Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Theoretical Framework
2.2. Data and Description
2.3. Response Variable of the Study
2.4. Data Analysis
3. Results
3.1. Descriptive Statistics
3.2. Binary Logistic Regression Estimates
3.3. Post-Analysis Estimation for Model Performance
4. Discussion
Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Stunting | Underweight | Wasting | |||
---|---|---|---|---|---|---|
% | p-Value | % | p-Value | % | p-Value | |
Sex of the Child | ||||||
Female | 48.28 | 0.18 | 48.12 | 0.40 | 45.11 | 0.305 |
Male | 51.72 | 51.88 | 54.89 | |||
Child’s Age | ||||||
Less than 6 months | 11.67 | p < 0.001 | 16.25 | p < 0.05 | 22.56 | p < 0.001 |
6–12 months | 8.47 | 14.06 | 25.56 | |||
13–18 months | 12.59 | 10.31 | 13.53 | |||
19–24 months | 18.76 | 14.69 | 9.77 | |||
25–36 months | 48.51 | 44.69 | 28.57 | |||
Birth’s Order Number | ||||||
1 | 39.82 | 0.208 | 34.06 | 0.57 | 33.08 | 0.113 |
2 | 27.92 | 30.31 | 36.09 | |||
3 | 23.80 | 26.25 | 20.30 | |||
4 or above | 8.47 | 9.38 | 10.53 | |||
Mother body-mass-index (BMI) | ||||||
<18.5 kg/m2 | 86.14 | p < 0.002 | 83.23 | p < 0.001 | 89.39 | 0.938 |
≥18.5 kg/m2 | 39.29 | 16.77 | 10.61 | |||
Education level | ||||||
Illiterate | 75.06 | p < 0.001 | 79.38 | p < 0.001 | 73.68 | p < 0.01 |
Primary | 10.07 | 10.00 | 9.02 | |||
Secondary/Middle | 10.76 | 7.19 | 8.27 | |||
Higher | 4.12 | 3.44 | 9.02 | |||
Residence | ||||||
Rural | 64.30 | p < 0.004 | 66.56 | p < 0.001 | 63.16 | 0.379 |
Urban | 35.70 | 33.44 | 36.84 | |||
Regions | ||||||
Punjab | 10.53 | p < 0.001 | 6.56 | p < 0.001 | 9.02 | p < 0.001 |
Sindh | 24.94 | 30.31 | 22.56 | |||
KPK | 13.96 | 14.37 | 20.30 | |||
Balochistan | 22.43 | 29.69 | 33.08 | |||
Gilgit Baltistan | 5.72 | 1.88 | 1.50 | |||
Islamabad-Capital | 3.20 | 0.94 | 0.75 | |||
Azad Jamu and Kahmir | 5.95 | 3.44 | 3.01 | |||
FATA | 13.27 | 12.81 | 9.77 | |||
Water Source | ||||||
Improved | 28.15 | p < 0.05 | 29.38 | p < 0.001 | 27.07 | p < 0.05 |
Un- improved | 71.85 | 70.62 | 72.93 | |||
Sanitation Facility | ||||||
Improved | 39.36 | p < 0.001 | 39.06 | p < 0.001 | 31.58 | p < 0.05 |
Un- improved | 60.64 | 60.94 | 68.42 | |||
Diarrhea | ||||||
Yes | 73.23 | p < 0.05 | 75.0 | p < 0.001 | 75.94 | p < 0.05 |
No | 26.77 | 25.0 | 24.06 | |||
Wealth Index | ||||||
Poorest | 41.19 | p < 0.001 | 45.31 | p < 0.001 | 33.08 | p < 0.001 |
Poorer | 28.38 | 28.12 | 34.59 | |||
Middle | 14.19 | 15.0 | 12.78 | |||
Richer | 9.38 | 8.44 | 12.78 | |||
Richest | 6.86 | 3.12 | 6.77 | |||
Mother Employment | ||||||
Not-Employed | 85.13 | p < 0.01 | 83.44 | p < 0.01 | 87.22 | p < 0.05 |
Employed | 14.87 | 16.56 | 12.78 | |||
Total | 39.40 | 27.37 | 11.88 |
Variables | Stunting | Underweight | Wasting | |||
---|---|---|---|---|---|---|
Odd Ratios | 95% CI | Odd Ratios | 95% CI | Odd Ratios | 95% CI | |
Sex of the child | Female (R) | |||||
Male | 1.15 | (0.89–1.49) | 1.08 | (0.81–1.44) | 0.72 | (0.49–1.07) |
Child’s age | <6 months (R) | |||||
6–12 months | 1.34 | (0.84–2.11) | 1.22 | (0.73–2.02) | 1.70 | (0.96–3.04) |
13–18 months | 1.14 | (0.72–1.79) | 0.80 | (0.46–0.46) | 0.70 | (0.36–1.36) |
19–24 months | 2.56 *** | (1.61–4.07) | 1.64 * | (1.98–2.74) | 1.50 * | (1.24–1.47) |
25–36 months | 1.94 *** | (1.80–3.80) | 1.83 ** | (1.22–2.76) | 1.03 * | (1.33–1.96) |
Age2 of the child | 0.96 * | (0.17–0.63) | 0.49 ** | (0.31–0.76) | 0.23 * | 0.29–0.36) |
Birth’s Order Number | Birth order number = 1 (R) | |||||
2 | 1.03 | (0.76–1.42) | 1.28 | (0.89–1.83) | 1.73 | (1.08–2.78) |
3 | 0.96 | (0.67–1.37) | 1.31 | (0.89–1.92) | 1.15 | (0.66–2.00) |
4 or above | 0.75 | (0.46–1.23) | 1.14 | (0.67–1.94) | 1.60 | (0.79–3.25) |
Mother body-mass-index (BMI) | <18.5 kg/m2 (R) | |||||
