Beni Reshav, Ramroop Shaun, Habyarimana Faustin
School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal - Pietermaritzburg, Pietermaritzburg, South Africa.
Arch Public Health. 2024 Sep 4;82(1):147. doi: 10.1186/s13690-024-01374-6.
Malnutrition is one of the most critical health challenges confronting public health agencies in developing nations. This study aimed to determine the scope and underlying factors contributing to malnutrition in West African countries, specifically Gabon, Gambia, Liberia, Mauritania, and Nigeria.
For this secondary data analysis, this study drew upon the demographic and health surveys (DHS) conducted within these West African nations. These surveys employed a complex sampling design involving a combination of stratification and cluster sampling in two stages, with varying probabilities of selection leading to weighted samples that effectively represented different components of the population. Given the intricacies of this sampling design, it is paramount to account for them when analyzing the survey data. To address this concern, this study applied a survey logistic regression model, which accommodates factors such as stratification, clustering, and sampling weights and departs from the assumption of independence inherent in the ordinary logistic regression model.
The outcomes of this model revealed several variables that emerged as statistically significant (p < 0.05) determinants of malnutrition. These influential factors encompass the region of the respondent, the current age of the mother, the highest level of education attained by the mother, the source of drinking water, the type of toilet facility, the household's wealth status, the age and gender of the child, and whether the child experienced a fever in the preceding two weeks.
These findings demonstrate with poignant clarity the importance of primary health care interventions in the recognition and management of malnutrition. The countries of interest should invest in public health care interventions including community workshops and outreach programs. Workshops may occur at primary health care facilities during queue waits, or health workers may work with community leaders to perform workshops in areas of high foot traffic, such as places of worship, shopping hubs and collection points for financial aid or grants.
营养不良是发展中国家公共卫生机构面临的最严峻的健康挑战之一。本研究旨在确定西非国家,特别是加蓬、冈比亚、利比里亚、毛里塔尼亚和尼日利亚营养不良的范围及潜在因素。
对于这项二次数据分析,本研究利用了在这些西非国家进行的人口与健康调查(DHS)。这些调查采用了复杂的抽样设计,分两个阶段进行分层抽样和整群抽样相结合,不同的选择概率导致加权样本能有效代表人口的不同组成部分。鉴于这种抽样设计的复杂性,在分析调查数据时考虑这些因素至关重要。为解决这一问题,本研究应用了调查逻辑回归模型,该模型考虑了分层、聚类和抽样权重等因素,偏离了普通逻辑回归模型固有的独立性假设。
该模型的结果显示,有几个变量成为营养不良的统计学显著(p < 0.05)决定因素。这些影响因素包括受访者所在地区、母亲的当前年龄、母亲所达到的最高教育水平、饮用水来源、厕所设施类型、家庭财富状况、孩子的年龄和性别,以及孩子在前两周是否发烧。
这些发现清晰有力地表明了初级卫生保健干预在识别和管理营养不良方面的重要性。相关国家应投资于公共卫生保健干预措施,包括社区讲习班和外展项目。讲习班可以在初级卫生保健设施排队等候期间举办,或者卫生工作者可以与社区领袖合作,在人流量大的地区,如礼拜场所、购物中心和财政援助或赠款领取点举办讲习班。