Undernutrition, polygynous context and family structure

A multilevel analysis of cross-sectional surveys of 350 000 mother–child pairs from 32 countries

Dados Bibliográficos

ID21881758
AutoresSeun Anjorin (0000-0003-0187-6410, University of Warwick), Olalekan Abdulrahman Uthman (0000-0002-8567-3081, University of Warwick), Edward Kwabena Ameyaw (0000-0002-6617-237X, University of Technology Sydney), Bright Opoku Ahinkorah (0000-0001-7415-895X, University of Technology Sydney), Vijay Kumar Chattu (0000-0001-9840-8335, University of Toronto), Bishwajit Ghose (0000-0003-4461-3821, University of Ottawa), Ghose Bishwajit (University of Ottawa), Abdul-Aziz Seidu (0000-0001-9734-9054, University of Cape Coast), Eugene Kofuor Maafo Darteh (0000-0003-4689-8891, University of Cape Coast), Sanni Yaya (0000-0002-4876-6043, University of Ottawa, autor correspondente)
Ano2020
Volume5
Fascículo10
Páginase002637
Data de publicação2020-10-01
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoBMJ Global Health (JOURNAL)
Identificadores do periódicoISSN: 2059-7908 • E-ISSN: 2059-7908
EditoraBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2020-002637
PMID33060094
OpenAlexW3093218024
IdiomaEN
Citações recebidas7
Referências citadas35

BACKGROUND: Contextual factors, especially where people live, has been linked to various health outcomes, therefore, there is an increasing focus on its implication for policies and implementation of health interventions. Polygyny is a widespread practice in sub-Saharan Africa that also reflects socioeconomic and sociocultural features. This study investigated the association between polygynous context and risk of undernutrition. METHODS: Recent Demographic and Health Surveys involving 350 000 mother-child pairs from 32 sub-Saharan African countries conducted between 2010 and 2018 as of March 2020, were analysed using relevant descriptive and 3-level multilevel logistic regression modelling. Undernutrition among under-5 was defined as underweight, stunting and wasting using the WHO Multicentre Growth Reference Study. Odd Ratio (OR) at 95% credible interval was used to report the associations. RESULTS: The prevalence of contextual polygyny varied widely across the 32 sub-Saharan African countries, the lowest (0%) found in one of the regions in South Africa and the highest (52%) in one of the regions in Uganda. Underweight, stunting and wasting were lowest in Uganda (3.5%, 9.3%-1.27%, respectively), stunting was highest in Mozambique (37.1%) while wasting was highest in Niger (7.7%). Furthermore, the results showed that the contextual prevalence of polygynous practice exacerbates the risk of underweight (1.003 (0.997-1.008)) and wasting (1.014 (1.007-1.021)) among under-5 children, even when gender inequality and sociodemographic indicators were adjusted for. Polygyny was negatively associated with stunting though not significant; multiple births had the strongest and positive association with the risk of undernutrition among under-5 children in sub-Saharan Africa. CONCLUSIONS: This study further corroborates the strong influence of contextual factors on health outcomes-which is undernutrition in this study. In addition to specific interventions aimed at reducing the prevalence of undernutrition, broader strategies that will address contextual issues are required

Body mass index · Cross-sectional study · Developing country · Economic growth · Environmental health · Geography · Logistic regression · Malnutrition · Polygyny · Population · Psychological intervention · Public health · Socioeconomic status · Sociology · Underweight · Wasting · Child Nutrition and Water Access · Demography · Gestational Diabetes Research and Management · Medicine · Sexual Differentiation and Disorders