This study assesses the prevalence of childhood undernutrition from 2001 to 2016 and estimate projections of undernutrition for 2016–2030 in Nepal.

The study used data from four rounds of a cross-sectional survey of Nepal Demographic and Health Survey (NDHS) conducted in 2001, 2006, 2011 and 2016. Descriptive analyses were conducted to calculate prevalence, binary logistic regression was used to test the significance of trends over time and autoregressive integrated moving average model was used to forecast the prevalence of childhood undernutrition.

The children and household member datasets from four NDHS were merged to assess the trends of childhood undernutrition in Nepal.

A total of 16 613 children (8399 male and 8214 female) under 5 years of age were selected for anthropometric measurements using a stratified cluster random sampling method.

Overall results show a decline in prevalence of stunting from 57·2 % to 35·8 % (P < 0·001), underweight from 42·7 % to 27 % (P < 0·001) and wasting from 11·2 % to 9·7 % (P < 0·05) from 2001 to 2016. However, different population subgroups have a higher prevalence of undernutrition than national average. Further, the analyses show that the prevalence of stunting will decline to 14·3 % and wasting to 8·4 % by 2030.

A remarkable decrease in the prevalence of stunting and underweight has been observed over the last 15 years. Nepal is likely to achieve the nutritional targets for stunting but not for wasting by 2030. Given large subpopulation variations, further improvement in undernutrition require more specific, targeted and localised programmes.

To investigate trends in child anthropometry in Senegal between 1990 and 2015 and relate them with potential causes. Several hypotheses were tested: changes in health status, income, diet and socio-economic status.

Statistical analysis of trends in anthropometric data: height, weight, BMI and associated Z-scores calculated with the CDC-2000 standard (Centers for Disease Control and Prevention): height-for-age (HAZ), weight-for-age (WAZ) and weight-for-height (WHZ). Trends were fitted with linear regression models and were related with changes in health and socio-economic status.

Nine nationally representative samples of Senegalese children aged 12–59 months, taken between 1986 and 2017 by Demographic and Health Surveys (DHS).

Children aged 12–59 months.

Over the 25 years of investigation, the average height of children increased by +1·88 cm, their average weight by +0·10 kg, but their BMI decreased by −0·53 kg/m2. Corresponding changes expressed in Z-scores were +0·454 in HAZ, +0·109 in WAZ and −0·302 in WHZ. This pattern of decreasing stunting while increasing wasting was correlated with decreasing child mortality, despite small changes in income per capita and in adult heights or BMI. Largest improvements in HAZ were among the lower socio-economic strata, while largest declines in WHZ were among higher socio-economic strata.

Decline in stunting appeared associated primarily with the control of infectious diseases, also responsible for the mortality decline. Increase in wasting was surprising. It appears associated with small changes in income per capita, and therefore in diet, in a context of increasing height.

To investigate the socio-economic differentials underlying minimum dietary diversity (MDD) among children aged 6–23 months in three economically diverse South-East Asian countries.

The outcome variable MDD was defined as the proportion of children aged 6–23 months who received foods from four of the seven recommended food groups within the 24 h prior to interview. The association between socio-economic factors and MDD, adjusting for relevant characteristics, was examined using logistic regression.

We used cross-sectional population data from recent Demographic and Health Surveys from Cambodia (2014), Myanmar (2015–16) and Indonesia (2012).

Total of 8364 children aged 6–23 months.

Approximately half of all children met the MDD, varying from 47·7 % in Cambodia (n 1023) to 58·2 % in Indonesia (n 2907) and 24·6 % in Myanmar (n 301). The likelihood (adjusted OR; 95 % CI) of meeting MDD increased for children in the richest households (Cambodia: 2·4; 1·7, 3·4; Myanmar: 1·8; 1·1, 3·0; Indonesia: 2·0; 1·6, 2·5) and those residing in urban areas (Cambodia: 1·4; 1·1, 1·9; Myanmar: 1·7; 1·2, 2·4; Indonesia: 1·7; 1·5, 1·9). MDD deprivation was most severe among children from the poorest households in rural areas. The association between mother’s labour force participation and MDD was positive in all three countries but reached significance only in Indonesia (1·3; 1·1, 1·5).

