Context Matters—Child Growth within a Constrained Socio-Economic Environment
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Context
2.2. Demographic Characteristics, Child Wellbeing, and Depression Scales
2.3. Physical Measurements
2.4. Statistical Analysis
3. Results
3.1. Differences in Demographic and Health Characteristics by Child Biological Sex and Income Vulnerability
3.2. Differences in Demographic and Health Characteristics by School Location
3.3. Factors Associated with Child Growth
3.4. Factors Associated with Child Resilience
3.5. Factors Associated with Child Education Domain
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Tanner, J.M. Growth as a Mirror of the Condition of Society: Secular Trends and Class Distinctions. Pediatr. Int. 1987, 29, 96–103. [Google Scholar] [CrossRef] [PubMed]
- Kmietowicz, Z. Children worldwide can grow to the same height, says WHO. BMJ 2006, 332, 1052. [Google Scholar] [CrossRef] [PubMed]
- de Onis, M.; Blössner, M.; Borghi, E. Prevalence and trends of stunting among pre-school children, 1990–2020. Public Health Nutr. 2011, 15, 142–148. [Google Scholar] [CrossRef] [PubMed]
- Ng, M.; Fleming, T.; Robinson, M.; Thomson, B.; Graetz, N.; Margono, C.; Mullany, E.C.; Biryukov, S.; Abbafati, C.; Abera, S.F.; et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014, 384, 766–781. [Google Scholar] [CrossRef]
- Stein, A.D.; Wang, M.; Martorell, R.; Norris, S.A.; Adair, L.S.; Bas, I.; Sachdev, H.S.; Bhargava, S.K.; Fall, C.H.; Gigante, D.P.; et al. Growth patterns in early childhood and final attained stature: Data from five birth cohorts from low- and middle-income countries. Am. J. Hum. Biol. 2009, 22, 353–359. [Google Scholar] [CrossRef]
- Greyling, L.; Mears, R. Demographic characteristics of Soweto: A comparison of 1993 and 2008. Financ. Bank. 2014, 3, 1290–1309. [Google Scholar]
- Popkin, B.M. Global nutrition dynamics: The world is shifting rapidly toward a diet linked with noncommunicable diseases. Am. J. Clin. Nutr. 2006, 84, 289–298. [Google Scholar] [CrossRef]
- South African State of the Cities Report 2006. Braamfontein. 2006. Available online: www.sacities.net (accessed on 8 August 2022).
- Cameron, N.; Kgamphe, J.S.; Leschner, K.F.; Farrant, P.J. Urban-rural differences in the growth of South African black children. Ann. Hum. Biol. 1992, 19, 23–33. [Google Scholar] [CrossRef]
- Richter, L.M.; Norris, S.A.; Swart, T.M.; Ginsburg, C. In-migration and living conditions of young adolescents in Greater Johannesburg, South Africa. Soc. Dyn. 2006, 32, 195–216. [Google Scholar] [CrossRef]
- Rahman, A.; Lovel, H.; Bunn, J.; Iqbal, Z.; Harrington, R. Mothers mental health & infant growth—A case–control study from Rawalpindi; Pakistan. Child Care Health Dev. 2014, 30, 21–27. [Google Scholar]
- National Cancer Institute. Theory at a Glance: A Guide for Health Promotion Practice; National Cancer Institute: Bethesda, MA, USA, 2005.
- Ogbonnaya, U.I.; Awuah, F.K. Quintile ranking of schools in South Africa and learners’ achievement in probability. Stat. Educ. Res. J. 2019, 18, 106–119. [Google Scholar] [CrossRef]
- Baron, E.C.; Davies, T.; Lund, C. Validation of the 10-item Centre for Epidemiological Studies Depression Scale (CES-D-10) in Zulu, Xhosa and Afrikaans populations in South Africa. BMC Psychiatry 2017, 17, 6. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ungar, M.; Liebenberg, L. Assessing Resilience Across Cultures Using Mixed Methods: Construction of the Child and Youth Resilience Measure. J. Mix. Methods Res. 2011, 5, 126–149. [Google Scholar] [CrossRef]
- Patel, L.; Pillay, J.; Henning, E.; Telukdarie, A.; Norris, S.; Graham, L.; Haffejee, S.; Sani, T.; Ntshingila, N.; Du-Plessis Faurie, A.; et al. Community of Practice for Social Systems Strengthening to Improve Child Well-Being Outcomes Findings from Wave 1: Tracking Child Wellbeing of Early Grade Learners and Their Families. 2021. Available online: https://www.unicef.org (accessed on 8 August 2022).
