scholarly journals Pregnant Women in Four Low-Middle Income Countries Have a High Prevalence of Inadequate Dietary Intakes That Are Improved by Dietary Diversity

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1560 ◽  
Author(s):  
Rebecca Lander ◽  
K. Hambidge ◽  
Jamie Westcott ◽  
Gabriela Tejeda ◽  
Tshilenge Diba ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Rural Areas ◽  
Dietary Diversity ◽  
Reproductive Age ◽  
Dietary Intakes ◽  
Middle Income ◽  
Total N ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Dietary Data

Background: Up-to-date dietary data are required to understand the diverse nutritional challenges of pregnant women living in low-middle income countries (LMIC). To that end, dietary data were collected from 1st trimester pregnant women in rural areas of Guatemala, India, Pakistan, and Democratic Republic of the Congo (DRC) participating in a maternal lipid-based nutrient supplement (LNS) Randomized Controlled Trial to examine dietary diversity (DD), usual group energy and nutrient intakes, and prevalence of inadequate dietary intakes. Methods: Two 24-h dietary recalls were conducted in ~240 pregnant women/site (total n = 966) prior to 12-week gestation. Adequate DD was assessed, i.e., ≥5 major food groups consumed within the past 24 h. Median, Q1, Q3 intakes (without LNS) of energy, macronutrients, 12 micronutrients, and phytate were examined. The “at risk” prevalence of inadequate intakes were based on international guidelines for pregnant women. Results: Dietary patterns varied widely among sites, with adequate DD reported: 20% (Pakistan), 25% (DRC), 50% (Guatemala), and 70% (India). Significantly higher intakes of most key nutrients were observed in participants with adequate DD. More than 80% of women in all sites had inadequate intakes of folate, vitamin B12, and choline, and >80% of women in India and DRC also had inadequate intakes of calcium, thiamine, riboflavin, and vitamin B6. Conclusions: Our data highlight the likely need for micronutrient supplementation in pregnancy, specifically multi-micronutrient interventions, and support the value of increasing DD as part of sustainable long-term nutrition programs for women of reproductive age in these poor rural settings in LMIC.

scholarly journals Prevalence and determinants of anaemia among children aged 0–59 months in a rural region of Armenia: a case–control study

2015 ◽  
Vol 19 (7) ◽  
pp. 1260-1269 ◽  
Author(s):  
Anahit Demirchyan ◽  
Varduhi Petrosyan ◽  
Viktoria Sargsyan ◽  
Kim Hekimian
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Regression Models ◽  
Severe Anaemia ◽  
Linear Regression Models ◽  
Middle Income ◽  
Middle Income Countries ◽  
Daily Diet ◽  
Younger Age ◽  
Low Middle Income Countries

AbstractObjectiveDespite the trend of increasing prevalence of childhood anaemia in Armenia, no studies exploring its risk factors have been conducted in the country. The present study aimed to investigate the prevalence and determinants of childhood anaemia in rural Armenia.DesignBlood Hb level was measured among a representative sample of children using the HemoCue Hb201+ analyser. The revealed cases with anaemia were compared with randomly selected non-anaemic controls. Mothers of cases and controls were interviewed. Logistic and linear regression models were fitted to identify the risk factors of anaemia and low Hb level, respectively.SettingTalin communities, Aragatsotn Province, Armenia.SubjectsChildren under 5 years of age in Talin region.ResultsOf the 729 studied children, 32·4 % were anaemic with 14·7 % having moderate/severe anaemia. Infants were the most affected group with 51·1 % being anaemic before 6 months and 67·9 % at 6–12 months of age. Fitted regression models identified the following predictors of anaemia: younger age, male gender, shorter birth length, anaemia during pregnancy, lower meal frequency per day, lack of meat in the diet, using dung cakes for heating and living in a community that received an incomplete set of nutrition interventions.ConclusionsThe study identified several modifiable risk factors that could be targeted to reduce childhood anaemia in rural Armenia and, possibly, in rural areas in other low-/middle-income countries. The suggested interventions include prevention and treatment of anaemia during pregnancy, provision of adequate complementary feeding to children with inclusion of meat in their daily diet and reduction of their exposure to biomass fuel smoke.

