Mobile phone application in the management of maternal and young child malnutrition: a review

Background: Malnutrition is one of the leading causes of maternal and young child mortality in underdeveloped countries, particularly during pregnancy and delivery. The effects of malnutrition in pregnant women include low birth weight, preterm birth, intrauterine growth restriction, nutrient deficiencies and reduced breast milk production. Mobile phone applications are widely used with features such as portability, ease of communication, storage at relatively low cost that makes such technology attractive to nutritionists. Objective: To assess if mobile phone applications can be beneficial in maternal and young child malnutrition intervention. Methods: Zotero reference management software was used to ensure the rigor and reproducibility of the review process. Based on defined key words, a search was conducted on Google Scholar, ScienceDirect, PubMed and Springer databases to retrieve all publications on mobile phone applications in maternal and young child malnutrition interventions. The study used ten articles from unique studies that met the study criteria and are reported in terms of authors, year, sample size, study design and outcome measure. Results: The articles revealed that mobile phone applications were highly useful in maternal and young child malnutrition intervention, prompting nutrition information seeking and facilitating communication with healthcare providers. Conclusion: Mobile phone applications are widely acknowledged, and beneficial in maternal and neonatal malnutrition management, they have the potential to improve maternal and young child nutritional status through self-monitoring. Given the low uptake of current mobile phone application, it should be given a significant consideration as a potential strategy for managing maternal and young child malnutrition.

Biofortification of common bean (Phaseolus vulgaris L.) with iron and zinc: Achievements and challenges.

Micronutrient deficiencies (hidden hunger), particularly in iron (Fe) and zinc (Zn), remain one of the most serious public health challenges, affecting more than three billion people globally. A number of strategies are used to ameliorate the problem of micronutrient deficiencies and to improve the nutritional profile of food products. These include (i) dietary diversification, (ii) industrial food fortification and supplements, (iii) agronomic approaches including soil mineral fertilisation, bioinoculants and crop rotations, and (iv) biofortification through the implementation of biotechnology including gene editing and plant breeding. These efforts must consider the dietary patterns and culinary preferences of the consumer and stakeholder acceptance of new biofortified varieties. Deficiencies in Zn and Fe are often linked to the poor nutritional status of agricultural soils, resulting in low amounts and/or poor availability of these nutrients in staple food crops such as common bean. This review describes the genes and processes associated with Fe and Zn accumulation in common bean, a significant food source in Africa that plays an important role in nutritional security. We discuss the conventional plant breeding, transgenic and gene editing approaches that are being deployed to improve Fe and Zn accumulation in beans. We also consider the requirements of successful bean biofortification programmes, highlighting gaps in current knowledge, possible solutions and future perspectives.

Nutritional Factors Associated With Maternal Depression Among Pregnant Women in Urban Low-Income Settlements in Nairobi, Kenya.

BACKGROUND: Nutritional deficiencies are common during pregnancy and a year after childbirth. At the same time, maternal depression affects many women during pregnancy up to 1 year after childbirth. The objectives of this study were to determine the associations between nutrition status, dietary intake, and maternal depression among pregnant women. METHODS: This was a cross-sectional study that included 262 pregnant women aged 15 to 49 years attending the antenatal clinic in 2 public health facilities in urban low-income settlements in Nairobi, Kenya. Maternal depression was assessed using Edinburgh Postnatal Depression Scale (EPDS). Mid-upper arm circumference (MUAC) was used to determine nutritional status. Dietary intake was assessed using the 24-hour recall, and brain essential nutrients were assessed through a questionnaire. Odds ratio was used to test the associations. All maternal characteristics with P < .001 in the univariable analysis were considered in the multivariable logistic regression, variables with P < .05 were considered significant. RESULTS: Of the 262 pregnant women, 33.6% (95% CI: 27.9-40.7) had depressive illness as indicated by EPDS >13. About 9.9% of pregnant women had MUAC < 23 cm. The study established statistically significant association between poor nutrition by MUAC and maternal depression (P < .001). Maternal depression was statistically significantly associated with inadequate intake of brain food essential (P = .002). Maternal depression was statistically significantly associated with lower income (P < .001). In multivariable regression analysis, the main predictor of maternal depression was poor nutrition (P < .004). CONCLUSION: These findings reveal an association between poor nutrition and maternal depression. These results suggest that nutritional deficiencies could be a contributing factor for maternal depression. Study recommends dietary interventions as cost-effective way to reduce deficiencies and improve mental health problems for pregnant women. Assessment of maternal depression and dietary intake be integrated as fundamental components of antenatal care.

Risk factors and experiences of prepartum depression in urban- low-income settlement Nairobi Kenya: a mixed-method study.

Background: Prepartum depression is common among pregnant women and has not been studied much in low and middle-income countries. Evidence shows that mental illnesses are prevalent in urban than in rural areas. The study objective was to determine the magnitude of prepartum depression, risk factors, and real-life experiences of depression among pregnant women. Method: A mixed-method cross-sectional study was conducted. It included 262 pregnant women attending antenatal clinics in two public health facilities in urban low-income settlement Nairobi, Kenya. Edinburgh Postnatal Depression Scale (EPDS) with cut-off >13 was used to classify clinical depressive illness. Further, a focus group discussion was conducted with 20 women identified with depression. Univariable analysis with Odd's Ratio was used to test associations. Variables with a p<0.05 in multivariable regression were considered significant. Result: Out of the 262 women, 33.6% were found to have clinical depression as indicated by EPDS score of >13. Women's gestational age was statistically significantly associated with prepartum depression [OR 4.27 (95% C.I. 2.08 - 8.79),  p<0.001]. Income level ≤ 5000 KES was statistically significantly associated with prepartum depression [OR 3.64 (95% C.I.1.25 -10.60), p=0.018]. Further, thematic analysis of qualitative indicated that poverty, lack of social support, domestic violence, and unfriendly health care were major contributors to prepartum depression. Conclusion: Significant numbers of pregnant women were found to experience depression. This prevalence rate indicates a high disease burden of women who live with depression, which is not diagnosed because screening of depression is not done in primary health care centers. This study calls for a need and consideration for screening for perinatal depression in primary health care facilities, mainly in resource-poor areas. Interventions targeting means of resolving conflicts in families are highly needed. Such steps would help achieve key sustainable development goals where maternal and child health remains key priority.