Review Article | | Peer-Reviewed

Determinants of Child Undernutrition in Tanzania: Agriculture and Season Perspective: A Review

Received: 7 November 2023    Accepted: 8 December 2023    Published: 8 January 2024
Views:       Downloads:
Abstract

The causes of undernutrition are known to be complex and interrelated which need responses and solutions from different sectors to effectively design proper nutrition interventions. The UNICEF conceptual framework is a useful tool for understanding the causes of undernutrition and serves as a guide for assessing and analysing the causes, particularly among children in developing countries. Identifying determinants of child nutrition status is a necessary step in designing interventions, policies and programme that can support the scaling up of nutrition. This review scrutinizes undernutrition and its determinants based on the UNICEF conceptual framework on malnutrition. Poor feeding practices and characteristic of complementary foods were observed as immediate causes while household’s food insecurity, environmental factors such as agricultural practices and seasonal influences as underlying determinants particularly in rural households. The highlight from this review suggests that seasons had significant impact on both immediate and underlying determinants of undernutrition and therefore intervention to improve nutrition status should consider variation in agriculture seasons. Lastly, multicomponent interventions focusing on agricultural interventions and practices that are affecting immediate changes in nutrition status among infants and young children are emphasized. Future attempt to improve children nutrition status in rural households should be multicomponent addressing nutrition sensitives farming practices including rural livestock intensification, poverty alleviation and considering agricultural seasons in all planning.

Published in Journal of Food and Nutrition Sciences (Volume 12, Issue 1)
DOI 10.11648/j.jfns.20241201.11
Page(s) 1-19
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Undernutrition, Feeding Practices, Nutrition-Sensitive Agriculture, Food Security, Seasons

