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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Veröffentlicht in:PloS one 2017-10, Vol.12 (10), p.e0186493
Hauptverfasser: Rabaoarisoa, Chitale Remonja, Rakotoarison, Rado, Rakotonirainy, Nivo Heritiana, Mangahasimbola, Reziky Tiandraza, Randrianarisoa, Alain Berthin, Jambou, Ronan, Vigan-Womas, Inès, Piola, Patrice, Randremanana, Rindra Vatosoa
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container_issue 10
container_start_page e0186493
container_title PloS one
container_volume 12
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.
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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). 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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. 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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 development</topic><topic>Child, Preschool</topic><topic>Childbirth &amp; labor</topic><topic>Children</topic><topic>Children &amp; youth</topic><topic>Chronic illnesses</topic><topic>Control methods</topic><topic>Determinants</topic><topic>Economic aspects</topic><topic>Empowerment</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Growth Disorders - epidemiology</topic><topic>Growth Disorders - prevention &amp; 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Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agricultural Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Advanced Technologies &amp; Aerospace Database</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access 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>
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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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