Gender dimensions of the impact of HIV/AIDS on stunting in children under five years in Zimbabwe.

BACKGROUND: HIV/AIDS can have a disastrous effect on household food and nutrition security outcomes such as stunting in children under 5. However, stunting and HIV/AIDS are highly gendered phenomena that need to be explored in order to get an in-depth understanding of the interrelationship. This study was therefore aimed at investigating gender dimensions of the impact of HIV/AIDS on stunting in children under 5 years in Zimbabwe. METHODS: The study uses a large scale nationally representative cross-sectional dataset of 13,854 Zimbabwean households for the year 2019. To test hypothesis 1, the study employs binary choice models (Probit and Logit) since the outcome variable household HIV/AIDS status is dichotomous. To test hypothesis 2 and 3, the study employs the Propensity Score Matching (PSM) approach to circumvent the self-selection problem in the creation of treatment and control groups for households affected by HIV/AIDS and those that are not. RESULTS: The results revealed that household HIV/AIDS status is independent of the gender of household head. On the other hand, the results for the PSM estimates show that the probability of the household having a stunted child under 5 years is higher for households with an HIV positive member compared to those without. In addition, female headed households with an HIV positive member are more likely to have a stunted child under 5 years compared to male headed households under similar circumstances. CONCLUSION: Overall, the results provide evidence of a higher risk of stunting among children from households affected by HIV/AIDS. The study offers three major findings. Firstly, the study finds no significant association between gender of the household head and household HIV/AIDS status. Secondly, households that have at least one HIV positive member are more likely to have a stunted child under 5 years. Lastly, female headed households with at least one HIV positive member are more likely to have a stunted child under 5 years compared to male headed household with similar HIV/AIDS status. The findings have important policy implications towards improved integration of HIV/AIDS status, household head gender and child nutrition services in affected households.

The impact of food fortification on stunting in Zimbabwe: does gender of the household head matter?

BACKGROUND: High prevalence of stunting in children under 5 years poses a major threat to child development in developing countries. It is associated with micronutrient deficiency arising from poor diets fed to children under 5 years. Food fortification is amongst the interventions focused at reducing the incidence of stunting in children under 5 years. METHODS: Using a large-scale household data from Zimbabwe, we investigated the gender-based importance of household adoption of food fortification on the proportion of stunted children in the household. We employed propensity score matching to mitigate self-selection bias associated with household adoption of food fortification. RESULTS: We offer three major findings. Firstly, we find statistically weak evidence that female headed households are more likely to adopt food fortification than their male counterparts. Secondly, food fortification reduces the proportion of stunted children in the household. Finally, in comparison to non-adopters, female headed households that adopt food fortification are more able to reduce the proportion of stunted children in their households than their male counterparts. CONCLUSION: The results highlight the need for policy makers to actively promote food fortification, as such interventions are likely to contribute to the reduction of stunting and to involve men in fortification interventions to improve on their knowledge and appreciation of fortified foods and the associated benefits.

The Potential Role of Mycotoxins as a Contributor to Stunting in the SHINE Trial.

Children in developing countries experience multiple exposures that are harmful to their growth and development. An emerging concern is frequent exposure to mycotoxins that contaminate a wide range of staple foods, including maize and groundnuts. Three mycotoxins are suspected to contribute to poor child health and development: aflatoxin, fumonisin, and deoxynivalenol. We summarize the evidence that mycotoxin exposure is associated with stunting, and propose that the causal pathway may be through environmental enteric dysfunction (EED) and disturbance of the insulin-like growth factor 1 (IGF-1) axis. The objectives of this substudy are to assess the relationship between agricultural and harvest practices and mycotoxin exposure; to evaluate associations between mycotoxin exposure and child stunting; and to investigate EED as a potential pathway linking mycotoxin exposure to child stunting, to inform potential areas for intervention.

Herding behavior in COVID-19 vaccine hesitancy in rural Zimbabwe: The moderating role of health information under heterogeneous household risk perceptions.

COVID-19 vaccine hesitancy poses a global health threat by potentially delaying the attainment of herd immunity to attenuate infection and transmission. Most governments across the world are engrossed with formulating strategies to surmount conservative group behavior such as vaccine hesitancy typical under risky and uncertain situations such as in the case of COVID-19. This paper examines herding behavior in vaccine hesitancy with a special focus on the moderating role of household access to health information from village health workers under different risk perceptions. We use the 2021 Zimbabwe Vulnerability Assessment Committee cross-section household national survey consisting of 13, 583 valid observations. Our major findings indicate that herding behavior plays a role in rural households' hesitancy to COVID-19 vaccine inoculation. Furthermore, whilst access to health information from village health workers reduces herding behavior in vaccine hesitancy, it does so more when the household perceives itself to be at high risk of contracting COVID-19. Analysing herding behavior in vaccine hesitancy can help policymakers develop more targeted vaccination strategies, such as promoting access to health information through channels like village health workers, especially for households at high risk of contracting COVID-19.

