Reducing child malnutrition in Tanzania. Combined effects of income growth and program interventions.

Malnutrition is associated with an inadequate diet, poor health and sanitation services and inadequate care for young children. A combination of income growth and nutrition interventions are therefore suggested to adequately tackle this issue [Haddad, L., Alderman, H., Appleton, S., Song, L., Yohannes, Y., 2003. Reducing child malnutrition: how far does income growth take us? World Bank Econ. Rev., 17, 107-131.], yet evidence to support this claim is often not available, especially for African settings. This paper evaluates the joint contribution of income growth and nutrition interventions towards the reduction of malnutrition. Using a four round panel data set from northwestern Tanzania we estimate the determinants of a child's nutritional status, including household income and the presence of nutrition interventions in the community. The results show that better nutrition is associated with higher income, and that nutrition interventions have a substantial beneficial effect. Policy simulations make clear that if one intends to halve malnutrition rates by 2015 (the MDG objective), income growth will have to be complemented by large scale program interventions.     

Misfortunes never come singly: Structural change,multiple shocks and child malnutrition in rural Senegal

This study considers the two most pronounced shocks Senegalese subsistence farmers struggle with, namely increasing purchase prices and droughts. We assess the relationship of these self-reported shocks with child health in a multi-shock approach to account for concomitance of adverse events from the natural, biological, economic and health sphere. We employ a unique farming household panel dataset containing information on children living in poor, rural households in eight regions of Senegal in 2009 and 2011 and account for structural changes occurring between survey periods due to the large scale, national Nutrition Enhancement Program. By zooming in to the micro level we demonstrate that Senegal as a Sahelian country, mainly reliant on subsistence agriculture, is very vulnerable to climate variability and international price developments: According to our conservative estimates, the occurrence of a drought explains 25% of the pooled weight-for-age standard deviation, income losses 31%. Our multi-shock analysis reveals that the shocks are perceived as more severe in 2011 with droughts explaining up to 44% of the standard deviation of child health, increased prices up to 21%. Yet, the concomitance of droughts and increased prices after the structural change, i.e. the Nutrition Enhancement Program, indicates that the health of children experiencing both shocks in 2011 has improved. We argue that these results are driven by the increase in rural household income as theoretically outlined in the agricultural household model. Thus, adequate policy responses to shocks do not only depend on the nature but also on the concomitance of hazardous events.     

Geography and culture matter for malnutrition in Bolivia

The prevalence of health problems and malnutrition in Bolivia is exceptionally high, even in comparison to other underdeveloped countries. This study analyzes the relationship between a two measures of child health--height-for-age and weight-for-age z-scores--and a set of physical and cultural determinants of child nutrition, including mother's characteristics, household assets and access to public services. The ultimate aim is to identify the most important determinants of child health and to measure the relative impact of each factor on the height and weight z-scores. A sequential strategy was adopted in order to estimate a two-equation linear model with correlated error terms. A major finding points to geographical and cultural variables as main causes of nutritional status and highlights the role of mother's anthropometrical characteristics. This study uses data on over 3000 children gathered from a Demographic and Health Survey (DHS).     

Nutritional status of adults in rural Mali.

An anthropometric assessment was conducted of 441 adults from six rural villages in southern Mali. As is typical for human populations, females are shorter and lighter than males. Both females (N = 320) and males (N = 121) are shorter and lighter than their U.S. counterparts. Mean weight in the sample is 53.4 +/- 8.5 kilos for females and 58.8 +/- 6.5 kilos for males. Mean height is 160.4 +/- 5.7 cm for females and 171.3 +/- 6.6 cm for males. The data for height in males are very similar to those reported from other surveys in Mali, and show no evidence for a positive secular trend in height. Mean body mass index (BMI) is 20.8 for females and 20.0 for males. These are lower than U.S. averages, but well above suggested cutoff points for malnutrition in adults. Average arm circumference is 26.5 cm for females and 26.4 cm for males. Females have relatively large arm circumferences due, in part, to the heavy manual labor they perform. Average head circumference is 53.0 cm for females and 54.8 cm for males. For both sexes, these values are more than 1 standard deviation (SD) below the U.S. means. Adult values for anthropometric measurements reflect childhood stresses of malnutrition and disease, and a lifetime of accommodation to a high-carbohydrate, low-protein diet, and hard physical labor. Females are significantly closer to the U.S. standards than males for weight, height, BMI, and arm circumference; these findings support the idea that females are buffered from environmental stresses relative to males. In addition, females exhibit significantly more variability than males for weight, arm circumference, and head circumference, but not for height, suggesting that variability in adult height does not reflect the presence or absence of female buffering or the level of environmental adversity.     

