Topical Area: Community and Public Health Nutrition, Aging and Chronic Disease, Obesity
This study investigates the role of food security, agriculture, dietary diversity, and socio-demographic factors on stunting of under-five children in 3 different ecological zones in Myanmar using panel survey data.
Methods : We conducted 2 repeated cross-sectional surveys among the same households in mountain, plain and delta areas of rural areas of Myanmar. We purposely selected two adjacent townships in each zone and from each township we randomly selected 20 villages proportionate to population size sampling. We then randomly selected 30 households in each village to achieve 1200 households with under 5-year children per state. We recruited 3231 households in the first survey in early 2016 and revisited the same households in late 2017 to assess seasonal variations. In each survey, we collected data on access to land for agriculture, home gardens, agricultural assets, types of crops, household assets, household dietary diversity, and household food insecurity access scale (HFIAS), as well as anthropometry from under 5 children. We used an app to collect data in both surveys electronically. We constructed village level scores for agricultural diversity and transportation. To assess risk factors we used multilevel logistic regression to adjust for survey design and within-person correlation from repeated surveys.
Results : We visited 90.4% of households in the second survey (N=2921). A total of 2049 under 5 children participated in the first survey and 1696 in the second. The percent of households that were food secure and had dietary diversity >=5 increased in the second survey but the overall prevalence of stunting increased from 40.4 % to 42.0 % with highest stunting prevalence in Chin state (62.4%). Univariate analysis showed owning agricultural land >2 acres, high village-average transportation score, household food insecurity and maternal height were associated with stunting. Multilevel mixed logistic regression showed maternal height, child age, wealth and transportation score were key determinants for stunting - Table 4.
Conclusions : The level of child stunting was high, especially in Chin state which had the highest levels of food insecurity. Food security is a problem in rural Myanmar but transportation was a significant risk factor that is commonly overlooked in nutrition interventions.
Funding Sources : Australian Research Council DP150102053
Professor of Global Public Health Nutrition
The University of Sydney
Min Kyaw Htet
Associate Dean International Relations
UWA Business School
The Univeristy of Sydney
Professor Human Geography
The Univeristy of Sydney