Maternal socioeconomic status and infant feeding practices underlying pathways to child stunting in Cambodia: structural path analysis using cross-sectional population data
Maternal socioeconomic status and infant feeding practices underlying pathways to child stunting in Cambodia: structural path analysis using cross-sectional population data
Objectives: To identify and investigate complex pathways to stunting among children aged 6–24 months to determine the mediating effects of dietary diversity and continued breast feeding on the association between socioeconomic factors and child stunting.
Design, setting and participants: We analysed the most recent cross-sectional Demographic and Health Survey data from Cambodia (2014). We applied structural path analysis on a sample of 1365 children to model the complex and inter-related pathways of factors determining children’s height for age. Explanatory variables included a composite indicator of maternal employment, household wealth, maternal education, current breastfeeding status and dietary diversity score. Results are presented both in terms of non-standardised and standardised coefficients.
Outcome measure: The primary outcome measure was height-for-age Z-scores as a continuous measure.
Results: Findings suggest that children’s dietary diversity and continued breast feeding mediate the association between socioeconomic status and children’s height. While there was no significant direct effect of maternal education on children’s height, results suggested significant indirect pathways through which maternal education effects children’s height; operating through household wealth, maternal employment, dietary diversity and continued breastfeeding status (p<0.001). Most notably, 41% of the effect of maternal employment on children’s height was mediated by either dietary diversity or continued breast feeding.
Conclusion: We provide evidence to support targeted nutrition interventions which account for the different ways in which underlying socioeconomic factors influence infant and young child feeding practices, and the potential impact on child nutritional status.
Cambodia, Child stunting, Demographic and Health Surveys, Maternal, Socioeconomic Status, Structural Path Analysis, nutrition, public health, community child health
Harvey, Chloe Mercedes
e69b10a8-85f5-4eeb-9932-4e92a59a097c
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
3 November 2022
Harvey, Chloe Mercedes
e69b10a8-85f5-4eeb-9932-4e92a59a097c
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Padmadas, Sabu S.
64b6ab89-152b-48a3-838b-e9167964b508
Harvey, Chloe Mercedes, Newell, Marie-Louise and Padmadas, Sabu S.
(2022)
Maternal socioeconomic status and infant feeding practices underlying pathways to child stunting in Cambodia: structural path analysis using cross-sectional population data.
BMJ Open, 12 (11), [e055853].
(doi:10.1136/bmjopen-2021-055853).
Abstract
Objectives: To identify and investigate complex pathways to stunting among children aged 6–24 months to determine the mediating effects of dietary diversity and continued breast feeding on the association between socioeconomic factors and child stunting.
Design, setting and participants: We analysed the most recent cross-sectional Demographic and Health Survey data from Cambodia (2014). We applied structural path analysis on a sample of 1365 children to model the complex and inter-related pathways of factors determining children’s height for age. Explanatory variables included a composite indicator of maternal employment, household wealth, maternal education, current breastfeeding status and dietary diversity score. Results are presented both in terms of non-standardised and standardised coefficients.
Outcome measure: The primary outcome measure was height-for-age Z-scores as a continuous measure.
Results: Findings suggest that children’s dietary diversity and continued breast feeding mediate the association between socioeconomic status and children’s height. While there was no significant direct effect of maternal education on children’s height, results suggested significant indirect pathways through which maternal education effects children’s height; operating through household wealth, maternal employment, dietary diversity and continued breastfeeding status (p<0.001). Most notably, 41% of the effect of maternal employment on children’s height was mediated by either dietary diversity or continued breast feeding.
Conclusion: We provide evidence to support targeted nutrition interventions which account for the different ways in which underlying socioeconomic factors influence infant and young child feeding practices, and the potential impact on child nutritional status.
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Accepted/In Press date: 24 September 2022
e-pub ahead of print date: 3 November 2022
Published date: 3 November 2022
Additional Information:
Funding Information:
This research was carried out as a part of a doctoral research project, supported by the UK Economic and Social Research Council (grant number ES/J500161/1).
Publisher Copyright:
© 2022 Author(s) (or their employer(s)).
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Keywords:
Cambodia, Child stunting, Demographic and Health Surveys, Maternal, Socioeconomic Status, Structural Path Analysis, nutrition, public health, community child health
Identifiers
Local EPrints ID: 473333
URI: http://eprints.soton.ac.uk/id/eprint/473333
ISSN: 2044-6055
PURE UUID: ecca3392-7e4a-4f91-8678-e1763528c99a
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Date deposited: 16 Jan 2023 17:34
Last modified: 17 Mar 2024 03:33
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Author:
Chloe Mercedes Harvey
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