Assessment of nutritional status among primary schoolchildren in krong bong district, daklak province

CERTIFICATION I certify this thesis has entirely done by myself. Within my knowledge quotations and data used in the thesis are cited and surveyed by highest precision sources. Phan Thi Ngoc Ngan TABLE OF CONTENTS CERTIFICATION TABLE OF CONTENTS LIST OF ABBREVIATIONS LIST OF TABLES LIST OF FIGURES ABSTRACT CHAPTER 1: PROBLEM STATEMENT ........................................................................... 1 1. Research backround ......................................................................................................... 1 1.1 Nutritional status in children in the world .....................................................................1 1.2 Nutritional status in children in Vietnam .......................................................................4 1.3 Current nutritional status in children in Krong Bong ....................................................6 1.4 Objective of the thesis ....................................................................................................8 1.4.1 General objective ........................................................................................................8 1.4.2 Specific objectives ......................................................................................................9 1.4.3 Research questions ......................................................................................................9 1.5 Scope of the research ....................................................................................................9 1.7 Structure of the thesis ...................................................................................................10 CHAPTER 2: LITERATURE REVIEW ........................................................................... 11 2.1 Measurement of nutritional status ................................................................................ 11 2.2 Anthropometric Indicators ........................................................................................... 12 2.3 Situation of nutritional status in the world ................................................................... 14 2.3.1 Characteristics of individuals children ......................................................................15 2.3.2 Characteristics of mothers/caregivers .......................................................................16 2.3.3 Characteristics of households....................................................................................18 2.4 Situation of nutritional status in Vietnam .................................................................... 20 2.5 Analytical Framework .................................................................................................. 22 CHAPTER 3: STUDY SUBJECTIVES AND METHODOLOGY ................................ 24 3.1General information about Krong Bong District .......................................................... 24 3.2 Study design ................................................................................................................. 25 3.2.1 Study setting ..............................................................................................................25 3.2.2 Sample size................................................................................................................26 3.2.3. Study subjects...........................................................................................................27 3.3 Statistical analysis ...................................................................................................... 27 3.4 Empirical Model........................................................................................................... 29 3.5 Variables in the model ................................................................................................. 31 3.5.1 Dependence variable .................................................................................................33 3.5.2 Independence variable ...............................................................................................34 CHAPTER 4: DESCRIPTION OF NUTRITIONAL STATUS IN KRONG BONG, DAK LAK .......................................................................................................................... 35 4.1 Characteristics of child nutritional status ..................................................................... 35 4.1.1 Prevalence of current nutritional status in children ..................................................36 4.1.2 Prevalence of nutritional status in children by chronic, delivery status and place of birth ................................................................................................................................39 4.1.3 Prevalence of nutrition status in children by mother/caregiver education and occupation ..........................................................................................................................40 4.1.4 Prevalence of factors related family..........................................................................41 4.2 Risk factors of nutritional status .................................................................................. 46 4.2.1. Univariate analysis ...................................................................................................46 4.2.2. Multivariate analysis ................................................................................................50 CHAPTER 5: CONCLUSION AND RECOMMENDATION ......................................... 54 5.1. Conclusion................................................................................................................... 54 5.1.1 Conclusion of situation of nutritional status .............................................................54 5.1.2 Conclusion of risk factors of nutritional status .........................................................55 5.2 Recommendations ........................................................................................................ 55 5.3 Researchers and developments .................................................................................... 56 REFERENCES ................................................................................................................... 1 APPENDICIES ................................................................................................................... 7 LIST OF ABBREVIATIONS BMI Body Mass Index CDC Centers for Disease Control and Prevention IOTF International Obesity Task Force FAO Food and Agriculture Organization HAZ Height for age z-score (stunting) MDGs Millennium Development Goals OR Odd Ratio PHC Primary Health Care SD Standard deviation UNICEF United Nations International Children’s Emergency Fund WAZ Weight for age z-score (underweight) WB World Bank WHO World Health Organization WHZ Weight for height z-score (wasting) LIST OF TABLES Table 1.2.3. The statistics on the nutritional status of children in Dak Lak province over the years (2005-2014) ..........................................................................................................7 Table 2.2.1. Overview of indicators and cut offs that are considered appropriate to assess malnutrition in school-aged children .......................................................................13 Table 2.2.2. Mean (± SD) prevalence (%) of malnutrition in school-aged children, by WHO region, weighted for quality score ...........................................................................14 Table 3.4. Summarizes the variables in this