The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar
Malnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the d...
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creator | Rabaoarisoa, Chitale Remonja Rakotoarison, Rado Rakotonirainy, Nivo Heritiana Mangahasimbola, Reziky Tiandraza Randrianarisoa, Alain Berthin Jambou, Ronan Vigan-Womas, Inès Piola, Patrice Randremanana, Rindra Vatosoa |
description | Malnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention.
A case-control study was conducted in children aged from 6 to 59.9 months, in 2014-2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods.
We included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1-5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6-3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2-2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1-2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3-0.7).
Interventions that could improve children's growth in these two areas include poverty reduction, women's empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services. |
doi_str_mv | 10.1371/journal.pone.0186493 |
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A case-control study was conducted in children aged from 6 to 59.9 months, in 2014-2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods.
We included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1-5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6-3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2-2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1-2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3-0.7).
Interventions that could improve children's growth in these two areas include poverty reduction, women's empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0186493</identifier><identifier>PMID: 29045444</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Animals ; Biochemistry, Molecular Biology ; Biology and Life Sciences ; Birth ; Birth weight ; Caregivers ; Case-Control Studies ; Cellular Biology ; Child development ; Child, Preschool ; Childbirth & labor ; Children ; Children & youth ; Chronic illnesses ; Control methods ; Determinants ; Economic aspects ; Empowerment ; Epidemiology ; Female ; Growth Disorders - epidemiology ; Growth Disorders - prevention & control ; Health aspects ; Households ; Humans ; Identification methods ; Immunology ; Infant ; Infections ; Infectious diseases ; Influence ; Intestine ; Life Sciences ; Low income groups ; Madagascar ; Madagascar - epidemiology ; Male ; Malnutrition ; Medicine and Health Sciences ; Meta-analysis ; Microbiology and Parasitology ; Models, Theoretical ; Nutrition ; Parasites - physiology ; People and Places ; Physical Sciences ; Poverty ; Poverty - prevention & control ; Power (Psychology) ; Pregnancy ; Public Health ; Reduction ; Regression models ; Research and Analysis Methods ; Risk analysis ; Risk factors ; Rural areas ; Rural Population - statistics & numerical data ; Sample size ; Santé publique et épidémiologie ; Social aspects ; Socioeconomic factors ; Women</subject><ispartof>PloS one, 2017-10, Vol.12 (10), p.e0186493</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Rabaoarisoa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Attribution</rights><rights>2017 Rabaoarisoa et al 2017 Rabaoarisoa et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c697t-6c357ee513dceff60f21d9482472e3758e851752a956ff037dcd86ae1ff4afe33</citedby><cites>FETCH-LOGICAL-c697t-6c357ee513dceff60f21d9482472e3758e851752a956ff037dcd86ae1ff4afe33</cites><orcidid>0000-0002-6174-8827 ; 0000-0001-7848-9297 ; 0000-0002-7325-9238</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646813/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646813/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29045444$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://pasteur.hal.science/pasteur-01634994$$DView record in HAL$$Hfree_for_read</backlink></links><search><contributor>Simeoni, Umberto</contributor><creatorcontrib>Rabaoarisoa, Chitale Remonja</creatorcontrib><creatorcontrib>Rakotoarison, Rado</creatorcontrib><creatorcontrib>Rakotonirainy, Nivo Heritiana</creatorcontrib><creatorcontrib>Mangahasimbola, Reziky Tiandraza</creatorcontrib><creatorcontrib>Randrianarisoa, Alain Berthin</creatorcontrib><creatorcontrib>Jambou, Ronan</creatorcontrib><creatorcontrib>Vigan-Womas, Inès</creatorcontrib><creatorcontrib>Piola, Patrice</creatorcontrib><creatorcontrib>Randremanana, Rindra Vatosoa</creatorcontrib><title>The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Malnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention.
A case-control study was conducted in children aged from 6 to 59.9 months, in 2014-2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods.
We included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1-5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6-3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2-2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1-2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3-0.7).
