Maternal and familial correlates of anthropometric typologies in the nutrition transition of Colombia, 2000–2010

Q2Q1Objective: We aimed to assess the maternal and family determinants of four anthropometric typologies at the household level in Colombia for the years 2000, 2005 and 2010. Design: We classified children <5 years old according to height-for-age Z-score (2) to assess stunting and overweight/obesity, respectively; mothers were categorized according to BMI to assess underweight (<18·5 kg/m2 ) and overweight/obesity (≥25·0 kg/m2 ). At the household level, we established four final anthropometric typologies: normal, underweight, overweight and dual-burden households. Separate polytomous logistic regression models for each of the surveyed years were developed to examine several maternal and familial determinants of the different anthropometric typologies. Setting: National and sub-regional (urban and rural) representative samples from Colombia, South America. Subjects: Drawing on data from three waves of Colombia’s Demographic and Health Survey/Encuesta Nacional de Salud (DHS/ENDS), we examined individual and household information from mothers (18–49 years) and their children (birth– 5 years). Results: Higher parity was associated with an increased likelihood of overweight and dual burden. Higher levels of maternal education were correlated with lower prevalence of overweight, underweight and dual burden of malnutrition in all data collection waves. In 2010, participation in nutrition programmes for children <5 years, being an indigenous household, food purchase decisions by the mother and food security classification were also associated with the four anthropometric typologies. Conclusions: Results suggest that maternal and family correlates of certain anthropometric typologies at the household level may be used to better frame policies aimed at improving social conditions and nutrition outcomes.Revista Internacional - Indexad

Maternal and familial correlates of anthropometric typologies in the nutrition transition of Colombia, 2000-2010

Objective: We aimed to assess the maternal and family determinants of four anthropometric typologies at the household level in Colombia for the years 2000, 2005 and 2010. Design: We classified children and lt;5 years old according to height-for-age Z-score ( and lt;-2) and BMI-for-age Z-score ( and gt;2) to assess stunting and overweight/obesity, respectively; mothers were categorized according to BMI to assess underweight ( and lt;18·5 kg/m2) and overweight/obesity (?25·0 kg/m2). At the household level, we established four final anthropometric typologies: normal, underweight, overweight and dual-burden households. Separate polytomous logistic regression models for each of the surveyed years were developed to examine several maternal and familial determinants of the different anthropometric typologies. Setting: National and sub-regional (urban and rural) representative samples from Colombia, South America. Subjects: Drawing on data from three waves of Colombia's Demographic and Health Survey/Encuesta Nacional de Salud (DHS/ENDS), we examined individual and household information from mothers (18-49 years) and their children (birth-5 years). Results Higher parity was associated with an increased likelihood of overweight and dual burden. Higher levels of maternal education were correlated with lower prevalence of overweight, underweight and dual burden of malnutrition in all data collection waves. In 2010, participation in nutrition programmes for children and lt;5 years, being an indigenous household, food purchase decisions by the mother and food security classification were also associated with the four anthropometric typologies. Conclusions: Results suggest that maternal and family correlates of certain anthropometric typologies at the household level may be used to better frame policies aimed at improving social conditions and nutrition outcomes. © The Authors 2018

Intimate partner violence as a predictor of antenatal care service utilization in Honduras

ABSTRACT Objective To describe the relationship between exposure to physical and/or sexual intimate partner violence (IPV) and indicators of antenatal care (ANC) service utilization among Honduran women of reproductive age. Methods Data from the 2011-2012 Honduras Demographic and Health Survey were analyzed to describe the relationship between self-reported exposure to IPV and two ANC outcomes: (1) sufficient ANC visits (defined by the Honduran Ministry of Health as five or more visits) and (2) early ANC initiation (within the first trimester). Multiple logistic regression was used to estimate effects of physical and sexual IPV on the outcomes, controlling for women’s age, education, literacy, residence, household size, religion, parity, wealth, husband’s age, and husband’s education. Results Of women who were married, had at least one living child 5 years or younger, and completed the IPV module (N = 6 629), 13.5% of them reported any physical IPV, and 4.1% reported both physical and sexual IPV. There was no significant association between IPV and early ANC; however, a significant relationship between IPV and sufficient ANC was found. Women who experienced any physical IPV (adjusted odds ratios (aOR) = 1.25; 95% confidence interval (CI): 1.00-1.56) or sexual IPV (aOR = 1.53; 95% CI: 1.08-2.16) were, respectively, 25% and 53% more likely to receive insufficient ANC. Conclusions Honduras has one of highest rates of interpersonal violence of any nation in the world. In Honduras, IPV is a contributor to this broader category of interpersonal violence as well as a risk factor for insufficient ANC. Our findings suggest that universal IPV screening during ANC as well as future initiatives aimed at reducing IPV might improve ANC utilization in the country

