Dietary diversity, environment and health-related factors of under-five children: evidence from cassava commercialization households in rural South-West Nigeria

Dietary diversity, nutritional status, and agricultural commercialization: evidence from adult men of rural farm households

Access to healthy and affordable diet hinged on the realization of Sustainable Development Goal 2, higher productivity and, economic prosperity while it is difficult for a poorly nourished people to achieve optimum production of goods and services. This study assessed whether dietary diversity (DD) and nutritional status of adult men are associated with crop commercialization index (CCI) levels of agricultural households in two states of Southwestern Nigeria. This research utilized 352 farm households, comprising 277 adult male members. The individual version of dietary diversity score (DDS) of 9 food groups was used to calculate adult men's DDS over a 24-h recall. Anthropometric data was obtained using body mass index (BMI) while CCI levels was estimated for each agricultural household. Logistic regression and ordered logit models were used to examine the determinants of adult men's dietary diversity and nutritional status respectively. Hundred percent of adult men consumed starchy staples, with 11.2% consuming egg, 5.8% milk and milk products and 0.4% consuming organ meat over 24-h recall. Adult men of CCI 2 and CCI 4 agricultural households recorded overweight prevalence of >20% in Ogun state while the association between DDS and CCI was statistically insignificant suggesting that being a member of any of the CCI households may not guarantee the consumption of healthy diets among adult men. From Logit regression analysis, it is more likely for adult men with higher farm size to attain the minimum DDS of 4 food groups than those with smaller size of farmland (OR = 4.78; 95% CI: 1.94, 11.76; p = 0.001). The age, farm experience, and cassava marketing experience were positively related to the likelihood of obtaining the minimum DDS. For adult men to achieve a healthy diet, their diet pattern must incorporate a more diversified intake of food from different food groups capable of improving their nutritional status. This study emphasized the need for relevant stakeholders to provide adequate nutrition knowledge intervention programmes capable of improving the diets and nutrition of adult men and other members of farm households.

Concordance and determinants of mothers' and children's diets in Nigeria: an in-depth study of the 2018 Demographic and Health Survey

OBJECTIVES

Improving the diversity of the diets in young children 6-23 months is a policy priority in Nigeria and globally. Studying the relationship between maternal and child food group intake can provide valuable insights for stakeholders designing nutrition programmes in low-income and middle-income countries.

DESIGN

We examined the relationship between maternal and child dietary diversity among 8975 mother-child pairs using the Nigeria 2018 Demographic and Health Survey (DHS). We assessed concordance and discordance between maternal and child food group intake using the McNemar's χ² test, and the determinants of child minimum dietary diversity (MDD-C) including women MDD (MDD-W) using hierarchical multivariable probit regression modelling.

SETTING

Nigeria.

PARTICIPANTS

8975 mother-child pairs from the Nigeria DHS.

PRIMARY AND SECONDARY OUTCOME MEASURES

MDD-C, MDD-W, concordance and discordance in the food groups consumed by mothers and their children.

RESULTS

MDD increased with age for both children and mothers. Grains, roots and tubers had high concordance in mother-child dyads (90%); discordance was highest for legumes and nuts (36%), flesh foods (26%), and fruits and vegetables (39% for vitamin-A rich and 57% for other). Consumption of animal source food (dairy, flesh foods, eggs) was higher for dyads with older mothers, educated mothers and more wealthy mothers. Maternal MDD-W was the strongest predictor of MDD-C in multivariable analyses (coef 0.27; 95% CI 0.25 to 0.29, p<0.000); socioeconomic indicators including wealth (p<0.000), mother's education (p<0.000) were also statistically significant in multivariable analyses and rural residence (p<0.000) was statistically significant in bivariate analysis.

CONCLUSION

Programming to address child nutrition should be aimed at the mother-child dyad as their food consumption patterns are related and some food groups appear to be withheld from children. Stakeholders including governments, development partners, non-governmental organizations, donors and civil society can act on these findings in their efforts to address undernutrition in the global child population.

Exploring dietary diversity, nutritional status of adolescents among farm households in Nigeria: do higher commercialization levels translate to better nutrition?

Purpose

This study aims to explore dietary diversity (DD) and nutritional status of adolescents among rural farm households in Southwestern Nigeria. It analyses whether higher commercialization levels of farm households translate to better nutrition.

Design/methodology/approach

This study was conducted in Ogun and Oyo States of Southwestern Nigeria, using primary data from 352 farm households with a total of 160 adolescent members. The individual version of dietary diversity score (DDS) of nine food groups was used to calculate adolescent DDS over a 24-h recall period. World Health Organization AnthroPlus software was used in analyzing adolescents’ anthropometric data (height-for-age z-score and body mass index-for-age z-score) while household crop commercialization index (CCI) was estimated for each farm household. Separate logit models were used to examine the drivers of adolescents’ DD and malnutrition.

