Skip to main content

Advertisement

SpringerLink
Log in

An Analysis of Cross Sectional Survey Data of Stunting Among Palestinian Children Less Than Five Years of Age

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

The object of this study is to report on determinants of stunting, defined as low height for age, among children in the occupied Palestinian territories. Using 2006–2007 cross sectional survey data collected by the Palestine Central Bureau of Statistics and using multivariate mixed model techniques for logistic regression, the relationships of stunting to characteristics of 9,051 Palestinian children less than 5 years of age living in the Palestinian territories were estimated. These characteristics included demographic and social characteristics of the child, geographic region, type of location (urban, rural, refugee camp) and food insecurity for each governorate. Listed in order of the greater contribution to the explained variation in stunting, children with lower birth weight (P < 0.0001), age greater than 12 months (P < 0.0001), higher levels of food insecurity (P < 0.0001), lower socio-economic status (P < 0.0001), mother illiterate (P = 0.004), urban areas (P = 0.008), and absence of supplementation to breast feeding during the first 4 months of the child’s life (P = 0.04) have significantly more stunting. Children living in refugee camps have lower rates of stunting than urban areas; however the difference does not reach statistical significance. The relationship between the child’s gender and stunting is not statistically significant. Lack of food security is directly linked to stunting. The continuing incidence of food insecurity means that the deleterious effects of under-nutrition will continue to affect the children of Palestine. Removing the avoidable causes of food insecurity in the occupied Palestinian territories will alleviate under-nutrition and its deleterious effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. World Health Organization Working Group on Infant Growth. (1995). An evaluation of infant growth: the use and interpretation of anthropometry in infants. WHO Bulletin, 73, 165–174.

    Google Scholar 

  2. United Nations Standing Committee on Nutrition. Stunting and young child development. (1997). In: Third Report on the World Nutrition Situation. United Nations Administrative Committee on Coordination/Sub-Committee on Nutrition, Geneva, Switzerland 1997. Available: http://www.unscn.org/layout/modules/resources/files/rwns3.pdf. Accessed Feb 15, 2011.

  3. Walker, S. P., Wachs, T. D., Gardner, J. M., Lozoffm, B., Wasserman, G. A., Pollitt, E., Carter, J. A., and the International Child Development Steering Group. (2007). Child development: risk factors for adverse outcomes in developing countries. The Lancet, 369, 145–157.

    Google Scholar 

  4. Lewit, E. M., Kerrebrock, N. (1997). Population-based growth stunting. The Future of Children. Children and Poverty, 7(2), 149–156.

    Google Scholar 

  5. Skuse, D., Albanese, A., Stanhope, R., Gilmour, J., & Voss, L. (1996). A new stress-related syndrome of growth failure and hyperphagia in children, associated with reversibility of growth-hormone insufficiency. The Lancet, 348(9024), 353–358.

    Article  CAS  Google Scholar 

  6. Food and Agricultural Organization of the United Nations in collaboration with the World Food Programme, Report of the Food Security Assessment, West Bank and Gaza Strip. Rome. (2003). Available: ftp://ftp.fao.org/docrep/fao/006/j1575e/j1575e01.pdf. Accessed Feb 23, 2011.

  7. United Nations World Food Program, Food and Agricultural Organization of the United Nations. (2007). West Bank and Gaza Strip: Comprehensive Food Security and Vulnerability Analysis, Table 2.6, Percentages of Food Security Groups by Governorate. January 2007, 1–78. Available: http://unispal.un.org/pdfs/CFSVA_WBGS.pdf. Accessed Feb 15, 2011.

  8. World Bank. (2008). The economic effects of restricted access to land in the West Bank 2008, 1–48. Available: http://siteresources.worldbank.org/INTWESTBANKGAZA/Resources/EconomicEffectsofRestrictedAccesstoLandintheWestBankOct.21.08.pdf. Accessed Dec 16, 2010.

  9. Food and Agricultural Organization of the United Nations. (2010). Country Profile: Food Security Indicators. Country: Occupied Palestinian Territories. Last updated October, 2010. Available: http://www.fao.org/fileadmin/templates/ess/documents/food_security_statistics/country_profiles/eng/Palestina_E.pdf. Accessed Feb 15, 2010.

  10. Palestinian Central Bureau of Statistics. (2007). Palestinian Family Health Survey, 2006: Preliminary Report. Ramallah, Palestine. April 7, 2007: 1–60. (http://www.pcbs.gov.ps/Portals/_pcbs/PressRelease/English_Report.pdf). Accessed Feb 23, 2011.

  11. SAS Institute, Inc. (2006). The GLIMMIX Procedure. SAS version 9.2. Cary, North Carolina, USA. SAS Institute, Inc.; 2006.

  12. Hsieh, F. Y. (1989) Sample size tables for logistic regression. Statistics in Medicine, 8, 795–802.

    Google Scholar 

  13. Ramli, A. K. E., Inder, K. J., Bowe, S. J., Jacobs, J., and Dibley, M. J. (2009). Prevalence and risk factors for stunting and severe stunting among under-fives in North Maluku province of Indonesia. BMC Pediatrics, 9, 64. doi:10.1186/1471-2431-9-64.

  14. Zottarelli, L. K., Sunif, T. S., & Rajaram, S. (2007). Influence of parental and socioeconomic factors on stunting in children under 5 years in Egypt. East Mediterranean Health, 13(6), 1330–1342.