study. ............................................................31 Table 4.1. Summary of children's BMI-for-Age ................................................................35 Table 4.1.1. Prevalence of nutrition status in children by commune, sex, age, number of children and ethnicity .........................................................................................................36 Table 4.1.1. Prevalence of nutrition status in children by commune, sex, age, number of children and ethnicity (con’t) .............................................................................................37 Table 4.1.2. Prevalence of nutritional status in children by chronic, delivery status and place of birth ......................................................................................................................39 Table 4.1.3. Prevalence of nutrition status in children by mother/caregiver education and occupation ...................................................................................................................40 Table 4.1.4a. Prevalence of nutritional status in children by boil drinking water, mosquito-net, latrine and garbage ......................................................................................41 Table 4.1.4b. Prevalence of nutritional status in children by family factors .....................43 Table 4.2.1a. Group variables of children ..........................................................................46 Table 4.2.1b. Group variables of mother/caregiver ...........................................................47 Table 4.2.1c. Group variables of households .....................................................................48 Table 4.2.2a. Group variables of children ..........................................................................50 Table 4.2.2b. Group variables of mother/caregiver ...........................................................50 Table 4.2.2c. Group variables of households .....................................................................51 LIST OF FIGURES Figure 1. Map of Dak Lak province showing Krong Bong district ...................................24 Figure 2: Krong Bong District Map ...................................................................................25 Figure 1.2.2. The statistics on the nutritional status of children over the years (19992014) (National Institute of Nutrition). ................................................................................6 Figure 2.5: Conceptual framework on the causes of malnutrition (UNICEF, 1997) .........23 Figure 3.1.3 Analytical framework: illustration of hypotheses related to the relationship between nutritional status in children and related factors. .................................................27 Figure 4.1. Prevalence of nutritional status in school-age children ...................................35 ABSTRACT Background: The nutritional status of children reflects the socioecomy of family and community as well as the efficiency of the health system. Malnutrition and overweight in school-age children are an important public health problem of the Ministry of Health and the Government of Vietnam. Within the country, Dak Lak province has the highest levels of malnutrition. Objectives: The aim of this study was to assess the nutritional status of primary school children and to find out factors associated with childhood malnutrition and overweight/obesity. Methods: A cross-sectional household survey was carried out on five primary schools of five communes in Krong Bong district, Dak Lak provinces during 30th March to 28th April, 2015 by interviewing 321 children and their mothers/caregivers by using questionnaire. Anthropometric measurement such as body weight (kg), and height of children (m2) was collected by using standard techniques. Body Mass index was used to define nutritional status according the WHO guideline. Result: Prevalence of malnutrition in Krong Bong district was 26.5%. School boys were more malnourished than school girls. Prevalence of overweight was 8.4% and school girls were more overweight than school boys. The occurrence of malnuttrition was dependence associated with commune and boil drinking water. Furthermore, the occurrence of overweight were dependence associated with gender of children, mother’s occupation, facility of birth, land-owning households. 1 ASSESSMENT OF NUTRITIONAL STATUS AMONG PRIMARY SCHOOL CHILDREN IN KRONG BONG DISTRICT, DAK LAK PROVINCE CHAPTER 1: PROBLEM STATEMENT 1. Research backround 1.1 Nutritional status in children in the world The nutritional status of children reflects the socioecomy of family and community as well as the efficiency of the health system. Malnutrition in school-age children are an important public health problem in the world. The worldwide number of children stunting was 171 million (167 million in developing countries) in 2010. The risk of childhood stunting reduced to 13 points from year 1990 to 2010, 39.7 (95%CI 38.1, 41.4) % down to 26.7 (95% CI 24.8, 28.7) % respectively. The expected trend was 21.8 (95% CI 19.8, 23.8) %, or 142 million, in 2020. The prevalence of stunting in Asia decreased faster than Africa during period from 1990 to 2010. Althougt Africa stunting has stagnated lower since 1990 at about 40% but little improvement is anticipated, while Asia showed at 49% in 1990 then reduced to 28% in 2010, decreasing from 190 million to 100 million. This trend will continue and that in 2020 Asia and Africa will have similar numbers of stunted children (68 million and 64 million, respectively). Rates were much lower (14% or 7 million in 2010) in Latin America (de Onis et al., 2012). In 2010, there were 43 million children in overweight and obesity (35 million in developing countries) and 92 million were at risk of overweight. The global prevalence 2 of childhood overweight and obesity increased from year 1990 to 2010, 4.2% (95% CI: 3.2%, 5.2%) up to 6.7% (95% CI: 5.6%, 7.7%) respectively. The expected trend was reach 9.1% (95% CI: 7.3%, 10.9%), or ~60 million, in 2020. The estimated prevalence of childhood overweight and obesity in Africa in 2010 and in 2020 were 8.5% (95% CI: 7.4%, 9.5%) and 12.7% (95% CI: 10.6%, 14.8%) respectively (de Onis et al., 2010). In September 2014, United Nations International Children’s Emergency Fund (UNICEF), World Health Organization (WHO) and the World Bank (WB) made public an updated final joint dataset on child malnutrition indicators (stunting, wasting, severe wasting, overweight and underweight) and new global & regional estimated for 2013. There were 161 million children under-five year olds were stunted, 51 million were wasted and 17 million were severely wasted, and 42 million were overweight and 99 million were underweight. The global trend of prevalence of stunting, wasting, severe wasting, and underweight decreased, while the prevalence of overweight increased in many regions. Between 2000 and 2013, the prevalence of overweight increased from 11% to 19% in Southern Africa, and from 3% to 7% in Southeastern Asia, and prevalence of stunting declined from 33% to 25%, or 199 million to 161 million children; prevalence of underweight was from 25% to 15%; prevalence of wasting in 2013 was estimated at almost 8% and nearly a third of that was for severe wasting, totaling 3%; and approximately two thirds of all wasted children lived in Asia and almost one third in Africa, with similar proportions for severely wasted children. In 2013, about half of all stunted children lived in Asia and over one third in Africa. This country has experience the smallest relative decreasing, with prevalence of underweight was down at 17% in 2013 and 23% in 1990, in Asia it