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      Mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa

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          Abstract

          Background

          Malnutrition remains one of the major public health concerns globally. To achieve the Sustainable Development Goal 2 which seeks to ensure that hunger and malnutrition are reduced by 2030, it is imperative to ascertain the factors influencing their occurrence. This study examined the prevalence and factors associated with mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa.

          Methods

          Demographic and Health Survey data from 25 sub-Saharan African countries were used for the study. The sample was made up of 125,280 mother–child dyads. Descriptive analysis was performed to determine the prevalence of overweight or obese mother (OWOBM) with a stunted child (OWOBM-SC), OWOBM with an underweight child (OWOBM-UC), OWOBM with a wasted child (OWOBM-WC), and OWOBM with any form of child’s undernutrition indicators (OWOBM-SUWC). Multilevel regression models were developed to examine the factors associated with these indicators. The results were presented using an adjusted odds ratio (AOR) with their respective 95% confidence interval (CI).

          Results

          Higher likelihood of OWOBM-SUWC was found among women aged 45–49 [AOR 2.20, 95% CI 1.70, 2.85], those with primary [AOR 1.32, 95% CI 1.21, 1.44] or secondary education [AOR 1.21, 95% CI 1.09, 1.35], and divorced women [AOR 1.32, 95% CI 1.02, 1.73]. However, lower odds of OWOBM-SUWC were observed among women who were working [AOR 0.82, 95% CI 0.76, 0.89] and those breastfeeding [AOR 0.75, 95% CI 0.70, 0.82]. The odds of OWOBM-SUWC was lower among females compared to male children [AOR 0.85, 95% CI 0.80, 0.90]. Compared to children aged <1 year, children of all other age groups were more likely to have OWOBM-SUWC. Other child characteristics significantly associated with OWOBM-SUWC were low birth weight [AOR 1.50, 95% CI 1.32, 1.71], having diarrhea [AOR 1.13, 95% CI 1.04, 1.24], and higher birth order [AOR 1.37, 95% CI 1.13, 1.66]. Children whose mothers used unimproved toilet facilities [AOR 0.90, 95% CI 0.83, 0.98], those who lived in rural areas [AOR 0.79, 95% CI 0.71, 0.87], and children from the Central [AOR 0.55, 95% CI 0.46, 0.65], Eastern [AOR 0.44, 95% CI 0.38, 0.52] and Western [AOR 0.76, 95% CI 0.65, 0.89] sub-Saharan Africa were less likely to have OWOBM-SUWC.

          Conclusion

          Combination of child, maternal, and contextual factors could explain mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa. Addressing this situation requires multidimensional policies and interventions that empower women through education and economic engagement. The observed sub-regional differences in policies and commitments related to addressing malnutrition suggest the need for comprehensive and coordinated efforts to implement and strengthen multisectoral comprehensive nutrition plans across sub-Saharan Africa. Sharing best practices and lessons learned can help improve the effectiveness and comprehensiveness of nutrition interventions and contribute to reducing the prevalence of malnutrition.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s41043-023-00479-y.

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          Most cited references41

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          The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies.

          Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalisability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover three main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. 18 items are common to all three study designs and four are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available on the Web sites of PLoS Medicine, Annals of Internal Medicine, and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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            Natural Selection of Parental Ability to Vary the Sex Ratio of Offspring

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              Dynamics of the double burden of malnutrition and the changing nutrition reality

              The double burden of malnutrition (DBM), defined as the simultaneous manifestation of both undernutrition and overweight and obesity, affects most low-income and middle-income countries (LMICs). This Series paper describes the dynamics of the DBM in LMICs and how it differs by socioeconomic level. This Series paper shows that the DBM has increased in the poorest LMICs, mainly due to overweight and obesity increases. Indonesia is the largest country with a severe DBM, but many other Asian and sub-Saharan African countries also face this problem. We also discuss that overweight increases are mainly due to very rapid changes in the food system, particularly the availability of cheap ultra-processed food and beverages in LMICs, and major reductions in physical activity at work, transportation, home, and even leisure due to introductions of activity-saving technologies. Understanding that the lowest income LMICs face severe levels of the DBM and that the major direct cause is rapid increases in overweight allows identifying selected crucial drivers and possible options for addressing the DBM at all levels.
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                Author and article information

                Contributors
                sanni.yaya@uOttawa.ca
                Journal
                J Health Popul Nutr
                J Health Popul Nutr
                Journal of Health, Population, and Nutrition
                BioMed Central (London )
                1606-0997
                2072-1315
                2 January 2024
                2 January 2024
                2024
                : 43
                : 1
                Affiliations
                [1 ]Department of Population and Health, University of Cape Coast, ( https://ror.org/0492nfe34) Cape Coast, Ghana
                [2 ]Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, ( https://ror.org/00cb23x68) Kumasi, Ghana
                [3 ]Department of Medical Laboratory Science, University of Cape Coast, ( https://ror.org/0492nfe34) Cape Coast, Ghana
                [4 ]Centre for Gender and Advocacy, Takoradi Technical University, ( https://ror.org/03kbmhj98) Takoradi, Ghana
                [5 ]College of Public Health, Medical and Veterinary Sciences, James Cook University, ( https://ror.org/04gsp2c11) Townsville, Australia
                [6 ]School of Clinical Medicine, University of New South Wales Sydney, ( https://ror.org/03r8z3t63) Sydney, Australia
                [7 ]School of Public Health, Faculty of Health, University of Technology Sydney, ( https://ror.org/03f0f6041) Sydney, Australia
                [8 ]Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, ( https://ror.org/054tfvs49) Hohoe, Ghana
                [9 ]School of International Development and Global Studies, University of Ottawa, ( https://ror.org/03c4mmv16) Ottawa, Canada
                [10 ]GRID grid.7445.2, ISNI 0000 0001 2113 8111, The George Institute for Global Health, , Imperial College London, ; London, UK
                Article
                479
                10.1186/s41043-023-00479-y
                10759505
                acb044ee-54f8-4920-8951-46a1bda78b84
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 20 July 2023
                : 24 November 2023
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Nutrition & Dietetics
                stunting,underweight,wasting,undernutrition,sub-saharan africa,demographic and health survey

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