Is quality of care a key predictor of perinatal health care utilization and patient satisfaction in Malawi?

Abstract Background The Malawi government encourages early antenatal care, delivery in health facilities, and timely postnatal care. Efforts to sustain or increase current levels of perinatal service utilization may not achieve desired gains if the quality of care provided is neglected. This study examined predictors of perinatal service utilization and patients’ satisfaction with these services with a focus on quality of care. Methods We used baseline, two-stage cluster sampling household survey data collected between November and December, 2012 before implementation of CARE’s Community Score Card© intervention in Ntcheu district, Malawi. Women with a birth during the last year (N = 1301) were asked about seeking: 1) family planning, 2) antenatal, 3) delivery, and 4) postnatal care; the quality of care received; and their overall satisfaction with the care received. Specific quality of care items were assessed for each type of service, and up to five such items per type of service were used in analyses. Separate logistic regression models were fitted to examine predictors of family planning, antenatal, delivery, and postnatal service utilization and of complete satisfaction with each of these services; all models were adjusted for women’s socio-demographic characteristics, perceptions of the closest facility to their homes, service use indicators, and quality of care items. Results We found higher levels of perinatal service use than previously documented in Malawi (baseline antenatal care 99.4%; skilled birth attendance 97.3%; postnatal care 77.5%; current family planning use 52.8%). Almost 73% of quality of perinatal care items assessed were favorably reported by > 90% of women. Women reported high overall satisfaction (≥85%) with all types of services examined, higher for antenatal and postnatal care than for family planning and delivery care. We found significant associations between perceived and actual quality of care and both women’s use and satisfaction with the perinatal health services received. Conclusions Quality of care is a key predictor of perinatal health service utilization and complete patient satisfaction with such services in Malawi. The current heightened attention toward perinatal health services and outcomes should be coupled with efforts to improve the actual quality of care offered to women in this country

Maternal and familial correlates of anthropometric typologies in the nutrition transition of Colombia, 2000-2010

Objective: We aimed to assess the maternal and family determinants of four anthropometric typologies at the household level in Colombia for the years 2000, 2005 and 2010. Design: We classified children and lt;5 years old according to height-for-age Z-score ( and lt;-2) and BMI-for-age Z-score ( and gt;2) to assess stunting and overweight/obesity, respectively; mothers were categorized according to BMI to assess underweight ( and lt;18·5 kg/m2) and overweight/obesity (?25·0 kg/m2). At the household level, we established four final anthropometric typologies: normal, underweight, overweight and dual-burden households. Separate polytomous logistic regression models for each of the surveyed years were developed to examine several maternal and familial determinants of the different anthropometric typologies. Setting: National and sub-regional (urban and rural) representative samples from Colombia, South America. Subjects: Drawing on data from three waves of Colombia's Demographic and Health Survey/Encuesta Nacional de Salud (DHS/ENDS), we examined individual and household information from mothers (18-49 years) and their children (birth-5 years). Results Higher parity was associated with an increased likelihood of overweight and dual burden. Higher levels of maternal education were correlated with lower prevalence of overweight, underweight and dual burden of malnutrition in all data collection waves. In 2010, participation in nutrition programmes for children and lt;5 years, being an indigenous household, food purchase decisions by the mother and food security classification were also associated with the four anthropometric typologies. Conclusions: Results suggest that maternal and family correlates of certain anthropometric typologies at the household level may be used to better frame policies aimed at improving social conditions and nutrition outcomes. © The Authors 2018