Determinants of stunting and wasting among Malian rural and urban adolescent girls

Purpose: In Sub-Saharan Africa, research on social determinants of nutritional status has often focused on children under 5-years of age and has used categorical boundaries based on international reference standards. The focus on adolescent girls is significant because there is limited literature regarding this group, and it is during adolescence when girls gain greater workloads, autonomy of food choices, and as a result of the adolescent growth spurt, require the greatest amount of calories respective to body weight since infancy. To better understand the causes of stunting and wasting among this vulnerable group, we will: 1) explore relationships between socioeconomic, demographic, energy expenditure, and geographic factors and growth data 2) analyze growth data through both categorical and continuous data.

Data and Methods : Anthropometric, socioeconomic, demographic, and energy expenditure data were analyzed from 1157 adolescent girls' ages 10 to 17 years from the Segou Region of Mali. Distances were calculated more recently from village centers along the major roads using georectified maps. Regression analyses were conducted to examine relationships between dependent and independent variables.

Results: The findings suggest that continuous data provide a better basis for modeling stunting and wasting compared to international reference categories. Further, age, the presence of servants, the greater number of wives in a compound, and living in an urban area correlate with improved nutritional status while wealthier families appear to correlate with greater stunting and wasting. Finally, energy expenditure has no significant correlation with stunting and wasting.

Conclusions and implications: While future studies concerning determinants of growth among adolescent girls should incorporate continuous data, the need exists for greater analysis of social determinants of stunting and wasting among this population. The findings have significant implications to developing nutrition intervention programs aimed at adolescents in Mali such that factors beyond socioeconomic indicators such as household structure and location should be more fully examined.