References
[1] Abeshu, M. A., Lelisa, A., & Geleta, B. (2016). Complementary Feeding: Review of Recommendations, Feeding Practices, and Adequacy of Homemade Complementary Food Preparations in Developing Countries–Lessons from Ethiopia. Frontiers in Nutrition, 3.
[2] Abubakar, A., Uriyo, J., Msuya, S. E., Swai, M., & Stray-Pedersen, B. (2012). Prevalence and risk factors for poor nutritional status among children in the Kilimanjaro region of Tanzania. International journal of environmental research and public health, 9(10), 3506-3518.
[3] Alexandre, M. A. A., Benzecry, S. G., Siqueira, A. M., Vitor-Silva, S., Melo, G. C., Monteiro, W. M.,... Alecrim, M. d. G. C. (2015). The association between nutritional status and malaria in children from a rural community in the Amazonian Region: a longitudinal study. PLoS Neglected Tropical Disease, 9(4), e0003743.
[4] Ali Naser, I., Jalil, R., Muda, W., Manan, W., Nik, W., Suriati, W.,... Abdullah, M. R. (2014). Association between household food insecurity and nutritional outcomes among children in Northeastern of Peninsular Malaysia. Nutrition research and practice, 8(3), 304-311.
[5] Ali, S., Zareba, F. E., Maruod, M. E., Elkhidir, E. E., & Mahmoud, T. E. (2016, 4 – 12 March). Climate Variability and Change: Implications for Household Food Security in North Kordofan State. Proceedings of the Summer-School Workshop, University of Western Kordofan; Sudan.
[6] Allen, L. H. (2012). Global dietary patterns and diets in childhood: implications for health outcomes. Annals of Nutrition and Metabolism, 61(Suppl. 1), 29-37.
[7] Altare, C., Delbiso, T. D., Mutwiri, G. M., Kopplow, R., & Guha-Sapir, D. (2016). Factors associated with stunting among pre-school children in southern highlands of Tanzania. Journal of Tropical Pediatrics, 62(5), 390-408.
[8] Ambikapathi, R., Schneider, K. R., Davis, B., Herrero, M., Winters, P., & Fanzo, J. C. (2022). Global food systems transitions have enabled affordable diets but had less favourable outcomes for nutrition, environmental health, inclusion and equity. Nature Food, 3(9), 764-779.
[9] Arimond, M., & Ruel, M. T. (2004). Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. The Journal of nutrition, 134(10), 2579-2585.
[10] Arimond, M., Wiesmann, D., Becquey, E., Carriquiry, A., Daniels, M., Deitchler, M.,... Kennedy, G. (2011). Dietary diversity as a measure of the micronutrient adequacy of women’s diets in resource-poor areas: summary of results from five sites. Washington, DC: FANTA-2 Bridge, FHI, 360, 2011.
[11] Azzarri, C., Zezza, A., Haile, B., & Cross, E. (2015). Does livestock ownership affect animal source foods consumption and child nutritional status? Evidence from rural Uganda. The Journal of Development Studies, 51(8), 1034-1059.
[12] Bailey, R. L., West, K. P., & Black, R. E. (2015). The Epidemiology of Global Micronutrient Deficiencies. Annals of Nutrition and Metabolism, 66, 22-33. https://doi.org/10.1159/000371618
[13] Bain, L. E., Awah, P. K., Geraldine, N., Kindong, N. P., Siga, Y., Bernard, N., & Tanjeko, A. T. (2013). Malnutrition in Sub–Saharan Africa: burden, causes and prospects. Pan African Medical Journal, 15(1).
[14] Bandoh, D. A., & Kenu, E. (2017). Dietary diversity and nutritional adequacy of under-fives in a fishing community in the central region of Ghana. BMC Nutrition, 3(1), 2.
[15] Barrett, B., Charles, J. W., & Temte, J. L. (2015). Climate change, human health, and epidemiological transition. Preventive medicine, 70, 69-75.
[16] Beilly, J. S., & Kurland, I. I. (1945). Relationship of maternal weight gain and weight of newborn infant. American Journal of Obstetrics and Gynecology, 50(2), 202-206.
[17] Betebo, B., Ejajo, T., Alemseged, F., & Massa, D. (2017). Household Food Insecurity and Its Association with Nutritional Status of Children 6–59 Months of Age in East Badawacho District, South Ethiopia. Journal of environmental and public health, 2017.
[18] Bhattacharya, S., Campbell, D. M., Liston, W. A., & Bhattacharya, S. (2007). Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC public health, 7(1), 168.
[19] Bhutta, Z. A., Ahmed, T., Black, R. E., Cousens, S., Dewey, K., Giugliani, E.,... Sachdev, H. (2008). What works? Interventions for maternal and child undernutrition and survival. The Lancet, 371(9610), 417-440.
[20] Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., Horton, S.,... Group, T. L. N. I. R. (2013). Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet, 382(9890), 452-477.
[21] Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., de Onis, M., Ezzati, M.,... Child Undernutr, S. (2008). Maternal and child undernutrition 1 - Maternal and child undernutrition: global and regional exposures and health consequences [Review]. Lancet, 371(9608), 243-260. https://doi.org/10.1016/s0140-6736(07)61690-0
[22] Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., De Onis, M., Ezzati, M.,... Group, C. U. S. (2008). Maternal and child undernutrition: global and regional exposures and health consequences. The Lancet, 371(9608), 243-260.
[23] Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., de Onis, M.,... Uauy, R. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries [Research Support, Non-U. S. Gov't
[24] Review. Lancet, 382(9890), 427-451. https://doi.org/10.1016/S0140-6736(13)60937-X
[25] Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., de Onis, M.,... Maternal Child Nutr Study, G. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet, 382(9890), 427-451. https://doi.org/10.1016/s0140-6736(13)60937-x
[26] Black, R. E., Victora, C. G., Walker, S. P., & Maternal Child Nutr Study, G. (2013). Maternal and Child Nutrition Study Group. Maternal and child undernutrition and overweight in low-income and middle-income countries (vol 382, pg 427, 2013). Lancet, 382(9890), 396-396. ://WOS:000322638500028
[27] Boo, F. L., Palloni, G., & Urzua, S. (2014). Cost–benefit analysis of a micronutrient supplementation and early childhood stimulation program in Nicaragua. Annals of the New York Academy of Sciences, 1308(1), 139-148.
[28] Bundara, N., Mwanri, L., & Masika, J. (2013). Addressing childhood under nutrition in Tanzania: Challenges and opportunities. African Journal of Food, Agriculture, Nutrition and Development, 13(1), 7288-7306.
