Estimating the impact of maternal sociodemographic factors on nutrition and anthropometric outcomes of mothers and children in South Africa.
Date
2021
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Abstract
The overriding purpose of this study was to determine the impact of maternal socioeconomic
and/or sociodemographic factors on both maternal and childhood nutrition and health in South
Africa. This study draws on a customised theoretical model that put into account the UNICEF
framework and the foetal-maternal interaction model as a probable theoretical model of
maternal and neonatal nutrition and morbidities. The framework is structured around four (4)
stages that result in both maternal and childhood nutritional intake and morbidity. In it, the
interplay between the UNICEF and the foetal-maternal relationship frameworks highlights that
maternal and childhood nutrition and health is not a simple problem with a single simple
solution. A similarly intricate series of approaches – multifaceted and multisectoral – are
necessary to effectively deal with it.
This study adopted a non-experimental quantitative research approach for extracting the
required data for this study. The researcher used a secondary data from the 2016 South Africa
Demographic and Health Survey (SA-DHS), which complies with common demographic
health surveys research design policy. The use of an explanatory research approach allows the
researcher to provide an in-depth evaluation, investigation, understanding and insight analysis
about the current state of maternal and under-fives health relative to nutrition in South Africa.
Consequently, a survey research design was used to enrolled 1460 participants into the study
from a total target population of 4081 – indicating that the SA-DHS is representative in nature.
The SA-DHS 2016 followed a stratified sample technique by employing a two-stage stratified
design with a probability proportional to size and systematic sampling of the dwelling units.
The findings from this study revealed that 73.11% of the respondents met the minimum
complementary feeding index relative to the 26.90% who did not. Furthermore, using the
household wealth index as a proxy indicator for maternal socioeconomic status of households,
the results statistically associate maternal socioeconomic status and complementary feeding
practice – where (X2 = 23.56; p-value = 0.000). Suggesting that high wealth index households
are more likely to meet the minimum acceptable dietary diversity relative to those with low
wealth index. Similarly, after controlling for confounders, the results from the logistic
regression negatively associate minimum acceptable diets with maternal education and
household wealth index. Indicating lower or no education and lower wealth index were
associated with not meeting the minimum acceptable diets of under-fives. On maternal BMI,
the results found that the average BMI for the sample was 28.06 kg/m2, with 63.60% of the
mothers either (overweight 29.85% or obese 33.75%), 33.91% regarded as having normal
weight and 2.49% regarded as underweight. As a result, the results from this study statistically
associated maternal employment (X2 = 18.18; p-value = 0.000), place of residence (X2 = 9.55;
p-value = 0.023), and household wealth index (X2 = 33.19; p-value = 0.000) with maternal
nutritional status in South Africa. Indicating that employed mothers, urban mothers and
mothers who fell under high income households are associated with higher rates of obesity. On
childhood nutritional status, 89.34% of the under-five children had normal weight-for-age
(WAZ), while only 5.20% of the children were either severely underweight or underweight
(WAZ). Regarding height-for-age Z scores (HAZ), 73.18% of the children had normal heightfor-
age, 15.66% were stunted, 7.04% were severely stunted, and 4.13% were tall. On weightfor-
age Z Scores (BAZ), 58.31% of the children had normal weight-for-age, 22.43% were
overweight, 16.09% were obese, and 3.17% were underweight. The results further found that
the level of malnutrition among under-five children were higher among unemployed mothers
than employed mothers as follows: severe stunting (77.50% vs 22.50%), being underweight by
WAZ (80.00% vs 20.00%), and obesity by BAZ (72.68% vs 27.32%) for unemployed and
employed mothers respectively. However, except for severe stunting, the prevalence of
malnutrition among under-five children were higher in urban areas than rural areas as follows:
underweight by WAZ (57.14% vs 42.86%), severe stunting (48.75% vs 51.25%), and obesity
by BAZ (56.28% vs 43.72%) for urban and rural areas children respectively. On the impact of
maternal socioeconomic factors on childhood nutritional and health outcomes, the bivariate
analyses negatively associated low maternal wealth index and stunting (HAZ) among underfives.
Both the bivariate and multivariate analyses associated maternal BMI with birthweights
and childhood nutritional status. Suggesting that higher maternal BMI led to higher weightfor-
age as well as higher height-for-age among under-fives.
In conclusion, the results from this study present a direct evaluation of the association between
maternal anthropometrics characteristics and childhood nutritional status. Poor infant and
young child feeding practices, on the other hand, is caused by low or poor maternal household
wealth index working synergistically with other factors such as urbanity, employment and
education. In summary, the findings presented in this study suggests that obesity and other
maternal- and child-related nutritional and health issues is a consequence of the complex
relationship among many factors including environmental (such as dietary intake), genetic (the
link between maternal BMI and childhood nutritional status), and
socioeconomic/sociodemographic factors (such as maternal age, parity, household wealth
index, education, employment, etc) which eventually result in energy imbalance that either
directly or indirectly impact on both maternal and childhood nutritional and health outcomes
in South Africa.
Description
Masters Degree. University of KwaZulu-Natal, Durban.