF) and its associated factors among 6–23-month breastfed infants and young children (IYC). We used secondary data from the China Nutrition Improvement Project on Children in Poor Areas in 2018. The status of CF was provided by parents of IYC through 24-h dietary recall. The study included 13,972 6–23-month-old breastfed IYC comprising 24.7% 6–8-month, 28.5% 9–11-month, 31.4% 12–17-month, and 18–23-month IYC. The highest percentage of IYC introduced to cereal foods was 84.8%. Nearly, 83.6% of 6–8-month infants were introduced to solid or semi-solid food. The prevalence of meeting requirements of non-dairy animal source food and minimum acceptable diet (MAD) was 75.3 and 35.1% of 6–23-month IYC, respectively, and was significantly higher in older than younger IYC (p < 0.001). Age of IYC, education level of parents, paternal employment, and nutrition knowledge of parents were positively associated factors for the prevalence of meeting requirements of MAD, and diarrhea at 2 weeks and maternal employment were negatively associated with MAD. Totally, the prevalence of meeting the requirements of MAD was relatively lower in breastfed IYC. The government should scale up appropriate CF with consideration of food availability.

Background and Objectives: Milk promotes the growth of children's height. However, the relationship between milk consumption and anemia or obesity remain unclear. We explored the association between milk consumption and the nutritional status of poor rural Chinese students, including anemia, height, weight, malnutrition, and overweight/obesity.Methods and Study Design: A total of 22,315 students aged 8-16 years were recruited. The frequency of milk consumption and other information were investigated using the questionnaire. Students' morning fasting height, weight, and whole-blood hemoglobin were measured. The children were classified as malnutrition, normal weight, and overweight/obesity according to their age-specific height and BMI. Multivariate linear and multiple logistic regression were used to analyze the association between milk consumption and nutritional status.Results: In total, 10.6% of students drank milk at least once a day. Compared to students who drank milk <1 time/week, The heights and weights of students who consumed milk 1-3 times/week, 4-6 times/week, and at least once per day were 0.8, 0.9, and 1.3 cm greater and 0.8, 0.6, and 1.0 kg heavier. Students who drank milk at least once a day (OR=0.817), and 1-3 times/week (OR=0.868) had a significantly lower prevalence of malnutrition. Students who drank milk 4-6 times/week (OR=0.472) had a significantly lower prevalence of anemia. However, no significant association was identified between milk consumption and overweight/obesity.Conclusions: Frequent consumption of milk was associated with these students having a lower risk of malnutrition and anemia, being taller, and being heavier. [ABSTRACT FROM AUTHOR]

In order to provide a policy basis for improving the early development of poor rural children, this paper uses quantitative data and quatitative research methods to study the early development of children in poor rural areas and the impact of family environmental quality on such development. The results show that the early development of poor rural children, especially the ability of social emotion is not perfect, and the quHty of family environment has a significant impact on the early development of poor rural children. Therefore, in order to improve the early development of rural children, it is necessary to attach importance to the improvement of family environment and increae the interaction with children. The government needs to establish and improve the mechanism of providing early development services, increase investment and find more efficient service model. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the effects of early comprehensive interventions on home environment and child neurodevelopment among children younger than 3 years in poor rural areas of China, as well as the underlying mediating and moderating mechanisms. STUDY DESIGN: Non-randomized intervention study was conducted among 216 children aged 0-3 years in Shanxi province of China. Based on a 2 x 2 factor design, children in Lin and Fenxi County were assigned to an intervention group with duration less than 1 year (n = 26) or an intervention group with duration longer than 1 year (n = 82), while children in Fangshan County served as a control group with duration less than 1 year (n = 30) or a control group with duration longer than 1 year (n = 78). METHODS: The control group received national public health services (NPHS), while the intervention group received NPHS plus comprehensive interventions covering health, nutrition, early psychosocial stimulation, and child protection. Home environment (Infant-Toddler Home Observation for Measurement of the Environment [HOME]) and child neurodevelopment (Ages and Stages Questionnaire [ASQ]) were measured by observation and interview with mothers after the intervention program. RESULTS: The intervention group showed significantly higher overall HOME, organization, learning materials, and involvement than the control group, only for a duration longer than 1 year. Children in the intervention group performed better in overall ASQ, fine motor, problem-solving, and personal-social than children in the control group. Moderated mediation analyses indicated that there were significantly indirect effects of treatment on overall ASQ through overall HOME, organization, and involvement only when the duration was longer than 1 year. CONCLUSIONS: Early comprehensive interventions longer than 1 year improve home environment and promote child neurodevelopment among children younger than 3 years in poor rural areas. What is more, effects of early comprehensive interventions longer than 1 year on child neurodevelopment were mediated by home environment. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the status of complementary feeding (CF) and its associated factors among 6-23-month breastfed infants and young children (IYC). We used secondary data from the China Nutrition Improvement Project on Children in Poor Areas in 2018. The status of CF was provided by parents of IYC through 24-h dietary recall. The study included 13,972 6-23-month-old breastfed IYC comprising 24.7% 6-8-month, 28.5% 9-11-month, 31.4% 12-17-month, and 18-23-month IYC. The highest percentage of IYC introduced to cereal foods was 84.8%. Nearly, 83.6% of 6-8-month infants were introduced to solid or semi-solid food. The prevalence of meeting requirements of non-dairy animal source food and minimum acceptable diet (MAD) was 75.3 and 35.1% of 6-23-month IYC, respectively, and was significantly higher in older than younger IYC ( p < 0.001). Age of IYC, education level of parents, paternal employment, and nutrition knowledge of parents were positively associated factors for the prevalence of meeting requirements of MAD, and diarrhea at 2 weeks and maternal employment were negatively associated with MAD. Totally, the prevalence of meeting the requirements of MAD was relatively lower in breastfed IYC. The government should scale up appropriate CF with consideration of food availability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Liu, Huo, Sun, Huang, Gong and Wang.)