The relationship between climate change induced natural disasters and selected nutrition outcomes: a case of cyclone Idai, Zimbabwe.

BACKGROUND: The increased frequency of climate induced natural disasters has exacerbated the risks of malnutrition in the already vulnerable regions. This study was aimed at exploring the effects of Cyclone Idai on nutrition outcomes of women of child-bearing age and children under 5 years. METHOD: The household-based cross-sectional study was conducted in Eastern Zimbabwe. Data were collected through face-to-face interviews to determine food consumption score (FCS) and household dietary diversity (HDDS), minimum dietary diversity for women (MDD-W) and minimum dietary diversity for children (MDD-C). Severity of Cyclone Idai was grouped into five categories based on the extent of damage to infrastructure and loss of human lives. Association between continuous and categorical variables was tested using Pearson correlation test and Chi square test, respectively. Linear and binary logistic regression was performed to investigate determinants of food security. RESULTS: A total of 535 households were interviewed. There was a significant correlation between severity of Cyclone Idai and MDD-W (p = 0.011), HDDS (p = 0.018) and FCS (p = 0.001). However, severity of Cyclone Idai was not a determinant of any nutrition outcome, but gender of household head was a negative predictor of HDDS (ß = - 0.734, p = 0.040), and marital status of household head was a positive predictor (ß = 0.093, p = 0.016) of FCS. CONCLUSION: The findings provide a good baseline to inform future programming of food aid activities during disasters. More so, our findings call for evidence-based policies regarding composition of a food aid basket and targeting of beneficiaries. The main strength of this study is that it is the first to investigate the effects of cyclones on food and nutrition security indicators and is based on a large sample size thus making our results generalisable.

Mopane worm value chain in Zimbabwe: Evidence on knowledge, practices, and processes in Gwanda District.

Consumption of edible insects is a potential solution to the growing need for protein. However, the wild harvested edible insects' value chain faces several challenges including limited knowledge on indigenous practices in the harvesting and processing and lack of information on roles of the different actors in the chain. A case study of Gonimbrasia belina, colloquially referred to as the 'mopane worm', was conducted to understand and identify determinants of participation in the value chain of the edible caterpillar. A cross sectional study was conducted in Gwanda (a rural district in Zimbabwe) to (a) understand the indigenous knowledge on harvesting and processing methods, (b) explore value addition and the traditional beliefs surrounding the utilisation of the mopane worm. Results showed that consumers (81.7%), and harvesters (76.6%) were the main actors in the mopane worm value chain. Using the Ordinary Least Squares (OLS) model, the following were shown to be determinants of participation in the mopane worm value chain: (a) gender (b) household size (c) marital status (d) religion and (e) household assets. Two primary processing methods of harvested mopane worm were distinguished i.e., boiling and roasting on ambers. Results showed lack of diversity in mopane worm-based products. Current culturally acceptable processing techniques need improvement and standardization to support sustainable mopane worm processing while optimising nutrient bio-accessibility.

Determinants of recent aflatoxin exposure among pregnant women in rural Zimbabwe.

SCOPE: Aflatoxins (AFs) are toxic secondary metabolites of Aspergillus species that contaminate staple foods such as maize and groundnuts. AF exposure during pregnancy has been associated with adverse birth outcomes in limited-scale surveys in sub-Saharan Africa. The objective of this study was to describe the determinants of AF exposure, using urinary aflatoxin M1 (AFM1) biomarkers and data generated by the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial for rural Zimbabwean women in early pregnancy. Sanitation Hygiene Infant Nutrition Efficacy is a large, cluster-randomized community-based trial in Zimbabwe designed to investigate the independent and combined effects of nutrition and hygiene interventions on early child growth. METHODS AND RESULTS: Urine samples collected from 1580 pregnant women in rural Zimbabwe at median gestational age of 13.9 wk were measured for AFM1. AFM1 was detected in 30% of samples (median of exposed, 162 pg AFM1/mg creatinine; range 30-6046 pg AFM1/mg). In multivariable ordinal logistic models, geographical location (p<0.001), seasonality (p < 0.001) and dietary practices (p = 0.011) were significant predictors of urinary AFM1. CONCLUSION: This is the largest AF biomarker survey conducted in Zimbabwe, and demonstrated frequent exposure in pregnant women with clear temporal and spatial variability in AF biomarker levels.