ABSTRACT
Background: Undernutrition among mothers and children is currently a major public health and development concern in Bangladesh. In literature relating to nutritional determinants, of particular interest is the geography, as regions with poor nutrition tend to pull down the overall nutritional status of the country. As such, reducing the regional gap can alone reduce overall undernutrition significantly, especially when regional gaps are high. The aim of this study is, therefore, to assess the magnitude of inequalities in undernutrition in children aged under 5 years in Bangladesh and their mothers, and relate this to the administrative divisions of the country. Methods: The Bangladesh Demographic and Health Surveys (1996–1997, 1999– 2000, 2004 and 2007) were the sources of data, and a total of 16 278 mother–child pairs whose records were complete for the required individual and household-level variables were included in the analysis. Maternal nutritional status was measured by the body mass index (BMI). Weight-for-age, height-for-age and weight-forheight z-scores were calculated by use of the World Health Organization (WHO) Child Growth Standards to assess the nutritional status of children aged under 5 years. General linear model, sequential linear and multinomial logistic regression analyses were done to assess the inequalities in maternal and child nutritional status among the six administrative divisions of Bangladesh. Socioeconomic variables that were controlled for were residency, education and occupation of the mothers and their husbands, house type and possession score in the household. Results: Maternal BMI and prevalence of underweight, stunting and wasting in children aged under 5 years were found to vary significantly according to administrative division. Of the six divisions, Sylhet was found to have highest prevalence of undernourished mothers and children. The trends from 1996 to 2007 also established Sylhet as the poorest-performing region overall. Conclusion: The Sylhet administrative division needs specially focused attention from policy-makers if the overall performance of the health, nutrition and population sector is to reach the targets set by the country.
ABSTRACT
Objetivou-se avaliar as condições socioeconômicas, o estado nutricional e o consumo alimentar de pré-escolares assistidos pelos Centros Educacionais Municipais (CEM) de Alfenas (MG). Foi realizado um estudo transversal, com 186 crianças. Avaliou-se o perfil socioeconômico, peso, estatura, idade, sexo e o consumo alimentar pelo instrumento de pesagem direta dos alimentos. Observou-se renda familiar de um a três salários mínimos, ensino fundamental incompleto, casa própria com saneamento básico, quatro a cinco habitantes por domicílio, dos quais, na maioria dois trabalhavam. A média de idade foi de 49,2 ± 12,9 meses. A baixa estatura foi o desvio nutricional mais prevalente (20,5 por cento). 72,6 por cento das crianças apresentaram ingestão energética abaixo da necessidade energética estimada (EER). Ao estratificar por faixa etária, de um a três anos, 78,4 por cento das crianças apresentaram ingestão acima da EER e de quatro a seis anos, 74,1 por cento apresentaram ingestão abaixo da EER. Todas as crianças apresentaram baixo consumo de cálcio e a maioria apresentou consumo abaixo da necessidade média estimada (EAR) para ferro. Apesar de alguns fatores biossocioeconômicos serem favoráveis, os desvios nutricionais e a ingestão inadequada de nutrientes estavam presentes, tornando-se necessária implementação de programa de controle nutricional nos CEM.
The objective of this article is to evaluate socioeconomic conditions, nutritional status and food intake of preschool children assisted at Municipal Educational Centers (CEMs) of Alfenas, Minas Gerais State, Brazil. A transverse study involving 186 children was performed. The socioeconomic profile, weight, height, age, sex and food intake by a direct weighting tool were evaluated. It was observed an income family of one to three minimum wages, incomplete fundamental learning, private house with basic sanitation, four to five inhabitants per house of whom two worked at most. The average age was 49.2 ± 12.9 months. The stunting rates were more prevalent among the children (20.5 percent). The whole, 72.6 percent of children have energy intake below Estimated Energy Intake (EER). However, when stratifying for age group, 78.4 percent of the children from 1 to 3 years old have high energy intake and 74.1 percent from 4 to 6 years old have inadequate energy intake. All children presented consumption below the Adequate Intake (AI) of calcium and most of them below to Estimated Average Requirement (EAR) of iron. Despite some biosocioeconomic factors be favorable to the nutritional status, malnutrition, and inadequate nutrient intake were present, which demanded the implementation of nutritional programs in CEMs.