BURDEN AND MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER 5 YEARS OF AGE
Main Article Content
Keywords
malnutrition, child under five, stunting, wasting, micronutrient deficiencies, feeding practices, maternal education, food security, healthcare access, public health.
Abstract
Child malnutrition has continued to be one of the major issues in contemporary global health despite efforts to address the problem. This malnutrition in its various forms, stunting, wasting, underweight, micronutrient deficiencies, and over nutrition which is emerging as an issue of concern affects the child mortality as well as the child’s development. According to the global health institution, World Health Organization, malnutrition alone kills nearly 45 % of children less than five years of age, that is more than three million, every year. This paper discusses the current status of malnutrition in children under the age of five and the possible risk factors together with ways which are implemented in order to treat the problem. This cross-sectional study carried out in the rural and peri-urban settings assesses the sociodemographic characteristics, feeding patterns, morbidity, and health care status in relation to malnutrition. Main outcomes indicate a high prevalence of stunting and wasting and vulnerabilities associated with mother’s education level, food insecurity, and health facility access. Despite progress in the reduction of stunting rate, food insecurity, and IYCF [Infant and Young Child Feeding practices] continues to be an issue. The research also identifies education, health, and nutrition programs as key areas for multi sectoral focus in efforts to address the scourge of malnutrition. In conclusion, the present observation highlights the need to tackle malnutrition in a practical and sustainable manner by tackling the health, food insecurity, and education sectors simultaneously.
References
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41. Kavle, J. A., & Landry, M. (2018). Addressing barriers to maternal nutrition in low- and middle-income countries: A review of the evidence and programme implications. Maternal & Child Nutrition, 14(1), e12508.
42. Martorell, R., & Zongrone, A. (2012). Intergenerational influences on child growth and undernutrition. Paediatric and Perinatal Epidemiology, 26(Suppl. 1), 302–314.
43. Mbuya, M. N. N., & Humphrey, J. H. (2016). Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: An opportunity for stunting reduction in developing countries. Maternal & Child Nutrition, 12(S1), 106–120.
44. Nisbett, N., et al. (2014). What drives and constrains effective leadership in tackling child undernutrition? Findings from Bangladesh, Ethiopia, India and Kenya. Food Policy, 49, 53–65.
45. Olofin, I., et al. (2013). Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: A pooled analysis of ten prospective studies. PLoS One, 8(5), e64636.
46. Puett, C., et al. (2012). Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh. Health Policy and Planning, 28(4), 386–399.
47. Roberton, T., et al. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: A modelling study. The Lancet Global Health, 8(7), e901–e908.
48. Smith, L. C., & Haddad, L. (2000). Explaining child malnutrition in developing countries: A cross-country analysis. IFPRI Research Report 111. International Food Policy Research Institute.
49. Suchdev, P. S., et al. (2012). Micronutrient powders to combat anemia in young children: A systematic review. Paediatrics, 130(4), e1074–e1085.
50. Wheeler, T., & von Braun, J. (2013). Climate change impacts on global food security. Science, 341(6145), 508–513.
2. Black, R. E., et al. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 382(9890), 427–451.
3. Checkley, W., et al. (2008). Maternal education, sanitation, and child mortality in less developed countries: A meta-analysis. The Lancet, 370(9594), 1650–1659.
4. Coates, J., et al. (2006). The food insecurity experience scale: Development of a global standard for food insecurity measurement. World Development, 34(5), 735–746.
5. Dewey, K. G. (2001). The role of complementary feeding in the prevention of malnutrition in infants and young children. Food and Nutrition Bulletin, 22(3), 217–224.
6. Ferro-Luzzi, A., et al. (2001). Food insecurity, poverty and nutrition: From analysis to action. World Development, 29(7), 1081–1092.
7. Humphrey, J. H. (2009). Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet, 374(9694), 1032–1035.
8. Lamberti, L. M., et al. (2011). The effect of diarrhea on childhood malnutrition in developing countries. Maternal & Child Nutrition, 7(s1), 1–17.
9. Lassi, Z. S., et al. (2013). Interventions to improve nutritional status and reduce infections in children under 5 years of age. Journal of Global Health, 3(2), 181–191.
