Author
Komal Bhatia
Bio: Komal Bhatia is an academic researcher from Philippine Institute for Development Studies. The author has contributed to research in topics: Medicine & Mental health. The author has an hindex of 1, co-authored 1 publications receiving 235 citations.
Topics: Medicine, Mental health, Psychology, Health care, Accountability
Papers
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International Food Policy Research Institute1, University of Indonesia2, Food and Agriculture Organization3, Philippine Institute for Development Studies4, Aga Khan University5, University of Ghana6, University of Cambridge7, Columbia University8, National University of Benin9, UNICEF10, University of Washington11, Mahidol University12, Public Health Foundation of India13
TL;DR: By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light and identifies bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlights actions to accelerate coverage and reach.
Abstract: In 2013, the Nutrition for Growth Summit called for a Global Nutrition Report (GNR) to strengthen accountability in nutrition so that progress in reducing malnutrition could be accelerated. This article summarizes the results of thefirst GNR. By focusing on undernutrition and overweight, the GNR puts malnutrition in a new light. Nearly every country in the world is affected by malnutrition, and multiple malnutrition burdens are the ‘‘new normal.’’ Unfortunately, the world is off track to meet the 2025 World Health Assembly (WHA) targets for nutrition. Many countries are, however, making good progress on WHA indicators, providing inspiration and guidance for others. Beyond the WHA goals, nutrition needs to be more strongly represented in the Sustainable Development Goal (SDG) framework. At present, it is only explicitly mentioned in 1 of 169 SDG targets despite the many contributions improved nutritional status will make to their attainment. To achieve improvements in nutrition status, it is vital to scale up nutrition programs. We identify bottlenecks in the scale-up of nutrition-specific and nutrition-sensitive approaches and highlight actions to accelerate coverage and reach. Holding stakeholders to account for delivery on nutrition actions requires a well-functioning accountability infrastructure, which is lacking in nutrition. New accountability mechanisms need piloting and evaluation, financial resource flows to nutrition need to be made explicit, nutrition spending targets should be established, and some key data gaps need to be filled. For example, many UN member states cannot report on their WHA progress and those that can often rely on data >5 y old. The world can accelerate malnutrition reduction substantially, but this will require stronger accountability mechanisms to hold all stakeholders to account. JN utrdoi: 10.3945/jn.114.206078.
261 citations
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TL;DR: In this article , the authors systematically map out and critically review the existing global literature on the relationship between social media usage, body image and eating disorders in young people aged 10-24 years.
Abstract: Background Eating disorders are a group of heterogenous, disabling and deadly psychiatric illnesses with a plethora of associated health consequences. Exploratory research suggests that social media usage may be triggering body image concerns and heightening eating disorder pathology amongst young people, but the topic is under-researched as a global public health issue. Aim To systematically map out and critically review the existing global literature on the relationship between social media usage, body image and eating disorders in young people aged 10–24 years. Methods A systematic search of MEDLINE, PyscINFO and Web of Science for research on social media use and body image concerns / disordered eating outcomes published between January 2016 and July 2021. Results on exposures (social media usage), outcomes (body image, eating disorders, disordered eating), mediators and moderators were synthesised using an integrated theoretical framework of the influence of internet use on body image concerns and eating pathology. Results Evidence from 50 studies in 17 countries indicates that social media usage leads to body image concerns, eating disorders/disordered eating and poor mental health via the mediating pathways of social comparison, thin / fit ideal internalisation, and self-objectification. Specific exposures (social media trends, pro-eating disorder content, appearance focused platforms and investment in photos) and moderators (high BMI, female gender, and pre-existing body image concerns) strengthen the relationship, while other moderators (high social media literacy and body appreciation) are protective, hinting at a ‘self-perpetuating cycle of risk’. Conclusion Social media usage is a plausible risk factor for the development of eating disorders. Research from Asia suggests that the association is not unique to traditionally western cultures. Based on scale of social media usage amongst young people, this issue is worthy of attention as an emerging global public health issue.
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TL;DR: In this paper , the authors evaluated whether and how community youth teams facilitating participatory adolescent groups, youth leadership and livelihood promotion improved school attendance, dietary diversity, and mental health among adolescent girls in rural India.
