Trends, Predictors, and Consequences of Child Undernutrition

儿童营养不良的趋势、预测因素和后果

• 批准号: 9468745
• 负责人: Apurv Soni
• 金额: $ 2.87万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-22 至 2021-09-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9468745
• 关键词: 5 year old; Academic achievement; Accounting; Address; Adolescent; Advocacy; African; Age; Anthropology; Area; Caring; Cessation of life; Characteristics; Child; Child Care; Child Development; Child Malnutrition; Child Mortality; Child health care; Clinical; Communities; Community Healthcare; Complex; Country; Data; Data Set; Data Sources; Decision Making; Development; Dietary intake; Disease; Economics; Environmental Risk Factor; Expenditure; Female; Food; Foundations; Funding; Gender; Goals; Government; Growth; Health; Health Status; Healthcare; Heterogeneity; High Prevalence; Household; Human Development; Hygiene; Impairment; India; Individual; Intervention; Investigation; Knowledge; Life; Life Cycle Stages; Life Expectancy; Malnutrition; Maternal Mortality; Mentorship; Methodology; Methods; Mission; Morbidity - disease rate; Mothers; National Institute of Child Health and Human Development; Newborn Infant; Nutritional; Observational Study; Outcome; Physicians; Policies; Positioning Attribute; Pregnant Women; Prevalence; Productivity; Publishing; Quality of life; Research; Research Infrastructure; Research Proposals; Resources; Role; Rural Health; Sanitation; Scientist; Series; Services; Surveys; Techniques; Training; United States National Institutes of Health; Water; Women' s Role; aged; base; career; clinical practice; community based participatory research; evidence base; experience; health disparity; improved; intervention program; low and middle-income countries; model building; multilevel analysis; population health; programs; spatiotemporal; trend

RR-7: ABSTRACT One out of every three children under the age of five in India are undernourished (48 million). To address this crisis, Indian government established a National Rural Health Mission (NRHM) program in 2005, which improved healthcare and nutritional services. Unfortunately, this efforts which spanned from 2005 to 2012 have yielded minimal improvement. Persistent child undernutrition limits growth, productivity, quality of life, and life expectancy of Indians. In other words, Indian children are unable to realize their full potential due to undernutrition. Our current understanding of child undernutrition in India is 1) outdated because most of the analyses uses data from 2005, before the implementation of NRHM program, 2) contradictory because investigations of predictors of child undernutrition in India with improper methodologies has produced inconsistent findings despite using the same data source), and 3) lacking because no national level study has assessed the consequences of child undernutrition. Therefore, this study will apply advanced geospatial and multilevel methods on publicly available nationally representative data from NICHD-funded India Human Development Survey (IHDS) series to fill these critical knowledge-gaps. The first of the two IHDS surveys was conducted in 2005 (IHDS-I) before the implementation of NRHM and surveyed 24,314 children aged five or less from 41,554 households. IHDS-II was conducted in 2012 and surveyed 42,152 households, including 34,621 that were surveyed in 2005, and collected information on 20,810 children under the age of five and 26,559 pre-adolescents. We will use this unique data source, the largest panel dataset on child undernutrition in India to investigate: Aim 1) the trends of child undernutrition in India from 2005 to 2012 in relation to NRHM, Aim 2) individual, household, and community level predictors of child undernutrition, and Aim 3) consequences of undernutrition in the first five years of life on development during pre-adolescent (8-11) years within the Indian socio-cultural context. Our investigation will define the heterogeneity in the burden of child undernutrition and its association with a variety of predictors across different regions of India. Moreover, it will elucidate the magnitude of its consequences on child development within the Indian context. Thus, this study will establish a foundation for addressing this humanitarian and economic crisis by identifying effective entry points for existing intervention. This proposal will also position me to take the next step towards my career goal of reducing health disparities among children through clinical practice in underserved regions, community-based research, and evidence-based advocacy. To accomplish the study aims and prepare me for my career, this research proposal is paired with a carefully curated training plan that includes specific graduate-level courses and individualized mentorship experiences with a team of technical and content experts.

RR-7：摘要 印度五岁以下的三个孩子中有一个人营养不良（4800万）。解决 这场危机，印度政府于2005年建立了一项国家农村卫生任务（NRHM）计划，该计划 改善医疗保健和营养服务。不幸的是，从2005年到2012年开始的这项努力有 产生最小的改善。持续的儿童营养不良限制了增长，生产力，生活质量和生活 印第安人的期望。换句话说，印度儿童由于 营养不良。 我们目前对印度儿童营养不良的理解是1）过时的，因为大多数分析 在实施NRHM计划之前，使用2005年以来的数据，2）矛盾，因为对 尽管方法论不当 使用相同的数据源）和3）缺乏，因为没有国家一级研究评估了后果 营养不良的儿童。 因此，本研究将对公开可用的高级地理空间和多级方法应用 来自NICHD资助的印度人类发展调查（IHDS）系列的全国代表性数据填写这些数据 关键的知识差距。两项IHDS调查中的第一次是在2005年（IHDS-I）进行的 NRHM的实施，并从41,554户家庭中调查了24,314名5岁以下的儿童。 IHDS-II是 2012年进行了调查，并调查了42,152户家庭，其中包括2005年进行调查的34,621户家庭，并收集了 有关20,810名五岁以下儿童和26,559名儿童的信息。我们将使用此独特数据 资料来源，印度儿童不舒服的最大面板数据集进行调查：目标1）儿童的趋势 从2005年到2012年，印度的营养不足与NRHM有关2）个人，家庭和社区 儿童营养不良的水平预测因素，目标3）在生命的头五年中，营养不良的后果 在印度社会文化背景下的青春期前（8-11）年期间的发展。 我们的调查将定义儿童不育儿负担的异质性及其与 印度不同地区的各种预测因子。此外，它将阐明其大小 在印度背景下对儿童发育的后果。因此，这项研究将为 通过确定现有干预的有效切入点来解决这种人道主义和经济危机。 该建议还将使我迈出下一步迈向减少健康差异的职业目标 通过服务不足地区的临床实践，基于社区的研究以及 基于证据的倡导。为了完成这项研究的目标并为我的职业做好准备，这项研究建议 与精心策划的培训计划配对，其中包括特定的研究生级课程和个性化的课程 由技术和内容专家团队的指导经验。