scholarly journals Role of Iron in the Reduction of Anemia Among Women of Reproductive Age in Low-Middle Income Countries: Insights From Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Sumera Aziz Ali ◽  
Shama Razzaq ◽  
Savera Aziz ◽  
Ahreen Allana ◽  
Arzina Aziz Ali ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Reproductive Age ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Women Of Reproductive Age ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract BackgroundIron deficiency anemia is a common public health problem problem among women of reproductive age (WRA) as it is can lead to unfavorable maternal and birth outcomes. Although studies are undertaken to assess the efficacy of iron, there are some gaps and limitations in the existing studies that need to be addressed. To address the gaps, we undertook a systematic review and meta-analysis to assess the existing evidence regarding the role of iron in decreasing anemia among WRA in low-middle-income countries.MethodsPubMed, Embase, and Science Direct were systematically searched using a comprehensive search strategy for randomized controlled trials published between 2000 to 2020. Mean change in hemoglobin level was assessed as a primary outcome. We performed a meta-analysis to estimate the pooled effect of all studies using standardized mean differences and their respective 95% CI. We assessed heterogeneity and publication bias using I2 statistics and Egger’s test respectively. This review was conducted with the help of updated guidelines based on the Preferred Reporting Items for Systematic Review and Meta-analysisResultsGenerally, the results demonstrated a favorable effect of iron therapy in improving hemoglobin levels with variation across studies. An overall pooled effect estimate for the role of iron therapy in decreasing the burden of anemia among WRA was -0.51 (95% CI: -1.03 to 0.01) (p = 0.04). Likewise, iron therapy improved ferritin levels and decreased the prevalence of anemia. The heterogeneity across included studies was found to be statistically significant as indicated by the parameters of heterogeneity (Q = 1191.60, I2 = 98.24%, p = 0.000). ConclusionIron therapy in any form may reduce the burden of anemia and improve the hemoglobin and ferritin levels, indicating improvement in iron-deficiency anemia. However, more evidence is needed to assess the morbidity associated with iron consumption such as side effects, work performance, economic outcomes, mental health, and compliance to the intervention with a special focus on married but non-pregnant women planning a pregnancy in near future. A systematic review and Meta-analysis registration: Registered with PROSPERO and ID is CRD42020185033

scholarly journals Interventions on Food Security and Water Uses for Improving Nutritional Status of Pregnant Women and Children Younger Than Five Years in Low-Middle Income Countries: A Systematic Review

2021 ◽  
Vol 18 (9) ◽  
pp. 4799
Author(s):  
Cristina Urgell-Lahuerta ◽  
Elena Carrillo-Álvarez ◽  
Blanca Salinas-Roca
Keyword(s):  
Systematic Review ◽  
Food Security ◽  
Global Health ◽  
Nutritional Status ◽  
Pregnant Women ◽  
Health Impact ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Global Health Issue

Malnutrition is a global health issue concerning children and pregnant women in low- and middle-income countries (LMICs). The aim of this review was to assess the health-impact outcomes of interventions addressing food security, water quality and hygiene in order to address the improvement of the nutritional status in children below five years and pregnant women in LMICs. Using PRISMA procedures, a systematic review was conducted by searching in biomedical databases clinical trials and interventions for children and pregnant women. Full articles were screened (nf = 252) and critically appraised. The review included 27 randomized and non-randomized trials and interventions. Based on the analysis, three agents concerning nutritional status were identified. First, exclusive breastfeeding and complementary feeding were fundamental elements in preventing malnutrition. Second, provision of sanitation facilities and the promotion of hygienic practices were also essential to prevent infections spread and the consequent deterioration of nutritional status. Finally, seasonality was also seen to be a relevant factor to consider while planning and implementing interventions in the populations under study. In spite of the efforts conducted over last decades, the improvement in food insecurity rates has remained insufficient. Therefore, the development of global health programs is fundamental to guide future actions.