[29] Carletto, G., Ruel, M., Winters, P., & Zezza, A. (2015). Farm-level pathways to improved nutritional status: introduction to the special issue. The Journal of Development Studies.
[30] Caulfield, L. E., de Onis, M., Blössner, M., & Black, R. E. (2004). Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. The American journal of clinical nutrition, 80(1), 193-198.
[31] Chegere, M. J., & Stage, J. (2020). Agricultural production diversity, dietary diversity and nutritional status: Panel data evidence from Tanzania. World Development, 129, 104856.
[32] Chikhungu, L. C., & Madise, N. J. (2014). Seasonal variation of child under nutrition in Malawi: is seasonal food availability an important factor? Findings from a national level cross-sectional study. Bmc Public Health, 14, Article 1146. https://doi.org/10.1186/1471-2458-14-1146
[33] Chirande, L., Charwe, D., Mbwana, H., Victor, R., Kimboka, S., Issaka, A. I., Agho, K. E. (2015). Determinants of stunting and severe stunting among under-fives in Tanzania: evidence from the 2010 cross-sectional household survey. BMC pediatrics, 15(1), 165.
[34] Chuwa, M., & Mgaya, B. B. (2013). FACTORS HINDERING BREASTFEEDING PRACTICES AMONG MOTHERS IN RURAL TANZANIA. African Journal of Midwifery & Women's Health, 7(2).
[35] Currie, J., & Ludwig, D. (2009). The Relationship Between Pregnancy Weight Gain and Birth Weight: A Within Family Comparison.
[36] Darapheak, C., Takano, T., Kizuki, M., Nakamura, K., & Seino, K. (2013). Consumption of animal source foods and dietary diversity reduce stunting in children in Cambodia. International archives of medicine, 6(1), 1.
[37] Dawkins, N., Shosho, N., Mamiro, P., & Pace, R. (2015). Food Insecurity and Maternal Education on Complementary Feeding Practices in a Rural Village in Tanzania. The FASEB Journal, 29(1 Supplement), 585.525.
[38] De Onis, M., & Branca, F. (2016). Childhood stunting: a global perspective. Maternal and Child Nutrition, 12(S1), 12-26.
[39] Dewey, K. G. (2013). The Challenge of Meeting Nutrient Needs of Infants and Young Children during the Period of Complementary Feeding: An Evolutionary Perspective [Article]. Journal of Nutrition, 143(12), 2050-2054. https://doi.org/10.3945/jn.113.182527
[40] Disha, A. D., Rawat, R., Subandoro, A., & Menon, P. (2012). Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data. African Journal of Food, Agriculture, Nutrition and Development, 12(2), 5895-5914.
[41] Duncan, E., Ashton, L., Abdulai, A., Sawadogo-Lewis, T., King, S., Fraser, E.,... Roberton, T. (2022). Connecting the food and agriculture sector to nutrition interventions for improved health outcomes. Food Security, 14(3), 657-675.
[42] Exavery, A., Kanté, A. M., Hingora, A., & Phillips, J. F. (2015). Determinants of early initiation of breastfeeding in rural Tanzania. International breastfeeding journal, 10(1), 27.
[43] Faber, M., Laubscher, R., & Berti, C. (2014). Poor dietary diversity and low nutrient density of the complementary diet for 6-to 24-month-old children in urban and rural KwaZulu-Natal, South Africa. Maternal & child nutrition.
[44] FAO. (2000). The State of Food Insecurity in the World 2000: When people live with hunger and fear starvation. FAO.
[45] FAO. (2009, 16 -18 November). Declaration of the World Summit on Food Security. World Summit on Food Security Rome.
[46] FAO. (2012). International Scientific Symposium on Food and Nutrition Security information: from Valid Measurement to Effective Decision Making.
[47] FAO. (2016). THE STATE OF FOOD AND AGRICULTURE: CLIMATE CHANGE, AGRICULTURE AND FOOD SECURITY.
[48] FAO. (2022). The state of food security and nutrition in the world 2022. Repurposing food and agricultural policies to make healthy diets more affordable.
[49] Fawzi, W. W., Herrera, M. G., Nestel, P., Amin, A. E., & Mohamed, K. A. (1998). A longitudinal study of prolonged breastfeeding in relation to child undernutrition. International journal of epidemiology, 27(2), 255-260.
[50] Ferro-Luzzi, A., Morris, S. S., Taffesse, S., Demissie, T., & D Amato, M. (2002). Seasonal undernutrition in rural Ethiopia: Magnitude, correlates, and functional significance. FOOD AND NUTRITION BULLETIN-UNITED NATIONS UNIVERSITY-, 23(2), 227-228.
[51] Frankenberger, T., Oshaug, A., & Smith, L. (1997). A definition of nutrition security CARE memo. CARE, Atlanta, GA.
[52] Galani, Y., Orfila, C., & Gong, Y. (2022). A review of micronutrient deficiencies and analysis of maize contribution to nutrient requirements of women and children in Eastern and Southern Africa. Critical Reviews in Food Science and Nutrition, 62(6), 1568-1591.
[53] Gewa, C. A., Oguttu, M., & Yandell, N. S. (2012). Maternal nutrition in rural Kenya: health and socio-demographic determinants and its association with child nutrition. Maternal and Child Nutrition, 8(3), 275-286. https://doi.org/10.1111/j.1740-8709.2011.00322.x
[54] Ghosh, S., & Shah, D. (2004). Nutritional problems in urban slum children. Indian pediatrics, 41(7), 682-696.
[55] Gillespie, S., & van den Bold, M. (2017). Agriculture, Food Systems, and Nutrition: Meeting the Challenge. Global Challenges.
[56] Gol, R. M., Kheirouri, S., & Alizadeh, M. (2022). Association of dietary diversity with growth outcomes in infants and children aged under 5 years: a systematic review. Journal of Nutrition Education and Behavior, 54(1), 65-83.
[57] Gomes, G. P., & Gubert, M. B. (2012). Breastfeeding in children under 2 years old and household food and nutrition security status [Article]. Jornal De Pediatria, 88(3), 279-282. https://doi.org/10.2223/jped.2173
[58] Gould, J. F. (2017). Complementary Feeding, Micronutrients and Developmental Outcomes of Children. In Complementary Feeding: Building the Foundations for a Healthy Life (Vol. 87, pp. 13-28). Karger Publishers.
[59] Haddad, L. (2013). From Nutrition Plus to Nutrition Driven: How to realize the elusive potential of agriculture for nutrition? Food and Nutrition Bulletin, 34(1), 39-44.
[60] Hammond, R. A., & Dubé, L. (2012). A systems science perspective and transdisciplinary models for food and nutrition security. Proceedings of the National Academy of Sciences, 109(31), 12356-12363.
