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Published in: BMC Pediatrics 1/2012

Open Access 01-12-2012 | Research article

Effect of mother’s education on child’s nutritional status in the slums of Nairobi

Authors: Benta A Abuya, James Ciera, Elizabeth Kimani-Murage

Published in: BMC Pediatrics | Issue 1/2012

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Abstract

Background

Malnutrition continues to be a critical public health problem in sub-Saharan Africa. For example, in East Africa, 48 % of children under-five are stunted while 36 % are underweight. Poor health and poor nutrition are now more a characteristic of children living in the urban areas than of children in the rural areas. This is because the protective mechanism offered by the urban advantage in the past; that is, the health benefits that historically accrued to residents of cities as compared to residents in rural settings is being eroded due to increasing proportion of urban residents living in slum settings. This study sought to determine effect of mother’s education on child nutritional status of children living in slum settings.

Methods

Data are from a maternal and child health project nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS). The study involves 5156 children aged 0–42 months. Data on nutritional status used were collected between October 2009 and January 2010. We used binomial and multiple logistic regression to estimate the effect of education in the univariable and multivariable models respectively.

Results

Results show that close to 40 % of children in the study are stunted. Maternal education is a strong predictor of child stunting with some minimal attenuation of the association by other factors at maternal, household and community level. Other factors including at child level: child birth weight and gender; maternal level: marital status, parity, pregnancy intentions, and health seeking behaviour; and household level: social economic status are also independently significantly associated with stunting.

