Wasting and associated factors among children under 5 years in five South Asian countries (2014-2018) : analysis of demographic health surveys

Child wasting continues to be a major public health concern in South Asia, having a prevalence above the emergency threshold. This paper aimed to identify factors associated with wasting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent demographic and health surveys (2014–2018) of five countries in South Asia was combined. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. Wasting prevalence was higher for children aged 0–23 months (25%) as compared to 24–59 months (18%), with variations in prevalence across the South Asian countries. The most common factor associated with child wasting was maternal BMI [adjusted odds ratio (AOR) for 0–23 months = 2.02; 95% CI: (1.52, 2.68); AOR for 24–59 months = 2.54; 95% CI: (1.83, 3.54); AOR for 0–59 months = 2.18; 95% CI: (1.72, 2.77)]. Other factors included maternal height and age, household wealth index, birth interval and order, children born at home, and access to antenatal visits. Study findings suggest need for nutrition specific and sensitive interventions focused on women, as well as adolescents and children under 2 years of age

Factors associated with stunting among children under 5 years in five South Asian countries (2014-2018) : analysis of Demographic Health Surveys

South Asia continues to be the global hub for child undernutrition with 35% of children still stunted in 2017. This paper aimed to identify factors associated with stunting among children aged 0–23 months, 24–59 months, and 0–59 months in South Asia. A weighted sample of 564,518 children aged 0–59 months from the most recent Demographic and Health Surveys (2014–2018) was combined of five countries in South Asia. Multiple logistic regression analyses that adjusted for clustering and sampling weights were used to examine associated factors. The common factors associated with stunting in three age groups were mothers with no schooling ([adjusted odds ratio (AOR) for 0–23 months = 1.65; 95% CI: (1.29, 2.13)]; [AOR for 24–59 months = AOR = 1.46; 95% CI: (1.27, 1.69)] and [AOR for 0–59 months = AOR = 1.59; 95% CI: (1.34, 1. 88)]) and maternal short stature (height < 150 cm) ([AOR for 0–23 months = 2.00; 95% CI: (1.51, 2.65)]; [AOR for 24–59 months = 3.63; 95% CI: (2.87, 4.60)] and [AOR for 0–59 months = 2.87; 95% CI: (2.37, 3.48)]). Study findings suggest the need for a balanced and integrated nutrition strategy that incorporates nutrition-specific and nutrition-sensitive interventions with an increased focus on interventions for children aged 24–59 months

Past drivers of and priorities for child undernutrition in South Asia : a mixed methods systematic review protocol

BACKGROUND: South Asia has one of the largest proportions of undernourished children in the world, especially stunting, wasting, and underweight as well as micronutrient deficiencies such as the deficiency of iron, vitamin A, and zinc. Undernutrition continues to pose a major threat to this region's economic and social growth. This systematic review aims to assess the drivers and identify priorities for child undernutrition in South Asia. It aims to appraise, synthesise, and summarise literature to create an evidence base that looks at multiple faces of macro and micro child undernutrition in South Asia. METHODS: A systematic review of published and grey literature on child undernutrition, including macro and micronutrient deficiencies, in South Asia covering the period January 2000 to September 2019 will be undertaken. Studies with all relevant study designs and those published in English will be considered for inclusion. Five academic databases will be searched: CINAHL, EMBASE, PubMed, PsycINFO, and Scopus, in addition to various grey literature sources. The analysis will incorporate a narrative synthesis, meta-ethnography or a meta-analysis as appropriate, depending on the nature of the retrieved data. Quality of the included studies will be assessed by validated tools. The UNICEF conceptual framework on child undernutrition will be used to frame findings. DISCUSSION: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. The protocol gives an insight into the scope and parameters for the systematic review to be carried out. SYSTEMATIC REVIEW REGISTRATION: The protocol was registered by the PROSPERO international prospective register of systematic reviews, reference CRD42018112696

COVID-19 and “ageing well” for the older migrants and refugees in rural Australia : the case of Bhutanese elders in Albury, New South Wales