[61] Han, X., Ding, S., Lu, J., & Li, Y. (2022). Global, regional, and national burdens of common micronutrient deficiencies from 1990 to 2019: A secondary trend analysis based on the Global Burden of Disease 2019 study. EClinicalMedicine, 44.
[62] Hasan, M. M., Kader, A., Asif, C. A. A., & Talukder, A. (2023). Seasonal variation in the association between household food insecurity and child undernutrition in Bangladesh: Mediating role of child dietary diversity. Maternal & child nutrition, 19(2), e13465.
[63] Hashim, T. H., Mgongo, M., Katanga, J., Uriyo, J. G., Damian, D. J., Stray-Pedersen, B., Msuya, S. E. (2017). Predictors of appropriate breastfeeding knowledge among pregnant women in Moshi Urban, Tanzania: a cross-sectional study. International breastfeeding journal, 12(1), 11.
[64] Heidkamp, R., Ayoya, M. A., Teta, I. N., Stoltzfus, R. J., & Marhone, J. P. (2015). Breastfeeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys. Maternal & child nutrition, 11(4), 737-748.
[65] Heidkamp, R. A., Ayoya, M. A., Teta, I. N., Stoltzfus, R. J., & Marhone, J. P. (2015). Complementary feeding practices and child growth outcomes in Haiti: an analysis of data from Demographic and Health Surveys. Maternal & child nutrition, 11(4), 815-828.
[66] Hetherington, J. B., Wiethoelter, A. K., Negin, J., & Mor, S. M. (2017). Livestock ownership, animal source foods and child nutritional outcomes in seven rural village clusters in Sub-Saharan Africa. Agriculture & Food Security, 6, 1-11.
[67] Hillbruner, C., & Egan, R. (2008). Seasonality, household food security, and nutritional status in Dinajpur, Bangladesh. Food and Nutrition Bulletin, 29(3), 221-231.
[68] Hirvonen, K., Taffesse, A. S., & Hassen, I. W. (2016). Seasonality and household diets in Ethiopia. Public Health Nutrition, 19(10), 1723-1730.
[69] Hoddinott, J., Headey, D., & Dereje, M. (2015). Cows, missing milk markets, and nutrition in rural Ethiopia. The Journal of Development Studies, 51(8), 958-975.
[70] Hotz, C., Loechl, C., de Brauw, A., Eozenou, P., Gilligan, D., Moursi, M.,... Meenakshi, J. V. (2012). A large-scale intervention to introduce orange sweet potato in rural Mozambique increases vitamin A intakes among children and women. British Journal of Nutrition, 108(1), 163-176.
[71] Hotz, C., Loechl, C., Lubowa, A., Tumwine, J. K., Ndeezi, G., Masawi, A. N.,... Meenakshi, J. V. (2012). Introduction of β-carotene–rich orange sweet potato in rural Uganda resulted in increased vitamin A intakes among children and women and improved vitamin A status among children. The Journal of nutrition, 142(10), 1871-1880.
[72] Huybregts, L., Houngbé, F., Salpéteur, C., Brown, R., Roberfroid, D., Ait-Aissa, M., & Kolsteren, P. (2012). The effect of adding ready-to-use supplementary food to a general food distribution on child nutritional status and morbidity: a cluster-randomized controlled trial. PLoS medicine, 9(9), e1001313.
[73] IFPRI. (2016). Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030.
[74] Jana, S., Frieder, G., Srijna, J., & Stefan, S. (2014). Food Security Impact Assessment in Tanzania.
[75] Jones, A. D., Shrinivas, A., & Bezner-Kerr, R. (2014). Farm production diversity is associated with greater household dietary diversity in Malawi: findings from nationally representative data. Food Policy, 46, 1-12.
[76] Kazaura, M. (2016). Exclusive breastfeeding practices in the Coast Region, Tanzania. African health sciences, 16(1), 44.
[77] Keats, E. C., Das, J. K., Salam, R. A., Lassi, Z. S., Imdad, A., Black, R. E., & Bhutta, Z. A. (2021). Effective interventions to address maternal and child malnutrition: an update of the evidence. The Lancet Child & Adolescent Health, 5(5), 367-384.
[78] Kemoe, L., Lanci, L., Mitra, P., Muehlschlegel, T., Okou, C., Spray, J.,... Unsal, F. (2022). Climate Change and Chronic Food Insecurity in Sub-Saharan Africa.
[79] Kimani-Murage, E. W., Wekesah, F., Wanjohi, M., Kyobutungi, C., Ezeh, A. C., Musoke, R. N.,... Griffiths, P. (2015). Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya [Article]. Maternal and Child Nutrition, 11(3), 314-332. https://doi.org/10.1111/mcn.12161
[80] Kinabo, J. L., Mwanri, A. W., Mamiro, P. S., Kulwa, K., Bundala, N. H., Picado, J.,... Mzimbiri, R. (2017). Infant and young child feeding practices on Unguja Island in Zanzibar, Tanzania: a ProPAN based analysis. Tanzania Journal of Health Research, 19(3).
[81] Kubuga, C., Lee, K., Song, S., & Song, W. O. (2016). The association between dietary diversity score and iron deficiency anemia among reproductive-aged women in Ghana. The FASEB Journal, 30(1 Supplement), 899.811-899.811.
[82] Kulwa, K. B., Kinabo, J. L., & Modest, B. (2006). Constraints on good child-care practices and nutritional status in urban Dar-es-Salaam, Tanzania. Food and Nutrition Bulletin, 27(3), 236-244.
[83] Kulwa, K. B., Mamiro, P. S., Kimanya, M. E., Mziray, R., & Kolsteren, P. W. (2015). Feeding practices and nutrient content of complementary meals in rural central Tanzania: implications for dietary adequacy and nutritional status. BMC pediatrics, 15(1), 1.
[84] Kumar, N., Harris, J., & Rawat, R. (2015). If they grow it, will they eat and grow? Evidence from Zambia on agricultural diversity and child undernutrition. The journal of development studies, 51(8), 1060-1077.
[85] Lamichhane, D. K., Leem, J. H., Kim, H. C., Park, M. S., Lee, J. Y., Moon, S. H., & Ko, J. K. (2016). Association of infant and young child feeding practices with under-nutrition: evidence from the Nepal Demographic and Health Survey. Paediatrics and International Child Health, 36(4), 260-269.
[86] Lartey, A. (2015). End hunger, achieve food security and improved nutrition and promote sustainable agriculture. UN Chronicle, 51(4), 6-8.
[87] Lumbanraja, S., Lutan, D., & Usman, I. (2013). Maternal weight gain and correlation with birth weight infants. Procedia-Social and Behavioral Sciences, 103, 647-656.
[88] M'Kaibi, F. K., Steyn, N. P., Ochola, S. A., & Du Plessis, L. (2017). The relationship between agricultural biodiversity, dietary diversity, household food security, and stunting of children in rural Kenya. Food science & nutrition, 5(2), 243-254.
[89] Mahmudiono, T., Sumarmi, S., & Rosenkranz, R. R. (2013). Household dietary diversity and child stunting in East Java, Indonesia. Asia Pacific Journal of Clinical Nutrition.
