Factors associated with stunting and catch-up growth among under-five children in Nairobi informal settlements
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Date
2019
Authors
Faye, Cheikh Mbacke
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Abstract
Childhood stunting is a public health concern in many low-and-middle income countries, as
it is associated with both short-term and long-term negative effects on child cognitive development,
physical health, and schooling outcomes. There is paucity of studies on recovery
from stunting among under five children in these countries. Most studies focused on the
recovery much later in adolescence. We used longitudinal data from two Nairobi urban settlements
to determine the incidence of recovery from stunting and understand the factors
associated with post-stunting linear growth among under-five children. A total of 1,816 children
were recruited between birth and 23 months and were followed-up until they reached
five years. We first looked at the time to recover from stunting using event history analysis
and Cox regression. Second, we used height-for-age z-score slope modelling to estimate
the change in linear growth among children who were stunted. Finally, we fitted a linear
regression model of the variation in HAZ on a second degree fractional polynomials in child’s
age to identify the factors associated with post-stunting linear growth. The principal findings
are: i) the incidence of recovery from stunting was 45% among stunted under-five children in
the two settlements; ii) timely child immunization, age at stunting, mother’s parity and household
socioeconomic status are important factors associated with time to recover from stunting
within the first five years of life; and iii) child illness status and age at first stunting,
mother’s parity and age have a strong influence on child post-stunting linear growth. Access
to child health services and increased awareness among health professionals and child
caregivers, would be critical in improving child growth outcomes in the study settings. Additionally,
specific maternal and reproductive health interventions targeting young mothers in
the slums may be needed to reduce adolescent and young mother’s vulnerability and
improve their child health outcomes
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Faye, Cheikh Mbacke, Factors associated with stunting and catch-up growth among under-five children in Nairobi's informal settlements, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/29764>