1.Undernutrition among children under 5 years of age in Yemen: Role of adequatechildcare provided by adults under conditions of food insecurity
Saber Al-Sobaihi ; Keiko Nakamura ; Masashi Kizuki
Journal of Rural Medicine 2016;11(2):47-57
Objective: This study examined the associations between the adequacy ofchildcare provided by adult caretakers and childhood undernutrition in rural Yemen,independent of household wealth and food consumption.
Methods: We analyzed data of 3,549 children under the age of 5 years livingin rural areas of Yemen based on the 2013 Yemen Baseline Survey of Mother and ChildHealth. Nutritional status was evaluated by the presence of underweight, stunting, andwasting according to the World Health Organization child growth standards. The impact ofchildcare including leaving children alone, putting older children into labor force, andthe use of antenatal care while pregnant on child undernutrition was assessed and adjustedfor food consumption by children, household composition, demographic and educationalbackground of caretakers, and household wealth.
Results: The prevalence of underweight, stunting, and wasting was 46.2%,62.6%, and 11.1%, respectively. Not leaving children alone, keeping children out of thelabor force, and use of antenatal care were associated with a lower risk of underweight(odds ratio [OR] = 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042) andstunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR = 0.78, P = 0.003). Afterfurther adjustment for food consumption, the associations between adequate childcareindicators and lower odds of stunting remained significant (OR = 0.73, P = 0.025; OR =0.72, P = 0.046; and OR = 0.76, P = 0.038).
Conclusions: A marked prevalence of stunting among rural children in Yemenwas observed. Adequate childcare by adult caretakers in families is associated with alower incidence of underweight and stunting among children under 5 years of age. Promotingadequate childcare by adult household members is a feasible option for reducingundernutrition among children in rural Yemen.
2.Changes in the configuration and patterns of physical activity among Mongolian adults, 2005–2013
Delgermaa DASHZEVEG ; Keiko NAKAMURA ; Kaoruko SEINO ; Saber AL-SOBAIHI ; Enkhtuya PALAM
Journal of Rural Medicine 2018;13(2):151-159
Objective: This study examined the change in physical activity status and patterns and their associations with urban and rural residence and employment status in Mongolia.Methods: We analyzed data from 7,738 adults aged from 20 to 64 years (n = 2,877 and 4,861 for 2005 and 2013, respectively) from the Mongolian STEPS Survey on the Prevalence of Non-Communicable Disease Risk Factors (NCD-STEPS survey). Physical activity in three domains, including work (occupational and household work); transport (walk or cycling); and leisure (sport or fitness) was measured by Global Physical Activity Questionnaire (GPAQ). Physical activity levels were classified into three groups: low, moderate, and high according to the GPAQ analysis framework. The associations between physical activity time, residential area, and employment status were examined using a multivariate negative binomial regression model.Results: The percentage of respondents with low-level physical activity increased from 10.9% in 2005 to 27.2% in 2013. The median minutes of physical activity time per week were 1,020 in 2005 and 600 in 2013. Physical activity time at work, transport and overall decreased in 2013. Work-related physical activity was the most dominant component of physical activity time (55.6% in 2005 and 54.6% in 2013), the transport domain was the second-highest contributor of physical activity time in 2005 (24.0%) and was replaced by the leisure domain (26.8%) in 2013. Rural residents practiced more physical activity at work, transport, and leisure than urban residents did in 2005 (prevalence ratio [PR]: 1.33, 95% confidence interval [CI]: 1.20–1.47; PR: 1.21, 95%CI: 1.14–1.29; and PR: 1.21, 95%CI: 1.13–1.30, respectively), but there was no significant difference by residential area in 2013. Mongolian adults with higher educational attainment, employee status, and non-employment status were less likely to engage in physical activity compared to those among adults with lower educational attainment and self-employed status.