Purpose The purpose of this study is to highlight the challenges and opportunities for the well-being of older migrants and refugees in rural Australia by learning from the example of the Bhutanese community in Albury, New South Wales. Design/methodology/approach This viewpoint focusses on health and aged care barriers that affect the well-being of older migrants and refugees in Australia. It also demonstrates how these can be intensified due to the COVID-19 pandemic. Findings Engagement though agriculture, and a sense of "belonging" strengthen the cultural well-being of the Bhutanese older adults in Albury. However, major issues remain as health-related resources and information are lacking in rural Australia. How this group's meaningful activities in Albury enabled collaborations to be built is shown in this working example and can provide lessons for other communities that experience similar problems of disconnection as they get older. Research limitations/implications The information regarding the Bhutanese older adults in Albury is primarily based on the authors' personal communication with the General Secretary of the Bhutanese Australian Community Support Group in Albury Wodonga Inc. Originality/value Australia's older population is growing rapidly, and older adults from culturally and linguistically diverse migrant and refugee backgrounds face numerous barriers such as limited linguistic, health and digital literacy. The authors describe common health and aged care issues that affect the well-being of older adults in rural Australia. They particularly emphasize those that occurred or intensified due to the COVID-19 pandemic. This novel information is now especially relevant to the health and aged care sectors in changing and diverse communities not only in Australia but also overseas

The effectiveness of interventions on nutrition social behaviour change communication in improving child nutritional status within the first 1000 days : evidence from a systematic review and meta-analysis

This systematic review and meta-analysis aimed to assess the robustness of designs and tools used in nutrition social behaviour change communication (NSBCC) interventions and establish their effectiveness. EBSCOhost as an umbrella database including Medline (Ovid) and CINAHL, EMBASE, and ProQUEST databases were searched for peer-reviewed articles from January 1960 to October 2018. Additional sources were searched to identify all relevant studies including grey literature. Studies' biases were assessed according to Cochrane handbook. Pooled estimate of effectiveness of interventions on infant and young child feeding (IYCF) practices and child nutritional status with 95% confidence intervals were measured using random-effects models. Eighty studies were included in this review: Fifty-one (64%) were cluster randomised controlled trials (RCTs), 13 (16%) were RCTs and 16 (20%) quasi-experimental. Of the included studies, 22 (27%) measured early initiation of breastfeeding, 38 (47%) measured exclusive breastfeeding, 29 (36%) measured minimum dietary diversity, 21 (26%) measured minimum meal frequency, 26 (32%) measured height for age z-scores (HAZ), 23 (29%) measured weight for height z-scores (WHZ), 27 (34%) measured weight for age z-scores (WAZ), 20 (25%) measured stunting, 14 (17%) measured wasting, and 11 (14%) measured underweight. The overall intervention's effect was significant for exclusive breastfeeding (EBF) (odds ratio = 1.73; 95% confidence interval [CI]: 1.35–2.11, p < 0.001), HAZ (standardized mean differences [SMD] = 0.19; 95% CI: 0.17–0.21; p < 0.001), WHZ (SMD = 0.02; 95% CI: 0.004–0.04; p < 0.001), and WAZ (SMD = 0.04; 95% CI: 0.02–0.06; p < 0.001). Evidence shows the effectiveness of NSBCC in improving EBF and child anthropometric outcomes. Further research should test the impact on child nutritional status with clearly specified and detailed NSBCC interventions

Do practices such as dowry and bride prices relate to violence among migrants in OECD countries? : a mixed methods systematic review protocol

This systematic review aims to make a significant contribution to knowledge on dowry and bride price practices in Organisation for Economic Co-operation and Development (OECD) countries, with a focus on Sudan, Zimbabwe and India. While, existing research evidences the ongoing prevalence of dowry and bride price among some migrant communities, there remains substantial gaps in research. The protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. It highlights the scope and methodology for the systematic review to be conducted. Studies will be included if they: (i) were conducted in English; (ii) if they were published between December 1993 and December 2019 because this is the period the dowry-related violence was included into the Declaration on the Elimination of Violence Against Women (iii) used qualitative, quantitative methods or mixed methods; were peer reviewed or grey literature; and (iv) covered analysed dowry and bride price practices and its impact among migrant communities in the OECD countries. Data extraction will be informed by the Joanna Briggs Institute Review for Systematic Reviews and Research Syntheses. The quality of evidence of the studies included will be assessed using the Joanna Briggs Institute tool for qualitative and quantitative studies, the Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) tool for grey literature and the Mixed Methods Appraisal Tool (MMAT) tool for mixed methods studies. Kappa statistics agreement will be used as an additional step to ensure quality ratings are fair and valid. The findings will be summarised into themes and narrated

