ACTUAL STATUS OF STUNTING AND DIETARY INTERVENTION EFFECTIVENESS FOR CHILDREN UNDER 5 YEARS OF AGE IN THE COASTAL AREA OF TIEN HAI, THAI BINH Author: Tran Quang Trung BACKGROUND ! " # $% & ' ( ) " " *+ &" " " ," ! + - ""#" (" "&. " - /"0 " "Actual status of stunting and dietary intervention effectiveness for children under 5 years of age in the coastal area of Tien Hai, Thai Binh" Study objectives: 1" &.&/ 2 - +3% " * # " " +3% " &.&/ 3. New contributions of the thesis + ) " &/4" + +'" " " + +3% 0-54 - " 678 4. Structure of the thesis & 9 % %* 1 & / : ! ; ": * ! < : ! : ** ! 2:*!):* Chapter 1 LITERATURE REVIEW 1 - Stunting situation of children in the world and Vietnam - Stunting malnutrition in the world: 99 *9 $ " =& & " ## # 3 #> % 3 1&/?@ 68 * - Stunting malnutrition of children in Vietnam:2 ' " ( " "99&/" % 99 ! $ &. 2. Causes of malnutrition. - Inadequate food in both quantity and quality, and infectious diseases: @' *+ + * &" A+"# 3+ " ' 2- B " - Lack of maternal and child health care services, knowledge of the caregivers, clean water and environmental sanitation. "" & " + # - Low socio-economic conditions, poverty, backwardness and unequal economic status. # 1 "" #2." " 3 3. Some intervention solutions to improve the stunted children. - Communication and education on nutrition and health care:1 " " " " - Medical intervention to children's nutrition status: & + =>"" " " - Intervention studies to improve children's diets: & " " B" "-"/ " & " Chapter 2 STUDIES SUBJECTS AND METHODOLOGY 2.1.Study subjects +,:"C$ &.2 + , : " 6 8 +3% & 6)8 : 2@?.! " 6"8:2)#? 2. 2.Methodology 2. 2.1 - Study design: " , : # " " + " *3 6@ 8 . 6.8 ** +3% > ,:" Intervention group: 63 = = =$ = 8 +"* Intervention group:2+ "* ' " 6@ 8 " 6@ 8 : = = . 54 - ( 3" " 2. 2.2.Sampling and sample size + Identify the stunting rate: : $&/ >-: DE + α = 6+8 648 ) $ -*% + Determine the rate of micronutrient deficiencies in the stunted children 25-48 months of age: F - ** -. + Intervention study:"! +3% " -": ( ) ( ) ( ) ( ) [ ] ( ) pp ppZppZ n − −+− = −− βα 648 #*3" + Formula for testing samples in the " study: D Z 2 (α αα α,β ββ β) 2s 2 64*8 6 µ + µ 8 #-.- 54 2.2.3. Technique applied in the study:) = = = $ G.B0 . $ H - # # H 54 6+; 5 48) 2.2.4.Data processing: 2-&/F" @ , ? ? ) ! - F " I): ( ) A BA Efficiency − = I"":1DJ. +. J Chapter 3. STUDY RESULTS 3.1. Malnutrition in children under 60 months of age and some related factors in the coastal area of Tien Hai, Thai Binh 3.1.1. Stunting among children under 5 years old Table 3.3. Rate of stunted children under 5 years old in the coastal area of Tien Hai @ 4 @ n n (%) n n (%) D7 % *6*$8 $68 <0.05 *+3 **% 6*8 *3 6*8 <0.05 +*$ *3 969*8 *3% 6**$8 K *+3% % %69$8 99 96*38 K 39+$ 3 %68 * %6$8 K Total 1471 342 (23.2) 1571 477 (30.4) <0.05 &** *+ *$>." ) * *3 7 -0,98 -1,3 -1,21 -1,27 -1,41 -1,43 -1,37 -0,68 -1,45 -0,25 -1,6 -1,4 -1,2 -1 -0,8 -0,6 -0,4 -0,2 0 ≤ 12 months 13-24 months 25-36 months 37-48 months 49-60 months Age group HAZ score Male Female Figure 3. 1.Distribution of HAZ score of each age group, by gender A4.#E - +*$ *+3% & 3 % 23,7 13,1 5,3 29,3 18,1 31,6 30 11,8 13,4 8,7 8,3 4,7 3,7 5,1 3,6 0 10 20 30 40 ≤ 12 months 13-24 months 25-36 months 37-48 months 49-60 months Age group Rate (%) Stunted Underweight Skinny Figure 3.4. Rate of 3 types of malnutrition, by age group +*$ $& Table 3.6. Analysis of the stunting combined with the others @ 6 D 38 4 6 D *38 & 6 D %98 * $* $* % $* ) F * % 9% % F IG * *9 B" % 9 % 3% 9 &*$) &. 6$* 8 "9 *9 9 Table 3.7.Regression model on relation of some family factors with the stunted children ' F" @" BA69 )8 BA69 )8 1 - Mother's occupation B 3 9$ G %$ $3 63+ 8 <0.05 *6+8 K 4 9 % $6 + 8 <0.05 *6% + 8 K & * % $6+*8 <0.05 36%+*8 K 2 - Latrine . F 9* * *6+$8 7 6+8 7 3 - Water sources & *3 2 *% 93 36+%8 <0.05 *6+8 <0.05 2 3* * *6+$8 <0.05 36+$8 <0.05 B 3 6*+38 K $6*+8 K 4 - Number of living children + $% K *%3 * 96 + 8 K 96 + $8 K & * - 3 & "37! " "7 Table 3.9. Regression model on relation of some individual factors with the stunting ' F" @" BA69 )8 BA69 )8 Birth weight K* ** *% 36*+$8 <0.01 36*+8 <0.01 +* $ % 7 % *%% $6 + 8 <0.01 $6 + $8 <0.05 Gender 4 33 * @ *3 36 + 8 <0.01 6* + 8 <0.01 Age group L 9 % *+3 $9 9* %$63+8 <0.01 %63+38 <0.01 +*$ $$ *$ 6$+8 <0.01 6+8 <0.01 *+3% %$ ** 96+$8 <0.01 963+8 <0.01 39+$ *9 * 36+%8 <0.01 *69+8 K Diet 1 3*% ? $3 *% 36 + 8 <0.01 36 + 8 <0.01 &*9" " &.678 0 3.2.Deficiency of micronutrients in stunted children aged 25-48 months in the baseline survey Table 3.11.Mean values of Hb, Zn in stunted children & +*$ *+3% & . M * ** M *M * E 6 ± 3.7 14.4 * 133 1 6 7.3 ± 1.7 * $ *M* 3 ( * : P<0.05) & * " - 54 +*$ *+3% ! - 7 [...]... 25- 36 months improved in both intervention and control groups, so that intervention effectiveness of diet achieved more (p0. 05 M12 95. 4 ± 5. 1 96.1 ± 5. 3 . K @ +@ -0.0 ± 0.3 5 0. 055 ± 0. 35 M* *M*3 687 <0. 05 <0. 05 K <0. 05 Rate of underweight W/A: n. 678 3.3. Effectiveness of dietary intervention on nutrition status of children 25- 48 months of age in some kindergartens in Tien Hai, Thai Binh Table 3.18.Intervention effectiveness to underweight. ""$ $ Table 3.28. Intervention effectiveness on children’s diets Intervention effectiveness - IE (%) 25- 36 months old 37-48 months old ) "