Conclusion

Overall, mothers’ education persists as a strong predictor of child’s nutritional status in urban slum settings, even after controlling for other factors. Given that stunting is a strong predictor of human capital, emphasis on girl-child education may contribute to breaking the poverty cycle in urban poor settings.
Literature
1.
go back to reference Stephenson LS, Latham MC, Ottesen EA: Malnutrition and parasitic helminth infections. Parasitology. 2000, 121 (Suppl): S23-38.CrossRefPubMed Stephenson LS, Latham MC, Ottesen EA: Malnutrition and parasitic helminth infections. Parasitology. 2000, 121 (Suppl): S23-38.CrossRefPubMed
2.
go back to reference Leenstra T, Petersen LT, Kariuki SK, Oloo AJ, Kager PA, terKuile FO: Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya. Eur J ClinNutr. 2005, 59 (1): 41-48.CrossRef Leenstra T, Petersen LT, Kariuki SK, Oloo AJ, Kager PA, terKuile FO: Prevalence and severity of malnutrition and age at menarche; cross-sectional studies in adolescent schoolgirls in western Kenya. Eur J ClinNutr. 2005, 59 (1): 41-48.CrossRef
3.
go back to reference United Nations: Standing Committee on Nutrition (SCN), 5th Report on the World Nutrition Situation. 2004, United Nations, Geneva United Nations: Standing Committee on Nutrition (SCN), 5th Report on the World Nutrition Situation. 2004, United Nations, Geneva
4.
go back to reference World Health Organization: World Health Report 2002: Reducing Risks, Promoting Healthy Life. 2002, WHO, Geneva World Health Organization: World Health Report 2002: Reducing Risks, Promoting Healthy Life. 2002, WHO, Geneva
5.
go back to reference Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS: Maternal and Child Undernutrition Study G: Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008, 371 (9609): 340-357. 10.1016/S0140-6736(07)61692-4.CrossRefPubMedPubMedCentral Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS: Maternal and Child Undernutrition Study G: Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008, 371 (9609): 340-357. 10.1016/S0140-6736(07)61692-4.CrossRefPubMedPubMedCentral
6.
go back to reference Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B: Developmental potential in the first 5 years for children in developing countries. Lancet. 2007, 369 (9555): 60-70. 10.1016/S0140-6736(07)60032-4.CrossRefPubMedPubMedCentral Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B: Developmental potential in the first 5 years for children in developing countries. Lancet. 2007, 369 (9555): 60-70. 10.1016/S0140-6736(07)60032-4.CrossRefPubMedPubMedCentral
7.
go back to reference Department of Economic and Social Affairs, Population Division; 2003. 2004, United Nations, New York Department of Economic and Social Affairs, Population Division; 2003. 2004, United Nations, New York
8.
go back to reference African Population and Health Research Center: Population and Health Dynamics in Nairobi Informal Settlements. 2002, APHRC, Nairobi African Population and Health Research Center: Population and Health Dynamics in Nairobi Informal Settlements. 2002, APHRC, Nairobi
9.
go back to reference Kimani-Murage EW, Ngindu AM: Quality of water the slum dwellers use: the case of a Kenyan slum. J Urban Health. 2007, 84 (6): 829-838. 10.1007/s11524-007-9199-x.CrossRefPubMedPubMedCentral Kimani-Murage EW, Ngindu AM: Quality of water the slum dwellers use: the case of a Kenyan slum. J Urban Health. 2007, 84 (6): 829-838. 10.1007/s11524-007-9199-x.CrossRefPubMedPubMedCentral
10.
go back to reference Gould WT: African mortality and the new 'urban penalty'. Health Place. 1998, 4 (2): 171-181. 10.1016/S1353-8292(98)00009-4.CrossRefPubMed Gould WT: African mortality and the new 'urban penalty'. Health Place. 1998, 4 (2): 171-181. 10.1016/S1353-8292(98)00009-4.CrossRefPubMed
11.
go back to reference Haddad L, Ruel MT, Garrett JL: Are Urban Poverty and Undernutrition Growing? Some Newly Assembled Evidence. World Devel. 1999, 27 (11): 1891-1904. 10.1016/S0305-750X(99)00093-5.CrossRef Haddad L, Ruel MT, Garrett JL: Are Urban Poverty and Undernutrition Growing? Some Newly Assembled Evidence. World Devel. 1999, 27 (11): 1891-1904. 10.1016/S0305-750X(99)00093-5.CrossRef
12.
go back to reference Fotso JC: Urban–rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa. Health Place. 2007, 13 (1): 205-223. 10.1016/j.healthplace.2006.01.004.CrossRefPubMed Fotso JC: Urban–rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa. Health Place. 2007, 13 (1): 205-223. 10.1016/j.healthplace.2006.01.004.CrossRefPubMed
13.