[90] Maonga, A. R., Mahande, M. J., Damian, J., & Msuya, S. E. (2016). Factors Affecting Exclusive Breastfeeding among Women in Muheza District Tanga Northeastern Tanzania: A Mixed Method Community Based Study [Article]. Maternal and Child Health Journal, 20(1), 77-87. https://doi.org/10.1007/s10995-015-1805-z
[91] Marques, A. H., O'Connor, T. G., Roth, C., Susser, E., & Bjørke-Monsen, A.-L. (2013). The influence of maternal prenatal and early childhood nutrition and maternal prenatal stress on offspring immune system development and neurodevelopmental disorders. Frontiers in neuroscience, 7.
[92] Marriott, B. P., White, A., Hadden, L., Davies, J. C., & Wallingford, J. C. (2012). World Health Organization (WHO) infant and young child feeding indicators: associations with growth measures in 14 low-income countries [Article]. Maternal and Child Nutrition, 8(3), 354-370. https://doi.org/10.1111/j.1740-8709.2011.00380.x
[93] Marriott, B. P., White, A. J., Hadden, L., Davies, J. C., & Wallingford, J. C. (2010). How well are infant and young child World Health Organization (WHO) feeding indicators associated with growth outcomes? An example from Cambodia. Maternal & child nutrition, 6(4), 358-373.
[94] Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E.,... Oken, E. (2022). The importance of nutrition in pregnancy and lactation: lifelong consequences. American journal of obstetrics and gynecology, 226(5), 607-632.
[95] Martin, R. M. (2001). Commentary: does breastfeeding for longer cause children to be shorter? International journal of epidemiology, 30(3), 481-484.
[96] Mason, J. B., Saldanha, L. S., Ramakrishnan, U., Lowe, A., Noznesky, E. A., Girard, A. W.,... Martorell, R. (2012). Opportunities for improving maternal nutrition and birth outcomes: synthesis of country experiences. Food and Nutrition Bulletin, 33(2_suppl1), S104-S137.
[97] Massawe, G. D. (2017). Farming systems and household food security in Tanzania: the case of Mvomero and Kishapu districts. University College Dublin (Ireland).
[98] Masset, E., Haddad, L., Cornelius, A., & Isaza-Castro, J. (2012). Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review. BMj, 344, d8222.
[99] Masuke, R., Msuya, S. E., Mahande, J. M., Diarz, E. J., Stray-Pedersen, B., Jahanpour, O., & Mgongo, M. (2021). Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: Cohort study. PloS one, 16(5), e0250562.
[100] Mavalankar, D. V., Gray, R. H., & Trivedi, C. (1992). Risk factors for preterm and term low birthweight in Ahmedabad, India. International journal of epidemiology, 21(2), 263-272.
[101] Mayorga-Martínez, A. A., Kucha, C., Kwofie, E., & Ngadi, M. (2023). Designing nutrition-sensitive agriculture (NSA) interventions with multi-criteria decision analysis (MCDA): a review. Critical Reviews in Food Science and Nutrition, 1-20.
[102] McLean, E., Cogswell, M., Egli, I., Wojdyla, D., & De Benoist, B. (2009). Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutrition, 12(04), 444-454.
[103] Meeker, J., & Haddad, L. (2013). A state-of-the-art review of agriculture-nutrition linkages.
[104] Menon, P., Bamezai, A., Subandoro, A., Ayoya, M. A., & Aguayo, V. (2015). Age‐appropriate infant and young child feeding practices are associated with child nutrition in India: insights from nationally representative data. Maternal & child nutrition, 11(1), 73-87.
[105] Metgud, C., Naik, V., & Mallapur, M. (2012). Effect of maternal nutrition on birth weight of newborn-a community-based study. Journal of Family Welfare, 58(2), 35-39.
[106] Mgongo, M., Chotta, N. A., Hashim, T. H., Uriyo, J. G., Damian, D. J., Stray-Pedersen, B.... Vangen, S. (2017). Underweight, Stunting and Wasting among Children in Kilimanjaro Region, Tanzania; a Population-Based Cross-Sectional Study. International journal of environmental research and public health, 14(5), 509.
[107] Mora, J. O., & Nestel, P. S. (2000). Improving prenatal nutrition in developing countries: strategies, prospects, and challenges. The American journal of clinical nutrition, 71(5), 1353s-1363s.
[108] Mrema, J. D., Elisaria, E., Mwanri, A. W., & Nyaruhucha, C. M. (2021). Prevalence and determinants of undernutrition among 6-to 59-months-old children in lowland and highland areas in Kilosa District, Tanzania: a cross-sectional study. Journal of nutrition and metabolism, 2021.
[109] Muhimbula, H. S., & Issa-Zacharia, A. (2010). Persistent child malnutrition in Tanzania: Risks associated with traditional complementary foods (A review). African Journal of Food Science, 4(11), 679-692.
[110] Mulu, E., & Mengistie, B. (2017). Household food insecurity and its association with nutritional status of under five children in Sekela District, Western Ethiopia: a comparative cross-sectional study. BMC Nutrition, 3(1), 35.
[111] Munisi, D. Z., Buza, J., Mpolya, E. A., & Kinung’hi, S. M. (2016). Schistosoma mansoni Infections, Undernutrition and Anaemia among Primary Schoolchildren in Two Onshore Villages in Rorya District, North-Western Tanzania. Plos One, 11(12), e0167122.
[112] Musumba, M., Palm, C. A., Komarek, A. M., Mutuo, P. K., & Kaya, B. (2022). Household livelihood diversification in rural Africa. Agricultural economics, 53(2), 246-256.
[113] Mutisya, M., Kandala, N.-b., Ngware, M. W., & Kabiru, C. W. (2015). Household food (in) security and nutritional status of urban poor children aged 6 to 23 months in Kenya. BMC public health, 15(1), 1052.
[114] NBS and ICF Macro. (2015-16). Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16.
[115] Netting, M. J., & Makrides, M. (2017). Complementary Foods: Guidelines and Practices. In Complementary Feeding: Building the Foundations for a Healthy Life (Vol. 87, pp. 1-12). Karger Publishers.
[116] Nisbett, N., Gillespie, S., Haddad, L., & Harris, J. (2014). Why worry about the politics of childhood undernutrition? World Development, 64, 420-433.
[117] Nkonde, C., Audain, K., Kiwanuka‐Lubinda, R. N., & Marinda, P. (2021). Effect of agricultural diversification on dietary diversity in rural households with children under 5 years of age in Zambia. Food Science & Nutrition, 9(11), 6274-6285.
[118] Nordang, S., Shoo, T., Holmboe-Ottesen, G., Kinabo, J., & Wandel, M. (2015). Women's work in farming, child feeding practices and nutritional status among under-five children in rural Rukwa, Tanzania. British Journal of Nutrition, 114(10), 1594-1603. https://doi.org/10.1017/s0007114515003116
