School of Public Health, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 3286, Kigali, Rwanda.
School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa.
BMC Public Health. 2024 Oct 9;24(1):2755. doi: 10.1186/s12889-024-20286-2.
Linear growth faltering remains a pervasive public health concern that affects many children worldwide. This study aimed to investigate possible maternal factors promoting normal linear growth among children aged 6-23 months of age from impoverished Rwandan households.
We used a three-stage cluster sampling procedure. The study population consisted of children aged six to 23 months and their mothers who lived in the study districts. A structured questionnaire helped to collect data from 807 selected mother-child dyads. The primary outcome variable was height-for-age Z scores. The main predictors were maternal income-generating activity, maternal education, maternal depression, household decision making, number of ANC visits, use of family planning method, types of family planning, and mode of delivery. We used univariate analysis to establish median, frequencies, and percentages. Furthermore, we used the Kruskal-Wallis, Mann-Whitney U, and Spearman rank correlation tests for bivariate analysis. We included in the final model of robust linear regression for multivariate analysis the potential confounding variables identified as significantly associated with the outcome (child age, participation in works for both parents, good handwashing practice, owning a vegetable garden, and the total number of livestock) along with maternal factors.
Maternal factors that promoted normal linear growth of children were the presence of maternal income generation activity (β= 0.640 [0.0269 1.253], p value = 0.041), the participation of the mother in the decision-making process of the household (β=0.147 [0.080 0.214], p-value < 0.001), and the higher frequency of consultations with ANC (β=0.189 [0.025 0.354], p-value = 0.024). Additionally, a combination of household decision-making with the number of ANC visits predicted an increase in the linear growth of the child (β=0.032 [0.019 0.045], p-value < 0.001).
Maternal factors such as maternal income-generating activity, maternal participation in household decision making, and increased number of ANC visits were found to promote normal child linear growth. These results contribute valuable information to the formulation of interventions and policies to improve child nutrition and growth in the community studied.
线性生长迟缓仍然是一个普遍存在的公共卫生问题，影响着全世界许多儿童。本研究旨在探讨可能促进卢旺达贫困家庭 6-23 个月龄儿童正常线性生长的产妇因素。
我们采用了三阶段聚类抽样程序。研究人群包括居住在研究地区的 6-23 个月龄儿童及其母亲。一份结构化问卷帮助从 807 对选定的母婴对子中收集数据。主要结局变量为身高年龄 Z 评分。主要预测因素是产妇创收活动、产妇教育、产妇抑郁、家庭决策、产前护理就诊次数、计划生育方法的使用、计划生育类型和分娩方式。我们使用单变量分析来确定中位数、频率和百分比。此外，我们还使用了 Kruskal-Wallis、Mann-Whitney U 和 Spearman 秩相关检验进行双变量分析。我们将与结局显著相关的潜在混杂变量（儿童年龄、父母双方都参加工作、良好的洗手习惯、拥有菜园和牲畜总数）以及产妇因素纳入稳健线性回归的最终模型中进行多变量分析。
促进儿童正常线性生长的产妇因素包括产妇创收活动的存在（β=0.640 [0.0269 1.253]，p 值=0.041）、母亲参与家庭决策过程（β=0.147 [0.080 0.214]，p 值<0.001）和更高频率的产前护理就诊（β=0.189 [0.025 0.354]，p 值=0.024）。此外，家庭决策与产前护理就诊次数的组合预测了儿童线性生长的增加（β=0.032 [0.019 0.045]，p 值<0.001）。
产妇创收活动、母亲参与家庭决策以及增加产前护理就诊次数等产妇因素被发现可促进儿童正常线性生长。这些结果为制定干预措施和政策以改善研究社区儿童营养和生长状况提供了有价值的信息。
