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Individual and contextual factors associated with childhood malnutrition : a multilevel analysis of the double burden of childhood malnutrition in 27 countries
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Ijaiya, Mukhtar A, Anjorin, Seun S. and Uthman, Olalekan A. (2022) Individual and contextual factors associated with childhood malnutrition : a multilevel analysis of the double burden of childhood malnutrition in 27 countries. Global Health Research and Policy, 7 (1). 44. doi:10.1186/s41256-022-00276-w ISSN 2397-0642.
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Official URL: https://doi.org/10.1186/s41256-022-00276-w
Abstract
Background
Malnutrition is a key global health challenge and a major contributor to childhood morbidity and mortality. In recent times, the contrasting coexistence of undernutrition including micronutrient deficiencies and overweight/obesity called double burden of malnutrition has been noted at individual, household or population level and/or at different times in life. The objective of this study was to examine individual, neighborhood and country level factors that are associated with the double burden of childhood malnutrition.
Methods
We conducted multivariable multilevel logistic regression analyses on the most recent demographic and health datasets from surveys conducted between 2015 and 2020 in low- and middle-income countries. We analyzed data of 138,782 children (level 1) living in 13,788 communities (level 2) from 27 countries (level 3).
Results
The results of our analysis show variation in childhood malnutrition across the 27 countries from as low as 6.5% in Burundi to as high as 29.5% in Timor Leste. After adjusting for all level factors, we found that those who were wasted/overweight tended to have had an episode of diarrhea or fever in the last two weeks preceding the survey, were part of a multiple birth, were being breastfed at the time of the survey and born to mothers with more than one under 5-child resident in neighborhoods with high illiteracy and unemployment rates. The intra-neighbourhood and intra-country correlation coefficients were estimated using the intercept component variance; 44.3% and 21.0% of variance in odds of double burden of childhood malnutrition are consequent upon neighborhood and country level factors respectively.
Conclusions
Evidence of geographical clustering in childhood malnutrition at community and country levels was found in our study with variability due to neighborhood level factors twice that of country level factors. Therefore, strategies in tackling the double burden of malnutrition must consider these shared drivers, contextual barriers and geographical clustering effects.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | ||||||
Journal or Publication Title: | Global Health Research and Policy | ||||||
Publisher: | BMC | ||||||
ISSN: | 2397-0642 | ||||||
Official Date: | 24 November 2022 | ||||||
Dates: |
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Volume: | 7 | ||||||
Number: | 1 | ||||||
Article Number: | 44 | ||||||
DOI: | 10.1186/s41256-022-00276-w | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Reuse Statement (publisher, data, author rights): | ** From PubMed via Jisc Publications Router ** History: received 12-05-2022; accepted 30-10-2022. | ||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||
Date of first compliant deposit: | 8 December 2022 | ||||||
Date of first compliant Open Access: | 8 December 2022 |
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