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Introduction: Malnutrition remains a childhood scourge in Sub Saharan Africa, Southern Africa, Zimbabwe and in the Insiza District, in particular. The district is rich in mineral (gold) deposits, vibrant agricultural (animal husbandry) and diverse ecosystems that has potential support self-sufficiency of its population. However, the cause to <5-year-old malnutrition and stunting remain to opaque requiring elucidation.
Materials and Methods: A mixed method approach, where both qualitative and quantitative research methods were used to elicit and describe in-depth people’s experiences on determinants of malnutrition and stunting in the Insiza District among the <5-year-olds. Statistical comparisons were performed by one-way analysis of variance (ANOVA), followed by Tukey-Kramer multiple comparison post hoc test using Graph Pad In Stat Software. Both probability and purposive sampling were used to triangulate and corroborate findings deriving meaning to explain the factors associated with wasting/ underweight.
Results: Children with birth weights ±2.4kG were predominant in the study sample (57%) when compared to those who were born with 2.5-3.0 kG or >3.1 kG birth weights [19 fold more]. Two meals per day were taken frequently (57%) a mong adults comparable with birth weight underweight frequencies and feeding habits of infants <5-year-olds (53%), showing food insecurity in Isiza District. Households that lived on < US$1.00/day formed relatively the most prominent majority (73%) when compared to those who lived on US$0.87-1.67/day (23%) or US$1.87-2.50 (2%) or US$2.53-3.33 (2%). Health-related expenses (18.3%), education expenses (25%) and staple food related expenses (56.7%) took the bulk of the income without meaningful effect on child malnutrition. Fathers were over represented as household income usage decision markers in households with malnourished and stunted <5-year-olds (43%) compared to mothers, the family or both parents. Poverty was present in 65% of the households which had malnourished and or stunted children. Malnourishment was from nutritional deficit and non-nutritional lack (25%) while 20% had malnutrition from other determinants other than food consumption score.
Conclusion: More than half (57%) children who developed malnutrition were underweight at birth and born in families with who had two meals a day (57%). Malnutrition was influenced negatively by marital status, household leadership, household income, size, religion, educations status and consumption scores.
Abbott S, Akhavi N, Armbruster D, Beggs K, Boyd E, Buckingham E, et al. Multi-sectorial Nutritional Satrategy 2014-2025 USAID: Washungton DC, USA; 2014.
UNICEF. Improving child nutrition The achievable imperative for global progress.United Nations Children’s Fund: New York, NY 10017 USA; 2013.
FAO, IFAD, UNICEF, WFP, W. The State of Food Security and Nutrition in the World 2018. Building climate resilience for food security and nutrition. Rome, FAO: Rome, FAO; 2018.
ZimVAC. Zimbabwe Vulnerability Assessment Committee (ZimVAC). Food and Nutrition Council (FNC) Harare, Zimbabwe; 2019.
International. ZNSAaI. Zimbabwe Demo-graphic and Health Survey 2015: Final Report; 2016.
[cited 2020 28 January 2020]
TSP. Transitional Stabilisation Programme Reforms Agenda October 2018 – December 2020. Towards a Prosperous & Empowered Upper Middle Income Society by 2030.Ministry of Finance and Economic Development: Harare, ZImbabwe; 2018.
Zimbabwe W D A. Zimbabwe-Infant mortality rate 2018; 2018
[cited 2020 13 April 2020];
Cogill B. Anthropometric indicators measurement guide. Food and Nutrition Technical Assistance Project, Washington, D.C.: Academy for Educational Development ; 2010.
Devi P Y and Geervani P. Determinants of nutritional status of rural pre-school children in Andhra Pradesh, India. Food Nutrition Bulletin; 2010.
Kinney MV, Kerber KJ, Black RE, Cohen B, Nkrumah F, Coovadia H, et al. Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why Do They Die? PLoS Med. 2010;7(6):e1000294.
Engle PL, Black MM, Behrman JR, Cabral de MM, Gertler PJ. Strategies to avoid the loss of developmental potential in more than 200 million children in the developing world. Lancet. 2007;369:229-242.
Organization WH. Reducing risks, promoting healthy life. The World Health Report 2002. Annex Table 3. Burden of disease in DALYs by cause, sex and mortality stratums in WHO regions, estimates for 2001. WHO: Geneva, Switserland. 2002;192.
Bhutta ZA, Ahmed T, Black RE, Cousens S, Dewey K. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008;371:417-440
Gulati J. Child Malnutrition: Trends and Issues. Anthropologist. 2010;12(2):131.
Ijarotimi OS. Determinants of Childhood Malnutrition and Consequences in Developing Countries. Current Nutrition Reports.2013;2(3):129-133.
Tesfu I. Assessment of possible risk factors of malnutrition under five years old children in Orotta National Pediatric Referral Hospital. Can J Biomed Res & Tech. 2019;1(3):1-7
Rajoo Y, Ambu S, Lim YAL, Rajoo K, Tey SC, Lu CW, et al. Neglected Intestinal Parasites, Malnutrition and Associated Key Factors: A Population Based Cross-Sectional Study among Indigenous Communities in Sarawak, Malaysia. PLoS One; 2017.
EBAF, Cangussu MCT, da Silva AAM, Assis AMO. (2010)Is malnutrition associated with crowding in permanent dentition? . Int J Environ Res Public Health. 2010;7:3531-3544.