Interventions that could improve children's growth in these two areas include poverty reduction, women's empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services.</description><subject>Age</subject><subject>Animals</subject><subject>Biochemistry, Molecular Biology</subject><subject>Biology and Life Sciences</subject><subject>Birth</subject><subject>Birth weight</subject><subject>Caregivers</subject><subject>Case-Control Studies</subject><subject>Cellular Biology</subject><subject>Child development</subject><subject>Child, Preschool</subject><subject>Childbirth & labor</subject><subject>Children</subject><subject>Children & youth</subject><subject>Chronic illnesses</subject><subject>Control methods</subject><subject>Determinants</subject><subject>Economic aspects</subject><subject>Empowerment</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Growth Disorders - epidemiology</subject><subject>Growth Disorders - prevention & control</subject><subject>Health aspects</subject><subject>Households</subject><subject>Humans</subject><subject>Identification methods</subject><subject>Immunology</subject><subject>Infant</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Influence</subject><subject>Intestine</subject><subject>Life Sciences</subject><subject>Low income groups</subject><subject>Madagascar</subject><subject>Madagascar - epidemiology</subject><subject>Male</subject><subject>Malnutrition</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Microbiology and Parasitology</subject><subject>Models, Theoretical</subject><subject>Nutrition</subject><subject>Parasites - physiology</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Poverty</subject><subject>Poverty - prevention & control</subject><subject>Power (Psychology)</subject><subject>Pregnancy</subject><subject>Public Health</subject><subject>Reduction</subject><subject>Regression models</subject><subject>Research and Analysis Methods</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Rural areas</subject><subject>Rural Population - statistics & numerical data</subject><subject>Sample size</subject><subject>Santé publique et épidémiologie</subject><subject>Social aspects</subject><subject>Socioeconomic 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importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar</title><author>Rabaoarisoa, Chitale Remonja ; Rakotoarison, Rado ; Rakotonirainy, Nivo Heritiana ; Mangahasimbola, Reziky Tiandraza ; Randrianarisoa, Alain Berthin ; Jambou, Ronan ; Vigan-Womas, Inès ; Piola, Patrice ; Randremanana, Rindra Vatosoa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c697t-6c357ee513dceff60f21d9482472e3758e851752a956ff037dcd86ae1ff4afe33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Animals</topic><topic>Biochemistry, Molecular Biology</topic><topic>Biology and Life Sciences</topic><topic>Birth</topic><topic>Birth weight</topic><topic>Caregivers</topic><topic>Case-Control Studies</topic><topic>Cellular Biology</topic><topic>Child 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Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rabaoarisoa, Chitale Remonja</au><au>Rakotoarison, Rado</au><au>Rakotonirainy, Nivo Heritiana</au><au>Mangahasimbola, Reziky Tiandraza</au><au>Randrianarisoa, Alain Berthin</au><au>Jambou, Ronan</au><au>Vigan-Womas, Inès</au><au>Piola, Patrice</au><au>Randremanana, Rindra Vatosoa</au><au>Simeoni, Umberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-10-18</date><risdate>2017</risdate><volume>12</volume><issue>10</issue><spage>e0186493</spage><pages>e0186493-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Malnutrition accounts for 45% of mortality in children under five years old, despite a global mobilization against chronic malnutrition. In Madagascar, the most recent data show that the prevalence of stunting in children under five years old is still around 47.4%. This study aimed to identify the determinants of stunting in children in rural areas of Moramanga and Morondava districts to target the main areas for intervention.
A case-control study was conducted in children aged from 6 to 59.9 months, in 2014-2015. We measured the height and weight of mothers and children and collected data on child, mother and household characteristics. One stool specimen was collected from each child for intestinal parasite identification. We used a multivariate logistic regression model to identify the determinants of stunting using backwards stepwise methods.
We included 894 and 932 children in Moramanga and in Morondava respectively. Stunting was highly prevalent in both areas, being 52.8% and 40.0% for Moramanga and Morondava, respectively. Stunting was most associated with a specific age period (12mo to 35mo) in the two study sites. Infection with Trichuris trichiura (aOR: 2.4, 95% CI: 1.1-5.3) and those belonging to poorer households (aOR: 2.3, 95% CI: 1.6-3.4) were the major risk factors in Moramanga. In Morondava, children whose mother had activities outside the household (aOR: 1.7, 95% CI: 1.2-2.5) and those perceived to be small at birth (aOR: 1.6, 95% CI: 1.1-2.1) were more likely to be stunted, whereas adequate birth spacing (≥24months) appeared protective (aOR: 0.4, 95% CI: 0.3-0.7).
Interventions that could improve children's growth in these two areas include poverty reduction, women's empowerment, public health programmes focusing on WASH and increasing acceptability, and increased coverage and quality of child/maternal health services.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29045444</pmid><doi>10.1371/journal.pone.0186493</doi><tpages>e0186493</tpages><orcidid>https://orcid.org/0000-0002-6174-8827</orcidid><orcidid>https://orcid.org/0000-0001-7848-9297</orcidid><orcidid>https://orcid.org/0000-0002-7325-9238</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2017-10, Vol.12 (10), p.e0186493 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_1952662414 |
source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
subjects | Age Animals Biochemistry, Molecular Biology Biology and Life Sciences Birth Birth weight Caregivers Case-Control Studies Cellular Biology Child development Child, Preschool Childbirth & labor Children Children & youth Chronic illnesses Control methods Determinants Economic aspects Empowerment Epidemiology Female Growth Disorders - epidemiology Growth Disorders - prevention & control Health aspects Households Humans Identification methods Immunology Infant Infections Infectious diseases Influence Intestine Life Sciences Low income groups Madagascar Madagascar - epidemiology Male Malnutrition Medicine and Health Sciences Meta-analysis Microbiology and Parasitology Models, Theoretical Nutrition Parasites - physiology People and Places Physical Sciences Poverty Poverty - prevention & control Power (Psychology) Pregnancy Public Health Reduction Regression models Research and Analysis Methods Risk analysis Risk factors Rural areas Rural Population - statistics & numerical data Sample size Santé publique et épidémiologie Social aspects Socioeconomic factors Women |
title | The importance of public health, poverty reduction programs and women's empowerment in the reduction of child stunting in rural areas of Moramanga and Morondava, Madagascar |
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