Impact of child nutrition training for mothers on the nutritional status of children: a propensity score matching approach
Keywords:Child nutrition training, PSM, Stunting, Wasting, Underweight
Background: Since mothers are the primary caregivers of children under five, their nutritional status depends on their mothers' capacity to feed and nurture them properly. However, mothers' poor child-feeding practices can also lead to child malnutrition. Mothers' nutritional education and childcare habits can improve children's health through child nutrition training. This study examines how child nutrition training for mother affects children's nutritional status in the impoverished Northern Bangladesh.
Methods: In this cross-sectional study, total of 300 mothers have been interviewed and data on demographic, socioeconomic, and child-specific related issues are gathered using simple random sampling from the study areas. The data comprise both treatment and control groups. Propensity score matching (PSM) method is applied to examine impact of child nutrition training for mothers on nutritional status of children in terms of stunting, wasting, and underweight.
Results: Empirical results of PSM revealed that the children whose mothers have received trainings have lower prevalence of stunting (0.357 SD), wasting (0.646 SD), and underweight (0.935 SD) as suggested by the average treatment effect on the treated.
Conclusions: In summary, this study found positive impact of child nutrition training programs. Therefore, it suggests that the government and NGOs should formulate better and expanded programs focusing on training mothers for the betterment of children’s nutritional status.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M. Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427-51.
UNICEF D. Levels and trends in child malnutrition. Key findings of 2019 edition. New York: UNICEF. 2019.
Welch RM, Graham RD. A new paradigm for world agriculture: meeting human needs: productive, sustainable, nutritious. Field Crops Res. 1999;60(1-2):1-10.
Monte C. Malnutrition: a secular challenge to child nutrition. J Pediatr (Rio J). 2000;76(3):S285-97.
Müller O, Krawinkel M. Malnutrition and health in developing countries. CMAJ. 2005;173(3):279-86.
Donegan S, Maluccio JA, Myers CK, Menon P, Ruel MT, Habicht JP. Two food-assisted maternal and child health nutrition programs helped mitigate the impact of economic hardship on child stunting in Haiti. J Nutr. 2010;140(6):1139-45.
Muss C. Impact of prenatal nutrition on the cerebral development of the infant. J Nursing, Social Studies, Public Heal Rehabilitation. 2011;3(4):139-54.
Jesmin A, Yamamoto SS, Malik AA, Haque MA. Prevalence and determinants of chronic malnutrition among preschool children: a cross-sectional study in Dhaka City, Bangladesh. J Heal Population Nutrit. 2011;29(5):494.
Ahmed T, Mahfuz M, Ireen S, Ahmed AS, Rahman S, Islam MM, Cravioto A. Nutrition of children and women in Bangladesh: trends and directions for the future. J Heal Population Nutr. 2012;30(1):1.
Umapathi N. Maternal education, child-care and nutritional status: Lessons from a nutritional program. Job Market Paper, Institute for Fiscal Studies and Centre for Microdata Methods and Practice, University College London. 2008.
White H, Masset E. Assessing interventions to improve child nutrition: a theory‐based impact evaluation of the Bangladesh Integrated Nutrition Project. Journal of International Development. J Develop Studies Asso. 2007;19(5):627-52.
Manda J, Gardebroek C, Khonje MG, Alene AD, Mutenje M, Kassie M. Determinants of child nutritional status in the eastern province of Zambia: the role of improved maize varieties. Food Security. 2016;8(1):239-53.
Waddington H, White H, Snilstveit B, Hombrados JG, Vojtkova M, Davies P et al. How to do a good systematic review of effects in international development: a tool kit. J Develop Effectiveness. 2012;4(3):359-87.
Khandker SR, Koolwal GB, Samad HA. Handbook on impact evaluation: quantitative methods and practices. World Bank Publications. 2009.
Becker SO, Ichino A. Estimation of average treatment effects based on propensity scores. Stata J. 2002;2(4):358-77.
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70(1):41-55.
Caliendo M, Kopeinig S. Some practical guidance for the implementation of propensity score matching. J Economic Surv. 2008;22(1):31-72.
Thavaneswaran A, Lix L. Propensity Score Matching in Observational Studies. Manitoba Centre for Health Policy. University of Manitoba, Canada. 2008.
Ickes SB, Baguma C, Brahe CA, Myhre JA, Adair LS, Bentley ME et al. Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study. BMC Nutr. 2017;3(1):1-10.
Reinsma K, Nkuoh G, Nshom E. The potential effectiveness of the nutrition improvement program on infant and young child feeding and nutritional status in the northwest and southwest regions of Cameroon, Central Africa. BMC Heal Serv Res. 2016;16:1-9.
Kalimbira AA, MacDonald C, Simpson JR. The impact of an integrated community-based micronutrient and health programme on stunting in Malawian preschool children. Pub Heal Nutr. 2010;13(5):720-29.
Remans R, Pronyk PM, Fanzo JC, Chen J, Palm CA, Nemser B et al. Multisector intervention to accelerate reductions in child stunting: an observational study from 9 sub-Saharan African countries. Am J Clin Nutr. 2011;94(6):1632-42.
Dewey KG. Reducing stunting by improving maternal, infant and young child nutrition in regions such as South Asia: evidence, challenges and opportunities. Maternal Child Nutrit. 2016;12:27-38.
Nikièma L, Huybregts L, Martin-Prevel Y, Donnen P, Lanou H, Grosemans J et al. Effectiveness of facility-based personalized maternal nutrition counseling in improving child growth and morbidity up to 18 months: A cluster-randomized controlled trial in rural Burkina Faso. PloS one. 2017;12(5):e0177839.
Berisha M, Ramadani N, Hoxha R, Gashi S, Zhjeqi V, Zajmi D et al. Knowledge, attitudes and practices of mothers in kosova about complementary feeding for infant and children 6-24 months. Med Arch. 2017;71(1):37.
Jemide JO, Ene-Obong HN, Edet EE, Udoh EE. Association of maternal nutrition knowledge and child feeding practices with nutritional status of children in Calabar South Local Government Area, Cross River State. Nigeria. Int J Home Sci. 2016;2(1):293-8.
Sethi V, Kashyap S, Seth V. Effect of nutrition education of mothers on infant feeding practices. Ind J Pediatr. 2003;70(6):463-6.