Abstract: To evaluate whether and how community youth teams facilitating participatory adolescent groups, youth leadership and livelihood promotion improved school attendance, dietary diversity, and mental health among adolescent girls in rural India.A parallel group, two-arm, superiority, cluster-randomised controlled trial with an embedded process evaluation.38 clusters (19 intervention, 19 control) in West Singhbhum district in Jharkhand, India. The intervention included participatory adolescent groups and youth leadership for boys and girls aged 10-19 (intervention clusters only), and family-based livelihood promotion (intervention and control clusters) between June 2017 and March 2020. We surveyed 3324 adolescent girls aged 10-19 in 38 clusters at baseline, and 1478 in 29 clusters at endline. Four intervention and five control clusters were lost to follow up when the trial was suspended due to the COVID-19 pandemic. Adolescent boys were included in the process evaluation only.Primary: school attendance, dietary diversity, and mental health; 12 secondary outcomes related to education, empowerment, experiences of violence, and sexual and reproductive health.In intervention vs control clusters, mean dietary diversity score was 4·0 (SD 1·5) vs 3·6 (SD 1·2) (adjDiff 0·34; 95%CI -0·23, 0·93, p = 0·242); mean Brief Problem Monitor-Youth (mental health) score was 12·5 (SD 6·0) vs 11·9 (SD 5·9) (adjDiff 0·02, 95%CI -0·06, 0·13, p = 0·610); and school enrolment rates were 70% vs 63% (adjOR 1·39, 95%CI 0·89, 2·16, p = 0·142). Uptake of school-based entitlements was higher in intervention clusters (adjOR 2·01; 95%CI 1·11, 3·64, p = 0·020). Qualitative data showed that the community youth team had helped adolescents and their parents navigate school bureaucracy, facilitated re-enrolments, and supported access to entitlements. Overall intervention delivery was feasible, but positive impacts were likely undermined by household poverty.Participatory adolescent groups, leadership training and livelihood promotion delivered by a community youth team did not improve adolescent girls' mental health, dietary diversity, or school attendance in rural India, but may have increased uptake of education-related entitlements.ISRCTN17206016.
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TL;DR: In this paper , the authors evaluated the impact of the COVID-19 pandemic on elective breast or colorectal cancer (CRC) procedure backlogs and attributable mortality, globally.
Abstract: Globally, 28.4 million non-emergent (‘elective’) surgical procedures have been deferred during the COVID-19 pandemic. This study evaluated the impact of the COVID-19 pandemic on elective breast- or colorectal cancer (CRC) procedure backlogs and attributable mortality, globally. Further, we evaluated the interaction between procedure deferrals and health systems, internationally. Relevant articles from any country, published between December 2019–24 November 2022, were identified through searches of online databases (MEDLINE, EMBASE) and by examining the reference lists of retrieved articles. We organised health system-related findings thematically per the Structures-Processes-Outcomes conceptual model by Donabedian (1966). Of 337 identified articles, we included 50. Eleven (22.0%) were reviews. The majority of included studies originated from high-income countries (n = 38, 76.0%). An ecological, modelling study elucidated that global 12-week procedure cancellation rates ranged from 68.3%–73%; Europe and Central Asia accounted for the majority of cancellations (n = 8,430,348) and sub-Saharan Africa contributed the least (n = 520,459). The percentage reduction in global, institutional elective breast cancer surgery activity ranged from 5.68%–16.5%. For CRC, this ranged from 0%–70.9%. Significant evidence is presented on how insufficient pandemic preparedness necessitated procedure deferrals, internationally. We also outlined ancillary determinants of delayed surgery (e.g., patient-specific factors). The following global health system response themes are presented: Structural changes (i.e., hospital re-organisation), Process-related changes (i.e., adapted healthcare provision) and the utilisation of Outcomes (i.e., SARS-CoV-2 infection incidence among patients or healthcare personnel, postoperative pulmonary complication incidence, hospital readmission, length of hospital stay and tumour staging) as indicators of health system response efficacy. Evidence on procedure backlogs and attributable mortality was limited, partly due to insufficient, real-time surveillance of cancer outcomes, internationally. Elective surgery activity has decreased and cancer services have adapted rapidly, worldwide. Further research is needed to understand the impact of COVID-19 on cancer mortality and the efficacy of health system mitigation measures, globally.
Cited by
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University of Melbourne1, Royal Children's Hospital2, Columbia University3, University of London4, World Health Organization5, American University of Beirut6, University of Oregon7, Public Health Foundation of India8, University College London9, Burnet Institute10, United Nations Population Fund11, University of Toronto12, Aga Khan University13, Obafemi Awolowo University14, Jawaharlal Nehru University15, UNICEF16, Kunming Medical University17
TL;DR: This Commission outlines the opportunities and challenges for investment in adolescent health and wellbeing at both country and global levels (panel 1).
1,976 citations
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TL;DR: It is shown that stunting is the best overall indicator of children's well‐being and an accurate reflection of social inequalities and the challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.
Abstract: Childhood stunting is the best overall indicator of children's well-being and an accurate reflection of social inequalities. Stunting is the most prevalent form of child malnutrition with an estimated 161 million children worldwide in 2013 falling below -2 SD from the length-for-age/height-for-age World Health Organization Child Growth Standards median. Many more millions suffer from some degree of growth faltering as the entire length-for-age/height-for-age z-score distribution is shifted to the left indicating that all children, and not only those falling below a specific cutoff, are affected. Despite global consensus on how to define and measure it, stunting often goes unrecognized in communities where short stature is the norm as linear growth is not routinely assessed in primary health care settings and it is difficult to visually recognize it. Growth faltering often begins in utero and continues for at least the first 2 years of post-natal life. Linear growth failure serves as a marker of multiple pathological disorders associated with increased morbidity and mortality, loss of physical growth potential, reduced neurodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. The severe irreversible physical and neurocognitive damage that accompanies stunted growth poses a major threat to human development. Increased awareness of stunting's magnitude and devastating consequences has resulted in its being identified as a major global health priority and the focus of international attention at the highest levels with global targets set for 2025 and beyond. The challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.