declined from 32% to 18% perspectively and in Latin America and the Caribbean from 8% to 3% same period. This means Asia and Latin America and the Caribbean were likely to meet the 3 Millennium Development Goals while Africa was likely to fall short, reaching about only half of the targeted reduction. In terms of regional breakdowns in numbers of overweight children in 2013, there were an estimated 18 million under-fives in Asia, 11 million in Africa and four million in Latin America and the Caribbean, countries with large populations like Argentina, Bolivia, Brazil, Chile and Peru observed levels of 7% and higher (UNICEF-WHO-The World Bank 2013). Source: Joint child malnutrition estimates - Levels and trends (UNICEF-WHO-The World Bank 2013). School age is the active growing phase of childhood (SCN news, 1998). The present scenario of health and nutritional status of the school-age children in India was very unsatisfactory. The national family health survey (NFHS) data showed that the 4 prevalence of underweight was 53% of children in rural areas and this varies across states. In the country, it was 53.4%, 45.8% and 47% for the years 1992, 1998, and 2006 respectively (Srivastava et al., 2012). Recently, a worldwide statistics of WHO on overweight and obesity was related to more deaths than underweight. Most of the world's population lived in countries where overweight and obesity killed more people than underweight (this includes all high-income and most middle-income countries). In 2013, there were 42 million children under the age of five were overweight or obese. In 2014, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 600 million were obese. In 2014, the prevalence of obesity and overweight was about 13%, 39%, of those world’s adult population (11% of men and 15% of women) and adults aged 18 years and over (38% of men and 40% of women) respectively. Therefore the worldwide prevalence of obesity was more than doubled between 1980 and 2014 (World Health Organization, 2015). 1.2 Nutritional status in children in Vietnam In Vietnam, child health has been causing deep worry, as evidenced by within the framework of the Millennium Development Goals, this issue is an important concern for the Ministry of Health and the Government. The National Plan of Action for Child Survival 2009-2015, developed with WHO support, has set the ambitious targets of reducing the neonatal mortality rate to less than 10 per 1000 live births and under-5 mortality to less than 18 per 1000 live births by 2015 (World Health Organization). Therefore, the WHO, UNICEF, Food and Agriculture Organization (FAO), though nutrition indicators and health, recommended that the progress and existing problem should be closely monitored in order to be able to intervene as soon as possible with preventive and effective strategies. Vietnam is one of the Asian countries that has 5 achieved considerable success in the process of poverty reduction and lowering the prevalence of malnourished children, especially children under-five years old (Ministry of Health, 2012). 6 Figure 1.2.2. The statistics on the nutritional status of children over the years (19992014) (National Institute of Nutrition). Thereby the problem of malnutrition in children under-five years old has decreased noticeably from 1999 to 2014. Prevalence of underweight was from 36.7% (1999) dropped to 14.5% (2014), and prevalence of stunting decreased from 38.7% (1999) to 24.9% (2014). During 16 years, the prevalence of underweight was 22.2% decrease, while stunting fell by 13.8%. Factors related to nutritional status including income, land-owning households, assets, animals raising (Srivastava et al., 2012) (Martorell et al., 1984) (Moestue, 2005) (Cesare et al., 2015). Land is one of an indicator to measure the economic level of family through deciding to plant trees adapt to each their ability and local weather. It may consider a family income factor. In addition, characteristics of Vietnamese culture is an agriculture, many factors related to income could not measure exactly as one plus one are two, actually it has some invisible factors could not be measured are risen family income. Therefore it is very difficult to identify precise income of working staff or household income only base on questionnaire. The economic conditions of households, shortage of rice, children have low birth weight, giving birth at home, not monitoring weight and children suffered from diarrhea in the last 2 weeks are the factors related to malnutrition status of children under-five year of age (Le Thi Huong, 2014a). 1.3 Current nutritional status in children in Krong Bong The proportion of malnutrition in children has differences between ecological zones and regions. Accordingly, in the geographic orientation for projects to prevent child malnutrition in the next level of the ecoregion has stunting rate, the highest of the 7 mountains and the north midlands, north central and Central Coast, Central Highlands is also very important (Ministry of Health, 2012). Thus, Dak Lak province has been selected as pilot site program on nutrition intervention project "Improving the health of mothers and children of ethnic minorities through behavioural health benefit (Atlantic Philanthropies) in the first two years (from 2011 to 2013). One of the reasons that Dak Lak was selected by the project due to its highest nationwide prevalence of malnutrition of children under age five (CCRD ORG). Table 1.2.3. The statistics on the nutritional status of children in Dak Lak province over the years (2005-2014) YEAR Underweight (SDD cân n ng/tu i) Total Moderate Severe Stunting (SDD chi u cao/tu i) Very severe Total WHZ (TCBP) Wasting Overweight Obesity WHz >+2 WHz >+3 Moderate Severe 2005 34.3 28.3 5.9 0.1 41.6 24.1 17.5 6.9 2006 2007 2008 2009 32,8 30.4 29.1 28,4 27,4 25.7 5,3 4.6 0,1 0.1 23,4 23.5 17,0 17.7 25,5 2,8 0,1 40,4 41.2 39.5 38,8 21,6 17,2 6,8 7.2 7.2 7,0 2010 2011 2012 27 25.6 24.6 23.8 22.9 22.1 2.8 2.4 2.2 0.4 0.3 0.3 36.9 35.5 34.5 22.6 21.5 21 14.3 14 13.5 8.2 7.9 7.8 WHz = 0.5 ha Plant tree Bivariable 0 = if family plant trees, 1 = reverse Raise animal Bivariable 0 = no animal, 1 = if there are animals, Tangible assets Bivariable 0 = no asset, 1 = if there are assets (radio, TV, motocycle, bicycle, good furniture) 33 Description Name of Variable Bivariable 0 = if child drinks boil water, reverse = 1 Bivariable 0 = no mosquito-net, 1 = if child uses mosquito-net sleeping Boil drinking water Mosquito-net Discrete variable, Latrine is used in a child family. 0 = built, 1 = dug, 2 = no lantrine Bivariable, 0 = no private kitchen, 1 = if there is a kitchen in child’s family Latrine Private kitchen Discrete variable, 0 = use government service, 1 = compost, 2 = burn, 3 = bury. Discrete variable, Electricity is in use in a child family. 0 = electricity of public source, 1 = generator, 2 = no electricity Discrete variable Distance from child's house to market, 0 = < 30 mins, 1 = (30min - 1 hrs) = 1, 2 = more than 1 hour Garbage Electricity Market distance 3.5.1 Dependence variable The study assessed the nutritional status in children in primary schools. Therefore in univariate analysis model, the dependent variables are the variable of anthropometry will be bivariable, showing nutritional status in children, but in multivariate analysis model, the dependent variables would be also the anthropometrical so showing the nutritional status in relationship with other factors concerns. 34 3.5.2 Independence variable Independence variable group was categorized into three groups in the analytical framework: variables of children, variables of mothers/caregivers, variables of households as endogenous and exogenous factors. 