Household-level determinants of nutritional status of pre-school children in northern Vietnam.

The significance of this paper is in offering the 1st multivariate analysis of nutritional status of 380 households with 129 Vietnamese children in 4 survey rounds between 1985-87 in 6 northern provinces (Ha Nam Ning Ha Son Binh Hai Hung Thai Bing Haiphong and Hanoi). In each province 2 villages were included that were comparable in size and socioeconomic status one with a primary health care (PHC) program and one without. Data included childrens weight height and hemoglobin household size age at infant weaning and 1st solid food recency of a diarrheal episode among household children the presence of a month long cough among any household member and province population density. Stepwise regression was performed to examin e the relationships between nutritional outcome (weight for age height for age weight for height and standardized weight and height increments) and several household level variables. The results indicated that there was a high prevalence of low weight for age (W/A) and low height for age (H/A) for all 4 survey rounds particularly among the older age group. Low weight for height (W/H) was less prevalent as was impairment of growth velocity; i.e. growth rates were normal inspite of lower weights and heights. Age was consistently and frequently associated with W/A H/A and W/H. Specifically the age of 1st receiving solid food was positively related with H/A (round 1). Male gender was positively related with W/H (round). Hemoglobin was positively related to W/A and H/A (round 1) and negatively related to W/H (round 3). A diarrheal episode occurring >1 month ago negatively associated with H/A (round 2) and positively associated with H/A (round 3). Having a growth chart in the household was positively related to W/H (round 4). There was also variability in the associations between incremental growth and household variables. Age specific analyses showed that older children have lower W/A and H/A (round 1) than <18 months children. Older children had higher weight and height increments except for round 4 weight increment. There is a steady upward increase in H/A for older children and a decline for younger ones who only show a slight increase in round 4 but had increases in growth increments. The discussion points to the conclusion that chronic undernutrition is prevalent with a suppression of the growth process. Children <24 months have better nutritional status but older children have better standardized height increments. Analysis is limited by missing data and other important household variables and further analyses are needed with a more comprehensive data collection.