TY  - JOUR
PY  - 2018//
TI  - Trends of child undernutrition in rural Ecuadorian communities with differential access to roads, 2004-2013
JO  - Maternal and child nutrition
A1  - Lopez, Velma K.
A1  - Dombecki, Carolyn
A1  - Trostle, James
A1  - Mogrovejo, Patricia
A1  - Castro Morillo, Nancy
A1  - Cevallos, William
A1  - Goldstick, Jason
A1  - Jones, Andrew D.
A1  - Eisenberg, Joseph N. S.
SP  - e12588
EP  - e12588
VL  - 14
IS  - 3
N2  - Road access can influence protective and risk factors associated with nutrition by affecting various social and biological processes. In northern coastal Ecuador, the construction of new roads created a remoteness gradient among villages, providing a unique opportunity to examine the impact of roads on child nutritional outcomes 10 years after the road was built. Anthropometric and haemoglobin measurements were collected from 2,350 children <5 years in Esmeraldas, Ecuador, from 2004 to 2013 across 28 villages with differing road access. Logistic generalized estimating equation models assessed the longitudinal association between village remoteness and prevalence of stunting, wasting, underweight, overweight, obesity, and anaemia. We examined the influence of socio-economic characteristics on the pathway between remoteness and nutrition by comparing model results with and without household-level socio-economic covariates. Remoteness was associated with stunting (OR = 0.43, 95% CI [0.30, 0.63]) and anaemia (OR = 0.56, 95% CI [0.44, 0.70]). Over time, the prevalence of stunting was generally decreasing but remained higher in villages closer to the road compared to those farther away. Obesity increased (0.5% to 3%) over time; wasting was high (6%) but stable during the study period. Wealth and education partially explained the better nutritional outcomes in remote vs. road villages more than a decade after some communities gained road access. Establishing the extent to which these patterns persist requires additional years of observation.<br><br>© 2018 John Wiley & Sons Ltd.<p />  <p>Language: en</p>
LA  - en
SN  - 1740-8695
UR  - http://dx.doi.org/10.1111/mcn.12588
ID  - ref1
ER  -