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Full-Text Articles in Medicine and Health Sciences
Effectiveness Of Unconditional Cash Transfers Combined With Lipid-Based Nutrient Supplement And/Or Behavior Change Communication To Prevent Stunting Among Children In Pakistan: A Cluster Randomized Controlled Trial, Sajid Bashir Soofi, Shabina Ariff, Gul Nawaz Khan, Atif Habib, Sumra Kureishy, Yasir Ihtesham, Masawar Hussain, Arjumand Rizvi, Muhammad Sajid, Zulfiqar Ahmed Bhutta
Effectiveness Of Unconditional Cash Transfers Combined With Lipid-Based Nutrient Supplement And/Or Behavior Change Communication To Prevent Stunting Among Children In Pakistan: A Cluster Randomized Controlled Trial, Sajid Bashir Soofi, Shabina Ariff, Gul Nawaz Khan, Atif Habib, Sumra Kureishy, Yasir Ihtesham, Masawar Hussain, Arjumand Rizvi, Muhammad Sajid, Zulfiqar Ahmed Bhutta
Department of Paediatrics and Child Health
Background: In Pakistan, the prevalence of stunting among children under-five years has remained above WHO critical thresholds (≥30%) over the last two decades.
Objective: We hypothesized that an unconditional cash transfer (UCT) combined with lipid-based nutrient supplement (LNS) and/or social and behavior change communication (SBCC) will prevent stunting among children 6-23 months of age.
Design: This was a four-arm, community-based cluster randomized controlled trial conducted in the district of Rahim Yar Khan, Pakistan. A total of 1729 children (UCT n = 434); (UCT+SBCC n = 433); (UCT+LNS n = 430) and (UCT+LNS+SBCC n = 432) were enrolled at 6 months …
Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem
Preconceptional Lipid-Based Nutrient Supplementation In 2 Low-Resource Countries Results In Distinctly Different Igf-1/Mtor Placental Responses, Marisol Castillo-Castrejon, Ivana V. Yang, Elizabeth J. Davidson, Sarah J. Borengasser, Purevsuren Jambal, Jamie Westcott, Jennifer F. Kemp, Ana Garces, Sumera Aziz Ali, Sarah Saleem
Community Health Sciences
Background: Preconceptional maternal small-quantity lipid-based nutrient supplementation (SQLNS) improved intrauterine linear growth in low-resource countries as demonstrated by the Women First Preconception Maternal Nutrition Trial (WF). Fetal growth is dependent on nutrient availability and regulated by insulin-like growth factor 1 (IGF-1) through changes in placental transfer capacity, mediated by the mechanistic target of rapamycin (mTOR) pathway.
Objectives: Our objective was to evaluate the role of placental mTOR and IGF-1 signaling on fetal growth in women from 2 low-resource countries with high rates of stunting after they received preconceptional SQLNS.
Methods: We studied 48 women from preconception through delivery who were …
Drivers Of Stunting Reduction In Peru: A Country Case Study, Luis Huicho, Elisa Vidal-Cárdenas, Nadia Akseer, Samanpreet Brar, Kaitlin Conway, Muhammad Islam, Elisa Juarez, Aviva Rappaport, Hana Tasic, Tyler Vaivada, Jannah Wigle, Zulfiqar Ahmed Bhutta
Drivers Of Stunting Reduction In Peru: A Country Case Study, Luis Huicho, Elisa Vidal-Cárdenas, Nadia Akseer, Samanpreet Brar, Kaitlin Conway, Muhammad Islam, Elisa Juarez, Aviva Rappaport, Hana Tasic, Tyler Vaivada, Jannah Wigle, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Peru reduced its under-5 child stunting prevalence notably from 31.3% in 2000 to 13.1% in 2016.
Objectives: We aimed to study factors and key enablers of child stunting reduction in Peru from 2000-2016.
Methods: Demographic and Health Surveys were used to conduct descriptive analyses [height-for-age z scores (HAZ) means and distributions, equity analysis, predicted child growth curves through polynomial regressions] and advanced regression analyses. An ecological (at department level) multilevel regression analysis was conducted to identify the major predictors of stunting decline from 2000 to 2016, and Oaxaca-Blinder decomposition was conducted to identify the relative contribution of each factor …
Stunting In Childhood: An Overview Of Global Burden, Trends, Determinants, And Drivers Of Decline, Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar Ahmed Bhutta
Stunting In Childhood: An Overview Of Global Burden, Trends, Determinants, And Drivers Of Decline, Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar Ahmed Bhutta
Woman and Child Health
Background: Progress has been made worldwide in reducing chronic undernutrition and rates of linear growth stunting in children under 5 y of age, although rates still remain high in many regions. Policies, programs, and interventions supporting maternal and child health and nutrition have the potential to improve child growth and development.
Objective: This article synthesizes the available global evidence on the drivers of national declines in stunting prevalence and compares the relative effect of major drivers of stunting decline between countries.
Methods: We conducted a systematic review of published peer-reviewed and gray literature analyzing the relation between changes in key …
Food Supplements To Reduce Stunting In Pakistan: A Process Evaluation Of Community Dynamics Shaping Uptake, Shehla Zaidi, Jai K. Das, Gul Nawaz Khan, Rabia Najmi Taha, Mashal Murad Shah, Sajid Bashir Soofi
Food Supplements To Reduce Stunting In Pakistan: A Process Evaluation Of Community Dynamics Shaping Uptake, Shehla Zaidi, Jai K. Das, Gul Nawaz Khan, Rabia Najmi Taha, Mashal Murad Shah, Sajid Bashir Soofi
Community Health Sciences
Background: There is an increasing interest in use of food supplements to prevent childhood stunting, however the evidence on the process indicators is scarce. We in this study explore the barriers to the effective implementation of food supplementation programs and the possible mitigation strategies which can guide the design of future programs.
Methods: We undertook a process evaluation of a stunting prevention food supplementation pilot program in rural Pakistan that distributed Wheat Soy Blend (WSB) to pregnant & lactating women, and Lipid-based Nutrient Supplement (LNS) and micronutrient powder (MNP) to < 5 years children. We used a mixed methods approach through a quantitative survey of 800 households and conducted 18 focused group discussion (FGDs) (with male and female caregivers), 4 FGDs (with Community Health Workers (CHWs)) and 22 key informant interviews (with district stakeholders) to evaluate the community side factors affecting uptake through five parameters: value, acceptability, receipt of supplement, usage and correct dosage.
Results: The findings show that proportionately few beneficiaries consumed the …
Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain
Determinants Of Linear Growth Faltering Among Children With Moderate-To-Severe Diarrhea In The Global Enteric Multicenter Study, Rebecca L. Brander, Patricia B. Pavlinac, Judd L. Walson, Grace C. John-Stewart, Marcia R. Weaver, Abu S. G Faruque, Anita K. M. Zaidi, Dipika Sur, Samba O. Sow, M Jahangir Hossain
Department of Paediatrics and Child Health
Background: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD.
Methods: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of ≥ 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with ΔLAZ. A …