{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T00:58:44Z","timestamp":1769821124917,"version":"3.49.0"},"reference-count":40,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T00:00:00Z","timestamp":1685491200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980023001076_as1\"><jats:title>Objective:<\/jats:title><jats:p>The study\u2019s objective was to investigate multiple underlying social, economic and agricultural determinants of stunting among under-five children in three distinct ecological areas in rural Myanmar.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023001076_as2\"><jats:title>Design:<\/jats:title><jats:p>Repeated cross-sectional surveys in three states of Myanmar.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023001076_as3\"><jats:title>Setting:<\/jats:title><jats:p>Rural households in Chin (mountainous), Magway (plains) and Ayeyarwady (delta).<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023001076_as4\"><jats:title>Participants:<\/jats:title><jats:p>From two purposively selected adjacent townships in each state, we randomly selected twenty villages and, in each village, thirty households with under-five children. Households in the first survey in 2016 were revisited in late 2017 to capture seasonal variations.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023001076_as5\"><jats:title>Results:<\/jats:title><jats:p>Stunting increased from 40\u00b74 % to 42\u00b70 %, with the highest stunting prevalence in Chin state (62\u00b74%). Univariate Poisson regression showed factors contributing to child stunting varied across the regions. Adjusted Poisson regression models showed that child\u2019s age and short maternal stature (aRR = 1\u00b714 for Chin, aRR = 1\u00b789 for Magway and aRR = 1\u00b786 for Ayeyarwady) were consistently associated with child stunting across three areas. For Chin, village-level indicators such as crop consumption (aRR = 1\u00b718), crop diversity (aRR = 0\u00b782) and land ownership (aRR = 0\u00b789) were significantly associated with stunting. In Magway, the number of household members (aRR = 1\u00b792), wealth status (aRR = 0\u00b746), food security status (aRR = 1\u00b714), land ownership (aRR = 0\u00b785) and in Ayeyarwady, women\u2019s decision-making (aRR = 0\u00b767) and indicators related to hygiene (aRR = 1\u00b713) and sanitation (aRR = 1\u00b745) were associated with stunting.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980023001076_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>Area-specific factors were associated with stunting. Maternal short stature and child age were consistent determinants of stunting. A multi-sectoral local approach, including improvements in transport, is needed to address the intergenerational malnutrition problem.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980023001076","type":"journal-article","created":{"date-parts":[[2023,5,31]],"date-time":"2023-05-31T04:57:29Z","timestamp":1685509049000},"page":"1644-1657","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Socio-economic and agricultural factors associated with stunting of under 5-year children: findings from surveys in mountains, dry zone and delta regions of rural Myanmar (2016\u20132017)"],"prefix":"10.1017","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6417-2942","authenticated-orcid":false,"given":"Min Kyaw","family":"Htet","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tran Thanh","family":"Do","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thet","family":"Wah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thant","family":"Zin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myat Pan","family":"Hmone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1285-8867","authenticated-orcid":false,"given":"Shahreen","family":"Raihana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Kirkwood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7944-2009","authenticated-orcid":false,"given":"Lwin Mar","family":"Hlaing","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1554-5180","authenticated-orcid":false,"given":"Michael J","family":"Dibley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,5,31]]},"reference":[{"key":"S1368980023001076_ref18","doi-asserted-by":"publisher","DOI":"10.3945\/jn.116.235879"},{"key":"S1368980023001076_ref28","doi-asserted-by":"publisher","DOI":"10.3961\/jpmph.21.120"},{"key":"S1368980023001076_ref15","unstructured":"15. 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Sibson, V (2014) A Nutrition and Food Security Assessment of the Dry Zone in Myanmar in June and July 2013: Report for Save the Children, WFP, and the Ministry of Livestock, Fisheries and Rural Development. https:\/\/reliefweb.int\/report\/myanmar\/nutrition-and-food-security-assessment-dry-zone-myanmar-june-and-july-2013 (accessed September 2021)."},{"key":"S1368980023001076_ref13","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2017.1330858"},{"key":"S1368980023001076_ref6","doi-asserted-by":"publisher","DOI":"10.1257\/aer.91.4.795"},{"key":"S1368980023001076_ref1","unstructured":"1. World Health Organisation (2020) UNICEF\/WHO\/The World Bank Group Joint Child Malnutrition Estimates: Levels and Trends in Child Malnutrition: Key Findings of the 2020 Edition. 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