Individual and contextual factors associated with childhood malnutrition:a multilevel analysis of the double burden of childhood malnutrition in 27 countries
作者机构：JhpiegoPlot 971Rueben Okoya CrescentOff Okonjo Iweala StreetWuye DistrictAbujaFCTNigeria Division of Health SciencesWarwick Centre for Global HealthWarwick Medical SchoolUniversity of WarwickCoventry CV47ALUK
出 版 物：《Global Health Research and Policy》 (全球健康研究与政策（英文）)
年 卷 期：2022年第7卷第1期
页 面：69-80页
学科分类：08[工学] 0812[工学-计算机科学与技术（可授工学、理学学位）]
主 题：Multilevel Malnutrition Childhood
摘 要：Background:Malnutrition is a key global health challenge and a major contributor to childhood morbidity and *** recent times,the contrasting coexistence of undernutrition including micronutrient deficiencies and overweight/obesity called double burden of malnutrition has been noted at individual,household or population level and/or at different times in *** objective of this study was to examine individual,neighborhood and country level factors that are associated with the double burden of childhood ***:We conducted multivariable multilevel logistic regression analyses on the most recent demographic and health datasets from surveys conducted between 2015 and 2020 in low-and middle-income *** analyzed data of 138,782 children(level 1)living in 13,788 communities(level 2)from 27 countries(level 3).Results:The results of our analysis show variation in childhood malnutrition across the 27 countries from as low as 6.5%in Burundi to as high as 29.5%in Timor *** adjusting for all level factors,we found that those who were wasted/overweight tended to have had an episode of diarrhea or fever in the last two weeks preceding the survey,were part of a multiple birth,were being breastfed at the time of the survey and born to mothers with more than one under 5-child resident in neighborhoods with high illiteracy and unemployment *** intra-neighbourhood and intra-country correlation coefficients were estimated using the intercept component variance;44.3%and 21.0%of variance in odds of double burden of childhood malnutrition are consequent upon neighborhood and country level factors ***:Evidence of geographical clustering in childhood malnutrition at community and country levels was found in our study with variability due to neighborhood level factors twice that of country level ***,strategies in tackling the double burden of malnutrition must consider these shared drivers,contextual barriers a
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