Ngui R, Aziz S, Chua KH, Aidil RM, Lee SC, Tan TK. Patterns and risk factors of soil-transmitted helminthiasis among Orang Asli Subgroups in Peninsular Malaysia. Am J Trop Med Hyg. 2015; 93(2):361-370.
Gedle D, Kumera G, Eshete T, Ketema K, Adugna H, and Feyera F. (2017)Intestinal parasitic infections and its association with undernutrition and CD4 T cell levels among HIV/AIDS patients on HAART in Butajira, Ethiopia. J Health Popul Nutr 36(15):1-10.
Missaye A, Dagnew M, Alemu A, and Alemu A. Prevalence of intestinal parasites and associated risk factors among HIV/AIDS patients with pre-ART and onART attending dessie hospital ART clinic, Northeast Ethiopia. AIDS Res Ther. 2013;10(1):19.
Mengist HM, Taye B, Tsegaye A. (2015) Intestinal parasitosis in relation to CD4+ T cells levels and anemia among HAART initiated and HAART naive pediatric HIV patients in a model ART center in Addis Ababa, Ethiopia. PloS one.2015;10(2): e0117715.
USAID. Zimbabwe: Nutrition Profile; 2018. [cited 2020 01 Feb 2020];
Moyo J. Malnourishment stunted growth. Development and Cooperation (D+C); 2019.
ZimVAC. Rural Livelihoods Assessment Report. Zimbabwe Vulnerability Assessment Committee (ZimVAC): Harare, Zimbabwe; 2017.
rigoyen C. Tackling Malnutrition in Zimbabwe.Centre for Public Impact-BCG Foundation: London, United Kingdom; 2017.
Hawkins T. Counting the cost of Zimbabwean land reform an opinion; 2012. [Cited 2020 01.02.2020]
Report GN. Zimbabwe nutrition profile Country Nutrition Profiles capture the burden of malnutrition at the global, regional, subregional and country level; 2018.
Tui SHK, Famba K. Beyond the silence: how can we create healthier food choices for people in Bulawayo townships? Int'l Crops Research Institute for the Semi-Arid Tropics (ICRISAT); 2019.
Zimbabwe K. Zimbabwe - Under-five mortality rate 46.2 (deaths per 1,000 live births) in 2018; 2019.
UN-Zimbabwe. Reduce Child Mortality; 2020 .
[cited 2020 15.02.2020]
Kairiza T, Kembo GD. Coping with food and nutrition insecurity in Zimbabwe: does household head gender matter? Agricultural and Food Economics; 2019. 7(1):24.
Newman T, Jimi A. Gender, poverty and inequality in the aftermath of Zimbabwe’s Land Reform: A transformative social policy perspective. J International Women's Studies. 2018; 19(5):45-62.
Stat Z. Census 2012 Provincial Report, Matebelalnd South, Zimbabwe Population Cenuss 2012: Causeway, Harare, Zimbabwe; 2012.
Inter-Censal Demographic Survey, 2017 Zim Stat: Causeway, Harare, ZImbabwe; 2017.
Sibal V. Foo: Identity of Culture and Religion. JOUR. 2018;6:10908-10915
Ansari S, Soltero EG, Lorenzo E, Lee RE. The impact of religiosity and dietary habits and physical activity in the minority women participating in the Health is Power (HIP) study. Prev Med Rep. 2016;5:210-213.
Nguyen NH, Kam S. Nutritional status and the characteristics related to malnutrition in children under-five years of age in Nghean, Vietnam. J Preventive Medicine Public Health. 2008;41(4):232-240
FNC-Zimbabwe. Zimbabwe National Nutrition Survey - 2018. Food and Nutrition Council (FNC) at SIRDC: Hatcliffe, Harare, Zimbawe; 2018.
Loaiza E. Maternal nutritional status.DHS Comparative Studies No. 24. Calverton, Maryland, USA: Macro International Inc; 2011.
ZIMSTAT. Ponerty anlysis-the poverty Datum Lines-March 2019. Zimabwe National Statitics Agency: Harare; 2019.
Bank W. The World Bank in Zimbabwe. The World Bank; 2020.
Ilesanmi OO. Women's visibility in decision making processes in Africa-Progress, Challenges, and Way Forward. Front. Sociol. 2018;3(38):1-7.
Zegenhagen S, Ranganathan M, Buller AM. Household decision-making and its association with intimate partner violence: Examining differences in men's and women's perceptions in Uganda. SSM Popul Health. 2019;8:100442.
Bjornlund H, Zuo A, Wheeler SA, Parry K, Pittock J, Mdemu M, et al. The dynamics of the relationship between household decision-making and farm household income in small-scale irrigation schemes in southern Africa. Agricultural Water Management. 2019;213:135-145
Lannotti L, Cunningham K, Ruel MT. Improving diet quality and micronutrient nutrition: Homestead food production inBangladesh. International Food Polcy Research Institute: Sustainable solutions for ending hunger and poverty: Washington, DC; 2012.
Ruel MT, Quisumbing AR, Balagamwala M. Nutritional -sensitive agriculture: what have we learned so far? Global Food Security. 2018;17:128-158.
Trijsburg L, Talsma EF, de Vries JHM, Kennedy G, Kujsten A, Brouwer ID. (2019)Diet quality indices for research in low-and middle-income countryies: a systematic review. Nutr Rev. 2019;77(8):515-540.