Showing papers by "Yves Martin-Prével published in 2000"

Economic crisis and malnutrition: socioeconomic determinants of anthropometric status of preschool children and their mothers in an African urban area.

Abstract: Objective: To assess the relative importance of socioeconomic and maternal/prenatal determinants of the nutritional situation of children , 6 years old in an urban African area after several years of economic crisis. Design: Cross-sectional cluster sample survey. Setting: Brazzaville, capital city of the Congo. Subjects: Information on socioeconomic characteristics was gathered from a random sample of 1368 households by house visits and anthropometric measurements were performed using standardized procedures on preschool children (n = 2373) and their mothers (n = 1512). Results: The influence of socioeconomic factors on the nutritional status of children, taking into account adjustment variables such as mother’s age and child’s age and sex was assessed. For stunting, as well as for the mean height-for-age index among children, the main determinants were economic level of the household (P = 0.048 and P = 0.004, respectively), schooling of the mother (P = 0.004 and P , 10 -3 ) and living in the peripheral district (P = 0.005 and P , 10 -3 ). The influence of socioeconomic determinants on weight-for-age and wasting was less straightforward. When adjusting, in addition, for maternal and prenatal factors (mother’s height and body mass index (BMI) and birth weight), most of the effects of the socioeconomic determinants on the nutritional status of children persisted somewhat, but the effect of the economic level on the stunting became not significant (P = 0.11). The mean BMI of mothers appeared to be related to the economic level of the household (P , 10 -4 ), to the marital status (P = 0.01) and to the occupation of the mother (P , 10 -4 ). Conclusions: Among the socioeconomic determinants of malnutrition in children, some, such as economic level of the household or schooling of the mother, seem to act mainly through prenatal factors, whereas others, mainly dwelling district characteristics, seem to influence more directly the children’s nutritional status.

Deterioration in the nutritional status of young children and their mothers in Brazzaville, Congo, following the 1994 devaluation of the CFA franc

Abstract: The effects of the January 1994 devaluation of the African Financial Community (CFA) franc on the nutritional situation of the populations concerned has been little documented. We report in this article on two nutritional cross-sectional surveys that were conducted before and after this devaluation (1993 and 1996) in two districts of Brazzaville, Congo. The surveys involved a representative sample of 4206 households with a child aged 4-23 months. Complementary feeding practices and the anthropometric indices of the children and their mothers were compared, adjusting for changes in household socioeconomic characteristics. The results show a decline in the quality of the first complementary foods offered to the infants, i.e. less frequent use of special transitional foods and imported complementary flours (of higher nutritional quality), and preparation of less nutritious local gruels. Overall, the nutritional situation had deteriorated, with greater levels of stunting and wasting among children, mothers with lower body mass index, and infants with reduced birth weights. Increased food prices would appear to be the direct cause of the decreased quality in complementary feeding, but factors other than the devaluation have also had an impact on household welfare. The influence of these factors on nutritional-status is discussed.

Dietary changes in African urban households in response to currency devaluation: foreseeable risks for health and nutrition.

Abstract: Objective: To investigate the effects of currency devaluation on dietary change and nutritional vulnerability of poor households in two African capital cities. Desigiz: A qualitative study based on 120 semistructured individual interviews and four focus group discussions in each city. Setting: Dakar, Senegal (western Africa) and Brazzaville, Congo (central Africa). Subjects: All of the subjects were randomly selected women from modest or poor households, who spoke the local common language and were responsible for household meal preparation. Only those likely to restrict the dynamic of focus group discussions (because of language, age or education) were excluded. Results: Changes were found in meal preparation characteristics (frequency, sharing pattern) and meal composition. There was frequent depletion of fat and vegetable contents in meals, frequent elimination of desserts and even the elimination of one daily meal. These changes specifically affected economically disadvantaged and socially isolated households, and those headed by women. Other changes were the reduction in the size of consumption units and the development of neighbourhoodspecific street food - which has been a growing trend in Brazzaville since the outset of the economic crisis but is more recent in Dakar. Co?zcZusions: If lasting, these changes pose a dual health risk, i.e. reducing dietary diversity and altering the bacteriological quality of prepared meals. In addition, attempts to reduce the consumption units were found to upset community ties that bind these societies.

[Nutrition, urbanization and poverty in subsaharan Africa].

Abstract: Africa is currently the continent with the highest urbanization rate in the world. This demographic upheaval has sometimes been considered as an opportunity for modernization but as early as the 1980s experts called attention to its potential impact on nutrition. In recent decades, economic problems and structural reforms have had dire effects on urban populations. Today increasing poverty and the effects of globalization have revived concerns about urban nutrition. Retarded growth and emaciation are less common than in urban areas than in rural areas, but disparities between the rich and poor are much greater. However, in some cities, the incidence of emaciation progressed the more during the 1990s, and now equals that in rural areas. In cities the level of obesity in adult women is a sign of nutritional transition but emaciation has also increased. Despite the wide variety of urban conditions, analysis of the underlying factors reveals several constants. For most of these factors, the characteristic feature of the urban environment is a further increase of social inequality.

Nutrition, urbanisation et pauvreté en Afrique subsaharienne

Abstract: ○ L'Afrique est le continent qui a actuellement le plus fort taux d'accroissement urbain dans le monde. Ce bouleversement demographique, parfois presente comme une chance car porteur de modernisation, avait des les annees quatre-vingts attire l'attention sur les implications potentielles en matiere de nutrition. Au cours des dernieres decennies, les difficultes economiques et les programmes d'ajustement structurel ont lourdement frappe les populations urbaines. Aujourd'hui, l'aggravation de la pauvrete et les effets incertains de la mondialisation reactualisent les questions de nutrition urbaine. Les prevalences de retard de croissance et de maigreur restent moins importantes qu'en milieu rural, mais la disparite entre menages riches et pauvres y est beaucoup plus forte. De plus, au cours des annees quatre-vingt-dix la maigreur y a parfois davantage progresse, atteignant meme dans certains pays le niveau du milieu rural. Chez les adultes le niveau d'obesite des femmes en milieu urbain est caracteristique d'un debut de transition nutritionnelle mais on a pu egalement noter des augmentations de la maigreur. Malgre la grande diversite des situations urbaines, l'analyse des facteurs sous-jacents permet de degager un certain nombre d'invariants: importance du revenu monetaire, de l'emploi du temps des femmes, des modifications du regime alimentaire, de l'hygiene de l'environnement, de l'acces aux services de sante. Pour la plupart de ces facteurs, la marque du milieu urbain est l'accroissement d'inegalites deja fortes.