The kell system in Senegal: phenotype and gene frequencies

The Kell gene frequencies, determined in Senegal are as follows: Our data enter the limits already known for black African populations.     

Private and public determinants of child nutrition in Nicaragua and Western Honduras

We present a multivariate regression model of nutritional indicators, including interactions between education levels and overall community development, as well as estimates of community fixed effects, for two data sets: the first one is from a 2001 nationwide household survey in Nicaragua while the second set was collected in the Western regions of Honduras in 2002, as part of an evaluation process for a family entitlement program. Maternal stature, age difference with an older sibling, household size and income are seen as the main determinants of anthropometric development. Within the more homogeneous communities of Western Honduras, woman's education is also related to the child's nutritional status. The importance of individual community variables is much lower and the inclusion of community fixed effects does not alter the other parameters. However, in the Honduran sample, overall community development (assessed through the community fixed effects) has a small but significant and synergistic effect on the impact of child and household variables. The characteristics of this study and the complex design of entitlement programs prevent an adequate evaluation of those interventions within the poverty reduction strategies. The improvement of intra-community targeting seems to be a key orientation for redesign. An improved socio-economic situation, sound population and family policies, and an appropriate preventive public health care still are safe investments towards improvement of child health and nutrition.     

Growth status, age, and grade as predictors of school continuation for Guatemalan Indian children

Schooling is considered by many researchers and agencies as an important contributor to individual and national development for populations living in the less developed countries. Accordingly, programs to increase school enrollment and continuation from grade to grade are being developed for many of these countries. This paper investigates the relationship of physical growth status (height, weight, and body composition), grade in school, and age to school continuation for a sample of Indian children living in a village near Guatemala City. It was found that physical growth status, a reflection of health and nutritional status, does not predict school continuation. A child's age and current grade in school do predict continuation. Most children leave school after reaching 9 years of age or after completing the second grade. It is suggested that children may learn enough to satisfy their parents' expectations by this age or grade. Also, the child's economic value to his or her family may be a significant reason for school drop-out.     

Going Where the Grass Is Greener: On the Study of Pastoral Mobility in Ferlo, Senegal

Based on a case study from Ferlo in Senegal, this paper discusses how pastoral mobility can be studied and understood with special emphasis on the use of GPS data. It has a dual objective: first, to investigate the methodological potential of using GPS data; second, to discuss the analytical use of GPS data for understanding mobility. The methodological potential for using GPS data is related to quantifying mobility and characterizing mobility patterns in space and time. Analytically, GPS data can be used in combination with qualitative information to make method triangulation. The GPS data can be used both prior to qualitative interviews to make informed questions about mobility and they can be used after qualitative investigations to illustrate points made or to reveal inconsistencies. The study shows that cattle walk about 5000 km per year (excluding night grazing) and different mobility patterns occur depending on the season. Issues such as the cattle complex and the notion of the independent, nomadic pastoralist are discussed in relation to pastoral mobility. Although cattle are of major importance to the Fulani, it is not important for them to walk with their animals, which are left to roam freely or supervised by paid herders. It is necessary to take into account all these issues if we want to go beyond the simple understanding of mobility as a means to find pasture and water.     

Height and BMI of Italian immigrants to the USA, 1908–1970

We analyze self-reported anthropometric data pertaining to 2140 adults who emigrated to the United States, mainly from southern Italy, between 1908-1928 and 1960-1970. The mean height of immigrant men was 165.5 cm: they were taller than contemporary southern Italian men by 0.5-7.3 cm in different periods. The mean height of the Italian immigrant women born before 1952 was 157.6 cm, less than the national average. At the end of the 1990s, national women average height was 162 cm, 159.5 cm for southern women. There were age-related increases of weight and BMI: overweight was more prevalent in the 40-49 years age category. In the male sample, the mean values of BMI were within the overweight range in all age classes. The prevalence of obesity was higher in the male sample than among US men, whereas it was virtually identical in the women's sample and much higher than the values reported for several European countries for the period 1970-1980.     

Paradoxical malnutrition in mother-child pairs: Untangling the phenomenon of over- and under-nutrition in underdeveloped economies

As economic development and urbanization proceed globally, the coexistence of under- and over-nutrition within the same household, sometimes termed ‘paradoxical’ or ‘dual burden’ malnutrition is increasingly being reported. We used Demographic and Health Survey data sets from 18 lower and middle income countries to explore paradoxical forms of malnutrition (maternal overweight with child underweight or stunting) in mother-child pairs. Multinomial logistic regression was used to estimate the odds of discordant pairs after adjusting for a number of important covariates. Several factors were significantly associated with an increased relative odds of discordant mother-child pairs, including working in subsistence agriculture, low levels of maternal education, more siblings in the household, and relative household poverty. However, many of these factors also predicted other combinations of poor nutritional status in mother-child pairs. We conclude that it is difficult to identify any specific factors that elevate risk above and beyond those that predict risk of maternal over-nutrition or child under-nutrition. Based on these analyses, it appears that paradoxical weight status between mothers and children can be best understood as a consequence of rapid secular increases in maternal weight, rather than a distinct nutritional condition with a discrete etiology.     

