Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Maternal profiles and social determinants of malnutrition and the MDGs: What have we learnt?

Authors: Edem M. A. Tette, Eric K. Sifah, Edmund T. Nartey, Peter Nuro-Ameyaw, Pricilla Tete-Donkor, Richard B. Biritwum

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Maternal socio-demographic and health profiles are important determinants of malnutrition in children. In the 1990s, malnutrition was associated with low-birth-weight, young mothers and low maternal socio-economic status at Princess Marie Louise Children’s Hospital (PML). It is not known how this has changed by efforts to achieve the Millennium Development Goals. We examined socio-demographic and health profiles of mothers of children with acute malnutrition and those without the condition to identify risk factors for malnutrition and focus on preventive efforts.

Methods

An unmatched case–control study was conducted in 2013 at PML, the largest facility for treating malnourished children in Ghana in 2013. Mothers of children with moderate and severe acute malnutrition were compared with mothers of well-nourished children. Weight-for-height was used to classify malnutrition. Record forms and a semi-structured questionnaire were used for data collection. An analysis was done with Stata 11.0 software.

Results

Altogether, 371 mothers were studied consisting of 182 mothers of malnourished children and 189 mothers of well-nourished children. Mothers of malnourished children were more likely to be unmarried or cohabiting, have lower family incomes, HIV infection and chronic disease. They were less likely to stay with or provide alternative care for their child. Awareness and use of social services, health insurance and a cash transfer programme were low. A remarkable reduction in the number of malnourished children occurred when families earned more than $250 USD a month. Over-nutrition was present in both groups of mothers.

