Nadia Akseer|Zaid Bhatti|Taufiq Mashal|Sajid Soofi|Rahim Moineddin|Robert E. Black|Zulfiqar A. Bhutta
Geospatial inequalities and determinants of nutritional status among women and children in Afghanistan: an observational study
Public Health Ontario|University of Toronto|Hospital for Sick Children|Aga Khan University|Ministry of Public Health|Aga Khan University|University of Toronto|Johns Hopkins University|Hospital for Sick Children|Public Health Ontario|University of Toronto|Johns Hopkins University|Aga Khan University
undernutrition pervasive condition afghanistan prevalence among highest world aimed comprehensively assess districtlevel geographical disparities determinants nutritional status stunting wasting underweight among women children afghanistanthe study used individualised data recent afghanistan national nutrition survey 2013 outcome variables based growth weight anthropometry data analysed linearly z scores dichotomous categories analysed data total almost 14 000 index motherchild pairs using bayesian spatial generalised least squares regression models accounting complex survey designwe noted childhood stunting underweight combined stunting wasting consistently highest districts farah nangarhar nuristan kunar paktia badakhshan provinces district prevalence ranged 4 84 childhood stunting 5 66 underweight child wasting exceeded 20 central highconflict regions bordered pakistan including east southeast south among mothers dual burden underweight overweight obesity existed districts north northeast central central highlands prevalence 1520 linear growth weight children independently associated household wealth maternal literacy maternal anthropometry child age food security geography improved hygiene sanitation conditions mothers bodymass index determined many factors addition ethnolinguistic status parity younger mothers 20 years old underweight shorter older mothers aged 2049 yearsafghanistans rapidly changing political socioeconomic insecurity landscape direct indirect implications population nutrition novel evidence study used understand multifactorial determinants identify granular disparities local level tracking planning implementation nutritional interventionsnone