The Relationship between Livestock Ownership and Child Stunting in Three Countries in Eastern Africa Using National Survey Data

PLOS ONE, Dec 2019

Livestock ownership has the potential to improve child nutrition through various mechanisms, although direct evaluations of household livestock and child stunting status are uncommon. We conducted an analysis of Demographic and Health Survey (DHS) datasets from Ethiopia (2011), Kenya (2008–2009), and Uganda (2010) among rural children under 5 years of age to compare stunting status across levels of livestock ownership. We classified livestock ownership by summing reported household numbers of goats, sheep, cattle and chickens, as well as calculating a weighted score to combine multiple species. The primary association was assessed separately by country using a log-binomial model adjusted for wealth and region, which was then stratified by child diarrheal illness, animal-source foods intake, sub-region, and wealth index. This analysis included n = 8079 children from Ethiopia, n = 3903 children from Kenya, and n = 1645 from Uganda. A ten-fold increase in household livestock ownership had significant association with lower stunting prevalence in Ethiopia (Prevalence Ratio [PR] 0.95, 95% CI 0.92–0.98) and Uganda (PR 0.87, 95% CI 0.79–0.97), but not Kenya (PR 1.01, 95% CI 0.96–1.07). The weighted livestock score was only marginally associated with stunting status. The findings varied slightly by region, but not by wealth, diarrheal disease, or animal-source food intake. This analysis suggested a slightly beneficial effect of household livestock ownership on child stunting prevalence. The small effect size observed may be related to limitations of the DHS dataset or the potentially complicated relationship between malnutrition and livestock ownership, including livestock health and productivity.

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The Relationship between Livestock Ownership and Child Stunting in Three Countries in Eastern Africa Using National Survey Data

September The Relationship between Livestock Ownership and Child Stunting in Three Countries in Eastern Africa Using National Survey Data Editor: Jacobus van Wouwe 0 TNO 0 NETHERLANDS 0 Emily M. Mosites 0 Peter M. Rabinowitz 0 Samuel M. Thumbi 0 Joel M. Montgomery 0 Guy H. Palmer 0 Susanne May 0 Ali Rowhani-Rahbar 0 Marian L. Neuhouser 0 Judd L. Walson 0 0 1 Department of Epidemiology, University of Washington , Seattle, WA , United States of America, 2 Department of Environmental and Occupational Health Sciences, University of Washington , Seattle, WA , United States of America, 3 Centre for Global Health Research, Kenya Medical Research Institute , Kisumu, Kenya, 4 Paul G. Allen School for Global Animal Health, Washington State University , Pullman, WA , United States of America, 5 Global Disease Detection, Centers for Disease Control and Prevention, Nairobi, Kenya, 6 Department of Biostatistics, University of Washington , Seattle, WA , United States of America, 7 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center , Seattle, WA , United States of America, 8 Department of Global Health, University of Washington , Seattle, WA , United States of America Livestock ownership has the potential to improve child nutrition through various mechanisms, although direct evaluations of household livestock and child stunting status are uncommon. We conducted an analysis of Demographic and Health Survey (DHS) datasets 5 years of age to compare stunting status across levels of livestock ownership. We classified livestock ownership by summing reported household numbers of goats, sheep, cattle and chickens, as well as calculating a weighted score to combine multiple species. The primary association was assessed separately by country using a log-binomial model adjusted for wealth and region, which was then stratified by child diarrheal illness, animal-source foods intake, sub-region, and wealth index. This analysis included n = 8079 children from Ethiopia, n = 3903 children from Kenya, and n = 1645 from Uganda. A ten-fold increase in household livestock ownership had significant association with lower stunting prevalence in Ethiopia (Prevalence Ratio [PR] 0.95, 95% CI 0.92-0.98) and Uganda (PR 0.87, 95% CI 0.79-0.97), but not Kenya (PR 1.01, 95% CI 0.96-1.07). The weighted livestock score was only marginally associated with stunting status. The findings varied slightly by region, but not by wealth, diarrheal disease, or animal-source food intake. This analysis suggested a slightly beneficial effect of household livestock ownership on child stunting prevalence. The small effect size observed may be related to limitations of the DHS dataset or the potentially - Competing Interests: The authors have declared that no competing interests exist. complicated relationship between malnutrition and livestock ownership, including livestock health and productivity. More than a quarter of the world’s children suffer from chronic malnutrition, resulting in linear growth failure (stunting), cognitive delay and increased risk of morbidity and mortality [1]. These consequences have profound implications for population health and economic improvement, as adults who were stunted as children have been shown to receive less education and achieve lower earnings [2, 3]. Rural areas in many resource-limited settings shoulder an unequal burden of malnutrition; rural children have nearly fifty percent higher stunting prevalence than children in urban areas [4]. In order to address stunting where the need is greatest, appropriate interventions must be developed which will be adopted by the families based on individual and community priorities [5]. Rural children commonly live in close proximity to livestock. These livestock may be an important determinant of child nutritional status, and promoting livestock production is a common development strategy. However, the overall influence of livestock ownership on child nutrition is not well understood as very few studies have examined the direct effect. A recent cross-sectional study in Kenya showed a small benefit of overall livestock ownership on child weight [6]. This effect could be mediated through livestock serving as direct sources of protein through meat, milk, and eggs or indirectly by increasing household income for food expenditure. An analysis of survey data in Uganda showed higher consumption of animal source foods in households with more livestock ownership, although this did not translate strongly into improved child growth outcomes [7]. However, randomized trials have also demonstrated that animal-source foods can improve weight gain and muscle development in children [8, 9]. Livestock ownership may also increase exposure to environmental contamination with fecal material and zoonotic pathogens [10, 11]. These exposures can lead to growth stunting by increasing overall metabolic demand, decreasing appetite, and by causing inflammatory patterns that reduce enter (...truncated)


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Emily M. Mosites, Peter M. Rabinowitz, Samuel M. Thumbi, Joel M. Montgomery, Guy H. Palmer, Susanne May, Ali Rowhani-Rahbar, Marian L. Neuhouser, Judd L. Walson. The Relationship between Livestock Ownership and Child Stunting in Three Countries in Eastern Africa Using National Survey Data, PLOS ONE, 2015, Volume 10, Issue 9, DOI: 10.1371/journal.pone.0136686