35 CHAPTER 4: DESCRIPTION OF NUTRITIONAL STATUS IN KRONG BONG, DAK LAK This chapter presented prevalence and risk factors of nutritional status of children, showed results of the study in order to address the specific research questions. 4.1 Characteristics of child nutritional status Table 4.1. Summary of children's BMI-for-Age (CDC, 2015) Nutritional Status Boys Girls Total Number of children assessed: 150 171 321 Underweight (< 5th %ile) 24% 28.7% 26.5% Normal BMI (5th - 85th %ile) 65.1% 65.1% 65.1% Overweight or obese (≥ 85th %ile) (Barlow and Expert, 2007) 11% 6% 8% Obese (≥ 95th %ile) 2% 4% 7% Figure 4.1. Prevalence of nutritional status in school-age children 36 Figure 4.1 showed that the prevalence of normal, malnutrition and overweight of school-age children in Krong Bong district were 65.1%, 26.5% and 8.4% respectively. 4.1.1 Prevalence of current nutritional status in children Table 4.1.1. Prevalence of nutrition status in children by commune, sex, age, number of children and ethnicity Nutritional Indicators Characteristics Malnutrition N (%) Normal N (%) Overweight N (%) Hoa Le (n=8) 0 (0%) 7 (87.5%) 1 (12.5%) Cu Pui (n=63) 4 (6.3%) 54 (85.7%) 5 (7.9%) Yang Rel (n=37) 7 (18.9%) 20 (54.1%) 10 (27%) Eatrul (n=27) 10 (34.5%) 17 (58.6%) 2 (6.9%) Hoa Son (n=184) 64 (34.8%) 111 (60.3%) 9 (4.9%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Boy (n=171) 49 (28.7%) 112 (65.5%) 10 (5.8%) Girl (n=150) 36 (24.0%) 97 (64.7%) 17 (11.3%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Age 6 (n=4) 2 (50%) 2 (50%) 0 (0%) Age 7 (n=50) 11 (22%) 30 (60%) 9 (18%) Commune Sex Age 37 Table 4.1.1. Prevalence of nutrition status in children by commune, sex, age, number of children and ethnicity (con’t) Nutritional Indicators Characteristics Malnutrition N (%) Normal N (%) Overweight N (%) Age 8 (n=59) 17 (28.8%) 37 (62.7%) 5 (8.5%) Age 9 (n=83) 20 (24.1%) 59 (71.1%) 4 (4.8%) Age 10 (n=41) 13 (31.7%) 24 (58.5%) 4 (9.8%) Age 11 (n=73) 19 (26%) 49 (67.1%) 5 (6.8%) Age 12 (n=8) 2 (25%) 6 (75%) 0 (0%) Age 14 (n=3) 1 (33.3%) 2 (66.7%) 0 (0%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) 1 child (n=45) 9 (20%) 32 (71.1%) 4 (8.9%) 2 children (n=135) 39 (28.9%) 85 (63%) 11 (8.1%) 3 children (n=79) 22 (27.8%) 49 (62%) 8 (10.1%) 4 children (n=38) 10 (26.3%) 24 (63.2%) 4 (10.5%) 5 children (n=24) 5 (20.8%) 19 (79.2%) 0 (0%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Age Number of children 38 Nutritional Indicators Characteristics Malnutrition N (%) Normal N (%) Overweight N (%) Kinh (n=230) 67 (29.1%) 144 (62.6%) 19 (8.3%) Ede (n=32) 8 (25%) 22 (68.8%) 2 (6.3%) Others (n=59) 10 (16.9%) 43 (72.9%) 6 (10.2%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Ethnicity Table 4.1 presented that the prevalence of malnutrition was high in Hoa Son (34.8%) and Eatrul communes (34.5%). The prevalence of overweight in Yang Reh (27%) was higher among communes. The prevalence of malnutrition school boys was higher than that of school girls, 28.7% (49 pupils in 171 observations) and 24.0% (36 pupils in 150 observations) perspectively. The proportion of malnutrition in group aged 8 and 10 was higher among age groups. The prevalence of overweight school girls was higher than that of school boys, 11.3% (17 pupils in 150 observations) and 5.8% (10 pupils in 171 observations) perspectively. The proportion of overweight in group aged 7 and 10 was higher among age groups. Families with two and three children had the higher prevalence of malnutrition than number of children in other families, 28.9% and 27.8% respectively. The prevalence of overweight was high in families with three and four children, 10.5% and 10.1% respectively. 39 Kinh was highest prevalence of malnutrition with 29.1% (67 pupils in 230 observations). Other ethnic minority groups such as Thai, Tay, Muong, Nung, Hmong, M'Nong was highest prevalence of overweight (10.2%). 4.1.2 Prevalence of nutritional status in children by chronic, delivery status and place of birth Table 4.1.2. Prevalence of nutritional status in children by chronic, delivery status and place of birth Nutritional Indicators Characteristics Chronic Delivery status Place of birth Malnutrition N (%) Normal N (%) Overweight N (%) No (n=304) 83 (27.3%) 195 (64.1%) 26 (8.6%) Yes (n=17) 2 (11.8%) 14 (82.4%) 1 (5.9%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Normal (n=303) 80 (26.4%) 200 (66%) 23 (7.6%) Operating (n=18) 5 (27.8%) 9 (50%) 4 (22.2%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Health clinic (n=298) 79 (26.5%) 199 (66.8%) 20 (6.7%) At Home (n=23) 6 (26.1%) 10 (43.5%) 7 (30.4%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) 40 Prevalence of malnutrition and overweight in children having not-chronic diseases were higher than children group having chronic diseases, 27.3%, 8.6% respectively. The prevalence of malnutrition between children born by operation and normal was not obviously different, 26.4% and 27.8% respectively. This issue was the same as variable group of place of birth, children born at home and at health clinics (such as commune health station, district hospital and others), 26.5% and 26.1% respectively. However, prevalence of children was born by operating and at home was 22.2% and 30.4% respective much more overweight than the other ones. 4.1.3 Prevalence of nutrition status in children by mother/caregiver education and occupation Table 4.1.3. Prevalence of nutrition status in children by mother/caregiver education and occupation Nutritional Indicators Characteristics Malnutrition N (%) Normal N (%) Overweight N (%) 12 (24%) 34 (68%) 4 (8%) Primary and higher (n=271) 73 (26.9%) 175 (64.6%) 23 (8.5%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Farmer (n=274) 72 (26.3%) 182 (66.4%) 20 (7.3%) Others (47) 13 (27.7%) 27 (57.4%) 7 (14.9%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) No school (n=50) Mother/ caregiver education Mother/ caregiver occupation 41 The higher prevalence of malnutrition and overweight were in group of mother’s education of primary, 26.9% and 8.5% respectively. The prevalence of malnutrition and overweight were higher in group mothers/caregivers with other occupations, 27.7% and 14.9% respectively. 4.1.4 Prevalence of factors related family a. Personality activities Table 4.1.4a. Prevalence of nutritional status in children by boil drinking water, mosquito-net, latrine and garbage Nutritional Indicators Characteristics Boil drinking water Mosquito-net Malnutrition N (%) Normal N (%) Overweight N (%) Yes (n=278) 67 (24.1%) 187 (67.3%) 24 (8.6%) No (n=43) 18 (41.9%) 22 (51.2%) 3 (7%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) No (n=40) 11 (27.5%) 27 (67.5%) 2 (5%) Yes (n=281) 74 (26.3%) 182 (64.8%) 25 (8.9%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) 42 Nutritional Indicators Characteristics Malnutrition N (%) Malnutrition N (%) Malnutrition N (%) Built (n=162) 47 (29%) 101 (62.3%) 14 (8.6%) Dug (n=128) 30 (23.4%) 88 (68.8%) 10 (7.8%) None (n=31) 8 (25.8%) 20 (64.5%) 3 (9.7%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Other (use gov. service) (n=121) 30 (24.8%) 77 (63.6%) 14 (11.6%) Compost (n=17) 4 (23.5%) 13 (76.5%) 0 (0%) Burn (n=173) 50 (28.9%) 112 (64.7%) 11 (6.4%) Bury (n=10) 1 (10%) 7 (70%) 2 (20%) 85 (26.5%) 209 (65.1%) 27 (8.4%) Latrine Garbage Total (n=321) Children drank boiled water were less malnutrition. The higher proportion of malnutrition was 41.9% in group of not-boiled drinking water. The higher proportion of overweight was 8.6% in group of boiled drinking water. 