Post-conflict household structures and underweight: a multilevel analysis of a community-based study in northern Uganda
Loading...
Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Public health nutrition
Abstract
To examine associations between household-level characteristics and
underweight in a post-conflict population.
Design: Nutritional status of residents in the Gulu Health and Demographic
Surveillance Site was obtained during a community-based cross-sectional study,
~ 6 years after the civil war. Household-level factors included headship, polygamy,
household size, child-to-adult ratio, child crowding, living with a stunted or
overweight person, deprived area, distance to health centre and socio-economic
status. Multilevel logistic regression models examined associations of household
and community factors with underweight, calculating OR, corresponding 95% CI
and intraclass correlation coefficients. Effect modification by gender and age was
examined by interaction terms and stratified analyses.
Setting: Rural post-conflict area in northern Uganda.
Subjects: In total, 2799 households and 11 312 individuals were included,
representing all age groups.
Results: Living in a female-headed v. male-headed household was associated (OR;
95% CI) with higher odds for underweight among adult men (2·18; 1·11, 4·27) and
girls <5 years (1·51; 0·97, 2·34), but lower odds among adolescent women aged
13–19 years (0·46; 0·22, 0·97). Higher odds was seen for residents living in
deprived areas (1·37; 0·97, 1·94), with increasing distance to health services
(P-trend <0·05) and among adult men living alone v. living in an average-sized
household of seven members (3·23; 1·22, 8·59). Residents living in polygamous
households had lower odds for underweight (0·79; 0·65, 0·97).
Conclusions: The gender- and age-specific associations between household-level
factors and underweight are likely to reflect local social capital structures.
Adapting to these is crucial before implementing health and nutrition
interventions.
Description
Keywords
Nutrition, Gender, Post-conflict, Social capital, Internally displaced persons
Citation
Schramm, S., Nielsen, J., Kaducu, F. O., Okumu, C. L., Ovuga, E., & Sodemann, M. (2018). Post-conflict household structures and underweight: a multilevel analysis of a community-based study in northern Uganda. Public health nutrition, 21(15), 2725-2734. doi:10.1017/S1368980018001581