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Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador

OBJECTIVES: We aimed to implement participatory research to answer a question posed by four Kichwa indigenous communities in Andean Ecuador about what actionable factors are associated with childhood stunting, overweight and food insecurity among their people. DESIGN: We used mixed methods including...

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Autores principales: Walrod, Jemie, Seccareccia, Erica, Sarmiento, Iván, Pimentel, Juan Pablo, Misra, Shivali, Morales, Juana, Doucet, Alison, Andersson, Neil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042540/
https://www.ncbi.nlm.nih.gov/pubmed/29982205
http://dx.doi.org/10.1136/bmjopen-2017-020760
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author Walrod, Jemie
Seccareccia, Erica
Sarmiento, Iván
Pimentel, Juan Pablo
Misra, Shivali
Morales, Juana
Doucet, Alison
Andersson, Neil
author_facet Walrod, Jemie
Seccareccia, Erica
Sarmiento, Iván
Pimentel, Juan Pablo
Misra, Shivali
Morales, Juana
Doucet, Alison
Andersson, Neil
author_sort Walrod, Jemie
collection PubMed
description OBJECTIVES: We aimed to implement participatory research to answer a question posed by four Kichwa indigenous communities in Andean Ecuador about what actionable factors are associated with childhood stunting, overweight and food insecurity among their people. DESIGN: We used mixed methods including household questionnaires, discussion groups with respondents of the questionnaires and anthropometric measurement of children (6 months to 12 years) from surveyed households. SETTING: The study involved four Andean indigenous communities transitioning from traditional to Western lifestyles. They subsist mainly on small-scale agriculture and have a rich cultural heritage including their traditional language. PARTICIPANTS: Anthropometric data were collected from 298 children from 139 households in four communities; all households completed the questionnaire. We held five discussion groups (6–10 participants each): three composed of mothers and two of farmers. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were stunting, overweight, food insecurity and their relationship with demographics, dietary habits and agricultural habits. RESULTS: Of 298 children, 48.6% were stunted and 43.3% overweight for age. Stunted children were more likely to live in households that sold livestock (ORa 1.77, 95% CIa 1.06 to 2.95) and with illiterate primary caretakers (ORa 1.81, 95% CIa 1.07 to 3.06), but were less likely to live in households with irrigation (ORa 0.47, 95% CIa 0.27 to 0.81). Overweight children were more likely to be male (ORa 1.87, 95% CIa 1.02 to 3.43) and live in a household that sold livestock (ORa 2.14, 95% CIa 1.14 to 4.02). Some 67.8% of children lived in a household with food insecurity, more frequently in those earning below minimum wage (ORa 2.90, 95% CIa 1.56 to 5.41) and less frequently in those that ate quinoa in the past 24 hours (ORa 0.17, 95% CIa 0.06 to 0.48). Discussion groups identified irrigation and loss of agricultural and dietary traditions as important causes of poor childhood nutrition. CONCLUSION: Many indigenous communities face tumultuous cultural, nutritional and epidemiological transitions. Community-based interventions on factors identified here could mitigate negative health outcomes.
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spelling pubmed-60425402018-07-16 Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador Walrod, Jemie Seccareccia, Erica Sarmiento, Iván Pimentel, Juan Pablo Misra, Shivali Morales, Juana Doucet, Alison Andersson, Neil BMJ Open Public Health OBJECTIVES: We aimed to implement participatory research to answer a question posed by four Kichwa indigenous communities in Andean Ecuador about what actionable factors are associated with childhood stunting, overweight and food insecurity among their people. DESIGN: We used mixed methods including household questionnaires, discussion groups with respondents of the questionnaires and anthropometric measurement of children (6 months to 12 years) from surveyed households. SETTING: The study involved four Andean indigenous communities transitioning from traditional to Western lifestyles. They subsist mainly on small-scale agriculture and have a rich cultural heritage including their traditional language. PARTICIPANTS: Anthropometric data were collected from 298 children from 139 households in four communities; all households completed the questionnaire. We held five discussion groups (6–10 participants each): three composed of mothers and two of farmers. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were stunting, overweight, food insecurity and their relationship with demographics, dietary habits and agricultural habits. RESULTS: Of 298 children, 48.6% were stunted and 43.3% overweight for age. Stunted children were more likely to live in households that sold livestock (ORa 1.77, 95% CIa 1.06 to 2.95) and with illiterate primary caretakers (ORa 1.81, 95% CIa 1.07 to 3.06), but were less likely to live in households with irrigation (ORa 0.47, 95% CIa 0.27 to 0.81). Overweight children were more likely to be male (ORa 1.87, 95% CIa 1.02 to 3.43) and live in a household that sold livestock (ORa 2.14, 95% CIa 1.14 to 4.02). Some 67.8% of children lived in a household with food insecurity, more frequently in those earning below minimum wage (ORa 2.90, 95% CIa 1.56 to 5.41) and less frequently in those that ate quinoa in the past 24 hours (ORa 0.17, 95% CIa 0.06 to 0.48). Discussion groups identified irrigation and loss of agricultural and dietary traditions as important causes of poor childhood nutrition. CONCLUSION: Many indigenous communities face tumultuous cultural, nutritional and epidemiological transitions. Community-based interventions on factors identified here could mitigate negative health outcomes. BMJ Publishing Group 2018-07-06 /pmc/articles/PMC6042540/ /pubmed/29982205 http://dx.doi.org/10.1136/bmjopen-2017-020760 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Public Health
Walrod, Jemie
Seccareccia, Erica
Sarmiento, Iván
Pimentel, Juan Pablo
Misra, Shivali
Morales, Juana
Doucet, Alison
Andersson, Neil
Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
title Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
title_full Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
title_fullStr Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
title_full_unstemmed Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
title_short Community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four Andean indigenous communities in Ecuador
title_sort community factors associated with stunting, overweight and food insecurity: a community-based mixed-method study in four andean indigenous communities in ecuador
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042540/
https://www.ncbi.nlm.nih.gov/pubmed/29982205
http://dx.doi.org/10.1136/bmjopen-2017-020760
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