A predictive model and socioeconomic and demographic determinants of under-five mortality in Sierra Leone.

Sierra Leone is among the countries that recorded high under-five child mortality rate in the world. To design and implement policies that can address this public health challenge, the present study developed a predictive model of factors that explained under-five mortality in Sierra Leone using the 2008 and 2013 Sierra Leone Demographic and Health Survey (SDHS) datasets. LASSO regression technique was used to select the predictors to build the under-five predictive single-level logit and multilevel logit models. Statistical analyses were performed in the R freeware version 3.6.1. About 588 (10.4%) and 1320 (11.1%) children under five were reported dead in 2008 and 2013, respectively. The significant predictors of under-five mortality in Sierra Leone were the total number of children ever born, number of children under five in the household, mother's birth in the last five years, mother's number of living children, and number of household members, household wealth, maternal contraceptive use and intention, number of eligible women in the household, type of toilet facility, sex of the child, and weight of the child at birth. The study identified certain predictors that deserve policy attention and interventions to strengthen the efforts of creating child welfare and survival atmosphere in Sierra Leone

Relationship Between Nutritional Status of Children Under Five with Parents Who Work

Background: Indonesia is one of 117 countries which has three crucial nutritional problems in children under fives, such as stunting, wasting and overweight. This study is important because nutritional status of children under fi ve years old was closely related with economic factors. While economic conditions of families depend on the work of both parents.Methods: The study design was cross sectional based on health research “Riskesdas 2007 and 2013”. Type of research was quantitative and qualitative methods. Samples consisted of children under fi ves years old of whom their parents were still alive and have completed the information for the questionnaires. The informants of the qualitative research came from caregivers, district nutrition offi cer, sub-district nutrition offi cer, district labor offi ce, and parliament at district. Quantitative data was processed and analyzed by SPSS version 15 under the licensed of NIHRD MOH RI. While primary data was explored by indepth interview and analyzed using content analyses. Result: There was no relationship between parents who were both working with the nutritional status of children under fi ves based on indicators: weight/age p= 0,77 (2007), p = 0,92 (2013); height/age p = 0,58 (2007), p = 0,71 (2013); weight/height p = 0,77 (2007), p =,33 (2013). These qualitative results were confi rmed by informants\u27 opinions that the nutritional status of children under fi ves years were not differ between those whose parents are working and not working. Conclusion: The analysis whether quantitative or qualitative found there was no signifi cant relationship between the nutritional status of children under fi ves to those both of the parents working. Recommendation: Nutritional problems should be solved inter-sectoraly, it does not guarantee that only the economic capacity to bring about positive impacts the nutritional status of children under five

The comparison of under-five-children’s nutrition status among ethnic groups in North of Iran, 1998 - 2013; Results of a three stages cross-sectional study

Background: Despite improvements in child health, malnutrition still remains one of the main public health challenges in Iran. Objectives: The aim of this study was to compare under nutrition among under-five children with regard to ethnicity in rural area in north Iran. Patients and Methods: In three cross-sectional studies 7575 subjects in three time-periods including 2339 children in 1998, 2749 in 2004, and 2487 in 2013, were evaluated. All under-five-children in 20 out of 118 villages were chosen by random sampling and assessed. Under nutrition was defined as underweight, stunting and wasting lower than -2 SD (Z < -2 SD). Results: Generally, stunting was declined 17.1% and underweight and wasting were increased 0.9% and 1%, respectively during 15 years (1998 - 2013). Underweight increased 0.5% in Fars-natives and 3.2% in Turkmans and it was decreased 0.9% in Sistanis. Statistical difference in Turkman children among the three stages of the study was significant (P = 0.001). Stunting has decreased 28.7% in Fars-natives and 35.1% in Sistanis, it was increased 9.3% in Turkman group. Statistical differences among three stages in inter-ethnic groups were significant (P = 0.001 for all). Compared the group with good economic status, the odds ratio was 1.831 in poor economic group (P = 0.001). The risk of under nutrition in Sistanis was 1.754 times more than in Fars-natives (P = 0.001). Conclusions: Under nutrition remains one of the main health problems in under-five-year children in north Iran being more common in Sistani children. Stunting in Sistani children deeply decreased while in Turkman children slightly increased during the 15-year period study. Poor economic status is a risk factor for under nutrition in this area. © 2015, Growth & Development Research Center

High Effective Coverage of Vector Control Interventions in Children After Achieving Low Malaria Transmission in Zanzibar, Tanzania.

