Browsing by Author "Zaharia, Sonia"

Now showing 1 - 3 of 3
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    Child stunting starts in utero: Growth trajectories and determinants in Ugandan infants
    (Maternal & Child Nutrition, 2022) Namirembe, Grace; Ghosh, Shibani; Ausman, Lynne M.; Shrestha, Robin; Zaharia, Sonia; Bashaasha, Bernard; Kabunga, Nassul; Agaba, Edgar; Mezzano, Julieta; Webb, Patrick
    Childhood stunting remains a public health burden worldwide. Although many studies have examined early life and in‐utero risk factors; most have been observational and have used analytic techniques that make inferences limited to population means, thereby obscuring important within‐group variations. This study addressed that important gap. Using data from a birth cohort of Ugandan infants (n = 4528), we applied group‐based trajectory modelling to assess diverse patterns of growth among children from birth to 1‐year old. A multinomial regression model was conducted to understand the relationship between risk factors and observed patterns across groups. We found that the onset of stunting occurred before birth and followed four distinct growth patterns: chronically stunted (Group 1), recovery (Group 2), borderline stunted (Group 3) and normal (Group 4). The average lengthfor‐ age z‐score (LAZ) at birth was −2.6, −3.9, −0.6 and 0.5 for Groups 1–4, respectively. Although both Groups 1 and 2 were stunted at birth, stunting persisted in Group 1 while children in Group 2 recovered by the fourth month. Group 3 exhibited mild stunting while Group 4 was normal. Wasting and underweight were observed in all groups, with the highest prevalence of underweight in Group 1. Wasting gradually increased among children born already stunted (Groups 1 and 2). This showed the importance of distinguishing children by their growth patterns rather than aggregating them and only comparing population averages against global growth standards. The design of nutrition interventions should consider the differential factors and potential for growth gains relative to different risks within each group.
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    Recovery without resilience? A novel way to measure nutritional resilience in Nepal, Bangladesh, and Uganda
    (Global Food Security, 2021) Bashaasha, Bernard; Zaharia, Sonia; Masters, William A.; Ghosh, Shibani; Shively, Gerald E.; Gurung, Sabi; Manohar, Swetha; Thorne-Lyman, Andrew L.; Kabunga, Nassul; Webb, Patrick
    People in fragile environments face various shocks that negatively affect their nutrition. Many governments put policy mechanisms in place to promote recovery of households after adverse shocks; however, resilience is difficult to measure because some apparent recovery could be the result of statistical randomness and reversion to trends. This paper demonstrates a new approach to measuring nutritional resilience in a population. As our starting point, we use the common definition of resilience as ‘recovery after decline’, but also require that the degree of recovery should exceed stochastic expectations. Using maternal and child nutrition data from Nepal, Bangladesh, and Uganda, we find that observed recovery is not always statistically significant and does not always satisfy this definition of resilience. We identify household and community factors that are correlated with measurable nutritional resilience, and recommend points of entry for policies designed to enhance resilience in resource-constrained settings.
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    Young Children Who Eat Animal Sourced Foods Grow Less Stunted: Findings of Contemporaneous and Lagged Analyses from Nepal, Uganda and Bangladesh
    (Research Square, 2020) Zaharia, Sonia; Ghosh, Shibani; Shrestha, Robin; Manohar, Swetha; Thorne-Lyman, Andrew; Bashaasha, Bernard; Kabunga, Nassul; Gurung, Sabi; Namirembe, Grace; Heneveld, Katherine; Liang, Lichen; Webb, Patrick
    In resource constrained countries, animal-sourced foods (ASFs) are an important nutrient-dense source of vitamins, minerals and macronutrients. While several studies have suggested the value of ASFs to child growth, most empirical evidence is based on cross-sectional data which can only provide information about the contemporaneous relationship between diet and anthropometric outcomes. This study uses longitudinal panel data for Nepal, Bangladesh, and Uganda to assess the association between contemporaneous as well as past ASF consumption and linear growth of children aged 6-24 months. Fixed effects models found that ASF consumption was significantly correlated with lower stunting, with a decline in stunting prevalence as high as 10% in Nepali children who had consumed any ASF in the previous year. Consuming two or more ASFs showed an even higher magnitude of association, ranging from a 10% decline in prevalence of stunting associated with lagged consumption in Bangladesh to a 16% decline in Nepal.