evidence-based blog of Filippo Dibari

Posts Tagged ‘Mozambique’

Associations of dietary diversity scores and micronutrient status in adolescent Mozambican girls

In Under-nutrition on March 17, 2017 at 3:08 pm

Korkalo, L., Erkkola, M., Heinonen, A.E. et al. Eur J Nutr (2017) 56: 1179.

(download for free)

Abstract

 

Purpose

In low-income settings, dietary diversity scores (DDSs) often predict the micronutrient adequacy of diets, but little is known about whether they predict levels of biochemical indicators of micronutrient status.

Methods

In 2010, we studied two samples of non-pregnant 14- to 19-year-old girls in central Mozambique, the first in January–February (‘hunger season’; n = 227) and the second in May–June (harvest season; n = 223). In this paper, we examined whether a low Women’s Dietary Diversity Score (WDDS) predicts a low concentration of haemoglobin, serum ferritin, zinc, and folate, and plasma retinol in adolescent Mozambican girls. We constructed three scores: WDDS based on 24-h recalls, WDDS15g based on 24-h recall and employing a 15 g limit, and 7dWDDS based on 7-day food frequency questionnaires. Logistic regression models, stratified by season, were used to estimate the odds of having a low concentration of a status indicator (≤25th percentile of the season-specific distribution or cut-off from the literature) in those with a low score compared to those with a higher score.

Results

In January–February, after adjusting for confounders, a low (≤3) WDDS and a low (≤5) 7dWDDS were each associated with higher odds of having low serum zinc compared to having a higher score, regardless of which of the two types of cut-offs for serum zinc was used. These associations were not present in May–June.

Conclusions

Our data from Mozambique suggest that dietary diversity is associated with serum zinc, but this association seems to be limited to the hunger season.

Characteristics and determinants of child malnutrition in Mozambique, 2003–11

In Uncategorized on December 19, 2016 at 1:36 pm

Cardoso, J., Allwright, L. & Salvucci, V. (2016) Characteristics and determinants of child malnutrition in Mozambique, 2003–11. 2016/147. Helsinki: UNU-WIDER.

(download pdf)

Child malnutrition continues to be a serious impediment to development both at the individual and national levels in many developing countries. In Mozambique, despite a high and sustained GDP growth, child malnutrition has been decreasing at a rather slow pace over the past 15 years.

In this study, using the Mozambican Demographic and Health Surveys 2003 and 2011 we find that household wealth, mother’s education, area of residence, and access to safe water and improved sanitation facilities have a strong relation with different measures of chronic child malnutrition.

Also, the relative importance of these variables remained mostly unchanged over time.

We conclude that continued and more focused and effective interventions aimed at directly reducing child malnutrition should be undertaken by all public and private actors involved.

Stock-outs of essential health products in Mozambique – longitudinal analyses from 2011 to 2013

In Under-nutrition on April 19, 2014 at 4:52 pm

by Wagenaar BH, Gimbel S, Hoek R, Pfeiffer J, Michel C, Manuel JL, Cuembelo F, Quembo T, Afonso P, Gloyd S, Sherr K.

Trop Med Int Health. 2014 Apr 11

 

Abstract

Objectives

To assess the relationship between health system factors and facility-level EHP stock-outs in Mozambique.

Methods

Service provisions were assessed in 26 health facilities and 13 district warehouses in Sofala Province, Mozambique, from July to August in 2011–2013. Generalised estimating equations were used to model factors associated with facility-level availability of essential drugs, supplies and equipment.

Results

Stock-out rates for drugs ranged from 1.3% for oral rehydration solution to 20.5% for Depo-Provera and condoms, with a mean stock-out rate of 9.1%; mean stock-out rates were 15.4% for supplies and 4.1% for equipment. Stock-outs at the district level accounted for 27.1% (29/107) of facility-level drug stock-outs and 44.0% (37/84) of supply stock-outs. Each 10-km increase in the distance from district distribution warehouses was associated with a 31% (CI: 22–42%), 28% (CI: 17–40%) or 27% (CI: 7–50%) increase in rates of drug, supply or equipment stock-outs, respectively. The number of heath facility staff was consistently negatively associated with the occurrence of stock-outs.

Conclusions

Facility-level stock-outs of EHPs in Mozambique are common and appear to disproportionately affect those living far from district capitals and near facilities with few health staff. The majority of facility-level EHP stock-outs in Mozambique occur when stock exists at the district distribution centre. Innovative methods are urgently needed to improve EHP supply chains, requesting and ordering of drugs, facility and district communication, and forecasting of future EHP needs in Mozambique. Increased investments in public-sector human resources for health could potentially decrease the occurrence of EHP stock-outs.

What linear programming contributes: world food programme experience with the “cost of the diet” tool.

In Under-nutrition on July 14, 2013 at 9:41 am

by Frega RLanfranco JGDe Greve SBernardini SGeniez PGrede NBloem Mde Pee S.

Food Nutr Bull. 2012 Sep;33(3 Suppl):S228-34.

Background – Linear programming has been used for analyzing children’s complementary feeding diets, for optimizing nutrient adequacy of dietary recommendations for a population, and for estimating the economic value of fortified foods.

Objective – To describe and apply a linear programming tool (“Cost of the Diet”) with data from Mozambique to determine what could be cost-effective fortification strategies.

Methods – Based on locally assessed average household dietary needs, seasonal market prices of available food products, and food composition data, the tool estimates the lowest-cost diet that meets almost all nutrient needs. The results were compared with expenditure data from Mozambique to establish the affordability of this diet by quintiles of the population.

Results – Three different applications were illustrated: identifying likely “limiting nutrients,” comparing cost effectiveness of different fortification interventions at the household level, and assessing economic access to nutritious foods. The analysis identified iron, vitamin B2, and pantothenic acid as “limiting nutrients.” Under the Mozambique conditions, vegetable oil was estimated as a more cost-efficient vehicle for vitamin A fortification than sugar; maize flour may also be an effective vehicle to provide other constraining micronutrients. Multiple micronutrient fortification of maize flour could reduce the cost of the “lowest-cost nutritious diet” by 18%, but even this diet can be afforded by only 20% of the Mozambican population.

Conclusions – Within the context of fortification, linear programming can be a useful tool for identifying likely nutrient inadequacies, for comparing fortification options in terms of cost effectiveness, and for illustrating the potential benefit of fortification for improving household access to a nutritious diet.

You can find more posts about linear programming clicking here.

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