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Risk factors for undernutrition of young children in a rural area of South Africa

Published online by Cambridge University Press:  22 December 2006

Mickey Chopra
Mickey Chopra*
Affiliation:
School of Public Health, University of the Western Cape, Private Bag x17, Bellville 7535, Western Cape, South Africa.
*
*Corresponding author: Email [email protected]
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Abstract

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Objective:

To identify the factors associated with childhood undernutrition.

Design:

Cross-sectional survey.

Setting:

Hlabisa health district in KwaZulu/Natal, South Africa.

Subjects:

Eight hundred and sixty-eight children aged 3–59 months.

Methods:

Questionnaire survey and anthropometric survey of 516 random house-holds with children in the health district. Multivariate analysis took into account the hierarchical relationships between the proposed risk factors. This conceptual model was built up during qualitative studies and with reference to international research in this area.

Results:

The mean Z-scores for weight-for-age and height-for-age were −0.52 (95% confidence interval (CI)−0.44 to −0.60) and −1.25 (95% CI −1.15 to −1.35), respectively. Of the children, 26.3% (95% CI 23.3–29.3%) were stunted, 12.0% (95% CI 9.8–4.2%) were underweight-for-age (UWFA) and only 1.3% were wasted. Migrant father, mother's education, literate mother, whether the house was made of traditional materials, the presence of a toilet, whether the last child was breast-fed, duration of breast-feeding and birth weight were found to be significantly related to UWFA, the latter with an odds ratio of more than eight.

Conclusion:

While there are individual health and feeding behaviours that need to be addressed, this study has also uncovered the maternal and socio-economic factors which present an array of constraints in the social environment shaping the infant feeding and caring practices employed by women. For the full potential of nutrition promotion activities to be realised, there is a need to address some of these ‘deeper’ constraints.

Keywords

UndernutritionSouth AfricaRuralChildrenLow birth weightBreast-feeding
Type
Research Article
Information
Public Health Nutrition , Volume 6 , Issue 7 , October 2003 , pp. 645 - 652
Copyright
Copyright © CABI Publishing 2003

References

1Pelletier, DL, Frongillo, EA Jr, Schroeder, DG, Habicht, JP. The effects of malnutrition on child mortality in developing countries. Bulletin of the World Health Organization 1995; 73(4): 443–8.Google ScholarPubMed
2Hunt, JM. Reversing productivity losses from iron deficiency: the economic case. Journal of Nutrition 2002; 132(Suppl. 4): 794S–801S.CrossRefGoogle ScholarPubMed
3Brown, J, Pollit, E. Malnutrition, poverty and intellectual development. Scientific American 1996 2: 38–43.CrossRefGoogle Scholar
4Labadarios, D., ed. The National Food Consumption Survey (NFCS): Children Aged 1–9 years, South Africa, 2001. Pretoria: National Department of Health, 2002.Google Scholar
5Marshall, CA. An evaluation of aspects of the PEM scheme for malnourished children in Guateng Province, 1995. South African Journal of Food Science and Nutrition 1996; 8(Suppl. 2): S11.Google Scholar
6McCoy, D. Evaluation of the South African Primary School Nutrition Programme. Durban: Health Systems Trust, 1998.Google Scholar
7Sanders, D. Success factors in community-based nutrition programmes. Food and Nutrition Bulletin 1999; 20(3): 307–14.CrossRefGoogle Scholar
8National Center for Health Statistics, Center for Disease Control. NCHS Growth Curves for Children Birth–18 years. Washington, DC: US Government Printing Office, 1978.Google Scholar
9Victora, CG, Huttly, SR, Fuchs, SC, Olinto, TA. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. International Journal of Epidemiology 1997; 26: 224–7.CrossRefGoogle ScholarPubMed
10Solarsh, GC, Sanders, D, Gibson, C, Gouws, E. Community based surveillance vs. sentinel site sampling in determining the nutritional state of children. South African Medical Journal 1994; 84: 747–52.Google Scholar
11SALDRU/World Bank. Report of Situational Analysis in South Africa. Cape Town: University of Cape Town Press, 1994.Google Scholar
12Waterlow, JS. Reflections on stunting. In: Gopolan, C, ed. Recent Trends in Nutrition. Delhi: Oxford University Press, 1993.Google Scholar
13Keller, W. The epidemiology of stunting. In: Waterlow, JC, ed. Linear Growth Retardation in Less Developed Countries. Vevey/New York: Nestle Nutrition/Raven Press, 1988.Google Scholar
14de Onis, M, Blössner, M, Villar, J. Levels and patterns of intrauterine growth retardation in developing countries. European Journal of Clinical Nutrition 1998; 52(Suppl. 1): S5–15.Google ScholarPubMed
15Kramer, M. Balanced protein/energy supplementation in pregnancy. Cochrane Review 1999. Oxford: Update Software.Google Scholar
16Ceesay, SM, Prentice, AM, Cole, TJ, Foord, F, Weaver, LT, Poskitt, EM, et al. Effects on birth weight and perinatal mortality of maternal dietary supplements in rural Gambia: 5 year randomised controlled trial. British Medical Journal 1997; 315: 786–90.CrossRefGoogle ScholarPubMed
17Wilkinson, D, Abdool Karim, SS, Harrison, A, Lurie, M, Colvin, M, Connolly, C, et al. Unrecognized sexually transmitted infections in rural South African women: a hidden epidemic. Bulletin of the World Health Organization 1999; 77(1): 22–8.Google ScholarPubMed
18Chopra, M, Ross, F. Causes of Malnutrition in a Rural Community: A Qualitative Study. Report to South African Participatory Poverty Analysis. Pretoria: World Bank, 1996.Google Scholar
19Kennedy, E. Approaches to linking agriculture and nutrition programmes. Health Policy and Planning 1994; 9(3): 294–305.CrossRefGoogle Scholar
20Quanine, J. Women and nutrition: Grameen Bank experience. In: Women and Nutrition. ACC/SCN State of the Art Series, Nutrition Policy Discussion Paper No 6. Geneva: World Health Organization, 1990.Google Scholar
21Shah, PM, Walimbe, SR, Dhole, VS. Wage earning mothers, mother substitutes and the care of young children in rural Maharashtra. Indian Paediatrics 1979; 16(2): 167–73.Google ScholarPubMed
22Mata, L. The Santa Maria Canque study: Health and survival of Mayan Indians under deprivation, Guatemala. In: Scrimshaw, NS, ed. Community-based Longitudinal Nutrition and Health Studies. Boston, MA: International Foundation for Developing Countries, 1995.Google Scholar
23Leslie, J. Women's nutrition: the key to improving family health in developing countries. Health Policy and Planning 1991; 6: 1–19.CrossRefGoogle Scholar
24Daniels, DL, Cousens, SN, Makoae, LN, Feachem, RG. A case-control study of the impact of improved sanitation on diarrhoea morbidity in Lesotho. Bulletin of the World Health Organization 1990; 68(4): 455–63.Google ScholarPubMed
25Vella, V, Tomkins, A, Nviku, J, Marshall, T. Determinants of nutritional status in south-west Uganda. Journal of Tropical Pediatics 1995; 41: 89–98.CrossRefGoogle ScholarPubMed
26Ricci, JA, Becker, S. Risk factors for wasting and stunting among children in Metro Cebu, Philippines. American Journal of Clinical Nutrition 1996; 63: 966–75.CrossRefGoogle ScholarPubMed