Balogun Oluwafemi Samson, Asif Atta Muhammad, Akbar Muhammad, Chesneau Christophe, Jamal Farrukh
Department of Northern Europe, School of Computing, University of Eastern Finland, 70211 Kuopio, Finland.
Department of Mathematics and Statistics, Faculty of Basic and Applied Sciences, International Islamic University, Islamabad 44000, Pakistan.
Children (Basel). 2021 Nov 4;8(11):1010. doi: 10.3390/children8111010.
Malnutrition among children is an important public health problem in Pakistan. Conventional indicators (stunting, wasting and underweight) are well known. However, there is a need for aggregate indicators in this perspective. The goal of this study is to assess the prevalence and trends of malnutrition among Pakistani children under the age of five using the so-called composite index of anthropometric failure (CIAF), a tool for calculating the whole aggregate burden of malnutrition. The data were extracted from the Pakistan Demographic and Health Survey 2012-2013. Mothers' education and socioeconomic statuses (SES) were assessed as important factors in malnutrition. Chi-squared analysis was used to check the bivariate association, and multiple logistic regression was used to identify the significant correlates of child malnutrition. Moreover, multiple correspondence analysis (MCA) was applied to strengthen the use of CIAF as an outcome variable. The study looked at 3071 children under the age of five, with 52.2% of them falling into the CIAF. Children of educated mothers had 43% fewer odds of being malnourished (OR (Odd Ratio) = 0.57, 95% CI (Confidence Interval) = 0.44-0.73). Additionally, a decreasing trend in malnutrition was found with increasing SES. There is a need to improve maternal education. Such programs focusing on increasing women's autonomy in making home decisions should be established. Furthermore, long-term interventions for improving home SES and effective nutritional methods should be examined. For policymakers, the use of CIAF is suggested since it provides an estimate of the entire burden of undernutrition.
儿童营养不良是巴基斯坦一个重要的公共卫生问题。传统指标（发育迟缓、消瘦和体重不足）广为人知。然而，从这个角度来看，需要综合指标。本研究的目的是使用所谓的人体测量失败综合指数（CIAF）来评估巴基斯坦五岁以下儿童营养不良的患病率和趋势，CIAF是一种计算营养不良总体负担的工具。数据取自2012 - 2013年巴基斯坦人口与健康调查。母亲的教育程度和社会经济地位（SES）被评估为营养不良的重要因素。使用卡方分析来检验双变量关联，并使用多元逻辑回归来确定儿童营养不良的显著相关因素。此外，应用多重对应分析（MCA）来加强将CIAF用作结果变量。该研究观察了3071名五岁以下儿童，其中52.2%属于CIAF范围。母亲受过教育的儿童营养不良的几率降低了43%（比值比（OR）= 0.57，95%置信区间（CI）= 0.44 - 0.73）。此外，发现随着SES的提高，营养不良呈下降趋势。有必要提高母亲的教育水平。应制定注重增强女性在家庭决策中自主权的此类项目。此外，应研究改善家庭SES的长期干预措施和有效的营养方法。对于政策制定者，建议使用CIAF，因为它能提供对营养不良总体负担的估计。
