Poverty and childhood undernutrition in developing countries : a multi-national cohort study

The importance of reducing childhood undernutrition has been enshrined in the United Nations’ Millennium Development Goals. This study explores the relationship between alternative indicators of poverty and childhood undernutrition in developing countries within the context of a multi-national cohort study (Young Lives). Approximately 2000 children in each of four countries – Ethiopia, India (Andhra Pradesh), Peru and Vietnam – had their heights measured and were weighed when they were aged between 6 and 17 months (survey one) and again between 4.5 and 5.5 years (survey two). The anthropometric outcomes of stunted, underweight and wasted were calculated using World Health Organization 2006 reference standards. Maximum-likelihood probit estimation was employed to model the relationship within each country and survey between alternative measures of living standards (principally a wealth index developed using principal components analysis) and each anthropometric outcome. An extensive set of covariates was incorporated into the models to remove as much individual heterogeneity as possible. The fully adjusted models revealed a negative and statistically significant coefficient on wealth for all outcomes in all countries, with the exception of the outcome of wasted in India (Andhra Pradesh) and Vietnam (survey one) and the outcome of underweight in Vietnam (surveys one and two). In survey one, the partial effects of wealth on the probabilities of stunting, being underweight and wasting was to reduce them by between 1.4 and 5.1 percentage points, 1.0 and 6.4 percentage points, and 0.3 and 4.5 percentage points, respectively, with each unit (10%) increase in wealth. The partial effects of wealth on the probabilities of anthropometric outcomes were larger in the survey two models. In both surveys, children residing in the lowest wealth quintile households had significantly increased probabilities of being stunted in all four study countries and of being underweight in Ethiopia, India (Andhra Pradesh) and Peru in comparison to children residing in the highest wealth quintile households. Random effects probit models confirmed the statistical significance of increased wealth in reducing the probability of being stunted and underweight across all four study countries. We conclude that, although multi-faceted, childhood undernutrition in developing countries is strongly rooted in poverty

Invited Review: Role of Livestock in Human Nutrition and Health for Poverty Reduction in Developing Countries

Livestock keeping is critical for many of the poor in the developing world, often contributing to multiple livelihood objectives and offering pathways out of poverty. Livestock keeping also affects an indispensable asset of the poor, their human capital, through its impact on their own nutrition and health. This paper outlines the linkages between livestock keeping and the physical well-being of the poor, and examines a number of commonly held beliefs that misrepresent livestock development issues related to these linkages. These beliefs limit the scope of intervention programs to promote livestock and limit their potential contribution to poverty reduction. Recognition of the complexity of the role livestock play in household decision-making and of the opportunities foregone due to these misconceptions can enhance the ability of livestock to contribute to human well-being in the developing world

A Review of Global Progress toward the Millennium Development Goal 1 Hunger Target

Background. The hunger component of the first Millennium Development Goal (MDG) aims to reduce the proportion of people who suffer from hunger by half between 1990 and 2015. In low- and middle-income countries, progress has been mixed, with approximately 925 million people hungry and 125 million and 195 million children underweight and stunted, respectively

Cereals and pulse-based ready-to-use therapeutic food as an alternative to the standard milk- and peanut paste-based formulation for treating severe acute malnutrition: A noninferiority, individually randomized controlled efficacy clinical trial

Background: The cost of current standard ready-to-use therapeutic food (RUTF) is among the major obstacles to scaling up community- based management of acute malnutrition (CMAM), an important child survival strategy. Identifying a cheaper alternative is a global public health priority. Objective: We sought to compare the efficacy of soya-maizesorghum RUTF (SMS-RUTF) with that of standard peanut paste- based RUTF (P-RUTF). Design: We used a nonblinded, parallel-group, simple randomized controlled trial along with a day care approach that enrolled 2 groups of children aged 6-23 and 24-59 mo, respectively, with severe acute malnutrition (SAM). Results: Intention-to-treat (ITT) and per-protocol (PP) analyses showed noninferiority of SMS-RUTF compared with P-RUTF for the recovery rate [ITT: Δ =-2.0% (95% CI:-7.6%, 3.6%); PP:-1.9% (95% CI: -5.3%, 1.4%)], weight gain [Δ = -0.7 g · kg-1 · d-1 (95% CI: -1.3, 0.0 g · kg-1 · d-1)], and length of stay [D = 2.0 d (95% CI: -1.7, 5.8 d)] in children ·-4 mo of age. In children ≥23 mo of age, the recovery rate of SMS-RUTF was inferior to that of P-RUTF [ITT: Δ = -20.8% (95% CI: -29.9%, -11.7%); PP: -17.2% (95% CI: -25.6%, -8.7%)]. Treatment with SMS-RUTF resulted in a greater increase in hemoglobin [0.670 g/dL (95% CI: 0.420, 0.921 g/dL); P < 0.001]. Treatment with both RUTFs resulted in the replenishment of all of the amino acids tested except for methionine. There were no differences at discharge between RUTF groups in fat mass [Δ = 0.3 kg (95% CI: -0.6, 1.6 kg); P = 0.341] or fat mass index [Δ = 0.4 kg/m2 (95% CI: -0.3, 1.1 kg/m2); P = 0.262]. By contrast, comparisons of fat-free mass indicated lower concentrations than the community controls after treatment with either of the 2 RUTFs [Δ = -1.3 kg (95% CI: -2.4, -0.1 kg) and P = 0.034 for comparison between community controls and the SMS-RUTF group; Δ = -1.8 kg (95% CI: -2.9, -0.6 kg) and P = 0.003 for comparison between community controls and the P-RUTF group]. Conclusion: SMS-RUTF can be used to treat SAM in children aged ·24 mo to reduce the costs of CMAM programs. More research is required to optimize SMS-RUTF for younger children. This trial was registered in the Pan African Clinical Trial Registry as PACTR201303000475166.SCOPUS: ar.jinfo:eu-repo/semantics/publishe