Abate Kalkidan Hassen, Belachew Tefera
1 Department of Population and Family Health, Institute of Health Science, Jimma University, Jimma, Ethiopia.
Nutr Health. 2017 Sep;23(3):193-202. doi: 10.1177/0260106017706253. Epub 2017 Jun 23.
The generation of cash from agricultural products is the mainstay of the livelihood of many households in developing countries. However, critics of cash cropping have highlighted its influence on dietary diversity and availability of food at the household level, eroding the potential for optimal child caring practices.
A community-based cross-sectional survey was carried out in three randomly selected coffee-producing districts of Jimma Zone in southwest Ethiopia. The underlying causes of malnutrition, food access, hygiene and care were assessed using the household food insecurity access scale, morbidity reports and infant and young child feeding practice core indicators of the World Health Organization. Anthropometric data were converted into weight for age, height for age, body mass index for age and weight for height Z-scores to determine child nutritional outcomes.
Prevalence of underweight, wasting, stunting and thinness were 14.2%, 9.1%, 24.1% and 9.9%, respectively. Multivariable logistic regression showed that children with suboptimal meal frequency were more than three times more likely to develop wasting (AOR = 3.3, p < 0.0001). Female children were twice as likely to develop wasting compared with males (AOR = 2.00, 4.1, p = 0.05). Children with suboptimal dietary diversity were almost four times as likely to develop stunting (AOR = 3.95, p < 0.0001). Those who were not exclusively breastfed during their first 6 months were almost five times as likely to develop stunting (AOR = 4.66, p < 0.0001).
The findings imply that in coffee-producing areas, child caring practices are stronger independent predictors of nutritional status than wealth or economic indicators alone.
农产品创收是发展中国家许多家庭生计的主要支柱。然而，经济作物种植的批评者强调了其对家庭层面饮食多样性和食物可获得性的影响，削弱了最佳儿童照料做法的潜力。
在埃塞俄比亚西南部吉马地区随机选择的三个咖啡产区开展了一项基于社区的横断面调查。使用家庭粮食不安全获取量表、发病率报告以及世界卫生组织的婴幼儿喂养实践核心指标，评估营养不良、食物获取、卫生和照料的潜在原因。将人体测量数据转换为年龄别体重、年龄别身高、年龄别体重指数和身高别体重Z评分，以确定儿童营养状况。
体重不足、消瘦、发育迟缓及体重偏轻的患病率分别为14.2%、9.1%、24.1%和9.9%。多变量逻辑回归显示，进餐频率欠佳的儿童发生消瘦的可能性高出三倍多（调整后比值比[AOR]=3.3，p<0.0001）。女童发生消瘦的可能性是男童的两倍（AOR=2.00，4.1，p=0.05）。饮食多样性欠佳的儿童发生发育迟缓的可能性几乎高出四倍（AOR=3.95，p<0.0001）。前6个月未纯母乳喂养的儿童发生发育迟缓的可能性几乎高出五倍（AOR=4.66，p<0.0001）。
研究结果表明，在咖啡种植区，儿童照料做法比单纯的财富或经济指标更能独立预测营养状况。
