Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Pelagia P. Melea

Abstract

Household-level double burden of malnutrition (HL-DBM) challenges traditional South African vertical malnutrition programs. Research has associated a household with an overweight/obese mother of reproductive age and her under 5-year-old child with signs of undernutrition (wasting, stunting, or thinness) with socioeconomic levels, maternal characteristics, features of the household, and child’s demographics. Grounded in the social determinants of health conceptual framework, this study aimed to investigate the determinants of HL-DBM in South Africa across the reproductive-child health continuum. Using the representative 2017 Wave 5 South African National Income Dynamics Study survey secondary data, a total sample of 314 homes met this non-experimental correlation study’s criteria for HL-DBM. Pearson’s Chi-Square tests and binary logistic regression were conducted to answer the research questions. Statistically significant associations were found between HL-DBM midstream determinants, including household (a) income level (p = 0.021), (b) food security (p = 0.052), and (c) main water supply (p = 0.011) and explained variances in HL-DBM in the study population. The midstream HL-DBM determinant, maternal marital status, (a) married (p < 0.005) and (b) divorced/separated (p < 0.005),was found to decrease the likelihood ratios of HL-DBM. As a proximal determinant, the child’s age was statistically significant during binary logistic regression such that younger age categories had increased likelihood ratios of being HL-DBM pair. This study’s positive social change impact results include contributing to the HL-DBM knowledge base and raising awareness to address the multisectoral double-duty drivers of HL-DBM.

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