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首页> 外文期刊>BMC Pediatrics >Determinants of stunting and severe stunting among Burundian children aged 6-23 months: evidence from a national cross-sectional household survey, 2014
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Determinants of stunting and severe stunting among Burundian children aged 6-23 months: evidence from a national cross-sectional household survey, 2014

机译：6-23个月大的布隆迪儿童发育迟缓和严重发育迟缓的决定因素：2014年全国横断面家庭调查的证据

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Burundi is one of the poorest countries and is among the four countries with the highest prevalence of stunting (58%) among children aged less than 5 years. This situation undermines the economic growth of the country as undernutrition is strongly associated with less schooling and reduced economic productivity. Identifying the determinants of stunting and severe stunting may help policy-makers to direct the limited Burundian resources to the most vulnerable segments of the population, and thus make it more cost effective. This study aimed to identify predictors of stunting and severe stunting among children aged less than two years in Burundi. The sample is made up of 6199 children aged 6 to 23 months with complete anthropometric measurements from the baseline survey of an impact evaluation study of the Performance-Based financing (PBF) scheme applied to nutrition services in Burundi from 2015 to 2017. Binary and multivariable logistic regression analyses were used to examine stunting and severe stunting against a set of child, parental and household variables such as child’s age or breastfeeding pattern, mother’s age or knowledge of malnutrition, household size or socio-economic status. The prevalence of stunting and severe stunting were 53% [95%CI: 51.8-54.3] and 20.9% [95%CI: 19.9-22.0] respectively. Compared to children from 6-11 months, children of 12-17 months and 18-23 months had a higher risk of stunting (AdjOR:2.1; 95% CI: 1.8-2.4 and 3.2; 95% CI: 2.8-3.7). Other predictors for stunting were small babies (AdjOR=1.5; 95% CI: 1.3-1.7 for medium-size babies at birth and AdjOR=2.9; 95% CI: 2.4-3.6 for small-size babies at birth) and male children (AdjOR=1.5, 95% CI: 1.4-1.8). In addition, having no education for mothers (AdjOR=1.6; 95% CI: 1.2-2.1), incorrect mothers’ child nutrition status assessment (AdjOR=3.3; 95% CI: 2.8-4), delivering at home (AdjOR=1.4; 95% CI: 1.2-1.6) were found to be predictors for stunting. More than to 2 under five children in the household (AdjOR=1.45; 95% CI: 1.1-1.9 for stunting and AdjOR= 1.5; 95% CI: 1.2-1.9 for severe stunting) and wealth were found to be predictors for both stunting and severe stunting. The factors associated with stunting were found to be applicable for severe stunting as well. Mother’s education level, mother’s knowledge about child nutrition status assessment and health facility delivery were predictors of child stunting. Our study confirms that stunting and severe stunting is in Burundi, as elsewhere, a multi-sectorial problem. Some determinants relate to the general development of Burundi: education of girls, poverty, and food security; will be addressed by a large array of actions. Some others relate to the health sector and its performance – we think in particular of the number of children under five in the household (birth spacing), the relationship with the health center and the knowledge of the mother on malnutrition. Our findings confirm that the Ministry of Health and its partners should strive for better performing and holistic nutrition services: they can contribute to better nutrition outcomes.
机译：布隆迪是最贫穷的国家之一，在4岁以下的儿童中，发育迟缓的患病率最高（58％）。这种状况破坏了该国的经济增长，因为营养不足与教育程度下降和经济生产率下降密切相关。确定发育迟缓和严重发育迟缓的决定因素可能有助于决策者将有限的布隆迪资源用于人口中最脆弱的人群，从而使其更具成本效益。这项研究旨在确定布隆迪两岁以下儿童发育迟缓和严重发育迟缓的预测因素。该样本由6199名6到23个月大的儿童组成，他们通过对基于绩效的筹资（PBF）计划从2015年至2017年在布隆迪的营养服务进行的影响评估研究的基线调查进行了完整的人体测量学测量。二元和多变量逻辑回归分析用于检查一组儿童，父母和家庭变量（例如孩子的年龄或母乳喂养方式，母亲的年龄或营养不良知识，家庭人数或社会经济状况）的发育迟缓和严重发育迟缓。发育迟缓和严重发育迟缓的患病率分别为53％[95％CI：51.8-54.3]和20.9％[95％CI：19.9-22.0]。与6-11个月的儿童相比，12-17个月和18-23个月的儿童发育迟缓的风险更高（调整率：2.1; 95％CI：1.8-2.4和3.2; 95％CI：2.8-3.7）。其他发育迟缓的预测指标是小婴儿（AdjOR = 1.5; 95％CI：中型婴儿出生时1.3-1.7; AdjOR = 2.9; 95％CI：2.4-3.6出生时小型婴儿） AdjOR = 1.5，95％CI：1.4-1.8）。此外，没有接受过母亲的教育（AdjOR = 1.6; 95％CI：1.2-2.1），不正确的母亲对儿童的营养状况评估（AdjOR = 3.3; 95％CI：2.8-4），在家分娩（AdjOR = 1.4） ; 95％CI：1.2-1.6）是发育迟缓的预测因子。发现家庭中五岁以下儿童中有2个以上（发育迟缓= 1.45; 95％CI：1.1-1.9;严重发育迟缓AdjOR = 1.5; 95％CI：1.2-1.9）和财富都是发育迟缓的预测因素和严重的发育迟缓。发现与发育迟缓相关的因素也适用于严重发育迟缓。母亲的受教育程度，母亲对儿童营养状况评估的知识以及提供医疗机构的知识是儿童发育迟缓的预测因素。我们的研究证实，与其他地方一样，布隆迪的发育迟缓和严重发育迟缓是一个多部门的问题。与布隆迪的总体发展有关的一些决定因素是：女童的教育，贫穷和粮食安全;将通过一系列动作来解决。其他一些与卫生部门及其绩效有关–我们尤其考虑家庭中五岁以下儿童的数量（生育间隔），与卫生中心的关系以及母亲对营养不良的知识。我们的研究结果证实，卫生部及其合作伙伴应努力争取提供更好的绩效和全面的营养服务：它们可以为改善营养结果做出贡献。

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