The impact of an income-generating activities programme on children and mothers' undernutrition in extreme poor rural Bangladeshi households.

OBJECTIVE: The current study assessed changes in children and mothers' nutritional status before and after raising Bangladeshi households out of extreme poverty through an income-generating activities (IGA) programme. DESIGN: Extreme poor households took part in the IGA programme for 2 years and recruitment took place over four waves in annual cycles. Children and mothers were measured with regarding their nutritional status before and after the IGA programme commenced. SETTINGS: Rural Bangladesh. SUBJECTS: Three-hundred and eighty-two children under 5 years of age at recruitment, and their mothers. RESULTS: After 2 years of the IGA programme, the prevalence of stunting significantly declined from 40·3 % to 33·0 % (P = 0·003), anaemia declined from 51·6 % to 44·0 % (P = 0·020) while mothers' CED (Chronic Energy Deficiency) declined from 52·0 % to 42·7 % (P < 0·001), but no significant changes were found in children's wasting, declining from 25·4 % to 21·5 %, underweight which remained the same at 43·2 %, while mothers' anaemia rose from 39·3 % to 42·7 %. There were also highly significant improvements in household socio-economic status. Increases in socio-economic security (especially in relation to cash savings and net income) and improvements in food quantity and quality (indicated by greater food diversity and animal food intake) were associated with normal nutritional status, and cessation of open defecation was associated with reduction in mothers' and child anaemia. CONCLUSION: The IGA programme was associated with increased household socio-economic security, such as asset accumulation, food security and sanitation, and with improvements in the nutritional status of children and their mothers in extreme poor households.

Regional variation in maternal and childhood undernutrition in Bangladesh: evidence from demographic and health surveys.

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-for-height 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.

Nutritional status of children from Papua New Guinea: associations with socioeconomic factors.

Growth faltering has been well documented in children from Papua New Guinea, although there is evidence that broad processes of modernization, such as cash cropping, have resulted in increased body size. It is not clear, however, what household socioeconomic factors may be associated with larger body size in populations undergoing early stages of modernization. This cross-sectional study examined the nutritional status of children between birth and 5 years of age living near Kanabea, Papua New Guinea, a relatively remote outpost in the highland fringe experiencing a limited cash economy. Weight and height were measured on 260 children from 190 households. The mean z-scores of -2.26 +/- 1.50 (SD) for height-for-age, -2.43 +/- 1.25 for weight-for-age, and -1.34 +/- 1.49 for weight-for-height are suggestive of both acute and chronic malnutrition. Using a cut-off value of < or = -2SD, 68.8% of the children were stunted and/or wasted. These values are similar to those from a 1992-93 survey in the district, revealing that malnutrition remains a problem in the area. In this largely traditional horticultural group, educated mothers and mothers who spoke pidgin and/or English in addition to the local language had children with better z-scores.