Determinants of Persistent Underweight among Children, Aged 6-35 Months, after Huge Economic Development and Improvements in Health Services in Oman

By Alasfoor, Deena; Traissac, Pierre et al. | Journal of Health Population and Nutrition, September 2007 | Go to article overview

Determinants of Persistent Underweight among Children, Aged 6-35 Months, after Huge Economic Development and Improvements in Health Services in Oman


Alasfoor, Deena, Traissac, Pierre, Gartner, Agnès, Delpeuch, Francis, Journal of Health Population and Nutrition


INTRODUCTION

In the last three decades, due to oil revenues and policy choices, the Sultanate of Oman has undergone drastic economic and sociodemographic changes. Between 1975 and 2003, its human deve-lopment status, as assessed by the human development index (HDI), experienced the world's largest observed increase for this period, from 0.493 to 0.780 (1). Oman now ranks 71 among 177 nations in the first quarter of the medium human development countries. In the same period, most health indicators witnessed major improvements (2). Between 1960 and 2002, the rate of infant mortality dropped from 164% to 11%, and the rate of mortality of children aged less than five years (under-five mortality) went down from 280% to 13% (3). Rate of infant immunization rose from 10% in 1980 to 99% in 2001 (4). Also, during the same period, the prevalence of different forms of undernutrition decreased markedly. Between 1980 and 1998, underweight among Omani children aged less than five years decreased from 62.9% to 17.9% and stunting from 20.3% to 10.4% (5,6). Wasting decreased from 12.8% in 1995 to 7.2% in 1998 (6). By the international standards of the World Health Organization (WHO) for prevalence of child malnutrition (7), level of underweight in Oman is still in the 'medium' range, even if the health of all Omani children can be monitored due to sufficient resources and adequate heath services.

The conceptual framework of our analysis is that of the international conceptual framework of the causes of malnutrition (8). Due to the specific Omani context, our hypotheses were that (a) the factors from the 'health environment and services' (with the exception of water supply which is historically important in Oman) and 'household food security' categories of the underlying causes of malnutrition (8) could be considered at a sufficient level (9) and (b) that risk factors of underweight could, thus, be more likely found in the child and maternal care categories (also without excluding the legacy of the predevelopment years via prenatal factors). Despite a few descriptive studies (10,11) or aimed at specific risk factors (10,12), no data were available to assess the relationships between a sufficiently large number of factors and the anthropometric status of children. Therefore, this study was aimed at assessing the risk factors of underweight among young Omani children. For that purpose, a matched case-control study was conducted among 6-35-month old children residing in four regions of Oman.

MATERIALS AND METHODS

Study design

A 1:1 case-control study with individual matching was deemed to be the most efficient for the study (13,14). Cases were defined as underweight children aged 6-35 months. Controls were non-underweight children matched by village of residence, sex, and age (within one month).

Study sample

For a 0.05 first-type error risk and a power of 0.80, assuming a 20% prevalence of exposure among controls, the sample size to detect an odds ratio of 2.0 was computed as 187 case-control pairs (n=374) (calculation performed with the Epitable module in the Epi Info software, version 6.04 (15)).

Cases were selected from four (Muscat, Dhakhilia, North and South Sharqia) of the 10 health regions in Oman which represent different situations and prevalences of underweight among children aged 0-59 month(s) (respectively 12.8%, 22.7%, 26.8%, and 19.7% in 1998) (6).

Inclusion of case-control pairs

In each commune, the Community Support Group members screened all children aged less than three years for cases and suitable controls using the reference growth charts and individual screening forms, including relevant inclusion/exclusion information. After verification at the Department of Nutrition of the Ministry of Health in Muscat, the case-control pairs were included based on age, validation of weight-for-age status (by calculation by computer), absence of any visible congenital diseases that might affect growth, and accuracy of the matching criteria, as reported by the field teams. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Determinants of Persistent Underweight among Children, Aged 6-35 Months, after Huge Economic Development and Improvements in Health Services in Oman
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.