Retraction: Chilinda, Z.B., et al. Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6-23 Months in Malawi. Nutrients 2021, 13, 178.

The article cited above [...].

Higher maternal autonomy is associated with reduced child stunting in Malawi.

Child undernutrition is a major health problem in Malawi. We assessed the association between maternal autonomy and child stunting in Malawi. We utilized nationally representative pooled cross-sectional data from the 2010 and 2015/16 Malawi Demographic and Health Surveys (MDHS), which included 7348 mother (28.1 ± 6.8 years, range 15-49 years)-child (27.6 ± 16.7 months, range 0-59 months) pairs. Maternal autonomy composite scores captured decision-making power, tolerance of domestic violence, and financial independence. The nutritional outcome measure was stunting (height-for-age z score < - 2). Logistic regression assessed associations between maternal autonomy and stunting, and dominance analysis evaluated the relative importance of the associated factors. From the two surveys combined, 39.2% were stunted. Stunting decreased from 45.0% in 2010 to 34.6% in 2015/16; concurrently, maternal autonomy improved and was evidently associated with stunting (aOR = 0.81, 95% CI = 0.71, 0.93; p = 0.002). However, this association was probably mediated by other factors associated with improved child nutrition, including maternal education and family wealth, which, along with child age, were associated with stunting in the dominance analysis. Concurrent interventional programs may also have contributed to the decrease in stunting between the surveys, thus moderating the effect of maternal autonomy.

Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6-23 Months in Malawi.

Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother-child dyads, respectively, (26.8 ± 6.8 years, range 15-49 years) and (13.9 ± 4.9 months, range 6-23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, p < 0.001). However, only 5.9% of the mother-child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24-2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.

After-school nutrition education programme improves eating behaviour in economically disadvantaged adolescents.

OBJECTIVE: To investigate whether an after-school nutrition education (ASNE) programme can improve the nutrition knowledge and healthy eating behaviour of adolescents from economically disadvantaged families. DESIGN: One-group pretest and posttest design. Nutrition knowledge and dietary intake were collected using a questionnaire, and anthropometric measurements were measured before and after the intervention. Nine components of healthy eating behaviour were assessed with reference to the Dietary Guideline of Taiwan. Pretest and posttest differences were analysed using generalised estimating equations. SETTING: Three after-school programmes in central and southern Taiwan. The ASNE programme comprised three monthly 1-h sessions (20-30-min lecture and 30-40-min interaction). PARTICIPANTS: A total of 153 adolescents aged 10-15 years from economically disadvantaged families (seventy-eight elementary students and seventy-five junior high school students). RESULTS: Elementary and junior high school students' nutrition knowledge scores (range 0-6) increased by 0·28 (+ 5·7 %, P = 0·02) and 0·30 points (+ 6·18 %, P = 0·02), respectively, but their fruit intake decreased by 0·36 serving/d (-22·9 %, P = 0·02) and 0·29 serving/d (-18·9 %, P = 0·03), respectively. Junior high school students' mean snacking frequency and fried food intake dropped to 0·75 d/week (-21·3 %, P = 0·008) and 0·10 serving/d (-28·8 %, P = 0·01), respectively. CONCLUSIONS: Short-term ASNE programmes can increase nutrition knowledge and reduce snacking frequency and fried food intake despite a decrease in fruit intake among adolescents from economically disadvantaged families.