Objective: To analyze complementary feeding status and issues among 6-23 month infants and young children(IYC) in poor rural regions in China to figure out actions further IYC nutrition in China., Methods: Using 2018 monitoring data from Project of Children Nutrition Improvement in Poor Rural Regions, 6-23 months infants were sampled with the method of a combination of provincial stratification, multi-stage stratified cluster, PPS and random equidistant. Complementary feeding practices were collected by 24 hours diet recall method and and parental knowledge on IYC feeding was collected by KAP questionnaire. Complementary diet was analyzed according to the World Health Organization& apos; s definition of infant and young child feeding indicators. Logistic regression model was used to analyze the influencing factors of minimum acceptable diet(MAD)., Results: A total of 40 910 infants(boys 21 153, girls 19 757) completed the survey. The proportion of infants 6-8 months of age who receive solid, semi-solid foods was 83.8%, the percentage of IYC who get minimum dietary diversity(MDD), minimum meal frequency(MMF), and MAD was 67.8%, 71.4% and 39.7%, respectively. The age of months, mother& apos; s educational level and parent& apos; s nutrition and feeding knowledge had significant impact on the outcome of MAD. The OR for month& apos; s age were 1.990 and 1.905(P& lt; 0.001), OR for mother education level was 1. 545(P& lt; 0.001) and OR for parent knowledge were 1.114 and 1.346(P& lt; 0.001)., Conclusion: Complementary feeding practices were poor in terms of the proportion of infants 6-8 months of age who introduced complementary foods, MDD, MMF and MAD in poor region of China.

This study explored how maternal and infant illness correlated with the risk of postpartum depression in the Chinese Qinba Mountains region. In total, 131 villages comprising 435 families with infants (≤6 months old) were randomly sampled. We collected data on maternal and infant illnesses and maternal health knowledge level. The Depression, Anxiety, and Stress Scale-21 was used to measure the risk of postpartum depression. We used descriptive statistics and multivariate logistic regression for the analysis. Infant overall health status was a risk factor for postpartum depression (odds ratio (OR) = 1.90, 95% Confidence Interval (95% CI) = 1.10~3.28), whereas maternal overall health status was not correlated with postpartum depression (OR = 1.36, 95% CI = 0.55~3.39). For specific illnesses, infants experiencing over two common illnesses in the past two weeks (OR = 1.98, 95% CI = 1.13~3.45) and mothers experiencing over two common pains within two weeks after delivery (OR = 1.77, 95% CI = 1.02~3.08) were risk factors for postpartum depression, whereas infants with mild and severe stunted growth, maternal C-section, and postpartum body mass index (normal or overweight) were not correlated with it (all p > 0.050). Maternal health knowledge was an important moderator of maternal and infant illnesses on the risk of postpartum depression. In conclusion, maternal and infant illness were essential factors for the risk of postpartum depression in a poor rural region in western China, which may be mainly affected by the feeling of uncertainty of illness. Improved maternal and infant health and enhanced maternal health knowledge might alleviate the risk of postpartum depression.