scholarly journals Development and validation of the Social Capital Assessment Tool in pregnancy for Maternal Health in Low and middle income countries (LSCAT-MH)

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027781 ◽  
Author(s):  
Thilini C Agampodi ◽  
Suneth B Agampodi ◽  
Nick Glozier ◽  
T A Lelwala ◽  
K D P S Sirisena ◽  
...  
Keyword(s):  
Social Capital ◽  
Maternal Health ◽  
Pregnant Women ◽  
Assessment Tool ◽  
Psychometric Validation ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
In Pregnancy ◽  
Low And Middle Income

ObjectivesSocial capital which implies ‘features of social organisation, such as trust, norms and networks that can improve the efficiency of society by facilitating coordinated actions’ is rarely assessed in relation to maternal health in low/middle-income countries (LMICs). A main reason for this research gap could be the unavailability of a specific tool to measure social capital in pregnancy. The study developed and validated an instrument to measure social capital among pregnant women.SettingWe developed the tool based on World Bank Social Capital Assessment Tool and its adaptations identified as applicable to LMIC from an initial systematic review. The study was conducted in Anuradhapura district in the North Central Province of Sri Lanka. Validation process was conducted in urban, rural and resettled communities.ParticipantsStudy participants of the cognitive validation included pregnant women from the three communities, and an expert panel including a social scientist, methodological expert, subject expert, public health officers. The psychometric validation was performed on 439 pregnant women permanently residing in the three communities.ResultsThe 24-item Low and middle income countries Social Capital Assessment Tool for Maternal Health (LSCAT-MH) demonstrated high internal consistency (Cronbach’s α=0.94). Factor analytical methods suggested a four-factor model of (1) neighbourhood networks (structural bonding), (2) domestic and neighbourhood cohesion (cognitive bonding), (3) social contribution and (4) social participation (structural bridging). Concurrent validity with antenatal mental ill health was confirmed through a negative correlation with the Edinburgh Postpartum Depression Scale. Test–retest reliability was high with intraclass correlation of 0.71 and a Pearson correlation of 0.83.ConclusionThe LSCAT-MH is a psychometrically valid and reliable tool to measure social capital in pregnancy. Predictive validity was not tested as the study was not a longitudinal follow-up.

scholarly journals Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries?

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Aleha Aziz ◽  
Sarah Saleem ◽  
Tracy L. Nolen ◽  
Nousheen Akber Pradhan ◽  
Elizabeth M. McClure ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neonatal Mortality ◽  
Pregnancy Outcomes ◽  
Low Birthweight ◽  
The Other ◽  
Middle Income ◽  
Live Births ◽  
Low Resource ◽  
Middle Income Countries ◽  
Low Middle Income Countries

Abstract Background Pakistan has among the poorest pregnancy outcomes worldwide, significantly worse than many other low-resource countries. The reasons for these differences are not clear. In this study, we compared pregnancy outcomes in Pakistan to other low-resource countries and explored factors that might help explain these differences. Methods The Global Network (GN) Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya, Zambia). Study staff enroll women in early pregnancy and follow-up soon after delivery and at 42 days to ascertain delivery, neonatal, and maternal outcomes. We analyzed the maternal mortality ratios (MMR), neonatal mortality rates (NMR), stillbirth rates, and potential explanatory factors from 2010 to 2018 across the GN sites. Results From 2010 to 2018, there were 91,076 births in Pakistan and 456,276 births in the other GN sites combined. The MMR in Pakistan was 319 per 100,000 live births compared to an average of 124 in the other sites, while the Pakistan NMR was 49.4 per 1,000 live births compared to 20.4 in the other sites. The stillbirth rate in Pakistan was 53.5 per 1000 births compared to 23.2 for the other sites. Preterm birth and low birthweight rates were also substantially higher than the other sites combined. Within weight ranges, the Pakistani site generally had significantly higher rates of stillbirth and neonatal mortality than the other sites combined, with differences increasing as birthweights increased. By nearly every measure, medical care for pregnant women and their newborns in the Pakistan sites was worse than at the other sites combined. Conclusion The Pakistani pregnancy outcomes are much worse than those in the other GN sites. Reasons for these poorer outcomes likely include that the Pakistani sites' reproductive-aged women are largely poorly educated, undernourished, anemic, and deliver a high percentage of preterm and low-birthweight babies in settings of often inadequate maternal and newborn care. By addressing the issues highlighted in this paper there appears to be substantial room for improvements in Pakistan’s pregnancy outcomes.