762 citations
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TL;DR: It is suggested that increasing on-farm diversity is not always the most effective way to improve dietary diversity in smallholder households and should not be considered a goal in itself.
Abstract: Undernutrition and micronutrient malnutrition remain problems of significant magnitude in large parts of the developing world. Improved nutrition requires not only better access to food for poor population segments, but also higher dietary quality and diversity. Because many of the poor and undernourished people are smallholder farmers, diversifying production on these smallholder farms is widely perceived as a useful approach to improve dietary diversity. However, empirical evidence on the link between production and consumption diversity is scarce. Here, this issue is addressed with household-level data from Indonesia, Kenya, Ethiopia, and Malawi. Regression models show that on-farm production diversity is positively associated with dietary diversity in some situations, but not in all. When production diversity is already high, the association is not significant or even turns negative, because of foregone income benefits from specialization. Analysis of other factors reveals that market access has positive effects on dietary diversity, which are larger than those of increased production diversity. Market transactions also tend to reduce the role of farm diversity for household nutrition. These results suggest that increasing on-farm diversity is not always the most effective way to improve dietary diversity in smallholder households and should not be considered a goal in itself. Additional research is needed to better understand how agriculture and food systems can be made more nutrition-sensitive in particular situations.
481 citations
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TL;DR: This commentary identifies and characterises NUCS with agronomic potential in SSA, especially in the semi-arid areas taking into consideration inter alia: (i) what can grow under water-scarce conditions, (ii) water requirements, and (iii) water productivity.
Abstract: Modern agricultural systems that promote cultivation of a very limited number of crop species have relegated indigenous crops to the status of neglected and underutilised crop species (NUCS). The complex interactions of water scarcity associated with climate change and variability in sub-Saharan Africa (SSA), and population pressure require innovative strategies to address food insecurity and undernourishment. Current research efforts have identified NUCS as having potential to reduce food and nutrition insecurity, particularly for resource poor households in SSA. This is because of their adaptability to low input agricultural systems and nutritional composition. However, what is required to promote NUCS is scientific research including agronomy, breeding, post-harvest handling and value addition, and linking farmers to markets. Among the essential knowledge base is reliable information about water utilisation by NUCS with potential for commercialisation. This commentary identifies and characterises NUCS with agronomic potential in SSA, especially in the semi-arid areas taking into consideration inter alia: (i) what can grow under water-scarce conditions, (ii) water requirements, and (iii) water productivity. Several representative leafy vegetables, tuber crops, cereal crops and grain legumes were identified as fitting the NUCS category. Agro-biodiversity remains essential for sustainable agriculture.
301 citations
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TL;DR: The combination of unimproved latrines and untreated drinking water was associated with an increased odds on stunting in Indonesia compared with improved conditions, and policy and programme responses must consider water, sanitation and hygiene interventions.
Abstract: Stunting in early life has considerable human and economic costs. The purpose of the study was to identify factors associated with stunting among children aged 0-23 months in Indonesia to inform the design of appropriate policy and programme responses. Determinants of child stunting, including severe stunting, were examined in three districts in Indonesia using data from a cross-sectional survey conducted in 2011. A total of 1366 children were included. The analysis used multiple logistic regression to determine unadjusted and adjusted odds ratios. The prevalence of stunting and severe stunting was 28.4 % and 6.7 %, respectively. The multivariate analysis on determinants of stunting identified a significant interaction between household sanitary facility and household water treatment (P for interaction = 0.007) after controlling for potential covariates: in households that drank untreated water, the adjusted odds on child stunting was over three times higher if the household used a unimproved latrine (adjusted odds ratio 3.47, 95 % confidence interval 1.73-7.28, P <0.001); however, in households that drank treated water, the adjusted odds on child stunting was not significantly higher if the household used an unimproved latrine (adjusted odds ratio 1.27, 95 % confidence interval 0.99-1.63, P = 0.06). Other significant risk factors included male sex, older child age and lower wealth quintile. The risk factors for severe stunting included male sex, older child age, lower wealth quintile, no antenatal care in a health facility, and mother’s participation in decisions on what food was cooked in the household. The combination of unimproved latrines and untreated drinking water was associated with an increased odds on stunting in Indonesia compared with improved conditions. Policies and programmes to address child stunting in Indonesia must consider water, sanitation and hygiene interventions. Operational research is needed to determine how best to converge and integrate water, sanitation and hygiene interventions into a broader multisectoral approach to reduce stunting in Indonesia.
208 citations