Findings

The study findings indicated that 100% of the adolescents consumed starchy staples while 0%, 3.1% and 12.5% consumed organ meat, milk/milk products and eggs, respectively. Results revealed that 74.1% and 21.2% of boys were stunted and thin while the prevalence in adolescent girls was 50.7% and 9.3%, respectively. Prevalence of stunting was found to be very high (60%–83%) in all the four CCI levels’ households indicating that belonging to highly commercialized households (CCI 3–4) may not necessarily translate to better nutrition of adolescent members. Food expenditure (p < 0.01) and access to piped water (p < 0.01) negatively influenced adolescents’ stunting mainly because of lower expenditure on food items and lower percent of household having access to piped water, respectively, while education (p < 0.01) had positive effects on adolescents’ DD.

Originality/value

Previous studies have contributed to the body of knowledge concerning the link between agricultural commercialization and nutrition using under-five children of the households. However, to the best of the authors’ knowledge, this is the first study that investigated the influence of CCI on DDS and nutritional status of adolescent members of farm households in Nigeria. This study fills this existing knowledge gap in investigating adolescents’ DD and malnutrition among smallholder farm households.

Assessing agricultural commercialization and rural infrastructure development in rural Southwestern Nigeria: evidence from smallholder cassava farmers

This study assessed agricultural commercialization and rural infrastructure development of smallholder cassava farmers in rural Southwestern Nigeria. The study was conducted in Nigeria with cross-sectional data collected from 352 smallholder cassava farmers. Crop commercialization index (CCI) was used to compute each farmer’s CCI and categorized into four levels while ordered logit model was employed to analyze the determinants of agricultural commercialization of cassava farmers in the study areas. Availability of some important rural infrastructures were assessed across cassava farmers’ commercialization levels. The results revealed that 13.1 % of cassava farmers did not participate in the sale of cassava roots while 86.9 % of them participated actively in the output market. The mean and maximum CCI in the study areas was 59.1 and 95.5 respectively. The results also showed that less than 40 % and 20 % of cassava farmers in all commercialization levels had access to electricity and piped water respectively. The ordered logit regression analysis indicated that age, transport cost, cassava marketing experience, and distance to market were among the determinants of agricultural commercialization. Therefore, stakeholders should expedite policy actions capable of promoting rural infrastructure development that will enhance agricultural production, marketing and improve the quality of life of rural farming communities.

Dietary diversity, food insecurity and the double burden of malnutrition among children, adolescents and adults in South Africa: Findings from a national survey

Childhood stunting remains a global public health problem. Many stunted children live in the same household as overweight or obese adults (the so-called double burden of malnutrition), evidence that quality as well as quantity of food is important. In recent years, food security measurement has shifted away from anthropometry (e.g., stunting) to experiential measures (e.g., self-reported hunger). However, given the continued problem of stunting, it is important that national surveys identify malnutrition.

Objectives

To examine the associations between a variety of food security indicators, including dietary diversity, with adult, child (0-4 years) (5-9 years) and adolescent (10-17 years) anthropometry. To estimate the prevalence of double burden households.

Methods

The study utilized cross-sectional data from the South African National Income Dynamics Survey NIDS (2008). We examined the associations between five food security indicators and anthropometry outcomes. The indicators were adult and child hunger in the household, self-reported household food sufficiency, food expenditure>60% of monthly expenditure and household dietary diversity. Multinomial and logistic regression models were employed to examine the associations with adult BMI categories and children's stunting and BMI.

Results

The prevalence of stunting was 18.4% and the prevalence of wasting and overweight was 6.8 and 10.4%, respectively. Children <5 and adolescents with medium dietary diversity were significantly more likely to be stunted than children with high dietary diversity. Among children <5, child hunger and medium dietary diversity were significantly associated with wasting. None of the food security indicators were associated with stunting in children aged 5-9. Among stunted children, 70.2% lived with an overweight or obese adult. Among adults, increased dietary diversity increased the risk of overweight and obesity.

Conclusion

Dietary diversity can be used as a proxy for poor nutritional status among children <5 years and adolescents but the relationship between dietary diversity and adult obesity is more complex. Given the double burden of malnutrition in many low- and middle-income countries, indicators of dietary quality remain important. These tools can be further refined to include an extra category for processed foods. Given the relative simplicity to collect this data, national surveys would be improved by its inclusion.

Nutrition Outcomes of Under-five Children of Smallholder Farm Households: Do Higher Commercialization Levels Lead to Better Nutritional Status?

The study investigated the nutritional status of under-five children of farm households. The study utilized primary data from 352 farm households with 140 under-five children. Household crop commercialization index (CCI) was used to estimate cassava farm household crop sale ratio and categorize the households into four commercialization levels while WHO Anthro software was employed to analyze under-five children anthropometric indices such as weight-for-age z-score (WAZ), height-for-age z-score (HAZ) and weight-for-height z-score (WHZ). Logit regression model (LRM) was used to examine the drivers of under-five children's nutritional status of farm households. The study found that 42.9%, 7.9% and 3.6% of the children are stunted, underweight and wasted respectively. The highest stunting level was recorded in zero level households (CCI 1). Although, some higher CCI households (medium-high and very-high level) recorded increased percent of stunted children. This revealed that being a member of low or high-level commercialization households may not guarantee better nutritional status of young children of farm households. The results of LRM indicated that the predictors of children nutritional status were child's age, farm size, access to electricity, healthcare and commercialization variables. Moreover, weak positive and negative relationships exist between CCI and children's nutrition outcomes as measured by the z-scores. The study recommended maternal nutrition-sensitive education intervention that can improve nutrition knowledge of mothers and provision of infrastructure that enhance increased farm production and promote healthy living among farm households.