\ud \ud Formerly a high malaria transmission area, Zanzibar is now targeting malaria elimination. A major challenge is to avoid resurgence of malaria, the success of which includes maintaining high effective coverage of vector control interventions such as bed nets and indoor residual spraying (IRS). In this study, caretakers' continued use of preventive measures for their children is evaluated, following a sharp reduction in malaria transmission. A cross-sectional community-based survey was conducted in June 2009 in North A and Micheweni districts in Zanzibar. Households were randomly selected using two-stage cluster sampling. Interviews were conducted with 560 caretakers of under-five-year old children, who were asked about perceptions on the malaria situation, vector control, household assets, and intention for continued use of vector control as malaria burden further decreases. Effective coverage of vector control interventions for under-five children remains high, although most caretakers (65%; 363/560) did not perceive malaria as presently being a major health issue. Seventy percent (447/643) of the under-five children slept under a long-lasting insecticidal net (LLIN) and 94% (607/643) were living in houses targeted with IRS. In total, 98% (628/643) of the children were covered by at least one of the vector control interventions. Seasonal bed-net use for children was reported by 25% (125/508) of caretakers of children who used bed nets. A high proportion of caretakers (95%; 500/524) stated that they intended to continue using preventive measures for their under-five children as malaria burden further reduces. Malaria risk perceptions and different perceptions of vector control were not found to be significantly associated with LLIN effective coverage While the majority of caretakers felt that malaria had been reduced in Zanzibar, effective coverage of vector control interventions remained high. Caretakers appreciated the interventions and recognized the value of sustaining their use. Thus, sustaining high effective coverage of vector control interventions, which is crucial for reaching malaria elimination in Zanzibar, can be achieved by maintaining effective delivery of these interventions

Under-5 Mortality in Tanzania: A Demographic Scenario.

The government of the United Republic of Tanzania has initiated the Integrated Management of Childhood Illness program to improve the health and wellbeing of children. Tanzania's under-five mortality rate is still 1.7 times higher than the world average and, in order to achieve its Millennium Development Goal 4 target, its annual reduction rate is quite low at 2.2. The main aim of the study is to examine under-five mortality combined with the Data from the Tanzania Demographic and Health Survey 2008 data was used. Odds ratios for infant and under-five mortality were estimated using logistic regression; crude and adjusting models were adopted. Mortality cases (18.3%) have been reported to children born with an interval of <24 months. Mothers with no education reported 14.6%, primary education mothers reported 11.1% and higher education reported only 5.3% (P<0.001). Therefore, maternal education plays is a major role on fertility and infant and under-five mortality behavior. Maternal education also influences a mother's behavior in her usage of available health services to improve the health of the children. Further in-depth analysis is immensely needed in this situation

Pengaruh Kepatuhan Minum Obat Anti Tuberkulosis dan Tingkat Konsumsi Energi Protein terhadap Perubahan Status Gizi Balita Gizi Buruk Penderita Tb Paru (Studi di Kecamatan Kesambi Kota Cirebon)