[119] Nti, C. A., & Lartey, A. (2008). Influence of care practices on nutritional status of Ghanaian children. Nutrition research and practice, 2(2), 93-99.
[120] Olney, D. K., Pedehombga, A., Ruel, M. T., & Dillon, A. (2015). A 2-year integrated agriculture and nutrition and health behavior change communication program targeted to women in Burkina Faso reduces anemia, wasting, and diarrhea in children 3–12.9 months of age at baseline: a cluster-randomized controlled trial. The Journal of nutrition, 145(6), 1317-1324.
[121] Osei, A., Pandey, P., Spiro, D., Nielson, J., Shrestha, R., Talukder, Z., Haselow, N. (2010). Household food insecurity and nutritional status of children aged 6 to 23 months in Kailali District of Nepal. Food and Nutrition Bulletin, 31(4), 483-494.
[122] Pobee, R., Akonor, P., & Bonsi, E. (2017). Orange-fleshed sweet potato based complementary food provides sufficient vitamin A for infants aged 6-12 months.
[123] Psaki, S., Bhutta, Z. A., Ahmed, T., Ahmed, S., Bessong, P., Islam, M.,... Nesamvuni, C. (2012). Household food access and child malnutrition: results from the eight-country MAL-ED study. Population health metrics, 10(1), 24.
[124] Rah, J., Akhter, N., Semba, R., De Pee, S., Bloem, M., Campbell, A.,... Kraemer, K. (2010). Low dietary diversity is a predictor of child stunting in rural Bangladesh. European Journal of Clinical Nutrition, 64(12), 1393-1398.
[125] Ramakrishnan, U., Young, M. F., & Martorell, R. (2017). Maternal Nutrition and Birth Outcomes. In Nutrition and Health in a Developing World (pp. 487-502). Springer.
[126] Ringler, C., Zhu, T., Cai, X., Koo, J., & Wang, D. (2010). Climate change impacts on food security in sub-Saharan Africa. Insights from Comprehensive Climate Change Scenarios.
[127] Risnes, K. R., Vatten, L. J., Baker, J. L., Jameson, K., Sovio, U., Kajantie, E.,... Painter, R. C. (2011). Birthweight and mortality in adulthood: a systematic review and meta-analysis. International journal of epidemiology, 40(3), 647-661.
[128] Ritchie, H., & Roser, M. (2017). Micronutrient deficiency. Our World in data.
[129] Roba, K. T., O’Connor, T. P., Belachew, T., & O’Brien, N. M. (2016). Variations between post-and pre-harvest seasons in stunting, wasting, and Infant and Young Child Feeding (IYCF) practices among children 6-23 months of age in lowland and midland agro-ecological zones of rural Ethiopia. The Pan African medical journal, 24.
[130] Ruel, M. T. (2002). Is dietary diversity an indicator of food security or dietary quality?
[131] Ruel, M. T., Alderman, H., Maternal, & Group, C. N. S. (2013). Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet, 382(9891), 536-551.
[132] Ruel, M. T., Quisumbing, A. R., & Balagamwala, M. (2018). Nutrition-sensitive agriculture: what have we learned so far? Global food security, 17, 128-153.
[133] Saaka, M., & Osman, S. M. (2013). Does household food insecurity affect the nutritional status of preschool children aged 6–36 Months? International Journal of Population Research, 2013.
[134] Saaka, M., & Rauf, A. A. (2015). Role of dietary diversity in ensuring adequate haematological status during pregnancy. International Journal of Medical Research & Health Sciences, 4(4), 749-755.
[135] Saaka, M., Wemakor, A., Abizari, A.-R., & Aryee, P. (2015). How well do WHO complementary feeding indicators relate to nutritional status of children aged 6–23 months in rural Northern Ghana? BMC public health, 15(1), 1.
[136] Saha, K. K., Frongillo, E. A., Alam, D. S., Arifeen, S. E., Persson, L. Å., & Rasmussen, K. M. (2009). Household food security is associated with growth of infants and young children in rural Bangladesh. Public Health Nutrition, 12(09), 1556-1562.
[137] Santos, L. P. d., & Gigante, D. P. (2013). Relationship between food insecurity and nutritional status of Brazilian children under the age of five. Revista Brasileira de Epidemiologia, 16(4), 984-994.
[138] Scaling Up Nutrition. (2012). UNITED NATIONS SYSTEMS. STANDING COMMITTEE ON NUTRITION. 2012. ‘Scaling up Nutrition Strategy 2012-2015’
[139] Scrimshaw, N. S. (2010). INCAP studies of nutrition and infection. Food and Nutrition Bulletin, 31(1), 54-67.
[140] Semali, I. A., Tengia-Kessy, A., Mmbaga, E. J., & Leyna, G. (2015). Prevalence and determinants of stunting in under-five children in central Tanzania: remaining threats to achieving Millennium Development Goal 4. BMC public health, 15(1), 1153.
[141] Sheffield, P. E., & Landrigan, P. J. (2011). Global climate change and children’s health: threats and strategies for prevention. Environmental health perspectives, 119(3), 291.
[142] Shetty, P. (2015). From food security to food and nutrition security: role of agriculture and farming systems for nutrition. Current Science, 109, 456-461.
[143] Shirima, C. P., Kimanya, M. E., Routledge, M. N., Srey, C., Kinabo, J. L., Humpf, H.-U.,... Gong, Y. Y. (2015). A prospective study of growth and biomarkers of exposure to aflatoxin and fumonisin during early childhood in Tanzania. Environmental health perspectives, 123(2), 173.
[144] Shrimpton, R., Victora, C. G., de Onis, M., Lima, R. C., Blössner, M., & Clugston, G. (2001). Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics, 107(5), e75-e75.
[145] Singh, A., Singh, A., & Ram, F. (2014). Household food insecurity and nutritional status of children and women in Nepal. Food and Nutrition Bulletin, 35(1), 3-11.
[146] Slavchevska, V. (2015). Agricultural production and the nutritional status of family members in Tanzania. The Journal of Development Studies, 51(8), 1016-1033.
[147] Smith, L. C., & Haddad, L. (2015). Reducing child undernutrition: past drivers and priorities for the post-MDG era. World Development, 68, 180-204.
[148] Stevens, G. A., Beal, T., Mbuya, M. N., Luo, H., Neufeld, L. M., Addo, O. Y., Brown, K. H. (2022). Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from population-representative surveys. The Lancet Global Health, 10(11), e1590-e1599.
[149] Stevens, G. A., Finucane, M. M., De-Regil, L. M., Paciorek, C. J., Flaxman, S. R., Branca, F., Nutr Impact Model Study, G. (2013). Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: a systematic analysis of population-representative data [Article]. Lancet Global Health, 1(1), E16-E25. ://WOS:000336422200009
