Graduate Institute of Public Health, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan.
Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan.
Nutrients. 2021 Jan 8;13(1):178. doi: 10.3390/nu13010178.
Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother-child dyads, respectively, (26.8 ± 6.8 years, range 15-49 years) and (13.9 ± 4.9 months, range 6-23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, < 0.001). However, only 5.9% of the mother-child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24-2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.
与环境卫生一样，水也是导致儿童营养不足的一个众所周知的因素。然而，家庭用水获取情况对饮食多样性的直接影响仍有待探索。我们评估了家庭用水获取情况与幼儿实现最低饮食多样性（MDD）之间的关联。我们利用了来自 2015/16 年马拉维人口与健康调查的全国代表性横断面数据，该调查包括 4727 对母子对，分别为（26.8±6.8 岁，范围 15-49 岁）和（13.9±4.9 个月，范围 6-23 个月）。家庭用水获取情况分为（1）基本或无获取，（2）中级，或（3）最佳。MDD 定义为在过去一天中，给孩子喂食世卫组织定义的四类食物中的至少四类。只有 27.7%的儿童达到了 MDD 标准；大多数达到 MDD 标准的儿童来自具有最佳用水条件的家庭（58.4%，<0.001）。然而，只有 5.9%的母子对来自具有最佳用水条件的家庭。在调整了协变量后，来自具有最佳用水条件的家庭的儿童比来自基本或无用水条件的家庭的儿童更有可能达到 MDD（aOR=1.74，CI=1.24-2.46）。我们的研究结果强调需要将基于水的策略纳入国家营养政策中，以增加马拉维婴幼儿的饮食多样性。