Conclusion

Low family income, unmarried status and type of child care were the main social determinants of malnutrition. There appears to be a reduction in the number of other poor socio-demographic characteristics in both the study and control groups compared to results from a previous study at the same centre, probably because of efforts toward attaining the MDGs. These findings suggest that prevention and optimum management need to involve multidisciplinary teams consisting of health professionals, social workers and/or key workers to enable families at risk to access social care and social protection interventions (MDG 1). This will make the management of malnutrition more effective, prevent relapse, protect the next child and address maternal over-nutrition.
Appendix
Available only for authorised users
Literature
1.
go back to reference Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.CrossRefPubMed Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet. 2008;371(9608):243–60.CrossRefPubMed
2.
go back to reference Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340–57.CrossRefPubMedPubMedCentral Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, et al. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371(9609):340–57.CrossRefPubMedPubMedCentral
4.
go back to reference UNICEF, WHO, The World Bank: Levels and Trends in Child Malnutrition. UNICEF 2014, UNICEF-WHO-The World Bank Joint Child Malnutrition Estimates for 2013. UNICEF, WHO, The World Bank: Levels and Trends in Child Malnutrition. UNICEF 2014, UNICEF-WHO-The World Bank Joint Child Malnutrition Estimates for 2013.
5.
go back to reference Rikimaru T, Yartey JE, Taniguchi K, Kennedy DO, Nkrumah FK. Risk factors for the prevalence of malnutrition among urban children in Ghana. J Nutr Sci Vitaminol (Tokyo). 1998;44(3):391–407.CrossRef Rikimaru T, Yartey JE, Taniguchi K, Kennedy DO, Nkrumah FK. Risk factors for the prevalence of malnutrition among urban children in Ghana. J Nutr Sci Vitaminol (Tokyo). 1998;44(3):391–407.CrossRef
6.
go back to reference Ighogboja SI. Some factors contributing to protein-energy malnutrition in the middle belt of Nigeria. East Afr Med J. 1992;69(10):566–71.PubMed Ighogboja SI. Some factors contributing to protein-energy malnutrition in the middle belt of Nigeria. East Afr Med J. 1992;69(10):566–71.PubMed
7.
go back to reference Maleta K, Virtanen SM, Espo M, Kulmala T, Ashorn P. Childhood malnutrition and its predictors in rural Malawi. Paediatr Perinat Epidemiol. 2003;17(4):384–90.CrossRefPubMed Maleta K, Virtanen SM, Espo M, Kulmala T, Ashorn P. Childhood malnutrition and its predictors in rural Malawi. Paediatr Perinat Epidemiol. 2003;17(4):384–90.CrossRefPubMed
8.
go back to reference Adekunle L. The effect of family structure on a sample of malnourished urban Nigerian children. Food Nutr Bull. 2005;26(2):230–3.CrossRefPubMed Adekunle L. The effect of family structure on a sample of malnourished urban Nigerian children. Food Nutr Bull. 2005;26(2):230–3.CrossRefPubMed
9.
go back to reference Van de Poel E, Hosseinpoor AR, Jehu-Appiah C, Vega J, Speybroeck N. Malnutrition and the disproportional burden on the poor: the case of Ghana. Int J Equity Health. 2007;6:21.CrossRefPubMedPubMedCentral Van de Poel E, Hosseinpoor AR, Jehu-Appiah C, Vega J, Speybroeck N. Malnutrition and the disproportional burden on the poor: the case of Ghana. Int J Equity Health. 2007;6:21.CrossRefPubMedPubMedCentral
10.
go back to reference Ruel MT, Levin CE, Armah-Klemesu M, Maxwell D, Morris SS. Good care practices can mitigate the negative effects of poverty and low maternal schooling on children’s nutritional status: evidence from Accra. In: FCND Discussion Paper No 62, Food Consumption & Nutrition Division. Washington D.C.USA: International Food Policy Research Institute; 1999. Ruel MT, Levin CE, Armah-Klemesu M, Maxwell D, Morris SS. Good care practices can mitigate the negative effects of poverty and low maternal schooling on children’s nutritional status: evidence from Accra. In: FCND Discussion Paper No 62, Food Consumption & Nutrition Division. Washington D.C.USA: International Food Policy Research Institute; 1999.
11.
go back to reference GHS. Annual report of the reproductive and child health and family health division. Accra: Ghana Health Service; 2007. GHS. Annual report of the reproductive and child health and family health division. Accra: Ghana Health Service; 2007.
12.
go back to reference Ghana Statistical Service, Ghana Health Service. Ghana demographic and health survey 2008. Calverton: IFC Macro; 2009. Ghana Statistical Service, Ghana Health Service. Ghana demographic and health survey 2008. Calverton: IFC Macro; 2009.
13.
go back to reference National Social Protection Strategy (NSPS). Investing in People. Government of Ghana, Ministry of Manpower, Youth and Employment .2008. National Social Protection Strategy (NSPS). Investing in People. Government of Ghana, Ministry of Manpower, Youth and Employment .2008.
14.
go back to reference UNDG. Indicators for Monitoring the Millennium Development Goals. In. New York: United Nations; 2003. UNDG. Indicators for Monitoring the Millennium Development Goals. In. New York: United Nations; 2003.
15.
go back to reference Ghana Health Service. Interim National Guidelines for Community-Based Management Of Severe Acute Malnutrition in Accra. Ghana Health Service. Interim National Guidelines for Community-Based Management Of Severe Acute Malnutrition in Accra.
