We sought to identify factors associated with linear growth among under-5 children in two urban informal settlements in Nairobi.

We used longitudinal data for the period 2007–2012 from under-5 children recruited in the two sites between birth and 23 months and followed up until they reached 5 years of age. We fitted a generalized linear model on height-for-age Z-scores using the generalized estimating equations method to model linear growth trajectories among under-5 children. Known for its flexibility, the model provides strong parameter estimates and accounts for correlated observations on the same child.

Two urban informal settlements in Nairobi, Kenya.

Under-5 children (n 1917) and their mothers (n 1679).

The findings show that child weight at birth, exclusive breast-feeding and immunization status were key determinants of linear growth among under-5 children. Additionally, maternal characteristics (mother’s age, marital status) and household-level factors (socio-economic status, size of household) were significantly associated with child linear growth. There were biological differences in linear growth, as female children were more likely to grow faster than males. Finally, the model captured significant household-level effects to investigate further.

Findings from the study point to the need to improve the targeting of child health programmes directed at the urban poor population in Nairobi. Specific modifiable determinants of child linear growth, particularly child weight at birth, exclusive breast-feeding, immunization status and mother’s background characteristics, should be considered when designing interventions aiming at addressing child health inequities in these settings.

To investigate the prevalence of vitamin A deficiency among lactating women in a poor urban population of Bangladesh, and to examine the relationship between various factors and vitamin A status.

Cross-sectional study.

Maternal and child health clinic in Dhaka City, Bangladesh.

A total of 120 lactating women aged 17–37 years were randomly selected from women who attended a local maternal and child health clinic in Dhaka City for immunisation of their children. Various socio-economic, personal characteristics, dietary intakes of vitamin A and anthropometric data were collected. Serum retinol (vitamin A) concentration was determined as a measure of vitamin A status.

Of the subjects, 37% had low serum vitamin A levels (<30 μg dl−1), with 13.3% having sub-clinical vitamin A deficiency (<20 μg dl−1). Eighty-seven per cent had vitamin A intakes below the recommended dietary allowance. The lactating women who were either illiterate or received only informal education had significantly (P = 0.002) lower serum vitamin A levels compared with those who received formal education. The women whose husbands received formal education had significantly (P = 0.05) higher serum vitamin A levels than those whose husbands were either illiterate or received only informal education. The serum vitamin A levels of women in households with poor sanitation/latrine practice were significantly (P = 0.03) lower than those of women in households with good sanitation/latrine practice. The women with one child had significantly (P = 0.015) lower serum vitamin A levels than those with two or more children. Women with a lactation period of 6 months or more had significantly (P = 0.034) lower serum vitamin A levels than women with a lactation period of less than 6 months. The women who consumed less than the median vitamin A intake (274.8 μg day−1) had significantly (P = 0.01) lower serum vitamin A levels than those who consumed more than the median vitamin A intake. By multiple regression analysis, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A were found to have significant independent relationships with serum vitamin A. The overall F-ratio (6.8) was highly significant (P = 0.000), the adjusted R2 was 0.16 (multiple R = 0.44).

A significant proportion of poor, urban, lactating women in Bangladesh have vitamin A deficiency. Among the various factors, education level of the women, number of living children, duration of lactation and dietary intake of vitamin A appear to be important in influencing the vitamin A status of these women.