Factors associated with stunting among hilltribe pre-school children in Thailand.
Keywords:hilltribe, pre-school children, stunting, consumption behavior, maternal factor
Pre-school children (0-5 years) are undergoing rapid changes in physical, mental, social,
emotional, and intellectual age. Such changes are the result of hereditary and environmental factors during the period of pregnancy and post-birth. If stunting occurs in pre-school children, it can have negative influences on both short-and-long-term health. The research objective was to study factors associated with stunting among hilltribe pre-school children in Mae Chaem District in the Chiang Mai Province. The study was a cross-sectional analytical study conducted between July to October 2020. The sample consisted of 170 hilltribe children aged between 3-5 conducted from July to October 2020, using primary data from the secondary data on children aged 3-5, who were measured in terms of height and recorded from seven healthcare facilities from October to December 2019. The research tool were structured interviews with closed-ended questions, which was used to interview the parents of these children and to test the quality of the tool. The content validity index (CVI) was 1, and the Cronbach’s alpha coefficient was 0.85. The statistical tools for analysis included descriptive statistics and logistic regression analysis. The results of the research were as follows: the maternal factors consisted of height, ethnicity, and exposure to secondhand smoke from family members while pregnant and exposure to secondhand smoke from family members after childbirth and during breastfeeding. The factors related to the children consisted of the consumption behavior of children from six months to two years and drinking cow’s milk. The results of the study can be applied to plan solutions of stunting issues in children by organizing health promotion activities or formulating policies to drive the cooperation of public health agencies, provincial administrative organizations, educational institutes, and the public sector for an appropriate implementation of the health enhancement among pre-school children.
2. Pannee P. Nursing role and sustainable development goal (SDGs). J The Royal Thai Army Nurses 2019;20:33-43.
3. Office of the National Economic and Social Development Council. Second goal: Stop hunger, achieve food security and raise the level of nutrition, and promote sustainable farmers [Internet]. 2021 [cited 2021 April 28, 2021]. Available from: http://sdgs.nesdc.go.th.
4. Bureau of Nutrition, Ministry of Public Health, 2006 World Health Organization growth standards manual in newborns - 5 years. Nonthaburi, Thailand: The Agricultural
Cooperative Federation of Thailand. Limited.; 2015.
5. Bureau of Nutrition, Ministry of Public Health. Manual for the implementation of nutrition health promotion in well child clinics for public health personnel. Bangkok, Thailand: National Office of Buddhism 2015.
6. Institute for Population and Social Research Mahidol University. Thai health report 2017. Nakhon Pathom: Amarin Printing & Publishing; 2017.
7. Maohsuwan L, Aekpalakorn W,Rueangdarakanon N, et al. 2008-2009 Forth national health evaluation survey report. Nonthaburi: Ministry of Public Health.; 2015.
8. Aekpalakorn W, Maohsuwan L, Rueangdarakanon N, et al. 2014 Fifth national health evaluation survey report. Nonthaburi: Ministry of Public Health.
9. Institute for Population and Social Research Mahidol University. Thai health report 2018. Nakhon Pathom: Amarin Printing & Publishing.; 2018.
10. Chiang Mai Provincial Public Health Office.Standard reporting group: Nutrition [Internet]. 2019 [cited 2021 February 10]. Available from: https://cmi.hdc.moph. go.th/hdc/reports/page.php?cat_id=46522b5bd1e06d24a5bd81917257a93c.11. Wayne W. Paired comparison test. Daniel
WW Biostatistics: A foundation for analysis in the health sciences. 6th ed New York,NY: John Wiley & Sons Inc. 1995:235-41.
12. Suthatworawut S, Chansamon P, Poonkum Y, et al. Reproductive health services - handbook for public health officers 2ed. Bangkok: The War Veterans Organization
of Thailand Printing; 2011.
13. Nshimyiryo A, Hedt-Gauthier B, Mutaganzwa C, et al. Risk factors for stunting among children under five years: A cross sectional population-based study in Rwanda using the 2015 Demographic and Health Survey. BMC Pub Health 2019;19:1-10.
