Maternal Factors in Child Stunting in Pakistan: Insights from The Demographic and Health Survey (DHS) 2017-18
June 7, 2024What is stunting?
Stunting is a condition in which inadequate nutrition, recurrent infections, and a lack of psychosocial stimulation impede children's growth and development. Stunted children have a height-for-age greater than two standard deviations below the World Health Organization's child growth guidelines average.
Why care about stunting in children?
Exploring the impact of stunting is critical since it affects brain development, resulting in lower IQ levels and earning potential in adulthood. Moreover, stunted children have poor immune systems, are more susceptible to diseases like diabetes, and die younger than non-stunted children.
Stunting in children under five in Pakistan
For the entire analysis in this article, the Demographic and Health Survey (DHS) 2017-18 was employed, obtained from Open Data Pakistan.
Figure 1 demonstrates that in 2017-18, around 35.62% of the children in Pakistan were stunted. This is higher than the South Asian average of 30% (Wali et al., 2020) and the global average of 22.0% (Global Nutrition Report, n.d.).
Baluchistan, FATA, and Sindh had the highest percentage of stunted children (both boys and girls) under the age of five in Pakistan, followed by the Northern Areas and NWFP. In contrast, Punjab and Azad Kashmir had significantly lower percentages, as shown in Figures 2, 3, and 4.
Figure 5 shows that maternal education levels and stunting in children are correlated; as a mother's education increases, the percentage of stunting decreases.
The negative correlation between mother’s phone ownership and stunting in children is evident in Figure 6. It illustrates that mothers who owned a phone had a lower stunting rate of 25.6% among children, compared to 42.2% among children whose mothers did not own a phone. This relationship is logical because mothers with access to phones will likely have better access to information and resources, which may lead to better health outcomes.
People with more income and wealth can provide nutritious food and healthcare for their children. As a result, we may see a link between income disparity and childhood stunting. The figure below shows that approximately 38% to 57% of children from the poor or the poorest class were stunted, compared to only 18% to 26% of children from the rich or richest class.
The graph below illustrates that stunting is more prevalent among children living in rural regions than in non-rural (urban) areas. This gap might be attributed to a variety of reasons, including differences in lifestyle, dietary habits, and access to healthcare.
In Pakistan, it is common to marry close relatives, such as cousins. However, evidence shows that this custom may contribute to a variety of health problems among children. Consanguineous marriages might raise the likelihood of genetic abnormalities and hereditary ailments owing to the parents' shared genetics. These health issues might vary from developmental delays and physical impairments to major medical disorders. Figure 9 demonstrates that children whose mothers had consanguineous marriages exhibited a slightly higher stunting rate of 37.5%, compared to 32.2% among those whose mothers did not have blood relations with their husbands.
Conclusion
We have discussed how different factors like wealth quintile are correlated with stunting in children. However, this does not necessarily imply that these indicators cause stunting in children. Our graphs help us identify areas for additional investigation and comprehend the possible impact of various maternal factors on stunting. To determine the causal link, one should use econometric methods.
References
Global Nutrition Report. (n.d.). Southern Asia Nutrition Profiles. Retrieved from https://globalnutritionreport.org/resources/nutrition-profiles/asia/southern-asia/
Wali, N., Agho, K. E., & Renzaho, A. M. N. (2020). Factors Associated with Stunting among Children under 5 Years in Five South Asian Countries (2014-2018): Analysis of Demographic Health Surveys. Nutrients, 12(12), 3875. https://doi.org/10.3390/nu12123875
By Sarah Maham