Undernutrition among children under 5 years of age in Yemen: Role of adequatechildcare provided by adults under conditions of food insecurity / Journal of Rural Medicine

ABSTRACT

<p><b>Objective:</b> This study examined the associations between the adequacy ofchildcare provided by adult caretakers and childhood undernutrition in rural Yemen,independent of household wealth and food consumption.</p><p><b>Methods:</b> We analyzed data of 3,549 children under the age of 5 years livingin rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and ChildHealth. Nutritional status was evaluated by the presence of underweight, stunting, andwasting according to the World Health Organization child growth standards. The impact ofchildcare including leaving children alone, putting older children into labor force, andthe use of antenatal care while pregnant on child undernutrition was assessed and adjustedfor food consumption by children, household composition, demographic and educationalbackground of caretakers, and household wealth.</p><p><b>Results:</b> The prevalence of underweight, stunting, and wasting was 46.2%,62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of thelabor force, and use of antenatal care were associated with a lower risk of underweight(odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) andstunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). Afterfurther adjustment for food consumption, the associations between adequate childcareindicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR =0.72, P = 0.046; and OR = 0.76, P = 0.038).</p><p><b>Conclusions:</b> A marked prevalence of stunting among rural children in Yemenwas observed. Adequate childcare by adult caretakers in families is associated with alower incidence of underweight and stunting among children under 5 years of age. Promotingadequate childcare by adult household members is a feasible option for reducingundernutrition among children in rural Yemen.</p>