scholarly journals Dietary intakes of women during pregnancy in low- and middle-income countries

2012 ◽  
Vol 16 (8) ◽  
pp. 1340-1353 ◽  
Author(s):  
Sun Eun Lee ◽  
Sameera A Talegawkar ◽  
Mario Merialdi ◽  
Laura E Caulfield
Keyword(s):  
Developing Countries ◽  
South America ◽  
Pregnant Women ◽  
Food Consumption ◽  
Dietary Intakes ◽  
Middle Income ◽  
Middle Income Countries ◽  
The Caribbean ◽  
Central South ◽  
Low And Middle Income

AbstractObjectiveTo provide a better understanding of dietary intakes of pregnant women in low- and middle-income countries.DesignSystematic review was performed to identify relevant studies which reported nutrient intakes or food consumption of pregnant women in developing countries. Macronutrient and micronutrient intakes were compared by region and the FAO/WHO Estimated Average Requirements. Food consumption was summarized by region.SettingDeveloping countries in Africa, Asia, and the Caribbean and Central/South America.SubjectsPregnant women in the second or third trimester of their pregnancies.ResultsFrom a total of 1499 retrieved articles, sixty-two relevant studies were analysed. The ranges of mean/median intakes of energy, fat, protein and carbohydrate were relatively higher in women residing in the Caribbean and Central/South America than in Africa and Asia. Percentages of energy from carbohydrate and fat varied inversely across studies in all regions, whereas percentage of energy from protein was relatively stable. Among selected micronutrients, folate and Fe intakes were most frequently below the Estimated Average Requirements, followed by Ca and Zn. Usual dietary patterns were heavily cereal based across regions.ConclusionsImbalanced macronutrients, inadequate micronutrient intakes and predominantly plant-based diets were common features of the diet of pregnant women in developing countries. Cohesive public health efforts involving improving access to nutrient-rich local foods, micronutrient supplementation and fortification are needed to improve the nutrition of pregnant women in developing countries.

scholarly journals Neonatal deaths in infants born weighing ≥ 2500 g in low and middle-income countries

2020 ◽  
Vol 17 (S2) ◽  
Author(s):  
Sarah Saleem ◽  
Farnaz Naqvi ◽  
Elizabeth M. McClure ◽  
Kayla J. Nowak ◽  
Shiyam Sunder Tikmani ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Neonatal Mortality ◽  
Global Network ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Live Births ◽  
Middle Income Countries ◽  
High Resource ◽  
Low Middle Income Countries ◽  
Increased Risk