[150] Stewart, C. P., Iannotti, L., Dewey, K. G., Michaelsen, K. F., & Onyango, A. W. (2013). Contextualising complementary feeding in a broader framework for stunting prevention [Article]. Maternal and Child Nutrition, 9, 27-45. https://doi.org/10.1111/mcn.12088
[151] Suseela, R., Behrman, J. A., Menon, P., & Quisumbing, A. R. (2012). Gender: A Key Dimension Linking Agricultural Programs to Improved Nutrition and Health.
[152] Swaminathan, M. (2014). Zero hunger. Science, 345(6196), 491-491.
[153] Tabrizi, F. M., & Barjasteh, S. (2015). Maternal hemoglobin levels during pregnancy and their association with birth weight of neonates. Iranian journal of pediatric hematology and oncology, 5(4), 211.
[154] Tafese, Z., & Kebebu, A. (2017). A systematic review of maternal feeding practice and its outcome in developing countries.
[155] Terefe, B., Birhanu, A., Nigussie, P., & Tsegaye, A. (2015). Effect of maternal iron deficiency anemia on the iron store of newborns in Ethiopia. Anemia, 2015.
[156] Ubeysekara, N. H., Jayathissa, R., & Wijesinghe, C. J. (2015). Nutritional status and associated feeding practices among children aged 6-24 months in a selected community in Sri Lanka: a cross sectional study. Eur J Prev Med, 3(2-1), 15-23.
[157] Udoh, E. E., & Amodu, O. K. (2016). Complementary feeding practices among mothers and nutritional status of infants in Akpabuyo Area, Cross River State Nigeria. SpringerPlus, 5(1), 2073.
[158] UNICEF. (1998). The state of the world's children 1998: Focus on nutrition. Oxford University Press.
[159] UNICEF. (2013). Improving child nutrition: the achievable imperative for global progress,.
[160] UNICEF. (2015a). The State of the World’s Children 2015: Reimagine the Future: Innovation for Every Child.
[161] UNICEF. (2015b). UNICEF’s approach to scaling up nutrition for mothers and their children. Discussion paper (Programme Division, Issue.
[162] UNICEF. (2016). FROM THE FIRST HOUR OF LIFE: Making the case for improved infant and young child feeding everywhere. UNICEF.
[163] UNICEF, W. a. (2003). The global strategy on infant and young child nutrition (IYCN) W. H. Organization.
[164] UNICEF, W. W. B. (2023). Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates: key findings of the 2023 edition. In Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates: key findings of the 2023 edition. UNICEF, New York; WHO, Geneva; World Bank, Washington,. https://www.who.int/publications/i/item/9789240073791
[165] Victor, R., Baines, S. K., Agho, K. E., & Dibley, M. J. (2014). Factors associated with inappropriate complementary feeding practices among children aged 6-23 months in Tanzania. Maternal and Child Nutrition, 10(4), 545-561. https://doi.org/10.1111/j.1740-8709.2012.00435.x
[166] Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J.,... Rollins, N. C. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.
[167] Victora, C. G., Bahl, R., Barros, A. J. D., Franca, G. V. A., Horton, S., Krasevec, J.,... Lancet Breastfeeding Series, G. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect [Article]. Lancet, 387(10017), 475-490. ://WOS:000368986800036
[168] Victora, C. G., Christian, P., Vidaletti, L. P., Gatica-Domínguez, G., Menon, P., & Black, R. E. (2021). Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. The Lancet, 397(10282), 1388-1399.
[169] Victora, C. G., de Onis, M., Hallal, P. C., Blössner, M., & Shrimpton, R. (2010). Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics, peds. 2009-1519.
[170] Von Grebmer, K., Bernstein, J., Resnick, D., Wiemers, M., Reiner, L., Bachmeier, M.,... Foley, C. (2022). Global hunger index: Food systems transformation and local governance. Welt Hunger Hilfe CONCERNWorldwide: Bonn/Dublin, Ireland.
[171] Wagah, M., Hodge, J., & Lewis, A. (2015). Leveraging Agriculture for Nutrition in East Africa (LANEA). In.
[172] Webb‐Girard, A., Cherobon, A., Mbugua, S., Kamau‐Mbuthia, E., Amin, A., & Sellen, D. W. (2012). Food insecurity is associated with attitudes towards exclusive breastfeeding among women in urban Kenya. Maternal & child nutrition, 8(2), 199-214.
[173] Weingärtner, L. (2009). The concept of food and nutrition security. Achieving food and nutrition security, 3, 21-52.
[174] Wenban-Smith, H. (2014). Rural-Urban Linkages: Tanzania Case Study.
[175] WHO. (1995). Physical status: The use of and interpretation of anthropometry, Report of a WHO Expert Committee (WHO technical report series no 854, Issue.
[176] WHO. (2008). Indicators for assessing infant and young child feeding practices, part 1: definitions; conclusions of a consensus meeting held 6-8 November 2007.
[177] WHO. (2010). Indicators for Assessing Infant and Young Child Feeding Practices. Part II: Measurement.
[178] WHO. (2021). Indicators for assessing infant and young child feeding practices: definitions and measurement methods.
[179] Wijesinha-Bettoni, R., Kennedy, G., Dirorimwe, C., & Muehlhoff, E. (2013). Considering seasonal variations in food availability and caring capacity when planning complementary feeding interventions in developing countries. International Journal of Child Health and Nutrition, 2(4), 335-352.
[180] Wordofa, M. G., & Sassi, M. (2020). Impact of agricultural interventions on food and nutrition security in Ethiopia: uncovering pathways linking agriculture to improved nutrition. Cogent food & agriculture, 6(1), 1724386.
[181] Woodhill, J., Kishore, A., Njuki, J., Jones, K., & Hasnain, S. (2022). Food systems and rural wellbeing: challenges and opportunities. Food Security, 14(5), 1099-1121.
[182] Young, S. L., Plenty, A. H., Luwedde, F. A., Natamba, B. K., Natureeba, P., Achan, J., Osterbauer, B. (2014). Household food insecurity, maternal nutritional status, and infant feeding practices among HIV-infected Ugandan women receiving combination antiretroviral therapy. Maternal and Child Health Journal, 18(9), 2044-2053.
[183] Zongrone, A., Winskell, K., & Menon, P. (2012). Infant and young child feeding practices and child undernutrition in Bangladesh: insights from nationally representative data. Public Health Nutrition, 15(9), 1697-1704.
Cite This Article
  • APA Style

