Trends, Predictors, and Consequences of Child Undernutrition

儿童营养不良的趋势、预测因素和后果

• 批准号: 9468745
• 负责人: Apurv Soni
• 金额: $ 2.87万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-22 至 2021-09-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9468745
• 关键词: 5 year old; Academic achievement; Accounting; Address; Adolescent; Advocacy; African; Age; Anthropology; Area; Caring; Cessation of life; Characteristics; Child; Child Care; Child Development; Child Malnutrition; Child Mortality; Child health care; Clinical; Communities; Community Healthcare; Complex; Country; Data; Data Set; Data Sources; Decision Making; Development; Dietary intake; Disease; Economics; Environmental Risk Factor; Expenditure; Female; Food; Foundations; Funding; Gender; Goals; Government; Growth; Health; Health Status; Healthcare; Heterogeneity; High Prevalence; Household; Human Development; Hygiene; Impairment; India; Individual; Intervention; Investigation; Knowledge; Life; Life Cycle Stages; Life Expectancy; Malnutrition; Maternal Mortality; Mentorship; Methodology; Methods; Mission; Morbidity - disease rate; Mothers; National Institute of Child Health and Human Development; Newborn Infant; Nutritional; Observational Study; Outcome; Physicians; Policies; Positioning Attribute; Pregnant Women; Prevalence; Productivity; Publishing; Quality of life; Research; Research Infrastructure; Research Proposals; Resources; Role; Rural Health; Sanitation; Scientist; Series; Services; Surveys; Techniques; Training; United States National Institutes of Health; Water; Women' s Role; aged; base; career; clinical practice; community based participatory research; evidence base; experience; health disparity; improved; intervention program; low and middle-income countries; model building; multilevel analysis; population health; programs; spatiotemporal; trend

RR-7: ABSTRACT One out of every three children under the age of five in India are undernourished (48 million). To address this crisis, Indian government established a National Rural Health Mission (NRHM) program in 2005, which improved healthcare and nutritional services. Unfortunately, this efforts which spanned from 2005 to 2012 have yielded minimal improvement. Persistent child undernutrition limits growth, productivity, quality of life, and life expectancy of Indians. In other words, Indian children are unable to realize their full potential due to undernutrition. Our current understanding of child undernutrition in India is 1) outdated because most of the analyses uses data from 2005, before the implementation of NRHM program, 2) contradictory because investigations of predictors of child undernutrition in India with improper methodologies has produced inconsistent findings despite using the same data source), and 3) lacking because no national level study has assessed the consequences of child undernutrition. Therefore, this study will apply advanced geospatial and multilevel methods on publicly available nationally representative data from NICHD-funded India Human Development Survey (IHDS) series to fill these critical knowledge-gaps. The first of the two IHDS surveys was conducted in 2005 (IHDS-I) before the implementation of NRHM and surveyed 24,314 children aged five or less from 41,554 households. IHDS-II was conducted in 2012 and surveyed 42,152 households, including 34,621 that were surveyed in 2005, and collected information on 20,810 children under the age of five and 26,559 pre-adolescents. We will use this unique data source, the largest panel dataset on child undernutrition in India to investigate: Aim 1) the trends of child undernutrition in India from 2005 to 2012 in relation to NRHM, Aim 2) individual, household, and community level predictors of child undernutrition, and Aim 3) consequences of undernutrition in the first five years of life on development during pre-adolescent (8-11) years within the Indian socio-cultural context. Our investigation will define the heterogeneity in the burden of child undernutrition and its association with a variety of predictors across different regions of India. Moreover, it will elucidate the magnitude of its consequences on child development within the Indian context. Thus, this study will establish a foundation for addressing this humanitarian and economic crisis by identifying effective entry points for existing intervention. This proposal will also position me to take the next step towards my career goal of reducing health disparities among children through clinical practice in underserved regions, community-based research, and evidence-based advocacy. To accomplish the study aims and prepare me for my career, this research proposal is paired with a carefully curated training plan that includes specific graduate-level courses and individualized mentorship experiences with a team of technical and content experts.

RR-7：摘要 在印度，每三名五岁以下儿童中就有一名营养不良（4 800万）。解决 在这场危机中，印度政府于2005年建立了国家农村卫生使命计划， 改善医疗保健和营养服务。不幸的是，从2005年到2012年的这一努力 取得了最小的改善。持续的儿童营养不良限制了生长、生产力、生活质量和生命 印第安人的期待换句话说，印度儿童无法充分发挥其潜力， 营养不良 我们目前对印度儿童营养不良的理解是过时的，因为大多数分析都是 使用2005年的数据，在NRHM计划实施之前，2）矛盾，因为调查 印度儿童营养不良的预测者使用不适当的方法得出了不一致的结果， 使用相同的数据来源），以及3）缺乏，因为没有国家一级的研究评估了后果 儿童营养不良。 因此，本研究将采用先进的地理空间和多层次的方法对公开可用的 来自NICHD资助的印度人类发展调查（IHDS）系列的全国代表性数据，以填补这些 关键的知识差距。两次IHDS调查中的第一次是在2005年进行的（IHDS-I）， 在全国儿童保健委员会的支持下，对来自41 554个家庭的24 314名5岁或5岁以下儿童进行了调查。IHDS-II是 2012年进行了调查，调查了42，152户家庭，其中包括2005年调查的34，621户，并收集了 关于20，810名5岁以下儿童和26，559名青春期前儿童的信息。我们将利用这些独特的数据 来源，印度儿童营养不良调查的最大面板数据集：目标1）儿童营养不良的趋势 2005年至2012年印度营养不良状况与NRHM目标2）个人、家庭和社区的关系 儿童营养不良的水平预测因素，以及目标3）生命头五年营养不良的后果 关于印度社会文化背景下青春期前（8-11）的发展。 我们的调查将确定儿童营养不良负担的异质性及其与 印度不同地区的各种预测因素。此外，它将阐明其规模 对印度儿童发展的影响。因此，本研究将为 通过确定现有干预措施的有效切入点，应对这一人道主义和经济危机。 这一提议也将使我朝着减少健康差距的职业目标迈出下一步 通过在服务不足地区的临床实践、基于社区的研究， 以证据为基础的宣传。为了实现学习目标并为我的职业生涯做好准备，本研究提案 与精心策划的培训计划相结合，其中包括特定的研究生课程和个性化的 与技术和内容专家团队的指导经验。