Kepatuhan minum obat anti tuberkulosis dan tingkat konsumsi energi protein merupakan kunci keberhasilan dalam penanganan status gizi balita gizi buruk penderita TB Paru. Penelitian ini bertujuan untuk mengetahui pengaruh kepatuhan minum obat anti tuberkulosis dan tingkat konsumsi energi protein terhadap perubahan status gizi balita gizi buruk penderita TB Paru di Kecamatan Kesambi Kota Cirebon. Jenis penelitian adalah explanatory research, menggunakan metode survei dengan pendekatan cross sectional. Populasi penelitian adalah sebanyak 30 balita, sedangkan besar sampel adalah semua populasi yaitu 30 balita.Pengambilan sampel dalam penelitian ini dilakukan dengan purposive. Adapun uji statistik yang digunakan adalah regresi linier sederhana dan regresi berganda variabel dummy. Hasil penelitian menunjukkan bahwa dari 30 balita yang menjadi sampel, 86,67% balita patuh minum obat anti tuberkulosis, 50,00% mempunyai tingkat kecukupan energi kurang (< 80% AKG), 3,33% balita mempunyai tingkat kecukupan protein kurang (< 80% AKG), dan 86,67% balita mengalami kenaikan status gizi (delta Z score). Hasil analis statistik menunjukkan ada pengaruh kepatuhan minum obat anti tuberkulosis terhadap perubahan status gizi balita (p 0,003), ada pengaruh tingkat konsumsi energi terhadap peubahan status gizi balita (p 0,000), ada pengaruh tingkat konsumsi protein terhadap perubahan status gizi balita (p 0,000), dan ada pengaruh kepatuhan minum obat anti tuberkulosis dan tingkat konsumsi energi protein terhadap perubahan status gizi balita (p 0,000). Kata Kunci: Kepatuhan minum obat, tuberkulosis, konsumsi energi protein, status gizi, balita, Cirebon The obedience in drinking anti tuberculosis and the level of protein energy consumption is the key of success in handling children under five nutrient status bad nutrient of lung tuberculosis patient. In order to know how far the handling success, both of the influences need to be examined in details. This research has purpose to know the influence of adherence of drinking anti tuberculosis medicine and the level of protein energy consumption against the change of children under five nutrient status, bad nutrient of lung tuberculosis patient at Kesambi Sub District, Cirebon City. Kind of research is explanatory research by using observation method with longitudinal approach. The reseach population is in the amount of 30 children under five, meanwhile the sample amount is all population, namely 30 children under five. The sample taking in the research conducted purposively. The statistical test that was used in this research was simple linear regression and multiple regression of variable dummy. The result of research indicates that from 30 children under five being the sample, 86,67% of children under five obey to drink anti tuberculosis, 50,00% has less energy sufficiency level (< 80% AKG), 3,33% of children under five have less a protein sufficiency level (<80% AKG, and 86,67% of children under five have the increasing of nutritional status (delta Z score). The result of statistical analysis indicates that there is an influence of obedience in drinking anti tuberculosis against the change of children under five nutritional status (p=0,000), there is an influence of energy consumption level against the change of children of under five nutritional status (p=0,000), there is also and influence of protein consumption level against the change of children under five nutritional status (p=0,000) and finally there is an influence of obedience in drinking anti tuberculosis medicine and protein energy consumption level against the change of children under five nutritional status (p=0,000). Keyword: Obedience in drinking tuberculosis medicine, protein energy consumption, nutritional status, children under five, Cirebo

Anthropometric Patterns and Correlates of Growth Attainment in Under-five Pakistani Children

This study investigates the question whether socio-economic, demographic and environmental variables within a household will affect the growth patterns of under-five Pakistani children. It also examines whether there are differentials in the growth patterns of these children by age and gender. Using the 1990-91 Demographic and Health Survey data, the focus is on children under-five years, the total children identified were 5902 while anthropometric measurement to assess the growth status was available for 4079 children. The results showed that nearly all the socio-demographic, economic and environmental variables were significantly associated with H/A and Wt/A. Children most likely to be stunted and underweight were those whose mothers were aged 40–44 years, mothers with no education, children from rural areas and children with birth interval 24 months, mother’s age, her education and having toilet facilities in the house positively associated with growth attainment. For the Weight/A model succeeding birth interval >24 months, mother’s age, her education and having toilet facilities and electricity in the house, and living in Punjab and NWFP province positively associated with growth attainment. This study will be useful for policy-makers to develop programmes and guidelines needed to improve those socio-economic, demographic and environmental factors, responsible for the poor nutritional status of children under-five years of age in Pakistan.