≥18.5 kg/m2 | 0.71 | (0.46–1.09) | 0.18 | (0.27–1.22) | 1.07 | (0.56–2.03) |
Education level | Illiterate (R) | |||||
Primary | 0.73 | (0.47–1.14) | 0.97 | (0.60–1.59) | 1.00 | (0.43–1.73) |
Secondary/Middle | 0.57 ** | (0.42–0.86) | 0.56 ** | (0.32–0.98) | 0.65 * | (0.30–0.38) |
Higher | 0.32 *** | (0.19–0.55) | 0.46 ** | (0.21–1.01) | 0.86 ** | (0.42–0.88) |
Residence | Rural (R) | |||||
Urban | 1.22 | (0.89–1.66) | 0.96 | (0.67–1.38) | 0.91 | (0.57–1.46) |
Regions | Punjab (R) | |||||
Sindh | 2.75 *** | (1.71–4.41) | 3.55 *** | (2.02–6.27) | 1.75 | (1.82–3.73) |
KPK | 1.73 ** | (1.07–2.81) | 2.04 ** | (1.11–3.74) | 1.89 * | (1.88–4.05) |
Balochistan | 2.98 *** | (1.82–4.91) | 3.48 *** | (1.94–6.22) | 3.04 ** | (1.43–6.45) |
Gilgit Baltistan | 0.89 | (0.46–1.72) | 0.43 | (0.15–1.17) | 0.29 | (0.06–1.43) |
Islamabad-Capital | 0.95 | (0.44–2.04) | 0.54 | (0.14–2.01) | 0.26 | (0.03–2.12) |
Azad Jamu and Kahmir | 1.21 | (0.65–2.24) | 0.74 | (0.31–1.74) | 0.49 | (0.14–1.66) |
FATA | 1.07 | (0.62–1.83) | 1.43 | (0.75–2.72) | 0.75 | (0.30–1.86) |
Water source | Un-Improved (R) | |||||
Improved | 0.65 ** | (0.47–0.92) | 0.53 *** | (0.37–0.76) | 0.70 ** | (0.08–0.82) |
Sanitation facility | Un-Improved (R) | |||||
Improved | 0.55 ** | (0.72–0.99) | 0.23 ** | (0.76–0.86) | 0.29 * | (0.35–0.43) |
Diarrhea | No (R) | |||||
Yes | 1.41 ** | (1.04–1.90) | 1.15 *** | (1.28–1.62) | 1.94 * | (1.49–1.59) |
Wealth Index * Mother Employment | Poorest # Not-Employed (R) | |||||
Poorest # Employed | 1.67 | (0.89–3.09) | 1.55 | (0.53–4.62) | 0.45 | (0.17–1.16) |
Poorer # Not-Employed | 0.82 | (0.56–1.17) | 0.78 | (0.51–1.18) | 1.28 | (0.74–2.23) |
Poorer # Employed | 0.94 | (0.41–2.12) | 0.73 | (0.52–1.84) | 1.15 | (0.38–3.49) |
Middle # Not-Employed | 0.59 | (1.38–0.93) | 0.63 | (0.29–1.08) | 0.84 | (0.64–1.73) |
Middle # Employed | 0.59 ** | (0.22–0.64) | 0.91 * | (0.37- 0.48) | 0.73 *** | (0.40- 0.75) |
Richer # Not-Employed | 0.41 *** | (0.25–0.69) | 0.49 ** | (0.25–0.94) | 0.86 | (0.37–0.45) |
Richer # Employed | 0.46 * | (0.40–0.32) | 0.83 * | (0.20–0.36) | 0.61 ** | (0.33–0.57) |
Richest # Not-Employed | 0.35 ** | (0.19–0.62) | 0.25 ** | (0.10–0.58) | 0.57 * | (0.20–0.58) |
Richest # Employed | 0.17 *** | (0.03–0.87) | 0.21 ** | (0.05–0.21) | 0.67 ** | (0.06–0.86) |
Number of observations = 1093 |
Classification | Indication | Percentage | ||
---|---|---|---|---|
Stunting | Underweight | Wasting | ||
Sensitivity | Pr(+|D) | 51.50% | 28.48% | 3.03% |
Specificity | Pr(−|~D) | 81.14% | 92.87% | 99.69% |
Positive predictive value | Pr(D|+) | 63.90% | 60.40% | 57.14% |
Negative predictive value | Pr(~D|−) | 72.07% | 77.26% | 88.22% |
False + rate for true ~D | Pr(+|~D) | 18.86% | 7.13% | 0.31% |
False − rate for true D | Pr(−|D) | 48.50% | 71.52% | 96.97% |
False + rate for classified + | Pr(~D|+) | 36.10% | 39.60% | 42.86% |
False − rate for classified − | Pr(D|−) | 27.93% | 22.74% | 11.78% |
Correctly classified | 69.48% | 75.07% | 88.03% |
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Shahid, M.; Xie, Y.; Bashir, S.; Noureen, N.; Song, J.; Malik, N.I.; Tang, K. Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan. Children 2024, 11, 872. https://doi.org/10.3390/children11070872
Shahid M, Xie Y, Bashir S, Noureen N, Song J, Malik NI, Tang K. Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan. Children. 2024; 11(7):872. https://doi.org/10.3390/children11070872
Chicago/Turabian StyleShahid, Muhammad, Yuantao Xie, Shamshad Bashir, Nazia Noureen, Jiayi Song, Najma Iqbal Malik, and Kun Tang. 2024. "Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan" Children 11, no. 7: 872. https://doi.org/10.3390/children11070872