INTRODUCTION: Child undernutrition is a major risk factor for child mortality and adult ill-health. Despite substantial progress in most health indicators, undernutrition remains high in Sri Lanka, with recent trends being unclear, owing to methodological differences in national surveys. METHODS: This study uses data from the 1987, 1993, 2000 and 2006-07 Demographic and Health Surveys (DHS) and the 2009 Nutrition and Food Security Survey (NFSS) to investigate trends and determinants of child undernutrition in Sri Lanka. The prevalence rates of stunting, underweight and wasting were re-estimated using the 2006 WHO growth standards to ensure consistency. Multivariate regression analysis was then undertaken to analyse the determinants of height-forage in children aged 9-23 months, and 24-59 months, and the relative impact of key factors was assessed using prediction models. RESULTS: Stunting and wasting substantially improved from 1987 to 2000, but rates stagnated from 2000 to 2006/07. Whilst economic inequalities in under nutrition were greater than in most other countries, the multivariate analysis found that maternal height, household wealth, length of breast-feeding and altitude are significant determinants of stunting, but differences in child feeding practices and other factors were not. Of these, maternal height and household wealth had the most influence. CONCLUSION: The results are consistent with the finding that food insecurity is the main driver of undernutrition, but more research is required to validate this. The strong relationship of child height with maternal height suggests that epigenetic factors, proxied by short maternal height, constrain the applicability of the WHO growth standards in Sri Lanka.
INTRODUCTION:Child undernutrition is a major risk factor for child mortality and adult ill-health. Despite substantial progress in most health indicators, undernutrition remains high in Sri Lanka, with recent trends being unclear, owing to methodological differences in national surveys. METHODS: This study uses data from the 1987, 1993, 2000 and 2006-07 Demographic and Health Surveys (DHS) and the 2009 Nutrition and Food Security Survey (NFSS) to investigate trends and determinants of child undernutrition in Sri Lanka. The prevalence rates of stunting, underweight and wasting were re-estimated using the 2006 WHO growth standards to ensure consistency. Multivariate regression analysis was then undertaken to analyse the determinants of height-forage in children aged 9-23 months, and 24-59 months, and the relative impact of key factors was assessed using prediction models. RESULTS: Stunting and wasting substantially improved from 1987 to 2000, but rates stagnated from 2000 to 2006/07. Whilst economic inequalities in under nutrition were greater than in most other countries, the multivariate analysis found that maternal height, household wealth, length of breast-feeding and altitude are significant determinants of stunting, but differences in child feeding practices and other factors were not. Of these, maternal height and household wealth had the most influence. CONCLUSION: The results are consistent with the finding that food insecurity is the main driver of undernutrition, but more research is required to validate this. The strong relationship of child height with maternal height suggests that epigenetic factors, proxied by short maternal height, constrain the applicability of the WHO growth standards in Sri Lanka.
Authors: Elizabeth S Rose; Meridith Blevins; Lazaro González-Calvo; Elisée Ndatimana; Ann F Green; Melanie Lopez; Omo Olupona; Sten H Vermund; Troy D Moon Journal: BMC Nutr Date: 2015-12-17
Authors: N P G C R Naotunna; M Dayarathna; H Maheshi; G S Amarasinghe; V S Kithmini; M Rathnayaka; L Premachandra; N Premarathna; P C Rajasinghe; G Wijewardana; T C Agampodi; S B Agampodi Journal: BMC Public Health Date: 2017-01-10 Impact factor: 3.295
Authors: Giao Huynh; Quynh H Ngoc Huynh; Ngoc Han T Nguyen; Quang Thanh Do; Van Khanh Tran Journal: Biomed Res Int Date: 2019-02-05 Impact factor: 3.411
Authors: Peter D Sly; Brittany Trottier; David Carpenter; Ubon Cha'on; Stephania Cormier; Betsy Galluzzo; Samayita Ghosh; Fiona Goldizen; Michelle Heacock; Paul Jagals; Hari Datt Joshi; Prachi Kathuria; Le Thai Ha; Melina S Magsumbol; Panida Navasumrit; Poornima Prabhakaran; Banalata Sen; Chris Skelly; Inoka Suraweera; Sathiarany Vong; Chador Wangdi; William A Suk Journal: Ann Glob Health Date: 2019-02-25 Impact factor: 2.462