Objective: To investigate the association between milk intake at breakfast and nutritional status of students attending the Nutrition Improvement Program for Rural Compulsory Education Students (NIPRCES) in 2016, and to provide basic data for improving the nutritional status of the poor rural pupils. Methods: Using the multi-stage stratified random cluster sampling method, 22 315 students from grade three to nine from primary and junior high schools were randomly selected from the 50 key counties under the monitor programs, in 22 provinces of NNIPRCS. Questionnaire was used. Among all the students, with equal number of genders, morning fasting height and weight were measured by trained investigators. Status of nutrition was classified as malnutrition, normal, overweight/obesity, by age-specific height and BMI. Multivariate linear and logistic regression methods were used to analyze the relationship between milk consumption and the status of nutrition of the students. Results: Only 31.4% of the students that were on the monitoring programs would drink milk at breakfast. Proportions of milk intake at breakfast were higher in students from the western regions, in lower grades and in girls ( P <0.05). The proportions of malnutrition and overweight/obesity were 11.0% and 10.0% respectively. After controlling factors as gender, age, ethnicity, region of residency and types of parental employment, students who drank milk at breakfast showed an average height of 0.4 cm taller than those who did not drink milk ( P =0.001). However, no significant relationships were noticed between milk intake at breakfast and weight, malnutrition or overweight/obesity. Conclusion: Milk intake at breakfast seemed associated with the height of the students under study, suggesting that this program can be promoted, especially in students from the poor rural areas.

Objective: To describe the rate of and identify the factors associated with introduction of solid, semi-solid or soft foods among infants aged 6-8 months in poor rural areas., Methods: A total of 1449 rural infants aged 6-8 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by probabilityproportional-to-size sampling( PPS) in August 2015. And designed questionnaires were used to collect information of infants feeding in the past 24 h and information of personal and family. The rate of introduction of solid, semi-solid or soft foods among infants aged 6-8 months was calculated according to WHO Indicators for Assessing Infant and Young Child Feeding Practices. Logistic regression analysis were used to analyze factors influencing introduction of solid, semi-solid or soft foods on infants aged 6-8 months., Results: 95. 4%( 1382/1449) of infants aged 6-8 months received solid, semi-solid or soft foods. Multi factors analysis showed that Tujia ethnic infants( OR = 2. 32, 95% CI1. 55-3. 47) and main caregivers' unqualified feeding knowledge( OR = 1. 39, 95% CI1. 10-1. 75) were risk factors of introduction of solid, semi-solid or soft foods., Conclusion: Most infants aged 6-8 months in poor rural areas received solid, semi-solid or soft foods. Infants who were Tujia ethnic or with unqualified caregivers ' feeding knowledge had higher risk of introduction of solid, semi-solid or soft foods.

Objective: To describe the situation and identify factors associated with malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan Province in 2015. Methods: 8 735 rural infants and young children aged 6-23 months in 30 poor counties of Wuling Mountains and Luoxiao Mountains in Hu'nan province were selected by township-level probability proportional to size sampling (PPS) in August 2015, infants' body length and weight were measured, and questionnaires were used to collect infants' information on personal and family, and feeding status in the past 24 h. The prevalence of stunting, underweight and wasting were calculated according to the Growth Standards of Child Aged Under 7 in China which was established in 2009 by Community Health Department of National Health and Family Planning Commission, China (formerly Chinese MOH), and the prevalence of malnutrition was calculated according to the classification of children with anthropometric failure. Multi non-conditional logistic regression model were used to analyze factors associated with malnutrition among infants and young children aged 6-23 months. Results: The prevalence of malnutrition among infants and young children aged 6-23 months was 13.7% (1 198/8 735), the prevalence of stunting, underweight and wasting among infants and young children aged 6-23 months were 4.8% (419/8 735), 9.7% (849/8 735) and 6.1% (531/8 735) respectively. Compared with male group, the OR value of malnutrition for the female group was 1.16; Compared with Han ethnic group, the OR value of malnutrition for the Miao and Tujia ethnic group were 0.83 and 0.66, respectively; Compared with mother with an education level of primary school or below, the OR value of malnutrition for the mother with junior high school, senior high school and university or above education were 0.65, 0.61 and 0.56, respectively; Compared with father with an education level of primary school or below, the OR value of malnutrition for the father with senior high school and university or above education were 0.71 and 0.61 respectively; Compared with normal birth weight group, the OR value of malnutrition for the low birth weight group and high birth weight group were 2.85 and 0.27 respectively; Compared with normal delivery group, the OR value of malnutrition for the premature delivery group was 1.37; all P values<0.05. Conclusion: The prevalence of malnutrition among infants and young children aged 6-23 months in poor rural areas in Hunan province in 2015 was high; Infants and young children who were female, Han ethnic, parents with low education, low birth weight and premature delivery had higher risk of malnutrition.