- Strauss, M. A historical exposition of spatial injustice and segregated urban settlement in South Africa. Fundamina 2019, 25, 135–168. [Google Scholar] [CrossRef]
- Jonah, C.M.P.; May, J.D. The nexus between urbanization and food insecurity in South Africa: Does the type of dwelling matter? Int. J. Urban Sustain. Dev. 2020, 12, 1–13. [Google Scholar] [CrossRef]
- Devereux, S.; Waidler, J. Why Does Malnutrition Persist in South Africa Despite Social Grants? (Food Security SA Working Paper Series). Report No.: 001; DST-NRF Centre of Excellence in Food Security: Pretoria, South Africa, 2017; Available online: www.foodsecurity.ac.za (accessed on 8 August 2022).
- Samson, M.; Heinrich, C.; Williams, M.; Kaniki, S.; Muzondo, T.; Mac Quene, K.; Van Niekerk, I. Quantitative Analysis of the Impact of the Child Support Grant. 2008. Available online: www.epri.org.za (accessed on 8 August 2022).
- Aguero, J.M.; Carter, M.R.; Woolard, I. The Impact of Unconditional Cash Transfers on Nutrition: The South African Child Support Grant; Southern Africa Labour and Development Research Unit Working Paper Number 06/08; SALDRU: Cape Town, South Africa, 2006; Available online: www.saldru.uct.ac.za (accessed on 8 August 2022).
- Samson, M.; Van, I.; Kenneth, N.; Quene, M. Designing and Iimplementing Social Transfer Programmes. 2010. Available online: http://epri.org.za/wp-content/uploads/2016/07/Designing-and-Implementing-Social-Transfer-Programmes-EPRI.pdf (accessed on 8 August 2022).
- Ryan, C. More People on Welfare than Have Jobs in SA. Moneyweb. 2018. Available online: https://www.moneyweb.co.za/news/south-africa/more-people-on-welfare-than-have-jobs-in-sa/ (accessed on 8 August 2022).
- Zembe-Mkabile, W.; Surrender, R.; Sanders, D.; Jackson, D.; Doherty, T. The experience of cash transfers in alleviating childhood poverty in South Africa: Mothers’ experiences of the Child Support Grant. Glob. Public Health 2015, 10, 834–851. [Google Scholar] [CrossRef]
- Molyneux, M.; Jones, N.; Samuels, F. Can cash transfer programmes have “transformative” effects? J. Dev. Stud. 2016, 52, 1087–1098. [Google Scholar] [CrossRef]
- Baird, S.; McIntosh, C.; Özler, B. Cash or Condition? Evidence from a Cash Transfer Experiment. Q. J. Econ. 2011, 126, 1709–1753. [Google Scholar] [CrossRef]
- Ruel, M.T.; Alderman, H.; Maternal and Child Nutrition Study Group. Nutrition-sensitive interventions and programmes: How can they help to accelerate progress in improving maternal and child nutrition? Lancet 2013, 382, 536–551. [Google Scholar] [CrossRef]
- Stinson, S. Sex differences in environmental sensitivity during growth and development. Am. J. Phys. Anthr. 1985, 28, 123–147. [Google Scholar] [CrossRef]
- Nyati, L.H.; Pettifor, J.M.; Ong, K.K.; Norris, S.A. Adolescent growth and BMI and their associations with early childhood growth in an urban South African cohort. Am. J. Hum. Biol. 2020, 33, e23469. [Google Scholar] [CrossRef] [PubMed]
- Nyati, L.H.; Pettifor, J.M.; Norris, S.A. The prevalence of malnutrition and growth percentiles for urban South African children. BMC Public Health 2019, 19, 492. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Santona, A.; Tagini, A.; Sarracino, D.; De Carli, P.; Pace, C.S.; Parolin, L.; Terrone, G. Maternal depression and attachment: The evaluation of mother–child interactions during feeding practice. Front. Psychol. 2015, 6, 1235. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Department of Child and Adolescent Health and Development. The Importance of Caregiver-Child Interactions for the Survival and Healthy Development of Young Children: A Review. 2004. Available online: http://apps.who.int (accessed on 8 August 2022).
