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Universität Heidelberg (2021)

The impact of climate variability on diets and child undernutrition in rural Burkina Faso

Mank, Isabel

Titre : The impact of climate variability on diets and child undernutrition in rural Burkina Faso

Auteur : Mank, Isabel

Université de soutenance : Universität Heidelberg

Grade : Doctor scientiarum humanarum (Dr.sc.hum.) 2021

Résumé partiel
Undernutrition continues to threaten millions of children’s lives, especially in developing countries. Climate change is projected to exacerbate inequalities and negatively impact child undernutrition directly and indirectly. The present study assessed the association between undernutrition of children aged <5 years living in subsistence farming households and climate change, as proxied by rainfall variability in rural Burkina Faso. Both children’s nutrition and health are likely to worsen with climate change. Indeed, climate change may halt or reverse efforts made to date to reduce undernutrition. This research was structured around four objectives (i) socio-economic risk factors for and (ii) associations of diets with child undernutrition, and (iii) the link between rainfall variability and child undernutrition. Additionally, (iv) a validation study was conducted to compare weighed agricultural yield of small-scale household fields against freely available satellite imagery as an additional link to child undernutrition. These objectives were addressed through the use of a variety of study instruments and statistical approaches requiring the involvement of outside domain experts. The interdisciplinary nature of this research combining health, diet and climate made the analyses and findings unique in its current form. Data was analyzed from an open dynamic cohort of initially 470 children between 7 and 60 months contributing to 1,439 person-years during three years of follow-up. The study design accounted for five local weather stations located in the Nouna Health and Demographic Surveillance System (HDSS) area to investigate the associations on different geographical- and time-scales. The following findings were made : First, undernutrition of children aged <5 years was found to remain a serious problem in the study area. In 2019, 19 % of the children in this study were stunted (chronic undernutrition) and 5 % were wasted (acute undernutrition). These children were found highly vulnerable to demographic and socio-economic factors including disease episodes and ethnical background, but also location, i.e. the geographical cluster they lived in. Second, dietary diversity was low in the study population. 92 % of the children did not reach the internationally recommend minimum dietary diversity of 5 or more food groups over the previous 24 hours. They commonly consumed sorghum, rice, Vitamin-A rich leaves, and oils and fats during the data collection period (the rainy season). The consumed foods were found to differ significantly between study clusters, but were undistinguishable between boys and girls. Based on a 7-day dietary recall, dietary patterns were identified through principal component analysis (PCA), which yielded three patterns of foods commonly consumed together : (i) market-based (pasta, eggs, poultry, sweets), legume-based (African locust bean, oils and fats, leaves, peanuts) and vegetable-based (okra, tomatoes, eggplant). Children, who followed the market- or legume-based diet were found less likely to be stunted, while children, who followed the vegetable-based diet had a lower risk for wasting

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