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ArtikelMultisector intervention to accelerate reductions in child stunting: an observational study from 9 sub-Saharan African countries  
Oleh: Remans, Roseline ; Pronyk, Paul M. ; Fanzo, Jessica C. ; Chen, Jiehua
Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The American Journal of Clinical Nutrition vol. 94 no. 06 (Dec. 2011), page 1632-1642 .
Topik: NUTRITION; Childhood Stunting
Ketersediaan
  • Perpustakaan FK
    • Nomor Panggil: A07.K.2011.02
    • Non-tandon: 1 (dapat dipinjam: 0)
    • Tandon: tidak ada
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Isi artikelBackground: In sub-Saharan Africa, ~40% of children <5 y old are stunted, with levels that have remained largely unchanged over the past 2 decades. Although the complex determinants of undernutrition are well recognized, few studies have evaluated strategies that combine nutrition-specific, health-based approaches with food system– and livelihood-based interventions. Objective: We examined changes in childhood stunting and its determinants after 3 y of exposure to an integrated, multisector intervention and compared these changes with national trends. Design: A prospective observational trial was conducted across rural sites in 9 sub-Saharan African countries with baseline levels of childhood stunting >20%. A stratified random sample of households and resident children <2 y old from villages exposed to the program were enrolled in the study. Main outcome measures included principal determinants of undernutrition and childhood stunting, which was defined as a height-for-age z score less than -2. National trends in stunting were generated from demographic and health surveys. Results: Three years after the start of the program in 2005–2006, consistent improvements were observed in household food security and diet diversity, whereas coverage with child care and disease-control interventions improved for most outcomes. The prevalence of stunting in children <2 y old at year 3 of the program (2008–2009) was 43% lower (adjusted OR: 0.57; 95% CI: 0.38, 0.83) than at baseline. The average national stunting prevalence for the countries included in the study had remained largely unchanged over the past 2 decades. Conclusion: These findings provide encouraging evidence that a package of multisector interventions has the potential to produce reductions in childhood stunting.
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