Region, Ward, and Area Name 1 |
---|
Region D: Meadowlands Zone 3, Ward 42 |
Region A: Ivory Park, Ward 77 |
Region F: Malvern, Ward 65 |
Region C: Doornkop, Ward 50 |
Region E: Alexandra, Ward 109 |
Female | Male | p-Value | |
---|---|---|---|
N | 75 | 86 | |
Age of caregiver | 35.4 (8.7) | 35.8 (9.1) | 0.759 |
Household size | 5.0 (2–12) | 5.0 (3–20) | 0.024 |
Social support grants | 2.0 (0–9) | 3.0 (0–10) | 0.923 |
Education level | |||
NSC or tertiary | 31 (41.3) | 30 (35.3) | 0.432 |
Up to secondary | 44 (58.7) | 55 (64.7) | |
Employment status | |||
Some employment | 25 (33.3) | 31 (36.0) | 0.718 |
Unemployed | 50 (66.7) | 55 (64.0) | |
Caregiver mental health | |||
No depression | 34 (47.2) | 32 (45.1) | 0.796 |
With depression | 38 (52.8) | 39 (54.9) | |
Food security domain δ | |||
No concern | 42 (80.8) | 45 (76.3) | 0.566 |
Some or major concern | 10 (19.2) | 14 (23.7) | |
Child health domain | |||
No concern | 15 (21.4) | 9 (11.5) | 0.177 |
Some concern | 30 (42.9) | 32 (41.0) | |
Major concern | 25 (35.7) | 37 (47.4) | |
Living conditions domain φ | |||
No concern | 60 (81.1) | 56 (70.0) | 0.111 |
Some concern | 14 (18.9) | 24 (30.0) | |
Age of the child | 6.5 (0.7) | 6.4 (0.7) | 0.558 |
Child resilience score | 44.1 (4.4) | 43.2 (4.1) | 0.185 |
Weight-for-age z-score | −0.08 (1.11) | −0.36 (1.38) | 0.167 |
Height-for-age z-score | −0.55 (1.28) | −0.70 (1.42) | 0.501 |
BMI-for-age z-score | 0.32 (1.21) | 0.14 (1.49) | 0.401 |
Lower Vulnerability | Higher Vulnerability | p-Value | |
---|---|---|---|
N | 110 | 48 | |
Age of caregiver | 35 (7.7) | 36 (9.9) | 0.554 |
Education level | |||
NSC or tertiary | 42 (38.5) | 19 (39.6) | 0.901 |
Up to secondary | 67 (61.5) | 29 (60.4) | |
Caregiver mental health | |||
No depression | 49 (49.0) | 17 (38.6) | 0.250 |
With depression | 51 (51.0) | 27 (61.4) | |
Food security domain | |||
No concern | 65 (79.3) | 22 (73.3) | 0.504 |
Some or major concern | 17 (20.7) | 8 (26.7) | |
Child health domain | |||
No concern | 19 (18.8) | 6 (12.8) | 0.535 |
Some concern | 43 (42.6) | 19 (40.4) | |
Major concern | 39 (38.6) | 22 (46.8) | |
Living conditions domain | |||
No concern | 79 (73.8) | 38 (79.2) | 0.475 |
Some concern | 28 (26.2) | 10 (20.8) | |
Age of the child | 6.4 (0.7) | 6.4 (0.7) | 0.880 |
Child resilience score | 43.4 (4.3) | 43.8 (4.1) | 0.664 |
Weight-for-age z-score | −0.07 (1.32) | −0.54 (1.08) | 0.023 |
Height-for-age z-score | −0.43 (1.25) | −1.13 (1.52) | 0.007 |
BMI-for-age z-score | 0.27 (1.38) | 0.23 (1.3) | 0.860 |
Alexandra | Doornkop | Ivory Park | Malvern | Meadowlands | Overall
p-Value | |
---|---|---|---|---|---|---|
N | 22 | 26 | 36 | 32 | 44 | |
Age of caregiver | 35.4 (7.6) | 35.8 (12.1) | 32.5 (7.9) i* | 35.6 (6.7) | 38.3 (8.9) | 0.071 |