    CAS  Google Scholar 

  15. Gluckman, P. D., & Hanson, M. A. (2006). The consequences of being born small—An adaptive perspective. Hormone Research in Paediatrics, 65(suppl 3), 5–14. doi:10.1159/000091500.

    CAS  Google Scholar 

  16. Guerrant, R. L., Oria, R. B., Moore, S. R., Oria, M. O. and Lima, A. A. (2008). Malnutrition as an enteric infectious disease with long-term effects on child development. Nutrition Reviews, 66(9), 487–505, 2008. doi:10.1111/j.1753-4887.2008.00082.x.

    Google Scholar 

  17. Baig-Ansari, N., Rahbar, M. H., Bhutta, Z. A., & Badruddin, S. H. (2006). Child’s gender and household food insecurity are associated with stunting among young Pakistani children residing in urban squatter settlements. Food and Nutrition Bulletin, 27(2), 114–127.

    PubMed  Google Scholar 

  18. Reyes, H., Pérez-Cuevas, R., Sandoval, A., Castillo, R., Santos, J. I., Doubova, S. V., et al. (2004). The family as a determinant of stunting in children living in conditions of extreme poverty: A case-control study. BMC Public Health, 4, 57. doi:10.1186/1471-2458-4-57.

    Article  PubMed  Google Scholar 

  19. Grantham-McGregor, S., Cheung, Y. B., Cueto, S., Glewwe, P., Richter, L., Strupp, B., et al. (2007). Child development in developing countries. The Lancet, 369, 60–67.

    Article  Google Scholar 

  20. Schoenbaum, M., & Tulchinsky, T. H. (1995). Gender differences in nutritional status and feeding patterns among infants in the Gaza Strip. American Journal of Public Health, 85, 965–969.

    Article  PubMed  CAS  Google Scholar 

  21. World Food Programme, occupied Palestinian territory. (2008). Safety nets study, June–July 2008. Prepared by Annemarie Hoogendoorn.

  22. United Kingdom Save the Children research report conducted by Near East Consulting supported by the Humanitarian Aid department of the European Commission. Life on the Edge: The struggle to survive and the impact of forced displacement in high risk areas of the occupied Palestinian territory. October 2009; 1–73. Available: http://www.savethechildren.org.uk/en/docs/English_Research_Report_with_Cover_low_res.pdf. Accessed Feb 15, 2011.

  23. Abdeen, Z., Greenough, P. G., Chandran, A., & Qasrawi, R. (2007). Assessment of the nutritional status of preschool-age children during the Second Intifada in Palestine. Food and Nutrition Bulletin, 28(3), 274–282.

    PubMed  Google Scholar 

  24. Halileh, S., & Gordon, N. H. (2005). Determinants of anemia in pre-school children in the occupied Palestinian territory. The Journal of Tropical Medicine, 52(1), 12–18.

    Google Scholar 

  25. Frisk, V., Amsel, R., & Whyte, H. (2002). The importance of head growth patterns in predicting the cognitive abilities and literacy skills of small-for-gestational-age children. Developmental Neuropsychology, 22(3), 565–593.

    Article  PubMed  Google Scholar 

  26. Barker, D. J. P. (1998). Mothers, babies and health in later life. London: Churchill Livingston.

    Google Scholar 

  27. Popkin, B. M., Richards, M. K., & Montiero, C. A. (1996). Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. Journal of Nutrition, 26, 3009–3016.

    Google Scholar 

  28. Sawaya, A. L., Martins, P., Hoffman, D., Roberts, S. B. (2003). chronic diseases in adulthood: A case study of Brazil. Nutrition Review, 61, 168–175.

    Google Scholar 

  29. Bhoomika, R. K., Rao, S. L., & Chandramouli, B. A. (2008). Cognitive development in children with chronic protein energy malnutrition. Behavioral and Brain Functions, 4(1), 31–42. doi:10.1186/1744-9081-4-31.

    Article  Google Scholar 

  30. Chang, S. M., Walker, S. P., Grantham-McGregor S,2, & Powell, C. A. (2002). Early childhood stunting and later behavior and school achievement. Journal of Child Psychology and Psychiatry, 43(6), 775–783.

    Article  PubMed  CAS  Google Scholar 

  31. World Food Program, December 2010 Operational Update. Available: http://unispal.un.org/UNISPAL.nsf/47D4E277B48D9D3685256DDC00612265/20882261B3433CCA8525782A00528B5B. Accessed Feb 15, 2011.

Download references

Acknowledgments

This work was partially supported by an opportunity grant from the National Science Foundation, ADVANCE Institutional Transformation Award SBE-0245054, start date 9/1/2003, end date 8/31/2008. The authors thank the Palestinian Central Bureau of Statistics for providing the data and to Salwa Massa’d for database preparation.

Author information

Authors and Affiliations

  1. Francis Payne School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4904, USA

    Nahida H. Gordon

  2. Department of Bioethics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH, 44106-4976, USA

    Nahida H. Gordon

  3. Center for Community and Public Health, Birzeit University, West Bank, Palestine

    Samia Halileh

Authors
  1. Nahida H. Gordon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samia Halileh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nahida H. Gordon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gordon, N.H., Halileh, S. An Analysis of Cross Sectional Survey Data of Stunting Among Palestinian Children Less Than Five Years of Age. Matern Child Health J 17, 1288–1296 (2013). https://doi.org/10.1007/s10995-012-1126-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-012-1126-4

Keywords

Search

Navigation