    Muhimbula, H. S. (2024). Determinants of Child Undernutrition in Tanzania: Agriculture and Season Perspective: A Review. Journal of Food and Nutrition Sciences, 12(1), 1-19. https://doi.org/10.11648/j.jfns.20241201.11

    Copy | Download

    ACS Style

    Muhimbula, H. S. Determinants of Child Undernutrition in Tanzania: Agriculture and Season Perspective: A Review. J. Food Nutr. Sci. 2024, 12(1), 1-19. doi: 10.11648/j.jfns.20241201.11

    Copy | Download

    AMA Style

    Muhimbula HS. Determinants of Child Undernutrition in Tanzania: Agriculture and Season Perspective: A Review. J Food Nutr Sci. 2024;12(1):1-19. doi: 10.11648/j.jfns.20241201.11

    Copy | Download

  • @article{10.11648/j.jfns.20241201.11,
      author = {Happiness Samuel Muhimbula},
      title = {Determinants of Child Undernutrition in Tanzania: Agriculture and Season Perspective: A Review},
      journal = {Journal of Food and Nutrition Sciences},
      volume = {12},
      number = {1},
      pages = {1-19},
      doi = {10.11648/j.jfns.20241201.11},
      url = {https://doi.org/10.11648/j.jfns.20241201.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jfns.20241201.11},
      abstract = {The causes of undernutrition are known to be complex and interrelated which need responses and solutions from different sectors to effectively design proper nutrition interventions. The UNICEF conceptual framework is a useful tool for understanding the causes of undernutrition and serves as a guide for assessing and analysing the causes, particularly among children in developing countries. Identifying determinants of child nutrition status is a necessary step in designing interventions, policies and programme that can support the scaling up of nutrition. This review scrutinizes undernutrition and its determinants based on the UNICEF conceptual framework on malnutrition. Poor feeding practices and characteristic of complementary foods were observed as immediate causes while household’s food insecurity, environmental factors such as agricultural practices and seasonal influences as underlying determinants particularly in rural households. The highlight from this review suggests that seasons had significant impact on both immediate and underlying determinants of undernutrition and therefore intervention to improve nutrition status should consider variation in agriculture seasons. Lastly, multicomponent interventions focusing on agricultural interventions and practices that are affecting immediate changes in nutrition status among infants and young children are emphasized. Future attempt to improve children nutrition status in rural households should be multicomponent addressing nutrition sensitives farming practices including rural livestock intensification, poverty alleviation and considering agricultural seasons in all planning.
    },
     year = {2024}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Determinants of Child Undernutrition in Tanzania: Agriculture and Season Perspective: A Review
    AU  - Happiness Samuel Muhimbula
    Y1  - 2024/01/08
    PY  - 2024
    N1  - https://doi.org/10.11648/j.jfns.20241201.11
    DO  - 10.11648/j.jfns.20241201.11
    T2  - Journal of Food and Nutrition Sciences
    JF  - Journal of Food and Nutrition Sciences
    JO  - Journal of Food and Nutrition Sciences
    SP  - 1
    EP  - 19
    PB  - Science Publishing Group
    SN  - 2330-7293
    UR  - https://doi.org/10.11648/j.jfns.20241201.11
    AB  - The causes of undernutrition are known to be complex and interrelated which need responses and solutions from different sectors to effectively design proper nutrition interventions. The UNICEF conceptual framework is a useful tool for understanding the causes of undernutrition and serves as a guide for assessing and analysing the causes, particularly among children in developing countries. Identifying determinants of child nutrition status is a necessary step in designing interventions, policies and programme that can support the scaling up of nutrition. This review scrutinizes undernutrition and its determinants based on the UNICEF conceptual framework on malnutrition. Poor feeding practices and characteristic of complementary foods were observed as immediate causes while household’s food insecurity, environmental factors such as agricultural practices and seasonal influences as underlying determinants particularly in rural households. The highlight from this review suggests that seasons had significant impact on both immediate and underlying determinants of undernutrition and therefore intervention to improve nutrition status should consider variation in agriculture seasons. Lastly, multicomponent interventions focusing on agricultural interventions and practices that are affecting immediate changes in nutrition status among infants and young children are emphasized. Future attempt to improve children nutrition status in rural households should be multicomponent addressing nutrition sensitives farming practices including rural livestock intensification, poverty alleviation and considering agricultural seasons in all planning.
    
    VL  - 12
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Human Nutrition and Consumer Sciences, College of Agriculture, Sokoine University of Agriculture, Morogoro, Tanzania

  • Sections