14. El Kishawi RR, Soo KL, Abed YA, et al. Prevalence and associated factors influencing stunting in children aged 2-5 years in the Gaza Strip-Palestine: a crosssectional study. BMC Pediatr 2017;17:1-7.
15. Sugiyanto J, Raharjo SS, Retno Dewi YL. The effect of exclusive breastfeeding and contextual factor of village on stunting in Bontang, East Kalimantan, Indonesia.J Epidemiol Pub Health 2019;4:222-33.
16. Fajariyah RN, Hidajah AC. Correlation between immunization status and mother’s height and stunting in children 2-5 years in Indonesia. BMC Pediatr 2020;8:89-96.
17. Thai Youth Encyclopedia. Meaning of ethnicity [Internet]. 1998 [cited 2021 March 30, 2021]. Available from: http://saranukromthai.or.th/sub/book/book.php?book=23&chap=5&page=t23-5- infodetail01.html.
18. Pattarakaeha Y. Food belief and postpartum practice of Hmong women Chiang Mai, Thailand: Chiang Mai University; 2008.
19. Srisawat B. 30 nations in Chiang Mai 2ed. Bangkok: O.S. Printing House; 2004.
20. Saeyang C, Yunak R, Oba N. Effects of applied health belief model on care giver’s nutrition providing behavior and body weight among underweight early children in Hmong. J Nursing and Health Sci 2014;8:120-9.
21. Thai Health Promotion Foundation. Effects of secondhand smoke on the health of those who are exposed to the smoke [Internet]. 2016 [cited 2021 April 28].
Available from: https://www.thaihealth.or.th/Content/42932 html.
22. Pourmasumi S, Eftekhar M, Sabeti P,et al. Relation of secondhand smoker on pregnancy outcome and newborns parameters. Womens Health Gynecol 2016;2:1-4.
23. Chelchowska M, Ambroszkiewicz J, Gajewska J, et al. Hepcidine and iron metabolism in pregnancy: Correlation with smoking and birth weight and length. Biol
Trace Elem Res 2016;173:14-20.
24. Thongmuangtunyatep K, Pongchangyou K, Malai C, et al. Effects of cigarette smoke in pregnant women on fetus: A systematic review. J Nursing Edu 2019;12:117-32.
25. Mzumara B, Bwembya P, Halwiindi H, et al. Factors associated with stunting among children below five years of age in Zambia: evidence from the 2014 Zambia Demographic and Health Survey. BMC Nutr 2018;4:1-8.
26. Agho KE, Inder KJ, Bowe SJ, et al. Prevalence and risk factors for stunting and severs stunting among under-fives in North Maluka province of Indonesia. BMC Pediatr 2009;9:1-10.
27. Aryastami NK, Shankar A, Kusumawardani N, et al. Low birth weight was the most dominant predictor associated with stunting
among children aged 12-23 months in Indonesia. BMC Nutr 2017;3:1-6.
28. Akombi BJ, Agho KE, Hall JJ, et al. Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis. BMC Pediatr 2017;17:1-16.
29. Suwanwaha S, Ampansirirat A, Suwanwaiphattana W. Factor related to nutritional status among preschool aged children: a systematic review. JBCNM
30. Yamborisut U, Horkiat J, Ditmetharoat M. 3 Tricks to good health in young children. Bangkok: Folk Doctor Foundation; 2015.
31. Katekowit B. Nutritional status and development of 3 - 5-year-old children in regional health center 4 area. J Nutr 2017;52:1-15.
32. Krueawisen B. Nutritional status and learning ability level of pre-school children Santisuksa Childcare Center. Chiang Mai, Thailand: Chiang Mai University; 2014.
33. Phiouxay P, Pilavong K. Nutritional status and factors associated with nutritional status of children aged 2-5 years, Sisatanak District, Vientiane Capital, Lao PDR,KKUJPHR 2014;7:58-63.
34. Wungrath J. Obesity among preschoolaged children in Thailand. J Pub Health 2018;48:356-70.
35. Thai Health Promotion Foundation. Campaign for children to drink 2 glasses of milk/day [Internet]. 2017 [cited 2021 April 28]. Available from: https://www. thaihealth.or.th/Content.html.