维吾尔族与汉族儿童肠道细菌群落分析

【背景】肠道菌群是人体的重要组成部分,在人体的多种生命活动中发挥着重要作用。【目的】探究维吾尔族和汉族儿童肠道细菌群落特征,为儿童营养健康状况监测和营养改善工作提供更有效精准的营养干预策略。【方法】从新疆维吾尔自治区泽普县维吾尔族和河南省民权县汉族人群中分别随机选取10?12岁学龄期儿童各20名,同一时间段收集其新鲜粪便,提取细菌总DNA,通过高通量测序和生物信息学分析,研究两地区健康维吾尔族儿童与汉族儿童肠道细菌群落的差异。【结果】获得测序序列2 007 100条,归类于994个OTU;所有样本共含15个细菌门139属。α多样性和β多样性分析表明,调查地区的2个民族儿童肠道细菌的丰富度和多样性均有统计学意义上的差异,维吾尔族儿童肠道细菌群落丰富度高于汉族儿童,而物种多样性不如汉族儿童。其中,维吾尔族儿童肠道细菌丰度相对占优势的门和属及其丰度值为：拟杆菌门(Bacteroidetes,63%)、厚壁菌门(Firmicutes,22%)、普氏菌属(Prevotella,61%)、琥珀酸弧菌属(Succinivibrio,9%)和粪杆菌属(Faecalibacterium,5%);汉族儿童肠道细菌丰度占优势的门和属及其丰度值为：厚壁菌门(57%)、拟杆菌门(23%)、粪杆菌属(16%)、普氏菌属(11%)和拟杆菌属(Bacteroides,11%)。【结论】调查地区维吾尔族与汉族儿童肠道细菌群落差异较大,这为进一步研究肠道菌群与膳食因素及人体营养健康状况之间的关系提供了依据。     

Feeding habits of the spotted hyaena in the Niokolo Koba National Park, Senegal

The food habits of the spotted hyaena were studied during the dry season in relation to food availability in the Niokolo Koba National Park, Senegal. Frequency of occurrence of the different foods was quantified by means of scat analysis; species occurrence in the diet was compared with availability in the study area. Large and medium-sized mammals, such as the buffalo, the hartebeest and the warthog, were eaten more often than expected.     

Height, health, and income in the US, 1984–2005

Height has been associated with better physical health when outcomes such as diabetes, heart disease, and obesity are considered, yet stature is rarely used in predicting comorbidities or as a proxy for physical health when analyzing outcomes such as income. Since height is a more exogenous measure than variables likely to be affected by lifestyle changes, such as obesity, observing labor market outcomes based on height may be revealing. In addition, gender and racial differences must be taken into account when analyzing the effects of height on physical health and labor market outcomes. This study utilizes the 1984--2005 samples of the Behavioral Risk Factor Surveillance System in estimating trends in height over time by gender and race, and in analyzing the relationship between height and physical health and labor market outcomes in the United States. Trends show that height has not changed substantially at a time when physical health, as indicated by the incidence of obesity, Type II diabetes, and cholesterol, has deteriorated, and earnings disparities across racial gaps persist. Results at mean values for males indicate that being 10cm taller is associated with a 14-47% increase in obesity, an 8-13% reduction in cholesterol prevalence, and a $1874-2306 income premium. For females, results indicate that being 10cm taller is associated with an 8-18% reduction in cholesterol, a 14% reduction in diabetes for white females, and an $891-2243 earnings premium.     

Patterns of growth and malnutrition among preschoolers in Belize

An anthropometric survey of 750 preschoolers was conducted during 1979 in Belize to assess nutritional status in two districts, one coastal and the other inland. Mothers were interviewed concerning reproductive history, child's health and dietary history, and associated factors. Analysis included the recognition of low arm circumference, weight-for-age, stature-for-age, and weight-for-stature. Survey results indicate that about 25% of the children, birth to 5 years old, show evidence of stunting, while 2.5% show evidence of wasting. Comparisons of rates of malnutrition by ethnic group reveal that the Maya and Garifuna (Black Carib) children are significantly more commonly malnourished than others. Applying a discriminant function to groups of children designated as “poor” and “better-than-average” growth classes reveals several factors which may be contributory to the etiology of preschool malnutrition in Belize. The frequency of diarrhea and age at introduction to solid foods, are significantly related to growth retardation among preschoolers. Analysis of 24-hour-diet recalls corroborates the patterning of malnutrition among ethnic groups.     

