Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville

Half the children under the age of 5 years in Papua New Guinea (PNG) are undernourished, more than double the global average with rural areas disproportionately affected. This study examines factors associated with stunting, wasting and underweight in cocoa growers’ children (<5 years) in the...

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Main Authors: Kirsten Black, Justin Beardsley, Jessica Hall, Merrilyn Walton, Floris Van Ogtrop, David Guest
Format: Article
Language:English
Published: BMJ Publishing Group 2020-08-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/8/e002478.full
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author Kirsten Black
Justin Beardsley
Jessica Hall
Merrilyn Walton
Floris Van Ogtrop
David Guest
author_facet Kirsten Black
Justin Beardsley
Jessica Hall
Merrilyn Walton
Floris Van Ogtrop
David Guest
author_sort Kirsten Black
collection DOAJ
description Half the children under the age of 5 years in Papua New Guinea (PNG) are undernourished, more than double the global average with rural areas disproportionately affected. This study examines factors associated with stunting, wasting and underweight in cocoa growers’ children (<5 years) in the Autonomous Region of Bougainville (ARoB), using data from a comprehensive 2017 cross-sectional livelihoods survey. Sixteen independent predictors for stunting, wasting and underweight were selected based on the UNICEF Conceptual Framework of Determinants of Undernutrition. We used multilevel logistic mixed regression models to measure the association of the explanatory variables with stunting, wasting and underweight. At the household level, the adjusted OR (aOR) of stunting (aOR=1.71,95% CI 1.14 to 2.55) and underweight (aOR=2.11, 95% CI 1.16 to 3.82) increased significantly among children from households with unimproved toilet facilities. The aOR for underweight also increased among children from households without access to clean drinking water (aOR=1.97, 95% CI 1.19 to 3.29). Short maternal stature was significantly associated with child stunting, the odds increased as maternal height decreased (from 150 to <155 cm, aOR=1.52, 95% CI 1.02 to 2.26) (<150 cm, aOR=2.37, 95% CI 1.29 to 4.35). At the individual level, the odds of a child being underweight increased with birth order (second born, aOR=1.92, 95% CI 1.09 to 3.36; third born, aOR=6.77, 95% CI 2.00 to 22.82). Compared with children less than 6 months, children aged 6–23 months and 24–59 months had a higher odds of being stunted (aOR=3.27, 95% CI 1.57 to 6.78 and aOR=2.82, 95% CI 1.40 to 5.67) and underweight (aOR=4.83, 95% CI 1.36 to 17.24 and aOR=4.59, 95% CI 1.29 to 16.26). No variables were found to be significant for wasting. Interventions that simultaneously target key life stages for women and children and the underlying social and environmental determinants are required for sustained improvements to undernutrition.
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spelling doaj-art-5058bd6a8af443b89d35f09c226dedaa2025-08-20T02:09:37ZengBMJ Publishing GroupBMJ Global Health2059-79082020-08-015810.1136/bmjgh-2020-002478Factors influencing undernutrition among children under 5 years from cocoa-growing communities in BougainvilleKirsten Black0Justin Beardsley1Jessica Hall2Merrilyn Walton3Floris Van Ogtrop4David Guest5University of Sydney, Sydney, New South Wales, AustraliaThe Marie Bashir Institute, Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, AustraliaSchool of Public Health, The University of Sydney, Sydney, New South Wales, AustraliaOffice of Teaching and Learning in Medicine, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, AustraliaSchool of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, AustraliaSydney Institute of Agriculture, School of Life and Environmental Sciences, The University of Sydney, Sydney, New South Wales, AustraliaHalf the children under the age of 5 years in Papua New Guinea (PNG) are undernourished, more than double the global average with rural areas disproportionately affected. This study examines factors associated with stunting, wasting and underweight in cocoa growers’ children (<5 years) in the Autonomous Region of Bougainville (ARoB), using data from a comprehensive 2017 cross-sectional livelihoods survey. Sixteen independent predictors for stunting, wasting and underweight were selected based on the UNICEF Conceptual Framework of Determinants of Undernutrition. We used multilevel logistic mixed regression models to measure the association of the explanatory variables with stunting, wasting and underweight. At the household level, the adjusted OR (aOR) of stunting (aOR=1.71,95% CI 1.14 to 2.55) and underweight (aOR=2.11, 95% CI 1.16 to 3.82) increased significantly among children from households with unimproved toilet facilities. The aOR for underweight also increased among children from households without access to clean drinking water (aOR=1.97, 95% CI 1.19 to 3.29). Short maternal stature was significantly associated with child stunting, the odds increased as maternal height decreased (from 150 to <155 cm, aOR=1.52, 95% CI 1.02 to 2.26) (<150 cm, aOR=2.37, 95% CI 1.29 to 4.35). At the individual level, the odds of a child being underweight increased with birth order (second born, aOR=1.92, 95% CI 1.09 to 3.36; third born, aOR=6.77, 95% CI 2.00 to 22.82). Compared with children less than 6 months, children aged 6–23 months and 24–59 months had a higher odds of being stunted (aOR=3.27, 95% CI 1.57 to 6.78 and aOR=2.82, 95% CI 1.40 to 5.67) and underweight (aOR=4.83, 95% CI 1.36 to 17.24 and aOR=4.59, 95% CI 1.29 to 16.26). No variables were found to be significant for wasting. Interventions that simultaneously target key life stages for women and children and the underlying social and environmental determinants are required for sustained improvements to undernutrition.https://gh.bmj.com/content/5/8/e002478.full
spellingShingle Kirsten Black
Justin Beardsley
Jessica Hall
Merrilyn Walton
Floris Van Ogtrop
David Guest
Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville
BMJ Global Health
title Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville
title_full Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville
title_fullStr Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville
title_full_unstemmed Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville
title_short Factors influencing undernutrition among children under 5 years from cocoa-growing communities in Bougainville
title_sort factors influencing undernutrition among children under 5 years from cocoa growing communities in bougainville
url https://gh.bmj.com/content/5/8/e002478.full
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