23 research outputs found
Participatory Women's Groups with Cash Transfers Can Increase Dietary Diversity and Micronutrient Adequacy during Pregnancy, whereas Women's Groups with Food Transfers Can Increase Equity in Intrahousehold Energy Allocation.
Background: There is scarce evidence on the impacts of food transfers, cash transfers, or women's groups on food sharing, dietary intakes, or nutrition during pregnancy, when nutritional needs are elevated. Objective: This study measured the effects of 3 pregnancy-focused nutrition interventions on intrahousehold food allocation, dietary adequacy, and maternal nutritional status in Nepal. Methods: Interventions tested in a cluster-randomized controlled trial (ISRCTN 75964374) were "Participatory Learning and Action" (PLA) monthly women's groups, PLA with transfers of 10 kg fortified flour ("Super Cereal"), and PLA plus transfers of 750 Nepalese rupees (∼US$7.5) to pregnant women. Control clusters received usual government services. Primary outcomes were Relative Dietary Energy Adequacy Ratios (RDEARs) between pregnant women and male household heads and pregnant women and their mothers-in-law. Diets were measured by repeated 24-h dietary recalls. Results: Relative to control, RDEARs between pregnant women and their mothers-in-law were 12% higher in the PLA plus food arm (log-RDEAR coefficient = 0.12; 95% CI: 0.02, 0.21; P = 0.014), but 10% lower in the PLA-only arm between pregnant women and male household heads (-0.11; 95% CI: -0.19, -0.02; P = 0.020). In all interventions, pregnant women's energy intakes did not improve, but odds of pregnant women consuming iron-folate supplements were 2.5-4.6 times higher, odds of pregnant women consuming more animal-source foods than the household head were 1.7-2.4 times higher, and midupper arm circumference was higher relative to control. Dietary diversity was 0.4 food groups higher in the PLA plus cash arm than in the control arm. Conclusions: All interventions improved maternal diets and nutritional status in pregnancy. PLA women's groups with food transfers increased equity in energy allocation, whereas PLA with cash improved dietary diversity. PLA alone improved diets, but effects were mixed. Scale-up of these interventions in marginalized populations is a policy option, but researchers should find ways to increase adherence to interventions. This trial was registered at www.controlled-trials.com as ISRCTN 75964374
Diet and physical activity for children's health: a qualitative study of Nepalese mothers’ perceptions
Objectives: Non-communicable diseases account
for 50% of all deaths in Nepal and 25% result
from cardiovascular diseases. Previous studies in
Nepal indicate a high burden of behavioural
cardiovascular risk factors, suggesting a low level
of knowledge, attitude and practice/behaviour
regarding cardiovascular health. The behavioural
foundation for a healthy lifestyle begins in early
childhood, when mothers play a key role in their
children’s lives. This qualitative study, conducted in a
Nepalese peri-urban community, aimed to explore
mothers’ perception of their children’s diet and
physical activity.
Design: We notated, tape-recorded and transcribed all
data collected from six focus group discussions, and
used qualitative content analysis for evaluation and
interpretation.
Setting: The study was conducted in the Jhaukhel-
Duwakot Health Demographic Surveillance Site in the
Bhaktapur district of Nepal.
Participants: Local health workers helped recruit 61
women with children aged 5–10 years. We distributed
participants among six different groups according to
educational status.
Results: Although participants understood the
importance of healthy food, they misunderstood its
composition, perceiving it as unappetising and
appropriate only for sick people. Furthermore,
participants did not prioritise their children’s
physical activities. Moreover, mothers believed they
had limited control over their children’s dietary
habits and physical activity. Finally, they opined that
health educational programmes would help
mothers and recommended various intervention
strategies to increase knowledge regarding a healthy
lifestyle.
Conclusions: Our data reveal that mothers of young
children in a peri-urban community of Nepal lack
adequate and accurate understanding about the impact
of a healthy diet and physical activity. Therefore, to
prevent future cardiovascular disease and other noncommunicable
diseases among children, Nepal needs
health education programmes to improve mothers’
cardiovascular health knowledge, attitude and
behaviour
Prevalence of cardiovascular health risk behaviors in a remote rural community of Sindhuli district, Nepal
BACKGROUND: Cardiovascular disease (CVD) is emerging as a public health menace among low and middle income countries. It has particularly affected the poorest. However, there is paucity of information about CVD risk factors profile among Nepalese rural communities where the majority of people live in poverty. Therefore, this study aimed to identify the prevalence of cardiovascular health risk behaviors in an outback community of Nepal. METHODS: We conducted a descriptive cross-sectional study in Tinkanya Village Development Committee (VDC), Sindhuli between January and March, 2014. Total 406 participants of age 20 to 50 years were selected randomly. Data were collected using WHO-NCD STEPwise approach questionnaires and analyzed with SPSS V.16.0 and R i386 2.15.3 software. RESULT: The mean age of participants was 36.2 ± 9 years. Majority of participants (76.3%) were from lower socio-economic class, Adibasi/Janajati (63.1%), and without formal schooling (46.3%). Smoking was present in 28.6%, alcohol consumption in 47.8%, insufficient fruits and vegetables intake in 96.6%, insufficient physical activity in 48.8%; 25.6% had high waist circumference, 37.4% had overweight and obesity. Average daily salt intake per capita was 14.4 grams ±4.89 grams. Hypertension was detected in 12.3%. It had an inverse relationship with education and socio-economic status. In binary logistic regression analysis, age, smoking, body mass index (BMI) and daily salt intake were identified as significant predictors of hypertension. CONCLUSION: Present study showed high prevalence of smoking, alcohol consumption, insufficient fruit and vegetable intake, daily salt intake, overweight and obesity and hypertension among remote rural population suggesting higher risk for developing CVD in future. Nepalese rural communities, therefore, are in need of population-wide comprehensive intervention approaches for reducing CVD health risk behaviors