Growth status of children in North West Syria: A comparison of three rural livelihood groups

Abstract

Undernutrition, a multifactorial phenomenon, has severe consequences. A study was conducted in Syria to compare nutritional differences in children from three rural livelihood groups: a "barley-livestock" group in the southeast (Khanasser), and an "olive/fruit tree" group and an "irrigation" group in the northwest of Aleppo province (Afrin). An anthropometric assessment was conducted on 541 rural children from 207 rural households and 199 urban children (2-10 years) from a middle income urban group. Comparisons were made with the 1978 NCHS/WHO (National Center for Health Statistics/World Health Organization) international growth reference (WHO, 1995) and a -2 SD Z-score was used as a cut-off. Prevalence rates and mean Z-scores were calculated and independent sample t-tests used to compare totals and age-group disaggregated children (both boys and girls). Total stunting prevalence was highest in the barley-livestock group (23%) and lowest in the irrigation group (12.5%). Girls in the barley-livestock group displayed the highest rates of stunting (28.3%), followed by the boys (22%) and the girls (21.08%) in the olive/fruit tree group. The prevalence of underweight children was highest in the barley-livestock and olive/fruit tree livelihood groups (14.29% and 13.25%, respectively). Wasting rates were very low. The rates of stunting and underweight were higher in the barley-livestock and olive/fruit tree groups, as compared with the country-level estimates of 20.8 percent and 12.9 percent respectively, in children under five. A comparison of rates and mean scores indicates that, amongst rural groups, there was considerable variation: the barley-livestock and olive/fruit tree group, belonging to drier and poorer areas, exhibited higher rates and lower mean scores.