Social capital and its relationship with malnutrition and anemia in children from rural coastal Ecuador.

INTRODUCTION: Social capital is considered an important determinant of health and overall wellbeing; however, to the best of the authors' knowledge, literature relating social capital to malnutrition in developing countries is still relatively small. This article examines the relationships between social capital and chronic malnutrition and anemia in a population of rural coastal children in Ecuador. METHODS: A cross-sectional study in two groups of 246 and 282 children under 5 years and their families was performed. Anemia and chronic malnutrition were analyzed as outcome variables. Variables about social capital were identified on the basis of the Social Capital Assessment Tool of the World Bank. Bivariate and multivariate logistic regression analyses were conducted. RESULTS: The prevalences of anemia and chronic malnutrition in the children were 15.0% and 12.8%, respectively. At the multivariate analysis, the variable 'mother has borrowed money' had an inverse association with chronic malnutrition (prevalence ratio (PR) 0.43, 95% confidence interval (CI) 0.20-0.90). Receiving and providing help after the earthquake of 2016 was significantly associated with a lower prevalence of chronic malnutrition (PR 0.52, 95%CI 0.28-0.97), but not with anemia. However, a mother being part of a community organization was associated with a 1.90 times higher prevalence of anemia (95%CI 1.04-3.48) in children than mothers who were not part of a community organization. CONCLUSION: The relationship between maternal social capital and the nutritional status of their children in rural communities seems to be positively related. However, a mother's participation in community organizations increases the prevalence of anemia in the children. These mixed results highlight the need for further studies focused on the different types of social capital and how they impact on health in deprived areas.

A Multi-causal Model for Chronic Malnutrition and Anemia in a Population of Rural Coastal Children in Ecuador.

OBJECTIVES: Chronic malnutrition and anemia are prevalent in developing countries. This research aimed to determine the prevalence of chronic malnutrition and anemia and their associated factors in children under five using a multi-causal model in a rural community in the coast of Ecuador. METHODS: The study included 314 children under 5 years old who were residents of San Isidro, Ecuador. Indicators of chronic malnutrition and anemia were identified. Mothers/caregivers were surveyed on socio-economic and environmental conditions, feeding and care practices, access to health services and biological characteristics. Bivariate and multivariable Poisson regression were performed. RESULTS: The prevalence was 12.42% (n = 39) for chronic malnutrition and 16.98% (n = 54) for anemia. There was a significant and independent association between chronic malnutrition and family income less than $80 USD per month (Prevalence Ratio [PR] = 2.74, 95% CI 1.04, 7.20), maternal height less than 150 cm (PR 3.00, 95% CI 1.69, 5.32) and residence in a household with more than 4 children (PR 3.05, 95% CI 1.48, 6.29). Anemia was 2.57 times higher (95% CI 1.17, 5.65) in children with more than two episodes of diarrhea in the last 6 months. Prenatal care (5 to 8 visits) provided a protective effect for anemia (PR 0.48, 95% CI 0.27, 0.89). CONCLUSIONS FOR PRACTICE: Findings support the need for comprehensive interventions targeted toward chronic malnutrition and anemia in children from rural coastal communities. Improvement of socioeconomic conditions, family planning, prenatal care and reduction of diarrheal diseases should be prioritized.