Historical trends in height, weight, and body mass: Data from U.S. Major League Baseball players, 1869-1983

We employ a unique dataset of Major League Baseball (MLB) players - a select, healthy population - to examine trends in height, weight, and body mass in birth cohorts from 1869 to 1983. Over that 115-year time period, U.S. born MLB players have gained, on average, approximately 3 in. (7.6 cm) in height and 27.0 lb (12.2 kg) in weight, which has contributed a 1.6-unit increase in the body mass index. Where comparable data are available, U.S. born MLB players are about 2.0 in. (5.1 cm) taller and 20.0 lb (9.1 kg) heavier but substantially less obese than males in the general U.S. population. But both groups exhibit similar height and weight trends; the majority of height and weight gains take place in cohorts that were born prior to World War II, followed by slower gains and occasional declines in height and weight for cohorts born in 1939 and later.     

Love, careers, and heights in France, 2001

Short men are less likely to be married or live in a permanent relationship than their taller counterparts. This pattern is not due to their social status. While blue-collar workers are shorter on average than managers, the effects of height on finding a mate are similar in the two social groups. Being tall is also economically advantageous for men. With identical educational attainment levels, tall men have better careers than short men as they are given greater supervisory responsibilities. In making a commitment, some women might take height into account as an anticipated indicator of future resources of the household. Choice of partner is also influenced by social norms--i.e., partners should be physically well-matched--which is more difficult for shorter men.     

Report: access to land at the northern periphery of Niokolo-Koba National Park, Senegal

Based on research conducted in Senegal in 2004, this field report focuses on the politics of access to land at the northern periphery of the Niokolo-Koba National Park, where a group of villages evicted from the national park were resettled in the 1970s. Conflicts over the allocation of land resurfaced in the 1980s, following the application of laws authorizing rural community councils to allocate use rights in village agricultural lands. The land claims of evicted villages were challenged by the rural council and local state authorities, who sought to define such claims as illegal or ambiguous based on exclusionary discourses of productive use of land, autochthony and citizenship. The politics of access to land at the northern periphery are shaped by land and administrative reforms undertaken since the end of colonial rule in Senegal and the on-going local transformation of authority and property relations under increasing commoditization and insecurity of land use rights.

Recent growth of children in the two Koreas: A meta-analysis

Height differences between the two Koreas were injected into the U.S. presidential debate. The purpose of this article is to report briefly the height, weight, and body mass index (BMI) differences between North and South Korean children by using previous sources and new data. This study employs South Korean data published by the Korean Research Institute for Standards and Science in 1997 and by the Korean Agency for Technology and Standards in 2004, comparing them to North Korean data stemming from the 1997 and 2002 nutritional surveys conducted by the United Nations. Furthermore, this article makes use of anthropometric measurements of North Korean refugee children immigrating to South Korea from 2000 to 2007. In 1997, South Korean preschool children were found on average to be 6-7 cm (2-3 in.) taller and about 3 kg (6.6 pounds) heavier than their Northern counterparts; in 2002, the average gap was about 8 cm (3 in.) and 3 kg (6.6 pounds), and the BMI gap was about 1. North Korean boys and girls escaping to South Korea were also found to be on average about 3-4 cm (1-1.6 in.) shorter and 1 kg (2.2 pounds) lighter than their Southern peers.     

Height and weight growth patterns of school age deaf children

Distance and velocity curves for height and weight were analyzed in a mixed longitudinal sample of American White, American Negro and Mexican-American deaf children 6 through 17 years of age. The heights of deaf boys and girls are, on the average, consistently below an accepted pediatric standard from six through ten years of age. Between 11 and 17 years, deaf White and Negro boys approximate the standard, while White and Negro girls are at or slightly below the standard. Deaf Mexican-American children are consistently below the height standard. For body weight, deaf boys are at or slightly below the standard from 6 to 11 years, and are at or slightly above the weight standard from 12 to 17 years of age. White and Negro deaf girls generally approximate the weight standard from eight years of age on. Mexican-American deaf girls are consistently below the standard until 13 years of age, while between 14 and 17 years they are at or above the standard. Height and weight velocity curves for deaf children parallel closely the incremental standards of Falkner ('62). The height velocity curve, however, appears to peak, on the average, about one year earlier in deaf children.     

Height, weight and earnings among coalminers in India

This paper analyses earning/wage differentials by height among coalmine workers in India. Our findings suggest that workers of above average height earn 9-17% more than their shorter counterparts and 6-13% more than average reference height. The results suggest that long-term investments in health human capital might ensure increase of labour productivity and thereby earnings, particularly in underdeveloped economies.