43 b. Family factors Table 4.1.4b. Prevalence of nutritional status in children by family factors Nutritional Indicators Characteristics Malnutrition N (%) Normal N (%) Overweight N (%) Poor (n=80) 23 (28.8%) 51 (63.8%) 6 (7.5%) Enough (n=213) 57 (26.8%) 139 (65.3%) 17 (8%) Middle class (n=28) 5 (17.9%) 19 (67.9%) 4 (14.3%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) None (n=64) 18 (28.1%) 44 (68.8%) 2 (3.1%) < 0.5 ha (n=231) 59 (25.5%) 150 (64.9%) 22 (9.5%) >= 0.5 ha (n=26) 8 (30.8%) 15 (57.7%) 3 (11.5%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Yes (n=251) 66 (26.3%) 161 (64.1%) 24 (9.6%) None (n=70) 19 (27.1%) 48 (68.6%) 3 (4.3%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Living standard Land Plant tree 44 Nutritional Indicators Characteristics Raise animal Tangible assets Private kitchen Malnutrition N (%) Normal N (%) Overweight N (%) None (n=85) 26 (30.6%) 53 (62.4%) 6 (7.1%) Yes (n=236) 59 (25%) 156 (66.1%) 21 (8.9%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) None (n=14) 4 (28.6%) 10 (71.4%) 0 (0%) Yes (n=307) 81 (26.4%) 199 (64.8%) 27 (8.8%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) None (n=86) 22 (25.6%) 56 (65.1%) 8 (9.3%) Yes (n=235) 63 (26.8%) 153 (65.1%) 19 (8.1%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Public source (n=302) 77 (25.5%) 200 (66.2%) 25 (8.3%) Generator (n=11) 6 (54.5%) 5 (45.5%) 0 (0%) 2 (25%) 4 (50%) 2 (25%) 85 (26.5%) 209 (65.1%) 27 (8.4%) Electricity No (n=8) Total (n=321) 45 Nutritional Indicators Characteristics Malnutrition N (%) Normal N (%) Overweight N (%) < 30 min (n=256) 73 (28.5%) 163 (63.7%) 20 (7.8%) 30min - 1 hrs (n=43) 9 (20.9%) 31 (72.1%) 3 (7%) > 1hrs (n=22) 3 (13.6%) 15 (68.2%) 4 (18.2%) Total (n=321) 85 (26.5%) 209 (65.1%) 27 (8.4%) Market distance The prevalence of malnutrition among living standard group was higher in poor and enough groups with 28.8% and 26.8% respectively. The higher proportion of overweight was in middle class group with 14.3%. Children were in the landless households, households own >= 0.5 ha had higher prevalence of malnutrition, 28.1%, 30.8% respectively. Households owned more land, the more children living in were overweight, with the higher prevalence in group of land-owning < 0.5 ha, and >= 0.5 ha, 9.5%, 11.5% perspective. The more households raised animals and owned assets, the more children were less malnutrition and overweight, and simultaneous overweight increasingly. The higher prevalence of malnutrition was in group of no animals and no assets, 30.6% and 28.6% respectively. The higher prevalence of overweight was in group of raise animals and owned assets, 8.9% and 8.8% respectively. 46 4.2 Risk factors of nutritional status 4.2.1. Univariate analysis a. Children variable group Table 4.2.1a. Variable group of children OR (95% CI) No. Characteristics Malnutrition 1 2 Age (year) Per a year increase Gender (male vs female) Overweight 0.99 (0.84-1.17) 0.78 (0.59-1.03) 0.85 (0.51-1.41) 1.96 (0.86-4.49) The risk of malnutrition was associated with a reduced age (OR: 0.99 and 95%CI: 0.84-1.17 per each year increased) and gender (OR: 0.85 and 95%CI: 0.51-1.41 male vs female). The risk of overweight was associated with a reduced age (OR: 0.78 and 95%CI: 0.59-1.03 per each year increased) and with gender (OR: 1.96; 95%CI: 0.86-4.49 male vs female). However, there were not significant differences in child’s age, gender. 47 b. Mother/caregiver variable group Table 4.2.1b. Variable group of mother/caregiver OR (95% CI) No. Characteristics Malnutrition Overweight Mother/caregiver education 1 (Primary and higher vs 1.18 (0.58-2.41) 1.12 (0.36-3.44) 1.22 (0.59-2.49) 2.36 (0.91-6.11) illiterate) Mother/caregiver occupation 2 (others (knitting, housewife, trading, salaried work) vs farmer) The risk of malnutrition was associated with an increase mother/caregiver education (OR: 1.18; 95%CI: 0.58-2.41 primary and higher vs illiterate) and mother occupation (OR: 1.22; 95%CI: 0.59-2.49 other occupations vs farmer). The risk of overweight was associated with an increase mother/caregiver education (OR: 1.12; 95%CI: 0.36-3.44 primary and higher vs illiterate) and mother/caregiver occupation (OR: 2.36; 95%CI: 0.91-6.11 other occupations vs farmer). However, there were not significant differences of mother/caregiver education and occupation. 48 c. Households level variable group (remaining variables) Table 4.2.1c. Variable group of households OR (95% CI) No. Characteristics Univariate analysis Malnutrition Overweight 1 Number of children, (Per number increase) 0.98 (0.78-1.24) 0.89 (0.61-1.29) 2 Commune (Hoa Le based) 1.77 (1.37-2.3) 0.84 (0.63-1.12) 3 Ethnicity (Kinh base) 0.72 (0.5-1.02) 1 (0.61-1.64) 0.34 (0.07-1.51) 0.54 (0.07-4.24) 1.39 (0.45-4.27) 3.86 (1.1-13.55) Chronic 4 (infected vs no infected) Delivery status 5 (operating vs normal ) 6 Place of birth (home vs health clinic ) 1.51 (0.53-4.3) 6.97 (2.39-20.3) 7 Living standard (per standard increase as poor, enough, middle class) 0.83 (0.53-1.3) 1.29 (0.63-2.67) 8 Land (land vs no land) 1.08 (0.66-1.77) 1.97 (0.89-4.37) 9 Plant tree (none vs yes) 0.97 (0.53-1.77) 0.42 (0.12-1.45) 10 Raise animal (no animal vs animal) 0.77 (0.44-1.35) 1.19 (0.46-3.1) 49 OR (95% CI) No. Characteristics Univariate analysis Malnutrition Overweight 11 Tangible assets (no asset vs assets) 1.02 (0.31-3.34) #NUM! 12 Boil drinking water (no vs yes) 2.28 (1.15-4.52) 1.06 (0.3-3.82) 13 Mosquito-net (no mosquito-net vs mosquito- 1 (0.47-2.12) net) 1.85 (0.42-8.28) 14 Latrine (built, dug vs no latrine) 0.85 (0.57-1.25) 0.96 (0.52-1.75) 15 Private kitchen (private kitchen vs no private kitchen ) 1.05 (0.59-1.86) 0.87 (0.36-2.1) 16 Garbage (Other (use gov. service) based) 1.03 (0.79-1.32) 0.82 (0.55-1.22) 17 Electricity (Public source based) 1.53 (0.78-3.01) 1.78 (0.71-4.44) 18 Market distance (|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | age | -.0117919 .0849123 -0.14 0.890 _cons | -.8619281 .3003331 -2.87 0.004 -.1782169 .1546331 -1.45057 -.273286 -------------+---------------------------------------------------------------2 | age | -.2464516 .1407721 -1.75 0.080 _cons | -1.322623 .4356399 -3.04 0.002 -.52236 .0294567 -2.176462 -.4687848 -----------------------------------------------------------------------------. mlogit nusta sex -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | sex | -.1645135 .2596609 _cons | -.8266786 .1712797 -0.63 0.526 -4.83 0.000 -.6734395 .3444126 -1.162381 -.4909765 -------------+---------------------------------------------------------------2 | sex | .6744155 .4219731 1.60 0.110 _cons | -2.415913 .3300432 -7.32 0.000 -.1526365 -3.062786 1.501468 -1.76904 -----------------------------------------------------------------------------. mlogit nusta childno -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | childno | -.0156574 .1168386 _cons | -.875035 .224068 -0.13 0.893 -3.91 0.000 -.2446568 .213342 -1.3142 -.4358698 -------------+---------------------------------------------------------------2 | childno | -.1188474 .1923308 -0.62 0.537 _cons | -1.866669 .3473689 -5.37 0.000 -.4958088 .2581141 -2.5475 -1.185839 -----------------------------------------------------------------------------. mlogit nusta Commune -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Commune | .5730894 .1320342 _cons | -2.760438 .475242 4.34 0.000 -5.81 0.000 .3143072 .8318717 -3.691895 -1.828981 -------------+---------------------------------------------------------------- 2 | Commune | -.176476 .1465782 _cons | -1.578469 .4229196 -1.20 0.229 -3.73 0.000 -.4637639 .110812 -2.407376 -.7495618 -----------------------------------------------------------------------------. mlogit nusta Ethnic -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Ethnic | -.3331598 .1807147 -1.84 0.065 -.6873542 .0210346 _cons | -.760569 .1457548 -5.22 0.000 -1.046243 -.4748949 -------------+---------------------------------------------------------------2 | Ethnic | .0026741 .2510997 0.01 0.992 -.4894722 .4948204 _cons | -2.047882 .2424056 -8.45 0.000 -2.522988 -1.572775 -----------------------------------------------------------------------------. mlogit nusta Chronic -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Chronic | -1.091751 .7672059 _cons | -.854159 .1310588 -1.42 0.155 -6.52 0.000 -2.595447 .4119448 -1.111029 -.5972885 -------------+---------------------------------------------------------------2 | Chronic | -.6241543 1.055944 _cons | -2.014903 .2087816 -0.59 0.554 -9.65 0.000 -2.693767 1.445458 -2.424107 -1.605699 -----------------------------------------------------------------------------. mlogit nusta Destat -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Destat | .3285041 .5732461 0.57 0.567 _cons | -.9162907 .1322876 -6.93 0.000 -.7950377 1.452046 -1.17557 -.6570119 -------------+---------------------------------------------------------------2 | Destat | 1.351893 .6399917 2.11 0.035 .0975323 2.606254 _cons | -2.162823 .2201778 -9.82 0.000 -2.594364 -1.731283 -----------------------------------------------------------------------------. mlogit nusta pob -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | pob | .4130315 .5332448 0.77 0.439 -.6321091 1.458172 _cons | -.923857 .1329788 -6.95 0.000 -1.184491 -.6632234 -------------+---------------------------------------------------------------2 | pob | 1.940898 .5457859 3.56 0.000 _cons | -2.297573 .2345743 -9.79 0.000 .8711769 3.010618 -2.75733 -1.837815 -----------------------------------------------------------------------------. mlogit nusta medu -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | medu | .1671273 .3635354 0.46 0.646 _cons | -1.041454 .3357754 -3.10 0.002 -.545389 .8796437 -1.699562 -.3833462 -------------+---------------------------------------------------------------2 | medu | .1107744 .5732402 0.19 0.847 _cons | -2.140066 .5285941 -4.05 0.000 -1.012756 1.234305 -3.176092 -1.104041 -----------------------------------------------------------------------------. mlogit nusta mojob -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | mojob | .1964531 .3651623 0.54 0.591 -.5192519 .912158 _cons | -.9273406 .1392243 -6.66 0.000 -1.200215 -.654466 -------------+---------------------------------------------------------------2 | mojob | .8583477 .4851687 1.77 0.077 -.0925655 1.809261 _cons | -2.208274 .2355727 -9.37 0.000 -2.669988 -1.74656 -----------------------------------------------------------------------------. mlogit nusta lstand -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | lstand | -.1896086 .2316456 -0.82 0.413 -.6436256 .2644084 _cons | -.7446622 .2266835 -3.29 0.001 -1.188954 -.3003707 -------------+---------------------------------------------------------------2 | lstand | .2568601 .3696843 _cons | -2.27419 0.69 0.487 .395963 -5.74 0.000 -.4677079 .981428 -3.050263 -1.498117 -----------------------------------------------------------------------------. mlogit nusta Land -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------- 1 | Land | .0799072 .2505795 0.32 0.750 _cons | -.969347 .2544983 -3.81 0.000 -.4112195 .5710339 -1.468154 -.4705396 -------------+---------------------------------------------------------------2 | Land | .6769267 .4071015 1.66 0.096 -.1209775 1.474831 _cons | -2.689271 .4618634 -5.82 0.000 -3.594506 -1.784035 -----------------------------------------------------------------------------. mlogit nusta ptree -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | ptree | -.0350124 .3079409 -0.11 0.909 _cons | -.8917496 .1461598 -6.10 0.000 -.6385655 .5685407 -1.178218 -.6052816 -------------+---------------------------------------------------------------2 | ptree | -.8692382 .6340698 -1.37 0.170 _cons | -1.903351 .2188101 -8.70 0.000 -2.111992 .3735158 -2.33221 -1.474491 -----------------------------------------------------------------------------. mlogit nusta ranim -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | ranim | -.2601232 .2840579 -0.92 0.360 -.8168664 .29662 _cons | -.7121954 .2394357 -2.97 0.003 -1.181481 -.24291 -------------+---------------------------------------------------------------2 | ranim | .1731989 .4894526 0.35 0.723 -.7861107 1.132508 _cons | -2.178532 .4307373 -5.06 0.000 -3.022762 -1.334303 -----------------------------------------------------------------------------. mlogit nusta asset -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | asset | .0173919 .606106 0.03 0.977 _cons | -.9162493 .5916027 -1.55 0.121 -1.170554 -2.075769 1.205338 .2432707 -------------+---------------------------------------------------------------2 | asset | 14.57547 1255.409 0.01 0.991 _cons | -16.57301 1255.409 -0.01 0.989 -2445.98 -2477.129 2475.131 2443.983 -----------------------------------------------------------------------------. mlogit nusta bdwat -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------- 0 | (base outcome) -------------+---------------------------------------------------------------1 | bdwat | .8257453 .3482572 2.37 0.018 .1431738 1.508317 _cons | -1.026416 .1423832 -7.21 0.000 -1.305482 -.7473501 -------------+---------------------------------------------------------------2 | bdwat | .0606246 .6525352 0.09 0.926 -1.218321 1.33957 _cons | -2.053055 .2168277 -9.47 0.000 -2.478029 -1.62808 -----------------------------------------------------------------------------. mlogit nusta monet -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | monet | -.002 .383346 -0.01 0.996 _cons | -.8979416 .3576956 -.7533443 -2.51 0.012 .7493443 -1.599012 -.1968711 -------------+---------------------------------------------------------------2 | monet | .6175578 .7632372 0.81 0.418 _cons | -2.602689 .7328278 -3.55 0.000 -.8783597 2.113475 -4.039005 -1.166373 -----------------------------------------------------------------------------. mlogit nusta latrin -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | latrin | -.1668776 .1988376 -0.84 0.401 -.5565922 _cons | -.8035022 -4.72 0.000 -1.137384 -.4696205 .170351 .2228369 -------------+---------------------------------------------------------------2 | latrin | -.0452276 .3098955 -0.15 0.884 _cons | -2.019248 .2753259 -7.33 0.000 -.6526117 -2.558877 .5621564 -1.47962 -----------------------------------------------------------------------------. mlogit nusta kitch -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | kitch | .047006 .2927809 _cons | -.9343092 .2516181 0.16 0.872 -3.71 0.000 -.526834 .620846 -1.427472 -.4411467 -------------+---------------------------------------------------------------2 | kitch | -.1400888 .4494715 -0.31 0.755 -1.021037 .7408592 _cons | -1.94591 .3779645 -5.15 0.000 -2.686707 -1.205113 -----------------------------------------------------------------------------. mlogit nusta garba ------------------------------------------------------------------------------ nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | garba | .0247894 .1298495 0.19 0.849 -.2297108 .2792897 _cons | -.9305868 .2072996 -4.49 0.000 -1.336887 -.5242871 -------------+---------------------------------------------------------------2 | garba | -.1966222 .2038339 -0.96 0.335 -.5961293 .2028848 _cons | -1.82311 .2978005 -6.12 0.000 -2.406788 -1.239432 -----------------------------------------------------------------------------. mlogit nusta elect -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | elect | .4250524 .3449516 1.23 0.218 _cons | -.9366006 .1329261 -7.05 0.000 -.2510404 1.101145 -1.197131 -.6760702 -------------+---------------------------------------------------------------2 | elect | .5765202 .4668836 1.23 0.217 _cons | -2.103455 .2136384 -9.85 0.000 -.3385549 