Associations between the household environment and stunted child growth in rural India: a cross-sectional analysis.
Associations between the household environment and stunted child growth in rural India: a cross-sectional analysis.
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DOI：
10.14324/111.444/ucloe.000014
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Parikh, Priti
中科院分区：
文献类型：
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作者：
Lee, Charlotte;Lakhanpaul, Monica;Stern, Bernardo Maza;Sarkar, Kaushik;Parikh, Priti
对印度来说，发育迟缓是一个尚未解决且日益严重的主要健康问题。有必要采取更广泛的跨学科跨部门办法，使环境和卫生等学科共同努力，共同制定适合社会文化的综合干预措施。然而，在印度大多数农村社区开发和应用这种综合的、多因素的儿童健康干预措施的证据仍然很少。在本文中，我们探索并展示了环境因素与发育迟缓之间的联系，从而突出了跨学科研究的范围。我们研究了印度拉贾斯坦邦农村地区5岁以下儿童的家庭环境特征与发育迟缓之间的关系。我们使用了人口与健康调查(DHS)-3印度（2005-2006）的数据，这些数据来自109,041个受访家庭的1194名儿童。多元logistic回归分析独立检验了以下因素之间的关系：(i)主要饮用水来源，（ii）主要卫生设施类型，（iii）主要烹饪燃料类型，以及（iv）农业土地所有权与儿童年龄发育迟缓调整之间的关系。结果表明，在调整儿童年龄后，家庭获得(i)改善的饮用水源与23%的几率降低相关[比值比(OR) = 0.77, 95%可信区间（CI） 0.5-1.00], （ii）改善的卫生设施与41%的几率降低相关（OR = 0.51, 95% CI 0.3-0.82），以及（iii）农业土地所有权与儿童发育迟缓几率降低30%相关(OR 0.70, 95% CI 0.51 - 0.94]。烹饪燃料来源与发育迟缓无关。我们的研究结果表明，需要从营养特异性转向适合环境的跨学科解决方案，其中包括环境改善。这不仅将改善贫困社区的生活条件，还将有助于解决印度最脆弱社区儿童营养不良的挑战。
Stunting is a major unresolved and growing health issue for India. There is a need for a broader interdisciplinary cross-sectoral approach in which disciplines such as the environment and health have to work together to co-develop integrated socio-culturally tailored interventions. However, there remains scant evidence for the development and application of such integrated, multifactorial child health interventions across India’s most rural communities. In this paper we explore and demonstrate the linkages between environmental factors and stunting thereby highlighting the scope for interdisciplinary research. We examine the associations between household environmental characteristics and stunting in children under 5 years of age across rural Rajasthan, India. We used Demographic and Health Survey (DHS)-3 India (2005–2006) data from 1194 children living across 109,041 interviewed households. Multiple logistic regression analyses independently examined the association between (i) the primary source of drinking water, (ii) primary type of sanitation facilities, (iii) primary cooking fuel type, and (iv) agricultural land ownership and stunting adjusting for child age. The results suggest, after adjusting for child age, household access to (i) improved drinking water source was associated with 23% decreased odds [odds ratio (OR) = 0.77, 95% confidence interval (CI) 0.5–1.00], (ii) improved sanitation facility was associated with 41% decreased odds (OR = 0.51, 95% CI 0.3–0.82), and (iii) agricultural land ownership was associated with 30% decreased odds of childhood stunting (OR 0.70, 95% CI 0.51–0.94]. The cooking fuel source was not associated with stunting. Our findings indicate that a shift is needed from nutrition-specific to contextually appropriate interdisciplinary solutions, which incorporate environmental improvements. This will not only improve living conditions in deprived communities but also help to tackle the challenge of childhood malnutrition across India’s most vulnerable communities.