“Our riches are our family” : the changing family dynamics & social capital for new migrant families in Australia

Immigration from collectivist cultures to Western countries often results in loss of social capital and changing family dynamics leading to isolation and acculturative stress. This study explored the impact of social and cultural changes experienced by seven migrant communities residing in Greater Western Sydney, Australia. It deconstructed the role of local community and networks in their initial settlement in absence of traditional forms of community support. Data were collected through fourteen focus group discussions (164 participants). Five major themes emerged: (i) changing gender roles and women empowerment; (ii) sending money home; (iii) culture shock and increased intercultural conflict; (iv) change in lifestyle from collective to individual culture; and (v) role of extended community in mitigating culture shock. These findings suggest that community interventions aimed at improving cultural and social engagement of migrants employ social capital framework. This will ensure enhanced communication within migrant families and communities from different cultural and linguistic backgrounds

Improving complementary feeding through community-based management of malnutrition in rural India

A baseline survey conducted during 2012 among selected districts with extremely marginalized populations in Bihar, Chhattisgarh, Jharkhand, and Odisha revealed high rates of malnutrition and poor infant and young child feeding (IYCF) practices. Among 3,489 children surveyed, 60.2 percent were stunted, 55.1 percent were underweight, and 24.4 percent were wasted. Only 23.9 percent of the children age 6–36 months received appropriate feeding from diverse food groups (AAM Unpublished). To address this issue, in 2012, the Action Against Malnutrition (AAM) project was created to attempt to effectively manage child malnutrition at the community level in seven blocks of these states. It targets children from birth to three years and is implemented collaboratively by the Public Health Resource Society, and the nongovernmental organizations Child in Need Institute, Chaupal, Ekjut, and Idea. The project will end in April 2016 and is financially supported by the Jamsetji Tata Trust

Addressing the Needs of Syrian and Iraqi Refugees in the Greater Blue Mountain Region: A Formative Assessment of Health and Community Services Needs

In the wake of recent global events, an increasing number of people have been forcibly displaced from their homes as a result of war, violence and human rights violations or for reasons of race, religion, nationality, political opinion or membership in a particular ethnic group. As a response to the global humanitarian crisis and ongoing conflict in Iraq and Syria, the Australian Government in 2015 committed to an intake of 12,000 humanitarian migrants[1] in addition to the humanitarian yearly intake. These Iraqi and Syrian refugee communities come with an extended background of war and displacement and it is imperative to understand their specific health needs and the impact of pre- and post-migration stressors on their mental health and well-being. It is possible that they may suffer from chronic health conditions, nutritional deficiencies and psychological problems. However, presently there is limited understanding of the growing health needs of these new refugees and the capacity of the system to adapt to their needs.[2] This research conducted a preliminary health needs assessment of the Iraqi and Syrian refugees living in the Nepean Blue Mountains region and assessed the services available to them. It focussed on understanding the (mental) health needs and priorities of the Iraqi and Syrian refugee communities and mapping these with the existing services to identify any gaps and challenges. Focus group discussions were conducted with the Iraqi and Syrian communities. Service providers who provide health, mental health, community and settlement services to migrants and refugees in the Nepean Blue Mountains Primary Health Network (NBMPHN) region were interviewed

Assessing the Impact of Post Migration Lifestyle Changes on Migrant Settlement Trajectories

Migration is a complex phenomenon which brings with it settlement and integrationrelated challenges. The research attempted to holistically view migrants’ settlement journeys as they cope with the dynamics of changing culture, society and socio-economic status. The research looked at successful settlement through the lens of migrants’ self-defined paths, journeys, contexts and experiences surrounding their migration and settlement. It focused on post-migration lifestyles and life experiences amongst seven migrant communities residing in Greater Western Sydney with regard to changes in income, employment status, social status, family dynamics, English language proficiency, availability of settlement services, and cultural integration