16.
go back to reference WHO. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva: World Health Organization; 2000. WHO. Management of the child with a serious infection or severe malnutrition. Guidelines for care at the first-referral level in developing countries. Geneva: World Health Organization; 2000.
18.
go back to reference Amsalu S, Zemene T. Risk factors for severe acute malnutrition in children under the age of five: A case–control study. Ethiop J Health Dev. 2008;22(1):21–5.CrossRef Amsalu S, Zemene T. Risk factors for severe acute malnutrition in children under the age of five: A case–control study. Ethiop J Health Dev. 2008;22(1):21–5.CrossRef
19.
go back to reference Egata G, Berhane Y, Worku A. Predictors of acute undernutrition among children aged 6 to 36 months in east rural Ethiopia: a community based nested case - control study. BMC Pediatr. 2014;14:91.CrossRefPubMedPubMedCentral Egata G, Berhane Y, Worku A. Predictors of acute undernutrition among children aged 6 to 36 months in east rural Ethiopia: a community based nested case - control study. BMC Pediatr. 2014;14:91.CrossRefPubMedPubMedCentral
20.
go back to reference Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226–34.CrossRefPubMed Black RE, Morris SS, Bryce J. Where and why are 10 million children dying every year? Lancet. 2003;361(9376):2226–34.CrossRefPubMed
22.
go back to reference Tette EMA, Sifah EK, Nartey ET. Factors affecting malnutrition in children and the uptake of interventions to prevent the condition. In: BMC Paediatrics. Tette EMA, Sifah EK, Nartey ET. Factors affecting malnutrition in children and the uptake of interventions to prevent the condition. In: BMC Paediatrics.
23.
go back to reference Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013;382(9891):536–51.CrossRefPubMed Ruel MT, Alderman H. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? Lancet. 2013;382(9891):536–51.CrossRefPubMed
24.
go back to reference Deleuze Ntandou Bouzitou G, Fayomi B, Delisle H. Child malnutrition and maternal overweight in same households in poor urban areas of Benin. Sante. 2005;15(4):263–70.PubMed Deleuze Ntandou Bouzitou G, Fayomi B, Delisle H. Child malnutrition and maternal overweight in same households in poor urban areas of Benin. Sante. 2005;15(4):263–70.PubMed
25.
go back to reference Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.CrossRefPubMed
26.
go back to reference Jehn M, Brewis A. Paradoxical malnutrition in mother-child pairs: untangling the phenomenon of over- and under-nutrition in underdeveloped economies. Econ Hum Biol. 2009;7(1):28–35.CrossRefPubMed Jehn M, Brewis A. Paradoxical malnutrition in mother-child pairs: untangling the phenomenon of over- and under-nutrition in underdeveloped economies. Econ Hum Biol. 2009;7(1):28–35.CrossRefPubMed
27.
go back to reference Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371(9610):417–40.CrossRefPubMed Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K, Giugliani E, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371(9610):417–40.CrossRefPubMed
28.
go back to reference Welfare-UNICEF MoEaS. National plan of action for orphans and vulnerable children. Accra: Ministry of Employment and Social Welfare-UNICEF; 2010. Welfare-UNICEF MoEaS. National plan of action for orphans and vulnerable children. Accra: Ministry of Employment and Social Welfare-UNICEF; 2010.
29.
go back to reference Addae-Korankye A. Challenges of financing health care in Ghasna: The case of National Health Insurance Scheme (NHIS). International Journal of Asian Social Science. 2013;3(2):511-522. Addae-Korankye A. Challenges of financing health care in Ghasna: The case of National Health Insurance Scheme (NHIS). International Journal of Asian Social Science. 2013;3(2):511-522.
30.
go back to reference Binka FN, Maude GH, Gyapong M, Ross DA, Smith PG. Risk factors for child mortality in northern Ghana: A case–control study. Int J Epidemiol. 1995;24:127–35.CrossRefPubMed Binka FN, Maude GH, Gyapong M, Ross DA, Smith PG. Risk factors for child mortality in northern Ghana: A case–control study. Int J Epidemiol. 1995;24:127–35.CrossRefPubMed
31.
go back to reference Hall DMB, Elliman D (eds.). Health for All Children, 4th edn. Oxford: Oxford Medical Publications. 2003. Hall DMB, Elliman D (eds.). Health for All Children, 4th edn. Oxford: Oxford Medical Publications. 2003.
32.
go back to reference Government HM. Working together to safeguard children, 2 edn. London: London TSO. 2009. Government HM. Working together to safeguard children, 2 edn. London: London TSO. 2009.
33.
go back to reference Saloojee H, De Maayer T, Garenne ML, Kahn K. What’s new? Investing risk factors for severe childhood malnutrition in a high HIV prevalence South African setting. Scan J Public Health. 2007;69:96–106.CrossRef Saloojee H, De Maayer T, Garenne ML, Kahn K. What’s new? Investing risk factors for severe childhood malnutrition in a high HIV prevalence South African setting. Scan J Public Health. 2007;69:96–106.CrossRef
Metadata
Title
Maternal profiles and social determinants of malnutrition and the MDGs: What have we learnt?
Authors
Edem M. A. Tette
Eric K. Sifah
Edmund T. Nartey
Peter Nuro-Ameyaw
Pricilla Tete-Donkor
Richard B. Biritwum
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2853-z

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue