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  • Title: Maternal risk factors for childhood malnutrition in the Mazowe District of Zimbabwe.
    Author: Radebe BZ, Brady P, Siziya S, Todd H.
    Journal: Cent Afr J Med; 1996 Aug; 42(8):240-4. PubMed ID: 8990569.
    Abstract:
    OBJECTIVE: To determine the maternal risk factors associated with childhood malnutrition. DESIGN: An unmatched case control study of 327 children < 5 years of age. SETTING: Primary health care clinics on the communal lands and commercial farms in the Mazowe District of Zimbabwe. MAIN OUTCOME MEASURES: The relationship between maternal risk factors and childhood malnutrition was analysed. To correct for confounding variables a forward stepwise logistic regression was performed. RESULTS: Odds ratio (95pc confidence limits) for childhood malnutrition were a working mother 5.69 (2.37 to 3.66) and lack of decision making power 2.86 (1.1 to 7.45) on the communal lands, and lack of extra income generating projects 3.92 (1.64 to 9.54) and previous death of a child 2.17 (1.08 to 4.39) on the commercial farms. In both areas malnutrition was associated with < or = 1 acre of land 3.66 (1.4 to 9.53) and p < 0.01 (Fisher's exact test) for the communal lands and commercial farms respectively), and father's income < or = Z$150/month 12.5 (2.5 to 100) and 5.56 (1.4 to 25.0) for the communal lands and commercial farms respectively. CONCLUSIONS: To reduce childhood malnutrition in the rural areas reduced maternal work load and increased decision making power, better access to health care plus more access to land and higher income are all critical issues. During October-December 1990 in Mazowe District, Zimbabwe, a case control study was conducted to determine the maternal risk factors associated with malnutrition in children younger than 5 and to compare child malnutrition and maternal risk factors between communal lands and commercial farms. 138 children lived on communal lands; 189 lived on commercial farms. Mothers on communal lands had a heavier workload than those on commercial farms. They were more likely to receive no support from the father than were their commercial farm counterparts (about 33% vs. 7%). There were no cases of kwashiorkor. Immunization and feeding practices were similar for both the commercial farm and communal land groups. The logistic regression revealed that maternal risk factors associated with malnutrition on communal lands were mother's employment (odds ratio [OR] = 5.69), possession of land equal to or less than 1 acre (OR = 3.66), mother's lack of decision-making power without a male relative (OR = 2.86), and the index child of birth order 3 or higher (OR = 2.34). In the bivariate analysis, father's income no greater than Z$150/month (OR = 12.5) was also associated with child malnutrition. In the bivariate analysis, the maternal risk factors on commercial farms included no extra income from income-generating projects (OR = 3.92), possession of land equal to or less than 1 acre (OR = 3.66), previous death of a child (OR = 2.17), and father's income no greater than Z$150/month (OR = 5.56). Unexpectedly, maternal education was not associated with child malnutrition. These findings indicate a need for a reduced maternal work load and increased decision-making power. Other critical issues to improve child nutrition were better access to health care and to land as well as a higher income.
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