Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys
Background: Understanding the drivers contributing to the decreasing trend in stunting is paramount to meeting the World Health Assembly’s global target of 40% stunting reduction by 2025. Methods: We pooled data from 50 Demographic and Health Surveys since 2000 in 14 countries to examine the relatio...
| Autores principales: | , , , , , |
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| Formato: | Journal Article |
| Lenguaje: | Inglés |
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MDPI
2019
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| Materias: | |
| Acceso en línea: | https://hdl.handle.net/10568/146813 |
| _version_ | 1855538283863343104 |
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| author | Argaw, Alemayehu Hanley-Cook, Giles De Cock, Nathalie Kolsteren, Patrick Huybregts, Lieven Lachat, Carl |
| author_browse | Argaw, Alemayehu De Cock, Nathalie Hanley-Cook, Giles Huybregts, Lieven Kolsteren, Patrick Lachat, Carl |
| author_facet | Argaw, Alemayehu Hanley-Cook, Giles De Cock, Nathalie Kolsteren, Patrick Huybregts, Lieven Lachat, Carl |
| author_sort | Argaw, Alemayehu |
| collection | Repository of Agricultural Research Outputs (CGSpace) |
| description | Background: Understanding the drivers contributing to the decreasing trend in stunting is paramount to meeting the World Health Assembly’s global target of 40% stunting reduction by 2025. Methods: We pooled data from 50 Demographic and Health Surveys since 2000 in 14 countries to examine the relationships between the stunting trend and potential factors at distal, intermediate, and proximal levels. A multilevel pooled trend analysis was used to estimate the association between the change in potential drivers at a country level and stunting probability for an individual child while adjusting for time trends and child-level covariates. A four-level mixed-effects linear probability regression model was fitted, accounting for the clustering of data by sampling clusters, survey-rounds, and countries. Results: Stunting followed a decreasing trend in all countries at an average annual rate of 1.04 percentage points. Among the distal factors assessed, a decrease in the Gini coefficient, an improvement in women’s decision-making, and an increase in urbanization were significantly associated with a lower probability of stunting within a country. Improvements in households’ access to improved sanitation facilities and drinking water sources, and children’s access to basic vaccinations were the important intermediate service-related drivers, whereas improvements in early initiation of breastfeeding and a decrease in the prevalence of low birthweight were the important proximal drivers. Conclusions: The results reinforce the need for a combination of nutrition-sensitive and -specific interventions to tackle the problem of stunting. The identified drivers help to guide global efforts to further accelerate stunting reduction and monitor progress against chronic childhood undernutrition. |
| format | Journal Article |
| id | CGSpace146813 |
| institution | CGIAR Consortium |
| language | Inglés |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | MDPI |
| publisherStr | MDPI |
| record_format | dspace |
| spelling | CGSpace1468132025-12-08T10:29:22Z Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys Argaw, Alemayehu Hanley-Cook, Giles De Cock, Nathalie Kolsteren, Patrick Huybregts, Lieven Lachat, Carl less favoured areas child nutrition surveys health malnutrition nutrition children demography developing countries Background: Understanding the drivers contributing to the decreasing trend in stunting is paramount to meeting the World Health Assembly’s global target of 40% stunting reduction by 2025. Methods: We pooled data from 50 Demographic and Health Surveys since 2000 in 14 countries to examine the relationships between the stunting trend and potential factors at distal, intermediate, and proximal levels. A multilevel pooled trend analysis was used to estimate the association between the change in potential drivers at a country level and stunting probability for an individual child while adjusting for time trends and child-level covariates. A four-level mixed-effects linear probability regression model was fitted, accounting for the clustering of data by sampling clusters, survey-rounds, and countries. Results: Stunting followed a decreasing trend in all countries at an average annual rate of 1.04 percentage points. Among the distal factors assessed, a decrease in the Gini coefficient, an improvement in women’s decision-making, and an increase in urbanization were significantly associated with a lower probability of stunting within a country. Improvements in households’ access to improved sanitation facilities and drinking water sources, and children’s access to basic vaccinations were the important intermediate service-related drivers, whereas improvements in early initiation of breastfeeding and a decrease in the prevalence of low birthweight were the important proximal drivers. Conclusions: The results reinforce the need for a combination of nutrition-sensitive and -specific interventions to tackle the problem of stunting. The identified drivers help to guide global efforts to further accelerate stunting reduction and monitor progress against chronic childhood undernutrition. 2019-10-16 2024-06-21T09:08:52Z 2024-06-21T09:08:52Z Journal Article https://hdl.handle.net/10568/146813 en Open Access MDPI Argaw, Alemayehu; Hanley-Cook, Giles; Cock, Nathalie De; Kolsteren, Patrick; Huybregts, Lieven; and Lachat, Carl. 2019. Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys. Nutrients 11(10): 2485. https://doi.org/10.3390/nu11102485 |
| spellingShingle | less favoured areas child nutrition surveys health malnutrition nutrition children demography developing countries Argaw, Alemayehu Hanley-Cook, Giles De Cock, Nathalie Kolsteren, Patrick Huybregts, Lieven Lachat, Carl Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys |
| title | Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys |
| title_full | Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys |
| title_fullStr | Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys |
| title_full_unstemmed | Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys |
| title_short | Drivers of under-five stunting trend in 14 low- and middle-income countries since the turn of the millennium: A multilevel pooled analysis of 50 demographic and health surveys |
| title_sort | drivers of under five stunting trend in 14 low and middle income countries since the turn of the millennium a multilevel pooled analysis of 50 demographic and health surveys |
| topic | less favoured areas child nutrition surveys health malnutrition nutrition children demography developing countries |
| url | https://hdl.handle.net/10568/146813 |
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