Mensah Peter Annor, Sawyerr Ruth Tobi, Christian Aaron Kobina
Regional Institute for Population Studies (RIPS), University of Ghana, Legon, Ghana.
Participatory Development Associates, Accra, Ghana.
BMC Nutr. 2024 Dec 6;10(1):157. doi: 10.1186/s40795-024-00969-0.
Stunting remains a public health concern in sub-Saharan Africa. Despite the evolving awareness of the effect of family composition on child health outcomes, the influence of sibling gender on stunting has seldom been consistent. The current study investigated the association between sibling composition and stunting among children under five years in Ghana.
This cross-sectional study utilized data from the most recent Ghana Demographic and Health Survey (GDHS 2022), focusing on 5416 mother-child dyads. Stunting prevalence was assessed through descriptive analysis, while logistic regression analysis was employed to examine the association between sibling composition and identify other risk factors associated with stunting.
The prevalence of stunting among children under five years of age was 18%. It was observed from the male sex-stratified model that having male siblings and having a combination of male and female siblings increased male children's odds of being stunted. In contrast, having siblings of either gender or having a combination of male and female siblings may not pose any stunting threats to female children as observed in the female sex-stratified model. Furthermore, being a male child (OR: 1.54; 95% CI: 1.25, 1.90) and never being breastfed (OR: 2.07; 95% CI: 1.31, 3.21) increased children's likelihood of stunting.
This study concludes that the extra nutrients boys require for healthy growth and development may increase their competition for nutrients, especially in households with limited resource. Parents and guardians are advised to be consciously aware of the subtle and apparent competition between male children and take appropriate measures to prevent children's deprivation of nutrition by their male siblings.
发育迟缓仍是撒哈拉以南非洲地区的一个公共卫生问题。尽管人们越来越意识到家庭构成对儿童健康结果的影响，但兄弟姐妹性别对发育迟缓的影响却很少一致。本研究调查了加纳5岁以下儿童的兄弟姐妹构成与发育迟缓之间的关联。
这项横断面研究利用了最新的加纳人口与健康调查（2022年加纳人口与健康调查）的数据，重点关注5416对母婴。通过描述性分析评估发育迟缓患病率，同时采用逻辑回归分析来检验兄弟姐妹构成之间的关联，并确定与发育迟缓相关的其他风险因素。
5岁以下儿童的发育迟缓患病率为18%。从男性分层模型中观察到，有男性兄弟姐妹以及有男性和女性兄弟姐妹的组合会增加男童发育迟缓的几率。相比之下，如女性分层模型所示，有任何性别的兄弟姐妹或有男性和女性兄弟姐妹的组合可能不会对女童构成任何发育迟缓威胁。此外，是男童（比值比：1.54；95%置信区间：1.25，1.90）和从未母乳喂养（比值比：2.07；95%置信区间：1.31，3.21）会增加儿童发育迟缓的可能性。
本研究得出结论，男孩健康成长和发育所需的额外营养可能会增加他们对营养的竞争，尤其是在资源有限的家庭中。建议父母和监护人有意识地意识到男童之间微妙和明显的竞争，并采取适当措施防止儿童被其男性兄弟姐妹剥夺营养。