go back to reference Brockerhoff M, Brennan E: The poverty of cities in developing countries. Population Devel. Rev. 1998, 24 (1): 75-114. 10.2307/2808123.CrossRef Brockerhoff M, Brennan E: The poverty of cities in developing countries. Population Devel. Rev. 1998, 24 (1): 75-114. 10.2307/2808123.CrossRef
14.
go back to reference Lalou R, LeGrand TK: Child Mortality in the Urban and Rural Sahel. Population. 1997, 9 (19): 147-168. Lalou R, LeGrand TK: Child Mortality in the Urban and Rural Sahel. Population. 1997, 9 (19): 147-168.
15.
go back to reference Handa S: Maternal Education and Child Height. Econ. Devel. Cult. Change. 1999, 47 (2): 421-439. 10.1086/452408.CrossRef Handa S: Maternal Education and Child Height. Econ. Devel. Cult. Change. 1999, 47 (2): 421-439. 10.1086/452408.CrossRef
16.
go back to reference Frost MB, Forste R, Haas DW: Maternal education and child nutritional status in Bolivia: finding the links. SocSci Med. 2005, 60 (2): 395-407. 10.1016/j.socscimed.2004.05.010.CrossRef Frost MB, Forste R, Haas DW: Maternal education and child nutritional status in Bolivia: finding the links. SocSci Med. 2005, 60 (2): 395-407. 10.1016/j.socscimed.2004.05.010.CrossRef
17.
go back to reference Kabubo-Mariara J, Ndenge GK, Mwabu DK: Determinants of Children’s Nutritional Status in Kenya: Evidence from Demographic and Health Surveys. J Afr Econ. 2008, 10.1093/jae/ejn024. Kabubo-Mariara J, Ndenge GK, Mwabu DK: Determinants of Children’s Nutritional Status in Kenya: Evidence from Demographic and Health Surveys. J Afr Econ. 2008, 10.1093/jae/ejn024.
18.
go back to reference Abuya BA, Onsomu EO, Kimani JK, Moore D: Influence of Maternal Education on Child Immunization and Stunting in Kenya. Matern Child Health J. 2011, 15: 1389-1399. 10.1007/s10995-010-0670-z.CrossRefPubMed Abuya BA, Onsomu EO, Kimani JK, Moore D: Influence of Maternal Education on Child Immunization and Stunting in Kenya. Matern Child Health J. 2011, 15: 1389-1399. 10.1007/s10995-010-0670-z.CrossRefPubMed
19.
go back to reference Glewwe P: Why Does Mother's Schooling Raise Child Health in Developing Countries?. Evidence from Morocco. J. Human Res. 1999, 34 (1): 124-159.CrossRef Glewwe P: Why Does Mother's Schooling Raise Child Health in Developing Countries?. Evidence from Morocco. J. Human Res. 1999, 34 (1): 124-159.CrossRef
20.
go back to reference Desai S, Alva S: Maternal education and child health: is there a strong causal relationship?. Demography. 1998, 35 (1): 71-81. 10.2307/3004028.CrossRefPubMed Desai S, Alva S: Maternal education and child health: is there a strong causal relationship?. Demography. 1998, 35 (1): 71-81. 10.2307/3004028.CrossRefPubMed
21.
go back to reference Cleland JG, Van Ginneken JK: Maternal education and child survival in developing countries: the search for pathways of influence. SocSci Med. 1988, 27 (12): 1357-1368. 10.1016/0277-9536(88)90201-8.CrossRef Cleland JG, Van Ginneken JK: Maternal education and child survival in developing countries: the search for pathways of influence. SocSci Med. 1988, 27 (12): 1357-1368. 10.1016/0277-9536(88)90201-8.CrossRef
22.
go back to reference Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M: Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003, 157 (2): 98-112. 10.1093/aje/kwf182.CrossRefPubMed Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M: Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003, 157 (2): 98-112. 10.1093/aje/kwf182.CrossRefPubMed
23.
go back to reference Black MM, Baqui AH, Zaman K, El Arifeen S, Black RE: Maternal depressive symptoms and infant growth in rural Bangladesh. Am J ClinNutr. 2009, 89 (3): 951 S-957S. Black MM, Baqui AH, Zaman K, El Arifeen S, Black RE: Maternal depressive symptoms and infant growth in rural Bangladesh. Am J ClinNutr. 2009, 89 (3): 951 S-957S.
24.
go back to reference Kenya National Bureau of Statistics (KNBS) ICF Macro: Kenya Demographic and Health Survey 2008–09. 2009, KNBS and ICF Macro, Calverton, Maryland Kenya National Bureau of Statistics (KNBS) ICF Macro: Kenya Demographic and Health Survey 2008–09. 2009, KNBS and ICF Macro, Calverton, Maryland
25.
go back to reference African Population and Health Research Cente: Health and Livelihood Needs Of Residents of Informal Settlements on Nairobi City. Occasional Study Report 1. 2009, APHRC, Nairobi African Population and Health Research Cente: Health and Livelihood Needs Of Residents of Informal Settlements on Nairobi City. Occasional Study Report 1. 2009, APHRC, Nairobi
26.