10. Maluccio, J. A., et al. (2009). The impact of improving nutrition in early childhood on health and productivity later in life. Food and Nutrition Bulletin, 30(1), 35–50.
11. Rollins, N. C., et al. (2016). Why invest in breastfeeding? The Lancet, 387(10017), 491–502.
12. Saha, K. K., et al. (2013). Maternal education and child undernutrition in Bangladesh. European Journal of Clinical Nutrition, 67(6), 541–548.
13. Smith, L. C., & Haddad, L. (2000). Explaining child malnutrition in developing countries: A cross-country analysis. IFPRI Research Report 111. International Food Policy Research Institute.
14. Zimmermann, M. B., et al. (2010). Effects of multiple micronutrient supplementation during pregnancy on maternal and child health outcomes: A systematic review. The Lancet, 376(9747), 1472–1482.
15. Bailey, R. L., West, K. P., & Black, R. E. (2015). The epidemiology of global micronutrient deficiencies. Annals of Nutrition and Metabolism, 66(Suppl. 2), 22–33.
16. Bhutta, Z. A., et al. (2013). Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? The Lancet, 382(9890), 452–477.
17. Bhutta, Z. A., et al. (2017). Severe childhood malnutrition. Nature Reviews Disease Primers, 3(1), 1–18.
18. Black, R. E., et al. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 382(9890), 427–451.
19. FAO, IFAD, UNICEF, WFP & WHO. (2020). The State of Food Security and Nutrition in the World 2020. FAO.
20. Global Nutrition Report. (2020). Action on equity to end malnutrition. Development Initiatives.
21. Hoddinott, J., et al. (2013). The economic rationale for investing in stunting reduction. Maternal & Child Nutrition, 9(Suppl. 2), 69–82.
22. Ng, M., et al. (2014). Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis. The Lancet, 384(9945), 766–781.
23. Popkin, B. M., Corvalan, C., & Grummer-Strawn, L. M. (2020). Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet, 395(10217), 65–74.
24. Ruel, M. T., Alderman, H., & the Maternal and Child Nutrition Study Group. (2013). Nutrition-sensitive interventions and programmes: How can they help to accelerate progress in improving maternal and child nutrition? The Lancet, 382(9891), 536–551.
25. Shekar, M., Kakietek, J., D'Alimonte, M., Walters, D., Rogers, H., Dayton Eberwein, J., ... & Hecht, R. (2017). Investing in nutrition: The foundation for development. World Bank.
26. Smith, L. C., & Haddad, L. (2015). Reducing child undernutrition: Past drivers and priorities for the post-MDG era. World Development, 68, 180–204.
27. UNICEF. (1990). Strategy for improved nutrition of children and women in developing countries. UNICEF Policy Review.
28. UNICEF. (2020). The state of the world’s children 2019: Children, food and nutrition. UNICEF.
29. UNICEF, WHO, & World Bank Group. (2020). Levels and trends in child malnutrition: Key findings of the 2020 edition.
30. Victora, C. G., et al. (2008). Maternal and child undernutrition: Consequences for adult health and human capital. The Lancet, 371(9609), 340–357.
31. WHO. (2016). Global health estimates 2016: Deaths by cause, age, sex, by country and by region, 2000–2016.
32. WHO. (2021). Malnutrition. https://www.who.int/news-room/fact-sheets/detail/malnutrition
33. Adair, L. S., et al. (2013). Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: Findings from five birth cohort studies. The Lancet, 382(9891), 525–534.
34. Briend, A., Khara, T., & Dolan, C. (2015). Wasting and stunting—similarities and differences: Policy and programmatic implications. Food and Nutrition Bulletin, 36(1_suppl1), S15–S23.
35. De Onis, M., & Branca, F. (2016). Childhood stunting: A global perspective. Maternal & Child Nutrition, 12(Suppl. 1), 12–26.
36. Dewey, K. G., & Adu-Afarwuah, S. (2008). Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries. Maternal & Child Nutrition, 4(S1), 24–85.
