Low birth weight, household socio-economic status, water and sanitation are associated with stunting and wasting among children aged 6-23 months: Results from a national survey in Ghana.

BACKGROUND: Stunting and wasting are key public health problems in Ghana that are significantly linked with mortality and morbidity risk among children. However, information on their associated factors using nationally representative data is scanty in Ghana. This study investigated the influence of Infant and Young Child Feeding (IYCF) indicators, socio-demographic and economic related factors, and water and sanitation on stunting and wasting, using nationally representative data in Ghana. METHODS: This is a secondary data analysis of the most recent (2017/2018) Ghana Multi-Indicator Cluster Survey (MICS) datasets. The multi-indicator cluster survey is a national cross-sectional household survey with rich data on women of reproductive age and children under the age of five. The survey used a two-stage sampling method in the selection of respondents and a computer-assisted personal interviewing technique to administer structured questionnaires from October 2017 to January 2018. The present study involved 2529 mother-child pairs, with their children aged 6 to 23 months. We used the Complex Sample procedures in SPSS, adjusting for clustering and stratification effects. In a bivariate logistic regression, variables with P-values ≤ 0.05 were included in a backward multivariate logistic regression to identify the significant factors associated with stunting and wasting. RESULTS: The mean age of children was 14.32 ± 0.14 months, with slightly more being males (50.4%). About 12% and 16% of the children were wasted and stunted, respectively. There were 39.4%, 25.9%, and 13.7% of children who, respectively, satisfied the minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). None of the IYCF indicators was significantly associated with stunting or wasting in the multivariate analysis but low socio-economic status, low birth weight, being a male child and unimproved toilet facilities were significantly associated with both wasting and stunting. CONCLUSION: Our findings suggest that aside from the pre-natal period, in certain contexts, household factors such as low socio-economic status and poor water and sanitation, may be stronger predictors of undernutrition. A combination of nutrition-specific and nutrition-sensitive interventions including the pre-natal period to simultaneously address the multiple determinants of undernutrition need strengthening.

Factors associated with overweight or obesity among post-partum women in the Tamale Metropolis, Northern Ghana: a cross-sectional study.

Introduction: adult overweight and obesity are public health challenges that are presently overwhelming health systems. Mothers are at an increased risk of overweight and obesity and its accompanying morbidities, especially after several deliveries; however, there is a paucity of data on the factors influencing this. As such, this study aimed to assess the prevalence and determinants of overweight or obesity among post-partum mothers. Methods: using a facility-based cross-sectional study design, mothers were selected as respondents by systematic random sampling between March and June 2018. Mothers of children less than 6 months or older than 24 months and mothers who did not attend antenatal care services were excluded from this survey. The outcome variable was overweight or obesity defined as Body Mass Index ≥ 25 kg/m2 and multivariable logistic regression was used to assess factors independently associated with overweight or obesity. Data was entered into and analysed using SPSS version 22. Results: analysis of 455 mothers showed that their average age was 28.0 ± 5.8 years. The prevalence of overweight or obesity was 41.8% (95% C.I = 37.2 - 46.3) and Christian mothers were twice more likely to be overweight or obese compared to their Muslim peers. Mothers who had a caesarean delivery were 36% (AOR = 1.36; 95% C.I = 1.11 - 1.66) more likely to be overweight or obese compared to those who had vaginal delivery. Mothers who consumed fresh fruits and vegetables were 42% (0.58; 0.46 - 0.72) less likely to be overweight or obese as compared to those who did not. We found a significant interaction between increasing age and parity whereby, increasing age among multiparous mothers was significantly less likely to be associated with overweight or obesity (0.92; 0.87 - 0.97) compared to primiparous mothers. Conclusion: prevalence of overweight or obesity was high, and determinants included socio-demographic factors, consumption of fruits and vegetables and gynaecological factors. Hence, strategies targeting younger women at the antenatal and delivery stages of pregnancy may improve the overall health of women by reducing caesarean sections and promoting breastfeeding.

Exclusive Breastfeeding and Associated Factors among Mothers with Twins in the Tamale Metropolis.

BACKGROUND: Exclusive breastfeeding (EBF) for the first six months after birth has been recommended by the WHO as the best infant feeding strategy. Data on EBF rates among twin infants in Ghana remain limited and for that matter hypothesized to be low. AIM: The study sought to measure the prevalence of EBF and identify associated factors among twins in the Tamale metropolis. METHODS: A cross-sectional survey involving 185 mother-twin pairs was conducted in four health facilities in the Tamale metropolis providing Child welfare Clinic (CWC) services. Socio-demographics data on both mother and twin were taken. Biomedical (e.g. perceived onset of lactation, confidence of producing enough milk, parity, delivery place, delivery type, time of breastfeeding initiation) and bio cultural factors (e.g. family cooperation for current infant feeding, breastfeeding counselling) were also obtained. In-depth interviews were also conducted with a sub sample of mothers (30) who were purposively selected to generate qualitative data on breastfeeding and associated cultural factors in twins as this data was necessary to aid in the explanation of the quantitative results. RESULTS: Only 17% of twin infants were exclusively breastfed for six months. Women who were not confident that they could produce enough breast milk were about 83% less likely to practice exclusive breast-feeding (EBF) compared to those who were confident that they could produce enough breast milk (AOR = 0.17; CI = 0.04, 0.73; p-value = 0.017). Moreover, mothers who had no access to radio were about 87% less likely to practice EBF (AOR = 0.13; CI = 0.02, 0.79; p-value = 0.017). Moreover, mothers who had no access to radio were about 87% less likely to practice EBF (AOR = 0.13; CI = 0.02, 0.79. CONCLUSIONS: The study shows that, ownership of radio, confidence of producing enough breast milk and admission of the children into NICU were identified as the most important factors affecting exclusive breastfeeding of twins. Beyond Educating, encouraging and assuring twin mothers of their abilities to produce enough breast milk to satisfy their children, healthcare professionals should pay more attention on providing appropriate information on breastfeeding to mothers and caregivers.