go back to reference Filmer D, Pritchett LH: Estimating wealth effects without expenditure data–or tears: an application to educational enrollments in states of India. Demography. 2001, 38 (1): 115-132.PubMed Filmer D, Pritchett LH: Estimating wealth effects without expenditure data–or tears: an application to educational enrollments in states of India. Demography. 2001, 38 (1): 115-132.PubMed
27.
go back to reference Raghunathan TE, Lepkowski JM, VanHoewyk J, Solenberger P: A multivariate technique for multiply imputing missing values using a sequence of regression models. Survey Methodology. 2001, 27: 85-95. Raghunathan TE, Lepkowski JM, VanHoewyk J, Solenberger P: A multivariate technique for multiply imputing missing values using a sequence of regression models. Survey Methodology. 2001, 27: 85-95.
28.
go back to reference Rubin DB: Multiple Imputation for Nonresponse in Surveys. 1987, Wiley, New YorkCrossRef Rubin DB: Multiple Imputation for Nonresponse in Surveys. 1987, Wiley, New YorkCrossRef
29.
go back to reference Lee KJ, Carlin JB: Multiple imputation for missing data: Fully conditional specification versus multivariate normal imputation. Am J Epidemiol. 2010, 171: 624-632. 10.1093/aje/kwp425.CrossRefPubMed Lee KJ, Carlin JB: Multiple imputation for missing data: Fully conditional specification versus multivariate normal imputation. Am J Epidemiol. 2010, 171: 624-632. 10.1093/aje/kwp425.CrossRefPubMed
30.
go back to reference Van Buuren S: Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res. 2007, 16: 219-242. 10.1177/0962280206074463.CrossRefPubMed Van Buuren S: Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res. 2007, 16: 219-242. 10.1177/0962280206074463.CrossRefPubMed
31.
go back to reference Hien NN, Kam S: Nutritional status and the characteristics related to malnutrition in children under five years of age in Nghean, Vietnam. J Prev Med Public Health. 2008, 41 (4): 232-240. 10.3961/jpmph.2008.41.4.232.CrossRefPubMed Hien NN, Kam S: Nutritional status and the characteristics related to malnutrition in children under five years of age in Nghean, Vietnam. J Prev Med Public Health. 2008, 41 (4): 232-240. 10.3961/jpmph.2008.41.4.232.CrossRefPubMed
32.
go back to reference Ukwuani FA, Suchindran CM: Implications of women's work for child nutritional status in sub-Saharan Africa: a case study of Nigeria. SocSci Med. 2003, 56 (10): 2109-2121. 10.1016/S0277-9536(02)00205-8.CrossRef Ukwuani FA, Suchindran CM: Implications of women's work for child nutritional status in sub-Saharan Africa: a case study of Nigeria. SocSci Med. 2003, 56 (10): 2109-2121. 10.1016/S0277-9536(02)00205-8.CrossRef
33.
go back to reference Wamani H, Astrom AN, Peterson S, Tumwine JK, Tylleskar T: Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatr. 2007, 7: 17-10.1186/1471-2431-7-17.CrossRefPubMedPubMedCentral Wamani H, Astrom AN, Peterson S, Tumwine JK, Tylleskar T: Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC Pediatr. 2007, 7: 17-10.1186/1471-2431-7-17.CrossRefPubMedPubMedCentral
34.
go back to reference Wamani H, Tylleskar T, Astrom AN, Tumwine JK, Peterson S: Mothers' education but not fathers' education, household assets or land ownership is the best predictor of child health inequalities in rural Uganda. Int J Equity Health. 2004, 3 (1): 9-10.1186/1475-9276-3-9.CrossRefPubMedPubMedCentral Wamani H, Tylleskar T, Astrom AN, Tumwine JK, Peterson S: Mothers' education but not fathers' education, household assets or land ownership is the best predictor of child health inequalities in rural Uganda. Int J Equity Health. 2004, 3 (1): 9-10.1186/1475-9276-3-9.CrossRefPubMedPubMedCentral
35.
go back to reference Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008, 371 (9608): 243-260. 10.1016/S0140-6736(07)61690-0.CrossRefPubMed Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008, 371 (9608): 243-260. 10.1016/S0140-6736(07)61690-0.CrossRefPubMed
36.
go back to reference Ministry of Public Health and Sanitation: National Strategy on Infant and Young Child Feeding Strategy 2007–2010. 2007, Ministry of Public Health and Sanitation, Nairobi, Kenya Ministry of Public Health and Sanitation: National Strategy on Infant and Young Child Feeding Strategy 2007–2010. 2007, Ministry of Public Health and Sanitation, Nairobi, Kenya
Metadata
Title
Effect of mother’s education on child’s nutritional status in the slums of Nairobi
Authors
Benta A Abuya
James Ciera
Elizabeth Kimani-Murage
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2012
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-12-80

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