37. Gillespie, S., Haddad, L., Mannar, V., Menon, P., & Nisbett, N. (2013). The politics of reducing malnutrition: Building commitment and accelerating progress. The Lancet, 382(9891), 552–569.
38. Haddad, L., et al. (2015). Global Nutrition Report 2015: Actions and accountability to advance nutrition and sustainable development. IFPRI.
39. Humphrey, J. H. (2009). Child undernutrition, tropical enteropathy, toilets, and handwashing. The Lancet, 374(9694), 1032–1035.
40. Imdad, A., Herzer, K., Mayo-Wilson, E., Yakoob, M. Y., & Bhutta, Z. A. (2011). Vitamin A supplementation for preventing morbidity and mortality in children from six months to five years of age. Cochrane Database of Systematic Reviews, 2011(12), CD008524.
41. Kavle, J. A., & Landry, M. (2018). Addressing barriers to maternal nutrition in low- and middle-income countries: A review of the evidence and programme implications. Maternal & Child Nutrition, 14(1), e12508.
42. Martorell, R., & Zongrone, A. (2012). Intergenerational influences on child growth and undernutrition. Paediatric and Perinatal Epidemiology, 26(Suppl. 1), 302–314.
43. Mbuya, M. N. N., & Humphrey, J. H. (2016). Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: An opportunity for stunting reduction in developing countries. Maternal & Child Nutrition, 12(S1), 106–120.
44. Nisbett, N., et al. (2014). What drives and constrains effective leadership in tackling child undernutrition? Findings from Bangladesh, Ethiopia, India and Kenya. Food Policy, 49, 53–65.
45. Olofin, I., et al. (2013). Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: A pooled analysis of ten prospective studies. PLoS One, 8(5), e64636.
46. Puett, C., et al. (2012). Cost-effectiveness of the community-based management of severe acute malnutrition by community health workers in southern Bangladesh. Health Policy and Planning, 28(4), 386–399.
47. Roberton, T., et al. (2020). Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: A modelling study. The Lancet Global Health, 8(7), e901–e908.
48. Smith, L. C., & Haddad, L. (2000). Explaining child malnutrition in developing countries: A cross-country analysis. IFPRI Research Report 111. International Food Policy Research Institute.
49. Suchdev, P. S., et al. (2012). Micronutrient powders to combat anemia in young children: A systematic review. Paediatrics, 130(4), e1074–e1085.
50. Wheeler, T., & von Braun, J. (2013). Climate change impacts on global food security. Science, 341(6145), 508–513.
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Jan 25, 2022
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Dr Atiq Ur Rahman, Dr. Ijaz Hussain, Dr Amna Saleh, Dr. Izaz Ali Shah, Dr Sher Alam Khan, & Dr Maira Nazar. (2022). BURDEN AND MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER 5 YEARS OF AGE. Journal of Population Therapeutics and Clinical Pharmacology, 29(01), 674-691. https://doi.org/10.53555/pzrz0893
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Author Biographies
Dr Atiq Ur Rahman
Resident Paediatrician, Ayub Teaching Hospital, Abbottabad
Dr. Ijaz Hussain
Resident Paediatrician, Saidu Group of Teaching Hospitals, Swat..
Dr Amna Saleh
Resident Paediatrician, Fauji Foundation Hospital, Rawalpindi,
Dr. Izaz Ali Shah
House officer Kabir Medical College, Naseer Teaching Hospital, Peshawar
Dr Sher Alam Khan
Resident Paediatrician, Combined Military Hospital, Abbottabad,
Dr Maira Nazar
Resident Paediatrician, Combined Military Hospital, Abbottabad,
How to Cite
Dr Atiq Ur Rahman, Dr. Ijaz Hussain, Dr Amna Saleh, Dr. Izaz Ali Shah, Dr Sher Alam Khan, & Dr Maira Nazar. (2022). BURDEN AND MANAGEMENT OF MALNUTRITION IN CHILDREN UNDER 5 YEARS OF AGE. Journal of Population Therapeutics and Clinical Pharmacology, 29(01), 674-691. https://doi.org/10.53555/pzrz0893