MDD deprivation among young children was significantly high in socio-economically disadvantaged families in all three study settings. MDD requirements are not being met for approximately half of young children in these three South-East Asian countries.

To describe trends of childhood stunting among under-5s in Uganda and to assess the impact of maternal education, wealth and residence on stunting.

Serial and pooled cross-sectional analyses of data from Uganda Demographic and Health Surveys (UDHS) of 1995, 2001, 2006 and 2011. Prevalence of stunting and mean height-for-age Z-score were computed by maternal education, wealth index, region and other sociodemographic characteristics. Multivariable logistic and linear regression models were fitted to survey-specific and pooled data to estimate independent associations between covariates and stunting or Z-score. Sampling weights were applied in all analyses.

Uganda.

Children aged <5 years.

Weighted sample size was 14 747 children. Stunting prevalence decreased from 44·8% in 1995 to 33·2% in 2011. UDHS reported stunting as 38% in 1995, underestimating the decline because of transitioning from National Center for Health Statistics/Centers for Disease Control and Prevention standards to WHO standards. Nevertheless, one in three Ugandan children was still stunted by 2011. South Western, Mid Western, Kampala and East Central regions had highest odds of stunting. Being born in a poor or middle-income household, of a teen mother, without secondary education were associated with stunting. Other persistent stunting predictors included small birth size, male gender and age 2–3 years.

Sustained decrease in stunting suggests that child nutrition interventions have been successful; however, current prevalence does not meet Millennium Development Goals. Stunting remains a public health concern and must be addressed. Customizing established measures such as female education and wealth creation while targeting the most vulnerable groups may further reduce childhood stunting.

To identify the association of household food insecurity (HFI) with anthropometric status, the risk of vitamin A deficiency and anaemia, morbidities such as cough and fever, and hospitalizations for diarrhoea and pneumonia in children under 5 years old.

Cross-sectional study using data from the 2006 Brazilian Demographic and Health Survey. HFI was measured with the Brazilian Food Insecurity Measurement Scale (EBIA). Vitamin A deficiency and anaemia were assessed in blood samples. Child morbidities were reported by the child’s mother and included cough, fever, and hospitalizations for diarrhoea and pneumonia. Regression results were expressed as unadjusted and adjusted OR and corresponding 95 % CI for severe food insecurity, with statistical significance set at P<0·05.

Nationally representative survey.

Children (n 4064) under 5 years old.

There was no association between HFI and vitamin A deficiency, pneumonia, wasting or overweight. The prevalence of cough, fever, hospitalization for diarrhoea and stunting were associated with degree of HFI severity. There was a significant association of morbidities and stunting with severe food insecurity (v. food secure). After controlling for confounders, the association between severe food insecurity (v. food secure/rest of food insecurity categories) and the prevalence of common morbidities remained strong, showing that severely food-insecure children had a greater likelihood of experiencing cough (adjusted OR=1·79) and of being hospitalized for diarrhoea (adjusted OR=2·55).

Severe HFI was associated with cough and severe diarrhoea among Brazilian children.

In many countries of the world millions of people are not registered at birth. However, in order to assess children’s nutritional status it is necessary to have an exact knowledge of their age. In the present paper we discuss the effects of insufficient or imprecise age data on estimates of undernutrition prevalence.

Birth registration rates and levels of stunting, underweight and wasting were retrieved from Multiple Indicator Cluster Surveys and Demographic and Health Surveys of thirty-seven sub-Saharan African countries, considering the subdivision in wealth quintiles. The composition of the cross-sectional sample used for nutritional evaluation was analysed using a permutation test. Logistic regression was applied to analyse the relationship between birth registration and undernutrition. The 95 % probability intervals and Student’s t test were used to evaluate the effect of age bias and error.

Heterogeneous sampling designs were detected among countries, with different percentages of children selected for anthropometry. Further, registered children were slightly more represented within samples used for nutritional analysis than in the total sample. A negative relationship between birth registration and undernutrition was recognized, with registered children showing a better nutritional status than unregistered ones, even within each wealth quintile. The over- or underestimation of undernutrition in the case of systematic over- or underestimation of age, respectively, the latter being more probable, was quantified up to 28 %. Age imprecision was shown to slightly overestimate undernutrition.