Household size | 5.0 (2–11) a* | 6.0 (3–12) f*** | 5.0 (2–11) | 4.0 (2–8) j*** | 6.0 (3–20) | <0.001 |
Social support grants | 2.5 (0–10) | 3.0 (0–5) f** | 3.0 (0–9) h* | 2.0 (0–6) j*** | 3.0 (0–9) | 0.001 |
Education level | ||||||
NSC or tertiary | 7 (31.8) | 9 (34.6) | 11 (30.6) | 16 (51.6) | 19 (43.2) | 0.384 |
Up to secondary | 15 (68.2) | 17 (65.4) | 25 (69.4) | 15 (48.4) | 25 (56.8) | |
Caregiver mental health | ||||||
No depression | 10 (52.6) | 10 (43.5) | 20 (58.8) | 17 (53.1) | 8 (23.5) | 0.037 |
With depression | 9 (47.4) | 13 (56.5) | 14 (41.2) | 15 (46.9) | 26 (76.5) | |
Employment status | ||||||
Some employment | 7 (31.8) | 8 (30.8) | 13 (36.1) | 15 (46.9) | 12 (27.3) | 0.483 |
Unemployed | 15 (68.2) | 18 (69.2) | 23 (63.9) | 17 (53.1) | 32 (72.7) | |
Food security domain | ||||||
No concern | 11 (64.7) | 12 (85.7) | 24 (88.9) | 20 (80.0) | 19 (70.4) | 0.281 |
Some or major concern | 6 (35.3) | 2 (14.3) | 3 (11.1) | 5 (20.0) | 8 (29.6) | |
Child health domain | ||||||
No concern | 3 (15.8) | 1 (4) | 10 (30.3) | 6 (19.4) | 4 (10.3) | 0.002 |
Some concern | 2 (10.5) | 10 (40) | 16 (48.5) | 15 (48.4) | 18 (46.2) | |
Major concern | 14 (73.7) | 14 (56) | 7 (21.2) | 10 (32.3) | 17 (43.6) | |
Access to basic services | ||||||
No concern | 15 (68.2) | 20 (80.0) | 21 (58.3) | 29 (90.6) | 30 (78.9) | 0.028 |
Some concern | 7 (31.8) | 5 (20.0) | 15 (41.7) | 3 (9.4) | 8 (21.1) | |
Age of the child | 6.5 (0.7) | 6.3 (0.5) | 6.3 (0.6) | 6.5 (0.7) | 6.5 (0.9) | 0.499 |
Child resilience score | 43.3 (3.7) | 45.0 (2.7) | 43.9 (5.1) | 42.9 (4.8) | 43.2 (3.8) | 0.349 |
Weight-for-age z-score | −0.35 (1.10) | 0.01 (1.30) | −0.38 (1.32) | 0.25 (1.09) | −0.51 (1.32) | 0.076 |
Height-for-age z-score | −0.67 (1.10) | −1.60 (1.69) e*, f***, g** | −0.61 (1.21) | 0.06 (1.10) | −0.48 (1.23) | <0.001 |
BMI-for-age z-score | 0.08 (1.31) a** | 1.53 (1.13) e***, f**, g*** | −0.01 (1.40) | 0.3 (1.00) | −0.32 (1.25) | <0.001 |
Height-for-Age Z-Score | BMI-for-Age Z-Score | |||||||
---|---|---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | Model 4 | Model 1 | Model 2 | Model 3 | Model 4 | |
Child factors | ||||||||
Health domain (ref: no concern) | ||||||||
Some concern | −0.19 (0.35) | −0.12 (0.36) | 0.03 (0.34) | 0.02 (0.33) | 0.00 (0.33) | −0.06 (0.33) | −0.02 (0.34) | −0.02 (0.34) |
Major concern | −0.41 (0.35) | −0.33 (0.35) | −0.11 (0.33) | −0.08 (0.34) | 0.18 (0.33) | −0.22 (0.33) | 0.05 (0.33) | 0.05 (0.33) |
Maternal factors | ||||||||
Education level (ref: NSC or tertiary) | ||||||||
Up to secondary | −0.40 (0.23) | −0.50 (0.24) * | −0.40 (0.24) | 0.46 (0.23)* | 0.50 (0.24) * | 0.50 (0.24) * | ||
Household-level factors | ||||||||