1.491595 -2.522179 -1.684732 -----------------------------------------------------------------------------. mlogit nusta mdist -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | mdist | -.4076422 .2602532 -1.57 0.117 -.917729 .1024446 _cons | -.8061449 .1392569 -5.79 0.000 -1.079083 -.5332064 -------------+---------------------------------------------------------------2 | mdist | .2774387 .3015212 _cons | -2.142715 0.92 0.358 .236263 -9.07 0.000 -.3135321 .8684095 -2.605782 -1.679648 -----------------------------------------------------------------------------mlogit nusta age -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | age | -.0117919 .0849123 _cons | -.8619281 .3003331 -0.14 0.890 -2.87 0.004 -.1782169 .1546331 -1.45057 -.273286 -------------+---------------------------------------------------------------2 | age | -.2464516 .1407721 _cons | -1.322623 .4356399 -1.75 0.080 -3.04 0.002 -.52236 .0294567 -2.176462 -.4687848 ------------------------------------------------------------------------------ . mlogit nusta sex -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | sex | -.1645135 .2596609 -0.63 0.526 _cons | -.8266786 .1712797 -4.83 0.000 -.6734395 .3444126 -1.162381 -.4909765 -------------+---------------------------------------------------------------2 | sex | .6744155 .4219731 1.60 0.110 _cons | -2.415913 .3300432 -7.32 0.000 -.1526365 -3.062786 1.501468 -1.76904 -----------------------------------------------------------------------------. mlogit nusta childno -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | childno | -.0156574 .1168386 _cons | -.875035 .224068 -0.13 0.893 -3.91 0.000 -.2446568 .213342 -1.3142 -.4358698 -------------+---------------------------------------------------------------2 | childno | -.1188474 .1923308 -0.62 0.537 _cons | -1.866669 .3473689 -5.37 0.000 -.4958088 .2581141 -2.5475 -1.185839 -----------------------------------------------------------------------------. mlogit nusta Commune -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Commune | .5730894 .1320342 _cons | -2.760438 .475242 4.34 0.000 -5.81 0.000 .3143072 .8318717 -3.691895 -1.828981 -------------+---------------------------------------------------------------2 | Commune | -.176476 .1465782 _cons | -1.578469 .4229196 -1.20 0.229 -3.73 0.000 -.4637639 .110812 -2.407376 -.7495618 -----------------------------------------------------------------------------. mlogit nusta Ethnic -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Ethnic | -.3331598 .1807147 -1.84 0.065 -.6873542 .0210346 _cons | -.760569 .1457548 -5.22 0.000 -1.046243 -.4748949 -------------+---------------------------------------------------------------2 | Ethnic | .0026741 .2510997 0.01 0.992 -.4894722 .4948204 _cons | -2.047882 .2424056 -8.45 0.000 -2.522988 -1.572775 -----------------------------------------------------------------------------. mlogit nusta Chronic -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Chronic | -1.091751 .7672059 _cons | -.854159 .1310588 -1.42 0.155 -6.52 0.000 -2.595447 .4119448 -1.111029 -.5972885 -------------+---------------------------------------------------------------2 | Chronic | -.6241543 1.055944 _cons | -2.014903 .2087816 -0.59 0.554 -9.65 0.000 -2.693767 1.445458 -2.424107 -1.605699 -----------------------------------------------------------------------------. mlogit nusta Destat -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Destat | .3285041 .5732461 0.57 0.567 _cons | -.9162907 .1322876 -6.93 0.000 -.7950377 1.452046 -1.17557 -.6570119 -------------+---------------------------------------------------------------2 | Destat | 1.351893 .6399917 2.11 0.035 .0975323 2.606254 _cons | -2.162823 .2201778 -9.82 0.000 -2.594364 -1.731283 -----------------------------------------------------------------------------. mlogit nusta pob -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | pob | .4130315 .5332448 0.77 0.439 -.6321091 1.458172 _cons | -.923857 .1329788 -6.95 0.000 -1.184491 -.6632234 -------------+---------------------------------------------------------------2 | pob | 1.940898 .5457859 3.56 0.000 _cons | -2.297573 .2345743 -9.79 0.000 .8711769 3.010618 -2.75733 -1.837815 -----------------------------------------------------------------------------. mlogit nusta medu -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | medu | .1671273 .3635354 0.46 0.646 _cons | -1.041454 .3357754 -3.10 0.002 -.545389 .8796437 -1.699562 -.3833462 -------------+---------------------------------------------------------------- 2 | medu | .1107744 .5732402 0.19 0.847 _cons | -2.140066 .5285941 -4.05 0.000 -1.012756 1.234305 -3.176092 -1.104041 -----------------------------------------------------------------------------. mlogit nusta mojob -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | mojob | .1964531 .3651623 0.54 0.591 -.5192519 .912158 _cons | -.9273406 .1392243 -6.66 0.000 -1.200215 -.654466 -------------+---------------------------------------------------------------2 | mojob | .8583477 .4851687 1.77 0.077 -.0925655 1.809261 _cons | -2.208274 .2355727 -9.37 0.000 -2.669988 -1.74656 -----------------------------------------------------------------------------. mlogit nusta lstand -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | lstand | -.1896086 .2316456 -0.82 0.413 -.6436256 .2644084 _cons | -.7446622 .2266835 -3.29 0.001 -1.188954 -.3003707 -------------+---------------------------------------------------------------2 | lstand | .2568601 .3696843 _cons | -2.27419 0.69 0.487 .395963 -5.74 0.000 -.4677079 .981428 -3.050263 -1.498117 -----------------------------------------------------------------------------. mlogit nusta Land -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | Land | .0799072 .2505795 0.32 0.750 _cons | -.969347 .2544983 -3.81 0.000 -.4112195 .5710339 -1.468154 -.4705396 -------------+---------------------------------------------------------------2 | Land | .6769267 .4071015 1.66 0.096 -.1209775 1.474831 _cons | -2.689271 .4618634 -5.82 0.000 -3.594506 -1.784035 -----------------------------------------------------------------------------. mlogit nusta ptree -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | ptree | -.0350124 .3079409 -0.11 0.909 -.6385655 .5685407 _cons | -.8917496 .1461598 -6.10 0.000 -1.178218 -.6052816 -------------+---------------------------------------------------------------2 | ptree | -.8692382 .6340698 -1.37 0.170 _cons | -1.903351 .2188101 -8.70 0.000 -2.111992 .3735158 -2.33221 -1.474491 -----------------------------------------------------------------------------. mlogit nusta ranim -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | ranim | -.2601232 .2840579 -0.92 0.360 -.8168664 .29662 _cons | -.7121954 .2394357 -2.97 0.003 -1.181481 -.24291 -------------+---------------------------------------------------------------2 | ranim | .1731989 .4894526 0.35 0.723 -.7861107 1.132508 _cons | -2.178532 .4307373 -5.06 0.000 -3.022762 -1.334303 -----------------------------------------------------------------------------. mlogit nusta asset -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | asset | .0173919 .606106 0.03 0.977 _cons | -.9162493 .5916027 -1.55 0.121 -1.170554 -2.075769 1.205338 .2432707 -------------+---------------------------------------------------------------2 | asset | 14.57547 1255.409 0.01 0.991 _cons | -16.57301 1255.409 -0.01 0.989 -2445.98 -2477.129 2475.131 2443.983 -----------------------------------------------------------------------------. mlogit nusta bdwat -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | bdwat | .8257453 .3482572 2.37 0.018 .1431738 1.508317 _cons | -1.026416 .1423832 -7.21 0.000 -1.305482 -.7473501 -------------+---------------------------------------------------------------2 | bdwat | .0606246 .6525352 0.09 0.926 -1.218321 1.33957 _cons | -2.053055 .2168277 -9.47 0.000 -2.478029 -1.62808 -----------------------------------------------------------------------------. mlogit nusta monet -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------- 1 | monet | -.002 .383346 -0.01 0.996 _cons | -.8979416 .3576956 -.7533443 -2.51 0.012 .7493443 -1.599012 -.1968711 -------------+---------------------------------------------------------------2 | monet | .6175578 .7632372 0.81 0.418 _cons | -2.602689 .7328278 -3.55 0.000 -.8783597 2.113475 -4.039005 -1.166373 -----------------------------------------------------------------------------. mlogit nusta latrin -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | latrin | -.1668776 .1988376 -0.84 0.401 -.5565922 _cons | -.8035022 -4.72 0.000 -1.137384 -.4696205 .170351 .2228369 -------------+---------------------------------------------------------------2 | latrin | -.0452276 .3098955 -0.15 0.884 _cons | -2.019248 .2753259 -7.33 0.000 -.6526117 -2.558877 .5621564 -1.47962 -----------------------------------------------------------------------------. mlogit nusta kitch -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | kitch | .047006 .2927809 0.16 0.872 _cons | -.9343092 .2516181 -3.71 0.000 -.526834 .620846 -1.427472 -.4411467 -------------+---------------------------------------------------------------2 | kitch | -.1400888 .4494715 -0.31 0.755 -1.021037 .7408592 _cons | -1.94591 .3779645 -5.15 0.000 -2.686707 -1.205113 -----------------------------------------------------------------------------. mlogit nusta garba -----------------------------------------------------------------------------nusta | Coef. Std. Err. z P>|z| [95% Conf. Interval] -------------+---------------------------------------------------------------0 | (base outcome) -------------+---------------------------------------------------------------1 | garba | .0247894 .1298495 0.19 0.849 -.2297108 .2792897 _cons | -.9305868 .2072996 -4.49 0.000 -1.336887 -.5242871 -------------+---------------------------------------------------------------- QUESTIONNAIRE ON HOUSEHOLD Date of survey: ……./…………../…………….. Code: …………………… A. General Information (Priority for mother/care givers of children will be an interviewee) 1. Household Information No. Full name Sex DOB Ethnicity Relative Education with Career Notes: • Education: 1. Illiteracy 2. Reading, writing 3. Primary 5. High school 6. College * Career: 1. Farmer 2. Knitting 4. Salary work 3. Trading 5. Housewife 6. Other. ………… 2. Please self access your living standard: 4. Secondary 7. University/higher Religion Poor Enough Middle class Excess 3. Total expenditure of your family in previous month (dong)  < 1.000.000  1.000.000-2.000.000  2.000.000-3.000.000 >3.000.000 4. Total food expenditure of your family in previous month (dong)  < 1.000.000  1.000.000-2.000.000  2.000.000-3.000.000 >3.000.000 5. Do you own any land?  Yes  No If yes, how much do you own? (ha)  [...]... prevalence of malnutrition in children in Krong Bong district was highest in the Dak Lak province in 2012, the percentage of underweight and stunting of under five-year children was 26.7% and 33.3% respectively ( k L k đi n t , 7/2012) This is the reason why the assessment of nutritional status among Primary school children in Krong Bong district, Dak Lak province was chosen for the thesis The unbalance in. .. related to the issue to be investigated 3.1 General information about Krong Bong District Krong Bong district is in Southern of Dak Lak province (People's Committee of Krong Bong District, 2015) Khanh Hoa Lam Dong Figure 1 Map of Dak Lak province showing Krong Bong district (in dark grey area) The total land area of the district is 1257.5 km2, occupy about 6.38% of Dak Lak province The total population... relation of the factors of household family level and nutritional status in children?  Is there any impact of maternal factors on the nutritional status of the schoolaged children? 1.5 Scope of the research The thesis focus on nutritional status among primary school children in Krong Bong district, Dak Lak province Underweight is defined as malnutrition Therefore nutritional status is defined as malnutrition,...1 ASSESSMENT OF NUTRITIONAL STATUS AMONG PRIMARY SCHOOL CHILDREN IN KRONG BONG DISTRICT, DAK LAK PROVINCE CHAPTER 1: PROBLEM STATEMENT 1 Research backround 1.1 Nutritional status in children in the world The nutritional status of children reflects the socioecomy of family and community as well as the efficiency of the health system Malnutrition in school-age children are an... Kinh majority migrating from Quang Nam (People's Committee of Krong Bong District, 2015) 3.2 Study design A cross-sectional household survey was carried out in five primary schools of five communes, Krong Bong district, Dak Lak provinces Children and their mothers/caregivers were interviewed by using questionnaire 3.2.1 Study setting The study randomly chose five communes from 13 communes in Krong Bong. .. Scope of the research was carried out on five primary schools of five communes in Krong Bong district, Dak Lak provinces by interviewing children and their mothers/caregivers by using questionnaire The five communes in Krong Bong district are Yang Reh, Hoa Le, Eatrul, Hoa Son and Cu Pui 10 1.6 General method Findings of economic theories that relate to the study topics and descriptive methodology of. .. Objective of the thesis 1.4.1 General objective The general objective of this study is to assess the nutritional status and their related factors among primary school children in Krong Bong district, Dak Lak province 9 1.4.2 Specific objectives  To assess the prevalence of malnutrition and overweight of the school-aged children  To determine the related factors to children including: sex, age and child nutritional. .. of 2012-2013 with total 2,481 children from two primary schools in urban and sub-urban of Ho Chi Minh City Result showed that prevalence of overweight/obesity of primary school children was 54.5% in Ho Thi Ky primary school and 31.2% in Phu Hoa Dong primary school in the beginning of school year, respectively After six months of intervention, prevalence of overweight/obesity reduced (from 43.5% to 37.8%,... found based on CDC In conclusion, the significant differences in prevalence of nutritional status was found among children aged 6-10 years according to the international criteria (Bui Thi Nhung, 2014) In 2012, a study conducted to assess the nutritional status and some related factors of children under 6 in Thuy Loi commune, Kim Ban district, Ha Nam province with the participation of 327 children –... difference in the prevalence of malnutrition between urban, rural and mountains areas, the reduction being highest in the urban regions and lowest in the mountains areas (Le Danh Tuyen, 2010) Group of authors in Vietnam National Institute of Nutrition were conducted an intervention study to reduce prevalence of overweight/obesity among school children through intervention activities in school year of 2012-2013 ... reason why the assessment of nutritional status among Primary school children in Krong Bong district, Dak Lak province was chosen for the thesis The unbalance in health care in the province compared... Nutritional status in children in the world .1 1.2 Nutritional status in children in Vietnam .4 1.3 Current nutritional status in children in Krong Bong 1.4 Objective of the... thesis focus on nutritional status among primary school children in Krong Bong district, Dak Lak province Underweight is defined as malnutrition Therefore nutritional status is defined as malnutrition,