Abstract Background Babies born weighing ≥ 2500 g account for more than 80% of the births in most resource-limited locations and for nearly 50% of the 28-day neonatal deaths. In contrast, in high-resource settings, 28-day neonatal mortality among this group represents only a small fraction of the neonatal deaths. Yet mortality risks for birth weight of ≥ 2500 g is limited. Knowledge regarding the factors associated with mortality in these babies will help in identifying interventions that can reduce mortality. Methods The Global Network’s Maternal Newborn Health Registry (MNHR) is a prospective, population-based observational study that includes all pregnant women and their pregnancy outcomes in defined geographic communities that has been conducted in research sites in six low-middle income countries (India, Pakistan, Democratic Republic of Congo, Guatemala, Kenya and Zambia). Study staff enroll all pregnant women as early as possible during pregnancy and conduct follow-up visits to ascertain delivery and 28-day neonatal outcomes. We analyzed the neonatal mortality rates (NMR) and risk factors for deaths by 28 days among all live-born babies with a birthweight ≥ 2500 g from 2010 to 2018 across the Global Network sites. Results Babies born in the Global Network sites from 2010 to 2018 with a birthweight ≥ 2500 g accounted for 84.8% of the births and 45.4% of the 28-day neonatal deaths. Among this group, the overall NMR was 13.1/1000 live births. The overall 28-day NMR for ongoing clusters was highest in Pakistan (29.7/1000 live births) and lowest in the Zambian/Kenyan sites (9.3/1000) for ≥ 2500 g infants. ≥ 2500 g NMRs declined for Zambia/Kenya and India. For Pakistan and Guatemala, the NMR remained almost unchanged over the period. The ≥ 2500 g risks related to maternal, delivery and newborn characteristics varied by site. Maternal factors that increased risk and were common for all sites included nulliparity, hypertensive disease, previous stillbirth, maternal death, obstructed labor, severe postpartum hemorrhage, and abnormal fetal presentation. Neonatal characteristics including resuscitation, hospitalization, congenital anomalies and male sex, as well as lower gestational ages and birthweights were also associated with increased mortality. Conclusions Nearly half of neonatal deaths in the Global Network sites occurred in infants born weighing ≥ 2500 g. The NMR for those infants was 13.1 per 1000 live births, much higher than rates usually seen in high-income countries. The changes in NMR over time varied across the sites. Even among babies born ≥ 2500 g, lower gestational age and birthweight were largely associated with increased risk of mortality. Since many of these deaths should be preventable, attention to preventing mortality in these infants should have an important impact on overall NMR. Trial registration: https://ClinicalTrials.gov Identifier: NCT01073475

scholarly journals Reasons for nonuse of contraceptive methods by women with demand for contraception not satisfied: an assessment of low and middle-income countries using demographic and health surveys

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Laísa Rodrigues Moreira ◽  
Fernanda Ewerling ◽  
Aluisio J. D. Barros ◽  
Mariangela Freitas Silveira
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Reproductive Age ◽  
Demographic And Health Surveys ◽  
Contraceptive Methods ◽  
Middle Income ◽  
Health Concerns ◽  
Middle Income Countries ◽  
Low And Middle Income ◽  
Lack Of Knowledge

Abstract Background Nonuse of contraceptive methods by women in need of contraception may impact their sexual and reproductive health. The aim of this study was to describe the reasons for nonuse of contraception among women with demand for contraception not satisfied in low and middle-income countries (considering both overall countries and various subgroups of women). Methods We used the latest Demographic and Health Survey data from 47 countries. A descriptive analysis of the reasons for nonuse of contraceptive methods was performed among sexually active women with demand for contraception not satisfied. The prevalence of each reported reason was also evaluated according to marital status, woman’s age and schooling, area of residence, wealth index, and parity. Wealth-related absolute inequality for each reason was also evaluated using the Slope Index of Inequality. A pro-rich inequality pattern means that the reason is more prevalent among the richest women while a pro-poor means the reason is more common among the poorest ones. Results On average, 40.9% of women in need of contraception were not using any contraceptive methods to avoid pregnancy. Overall, the most prevalent reasons for nonuse of contraceptives were “health concerns” and “infrequent sex,” but the prevalence of each reason varied substantially across countries. Nonuse due to “opposition from others” was higher among married than unmarried women; in turn, the prevalence of nonuse due to “lack of access” or “lack of knowledge” was about two times higher in rural areas than in urban areas. Women with less schooling more often reported nonuse due to “lack of access.” Pro-rich inequality was detected for reasons “health concerns,” “infrequent sex,” and “method-related”, while the reasons “other opposed,” “fatalistic,” “lack of access,” and “lack of knowledge” were linked to patterns of pro-poor inequality. Conclusions Family planning promotion policies must take into account the different reasons for the nonuse of contraceptive methods identified in each country as well as the contextual differences regarding women of reproductive age (such as social norms and barriers that prevent women from accessing and using contraceptives).

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

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