Household size | −0.13 (0.06) * | −0.10 (0.06) | 0.05 (0.06) | 0.05 (0.06) | ||||
Additional income (ref: No) | ||||||||
Yes | 0.50 (0.25) * | 0.44 (0.24) | −0.05 (0.24) | −0.05 (0.24) | ||||
Have bed to sleep (ref: No) | ||||||||
Yes | 0.84 (0.41) * | 0.79 (0.40) | −0.41 (0.40) | −0.41 (0.40) | ||||
Home protects from rain (ref: No) | ||||||||
Yes | −0.62 (0.40) * | −0.57 (0.41) | 0.66 (0.40) | 0.66 (0.40) | ||||
Access to toilet (ref: No) | ||||||||
Yes | −0.54 (0.37) | −0.71 (0.38) | −0.21 (0.37) | −0.21 (0.37) | ||||
R2 | 0.016 | 0.043 | 0.179 | 0.002 | 0.032 | 0.039 | ||
F-test | 2.52 | 4.11 ** | 3.83 | 0.228 |
Child Resilience Score | |||
---|---|---|---|
Model 1 | Model 2 | Model 3 | |
Child factors | |||
Child sex (ref: Female) | |||
Male | −1.51 (0.74) * | −1.63 (0.75) * | −1.80 (0.74) * |
Maternal factors | |||
Caregiver depression (ref: none) | |||
With depression | −1.97 (0.75) ** | −2.15 (0.75) ** | −2.26 (0.74) ** |
Household-level factors | |||
Household size | −0.22 (0.18) | −0.28 (0.18) | |
Additional income (ref: No) | |||
Yes | −1.57 (0.77) * | −1.42 (0.77) | |
R2 | 0.086 | 0.122 | |
F-test | 2.39 |
Education Domain | Progress Item | Afraid Item | ||||
---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 1 | Model 2 | Model 1 | Model 2 | |
Child factors | ||||||
Overweight and obesity (ref: none) With overweight and obesity | 0.19 (0.03–0.76) * | 0.25 (0.06–0.84) * | 3.42 (1.05–15.51) | 3.37 (1.03–15.3) | 1.27 (0.62–2.63) | 1.31 (0.63–2.74) |
Child resilience | 0.89 (0.79–1.01) | 0.89 (0.79–0.99) * | 1.12 (1–1.26) * | 1.13 (1.01–1.27) * | 0.93 (0.86–1.01) | 0.92 (0.85–1) |
Household factors | ||||||
Employment (ref: some employment) Unemployed | 0.31 (0.11–0.89) * | 0.31 (0.11–0.79) * | 2.56 (0.97–6.9) | 2.54 (0.97–6.85) | 0.95 (0.48–1.91) | 0.93 (0.46–1.88) |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Nyati, L.H.; Patel, L.; Haffejee, S.; Sello, M.; Mbowa, S.; Sani, T.; Norris, S.A. Context Matters—Child Growth within a Constrained Socio-Economic Environment. Int. J. Environ. Res. Public Health 2022, 19, 11944. https://doi.org/10.3390/ijerph191911944
Nyati LH, Patel L, Haffejee S, Sello M, Mbowa S, Sani T, Norris SA. Context Matters—Child Growth within a Constrained Socio-Economic Environment. International Journal of Environmental Research and Public Health. 2022; 19(19):11944. https://doi.org/10.3390/ijerph191911944
Chicago/Turabian StyleNyati, Lukhanyo H., Leila Patel, Sadiyya Haffejee, Matshidiso Sello, Sonia Mbowa, Tania Sani, and Shane A. Norris. 2022. "Context Matters—Child Growth within a Constrained Socio-Economic Environment" International Journal of Environmental Research and Public Health 19, no. 19: 11944. https://doi.org/10.3390/ijerph191911944