Selection bias towards registered children and underestimation of children’s age can lead to an underestimation of the prevalence of undernutrition.

To explore the relationship between women’s empowerment and WHO recommended infant and young child feeding (IYCF) practices in sub-Saharan Africa.

Analysis was conducted using data from ten Demographic and Health Surveys between 2010 and 2013. Women’s empowerment was assessed by nine standard items covering three dimensions: economic, socio-familial and legal empowerment. Three core IYCF practices examined were minimum dietary diversity, minimum meal frequency and minimum acceptable diet. Separate multivariable logistic regression models were applied for the IYCF practices on dimensional and overall empowerment in each country.

Benin, Burkina Faso, Ethiopia, Mali, Niger, Nigeria, Rwanda, Sierra Leone, Uganda and Zimbabwe.

Youngest singleton children aged 6–23 months and their mothers (n 15 153).

Less than 35 %, 60 % and 18 % of children 6–23 months of age met the criterion of minimum dietary diversity, minimum meal frequency and minimum acceptable diet, respectively. In general, likelihood of meeting the recommended IYCF criteria was positively associated with the economic dimension of women’s empowerment. Socio-familial empowerment was negatively associated with the three feeding criteria, except in Zimbabwe. The legal dimension of empowerment did not show any clear pattern in the associations. Greater overall empowerment of women was consistently and positively associated with multiple IYCF practices in Mali, Rwanda and Sierra Leone. However, consistent negative relationships were found in Benin and Niger. Null or mixed results were observed in the remaining countries.

The importance of women’s empowerment for IYCF practices needs to be discussed by context and by dimension of empowerment.

Anaemia currently affects 40–80 % of women in Africa. While risk factors for anaemia have been intensively studied, research has rarely compared risk factors between mild anaemia and moderate/severe anaemia. Also, the contribution of neighbourhood to the prevalence of anaemia has been rarely studied. The aim of the present study was to identify and compare individual and contextual factors associated with various levels of anaemia among women.

A multilevel analysis of data from the 2001 Mali Demographic and Health Survey (n 3763) was carried out. Outcomes variables were mild anaemia, moderate-to-severe anaemia and any anaemia. Multilevel regression analyses were performed for each outcome.

Mali, West Africa.

Women (n 3763) aged 15 to 49 years, including 512 pregnant women.

Among the eleven potential risk factors included in the models, two factors were associated with mild anaemia (BMI and education), three with any anaemia (pregnancy, BMI and education) and six with moderate-to-severe anaemia (pregnancy, BMI, education, wealth, childhood residency and region of residence). Clustering of anaemia within communities was 20 % for moderate-to-severe anaemia and 13 % for mild anaemia. Despite significant differences in the prevalence of anaemia across regions in Mali, no difference between regions in the risk of mild anaemia was found and only the region of Gao showed a significantly higher risk of moderate-to-severe anaemia.

The findings indicate that sociodemographic risk factors as well as clustering of anaemia varies with the severity of anaemia. Specific studies are needed to identify risk factors of mild anaemia as well as its consequences, as mild anaemia accounts for 20–40 % of total prevalence of anaemia in Africa.

To examine the effects of socioeconomic status and biocultural variables (planned pregnancy, prenatal care, timing of initiation of breast-feeding and caesarean section delivery) on breast-feeding duration in Peru using structural equation models.

Structural equation models were analysed with LISREL using data from the 1991–92 Peruvian Demographic and Health Survey.

Models were tested among 6020 women whose last child was born within 5 years of the survey and among 2711 women whose last child was born 2–5 years preceding the survey.

Unplanned pregnancy and socioeconomic status had a negative influence on breast-feeding duration. Prenatal care was positively associated with the timing of breast-feeding initiation in both samples and with breast-feeding duration in the whole sample. The timing of breast-feeding initiation was inversely associated with breast-feeding duration only in the sample of older children.

These results imply that an unplanned pregnancy, a delayed breast-feeding initiation, and higher socioeconomic status are risk factors for an earlier discontinuation of breast-feeding through complex mechanisms involving direct and indirect effects.