The impact of maternal health insurance coverage and adequate healthcare services utilisation on the risk of under-five mortality in Nigeria: a cross-sectional study

Background

Despite the progress in reducing under-five mortality (U-5 M) in recent years, these deaths remain considerably high in Nigeria. This could be attributed to poor health policies including inequality of health insurance coverage and access to adequate healthcare services utilisations which has remained inimical to achieving sustainable development goals (SDGs). Therefore, this study examined the impact of maternal health insurance coverage and adequate healthcare services utilisation on the risk of U-5 M in Nigeria.

Methods

The data for the study were derived from the 2018 Nigeria Demographic and Health Survey and comprised a weighted sample of 127,545 birth histories of childbearing women. Descriptive and analytical analyses were carried out, including frequency tables and multivariate using Cox proportional regression. The results were presented as hazard ratios (HR) with 95% confidence intervals (CIs). Data were analyzed using Stata software version 15.1.

Results

The results showed that 14.3% of the sampled birth histories of the childbearing women were children who died before age 5. The results further showed that 97.7% of the children were of mothers who have health insurance and over one-half (56.5%) were children whose mothers had adequate healthcare services utilisation. The risk of under-five death was significantly lower among the children of mothers who were covered by health insurance (HR: 0.66, CI: 0.42–1.02) and those whose mothers utilised adequate healthcare services (HR: 0.78, CI: 0.68–0.90). A similar result was observed among children whose mothers reported that distance to the health facility was not a problem (HR: 0.81, CI: 0.72–0.86). Some mothers’ characteristics including educational attainment, wealth quintile and region of residence significantly influenced the risk of U-5 M.

Conclusions

The study established that maternal health insurance coverage and adequate healthcare services utilisation were found to be protective factors against the risk of U-5 M. Also, the revealed low health insurance coverage of mothers calls for more pragmatic policy and intervention programmes through health insurance to achieve SDGs targets of ending preventable deaths of children under 5 years of age and ensuring quality, as well as universal access to maternal and child healthcare services.

Investigating food insecurity, health and environment-related factors, and agricultural commercialization in Southwestern Nigeria: evidence from smallholder farming households

Hunger and food insecurity remained some of the serious challenges facing our world in present time with great concerns from Sub-Saharan Africa especially countries like Nigeria. This study investigates food insecurity (FI), health and environment-related factors, and agricultural commercialization among smallholder farm households. This study was conducted in Southwestern Nigeria utilizing cross-sectional survey data from 352 farm households and employed multi-stage sampling procedure. The household FI levels was determined using food insecurity access scale (HFIAS), crop commercialization index (CCI) was used to compute each household's CCI (four levels), while ordered logit model was used to analyse factors influencing FI. Health and environment-related factors' access were assessed across each FI category. The results indicated that about 13% of cassava farm households are non-participant in the marketing of their produce. The findings revealed that less than 20%, 30%. and 40% of households in all four FI categories had access to piped water, improved toilet facilities, and electricity respectively. The ordered logit regression analysis indicated that age, gender, education level, farm experience, nonfarm income, and ownership of motorcycle significantly influencing FI in the study areas. Therefore, this study stressed the implementation of policy actions capable of promoting rural infrastructure development that will lead to increased agricultural production, marketing, and improved quality of life of rural dwellers.

Assessing Food Insecurity and Its Drivers among Smallholder Farming Households in Rural Oyo State, Nigeria: The HFIAS Approach

Hunger and food insecurity take center stage in most debates in Africa, and in recent times with serious concerns about Nigeria. This study assessed food insecurity among farming households in rural Oyo State, Nigeria, using cross-sectional datasets from 211 farming households through a multi-stage sampling procedure. The Household Food Insecurity Access Scale (HFIAS) module was employed in assessing food insecurity status of farming households, and the ordered logit model (OLM) was used to analyze factors influencing food insecurity among farming households. The results revealed that 12.8% of the farming households were food secure while 87.2% had varying levels of food insecurity. The OLM results indicated that age, household head’s years of schooling, gender, farm size, farm experience, non-farm income, food expenditure, and access to extension service significantly influenced food insecurity among farming households. Based on the findings, efforts should be geared towards promoting households’ education-related intervention programs in order to improve their nutrition-related knowledge that can enhance their food security status. Additionally, there should be provision of rural infrastructural facilities such as piped water, rural electrification, and healthcare service that promote healthy living and enhance households’ agricultural productivity.