title: Undernutrition Among Infants and Children in Nepal: Maternal Health Services and Their Roles to Prevent it.
abstract: Objectives Appropriate infant and young child feeding (IYCF) for children aged 6-23 months includes adequate dietary diversity, appropriate meal frequency, and continued breastfeeding. Mothers receiving antenatal care (ANC) and postnatal care (PNC) may adopt better IYCF. This study examined the association of ANC or PNC attendance with IYCF and child nutrition status. Methods A cross-sectional study was performed on 400 mother-child pairs in rural Nepal. Mothers were interviewed about their history of ANC and PNC attendance and IYCF; the height and weight of their children were measured. IYCF was measured with infant and child feeding index (ICFI) aggregating scores of dietary diversity, meal frequency, continued breastfeeding, and dietary variety. Lower ICFI scores indicated poorer IYCF practices. Multiple regression and logistic regression examined the association of ANC and PNC attendance with ICFI scores and undernutrition, respectively. Results Absence of ANC (β = -1.01, P = 0.011) and absence of PNC (β = -1.01, P = 0.011) were negatively associated with ICFI scores. Additionally, absence of ANC was positively associated with underweight (AOR 3.37; 95 % CI 1.42-9.92 for children 6-11 months, AOR 3.43; 95 % CI 1.41-8.32 for children 12-23 months) and stunting (AOR 6.51; 95 % CI 2.11-20.10 for children 6-11 months, AOR 3.32; 95 % CI 1.50-7.31 for children 12-23 months). Similarly, children tended to be underweight and stunted if their mothers did not receive any PNC. Conclusion Absence of ANC and PNC were associated with poor IYCF, underweight, and stunting in children.
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Khem
authors.initials: K
authors.lastname: Pokhrel
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. keikonanishi@yahoo.co.jp.
authors.forename: Keiko
authors.initials: K
authors.lastname: Nanishi
authors.affiliation: Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Poudel
authors.affiliation: Integrated Development Foundation, Teku, Kathmandu, Nepal.
authors.forename: Kalpana Gaulee
authors.initials: KG
authors.lastname: Pokhrel
authors.affiliation: Nepali Technical Assistance Group, Maitighar, Kathmandu, Nepal.
authors.forename: Kalpana
authors.initials: K
authors.lastname: Tiwari
authors.affiliation: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Masamine
authors.initials: M
authors.lastname: Jimba
mesh_terms: D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008427:Maternal Health Services / Q000458:organization & administration*; D009035:Mothers; D009390:Nepal / Q000453:epidemiology; D009752:Nutritional Status; D011247:Pregnancy; D012424:Rural Population; D013851:Thinness / Q000453:epidemiology*
keywords: Antenatal care; Complementary feeding; Nepal; Stunting; Underweight