Department of Mathematics & Statistics, International Islamic University Islamabad, Pakistan.
Department of Statistics, Lahore College for Women University, Lahore, Pakistan.
Nutrition. 2024 Nov;127:112523. doi: 10.1016/j.nut.2024.112523. Epub 2024 Jun 27.
Child malnutrition is a very serious health issue globally, particularly in emerging countries. Among South Asian countries, Pakistan has been observed to have a high prevalence of child malnutrition. In spite of the implementation of many health strategies and preventive measures for vulnerable populations, this issue is still unresolved and needs further investigation. The purpose of this study was to investigate the role of various social-, maternal-, and child-level factors considered to be responsible for nutritional health disparities among children.
An assessment method of malnutrition, i.e., Composite Index of Anthropometric Failure (CIAF), was used to detect the prevalence of malnutrition among children under 5 years of age in Pakistan in order to present a comprehensive view that was lacking conventional indices of malnutrition. A binary logistic regression model was fitted to assess the link between malnutrition and socioeconomic, maternal, and child attributes based on CIAF data compiled from weight-for-height, weight-for-age, and height-for-age Z-scores using data from the Pakistan Demographic Health Survey (2017-2018).
A total of 4224 children under 5 years of age were included in the analysis. Approximately half of the children (45.34%) comprised anthropometric failures for the overall prevalence of undernutrition based on CIAF. The results of this study revealed that the leading determinant associated with CIAF was the child's age in months, small birth size, lack of breastfeeding, lack of maternal education, poor economic status of the household, and poor-quality water sources. The factors associated with stunting comprised the child's age in months, small child birth size, underweight maternal body mass index, and uneducated mothers. Only one factor-low household economic profile-was significantly associated with waste. Sindh, Baluchistan, and Khyber Pakhtunkhwa provinces had a higher risk of having wasted children. On the other hand, children aged 25-36 months had higher, small child birth size, underweight maternal BMI, un-educated mother, un-educated father, low economic profile of household experiencing of being underweight.
The findings of this study reinforce the significance of maternal health, parental education, and household economic profile in the prevention of malnutrition within young children of adequate birth size, as well as better overall health care up to adolescence in Pakistan. Well-nourished individuals are a valuable human resource and a requirement for a nation's progress and prosperity. In emerging nations such evidence-based policies are crucial for fostering children's optimal physical and mental development to ensure a healthier future generation. Therefore, the execution of national health policies aimed at the improvement of maternal and societal factors could result in improved nutrition levels among children below 5 years of age in Pakistan.
儿童营养不良是一个非常严重的全球性健康问题，尤其是在新兴国家。在南亚国家中，巴基斯坦被认为儿童营养不良的发病率很高。尽管针对弱势群体实施了许多卫生战略和预防措施，但这个问题仍未得到解决，需要进一步调查。本研究旨在探讨各种社会、产妇和儿童层面的因素在儿童营养健康差异方面的作用。
使用营养不良评估方法，即综合人体测量失败指数（CIAF），来检测巴基斯坦 5 岁以下儿童的营养不良患病率，以提供常规营养不良指标所缺乏的综合观点。根据体重身高、体重年龄和身高年龄 Z 分数的 CIAF 数据，使用 2017-2018 年巴基斯坦人口健康调查的数据，拟合二元逻辑回归模型来评估营养不良与社会经济、产妇和儿童属性之间的关系。
共纳入 4224 名 5 岁以下儿童。根据 CIAF，大约一半的儿童（45.34%）存在营养不足的人体测量失败。本研究结果表明，与 CIAF 最相关的主要决定因素是儿童的月龄、出生时体型较小、没有母乳喂养、母亲没有接受教育、家庭经济状况较差和水质较差。与发育迟缓相关的因素包括儿童的月龄、出生时体型较小、母亲体重指数偏低和母亲未受教育。只有一个因素——家庭经济状况较差——与消瘦显著相关。信德省、俾路支省和开伯尔-普赫图赫瓦省的儿童患有消瘦的风险更高。另一方面，25-36 月龄的儿童更有可能出现体重不足、出生时体型较小、母亲体重指数偏低、母亲未受教育、父亲未受教育、家庭经济状况较差等情况。
本研究结果强调了产妇健康、父母教育和家庭经济状况在预防巴基斯坦正常出生大小的幼儿营养不良以及改善青春期前儿童整体健康方面的重要性。营养良好的个人是一种宝贵的人力资源，是国家进步和繁荣的必要条件。在新兴国家，基于证据的政策对于促进儿童最佳身体和心理健康发展以确保更健康的后代至关重要。因此，执行旨在改善产妇和社会因素的国家卫生政策可能会提高巴基斯坦 5 岁以下儿童的营养水平。
