Background: Stunting and wasting are key public health problems in Ghana that are significantly linked with mortality and morbidity risk among children. However, information on their associated factors using nationally representative data is scanty in Ghana. This study investigated the influence of Infant and Young Child Feeding (IYCF) indicators, socio-demographic and economic related factors, and water and sanitation on stunting and wasting, using nationally representative data in Ghana. Methods: This is a secondary data analysis of the most recent (2017/2018) Ghana Multi-Indicator Cluster Survey (MICS) datasets. The multi-indicator cluster survey is a national cross-sectional household survey with rich data on women of reproductive age and children under the age of five. The survey used a two-stage sampling method in the selection of respondents and a computer-assisted personal interviewing technique to administer structured questionnaires from October 2017 to January 2018. The present study involved 2529 mother-child pairs, with their children aged 6 to 23 months. We used the Complex Sample procedures in SPSS, adjusting for clustering and stratification effects. In a bivariate logistic regression, variables with P-values ≤ 0.05 were included in a backward multivariate logistic regression to identify the significant factors associated with stunting and wasting. Results: The mean age of children was 14.32 ± 0.14 months, with slightly more being males (50.4%). About 12% and 16% of the children were wasted and stunted, respectively. There were 39.4%, 25.9%, and 13.7% of children who, respectively, satisfied the minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). None of the IYCF indicators was significantly associated with stunting or wasting in the multivariate analysis but low socio-economic status, low birth weight, being a male child and unimproved toilet facilities were significantly associated with both wasting and stunting. Conclusion: Our findings suggest that aside from the pre-natal period, in certain contexts, household factors such as low socio-economic status and poor water and sanitation, may be stronger predictors of undernutrition. A combination of nutrition-specific and nutrition-sensitive interventions including the pre-natal period to simultaneously address the multiple determinants of undernutrition need strengthening.

Objective Household food insecurity is positively associated with depression; however, the association among adolescents is not well known. We examined the association between household food insecurity and depression among adolescent girls in Northern Ghana. Methods We analysed data from the Ten2Twenty-Ghana randomised controlled trial end-line for adolescent girls aged 10–17 years (n=582). The girls were chosen at random from 19 primary schools in the Mion District of Ghana’s northern region. The children’s depression inventory and the Food Insecurity Experience Scale were used in face-to-face interviews to assess depression and household food insecurity. Hierarchical survey binary logistic regression and linear mixed models were used to examine the association between household food insecurity and depressive symptoms. We took into account a number of potential confounders in the analysis, such as life satisfaction, self-efficacy, self-esteem, health complaints, child’s age, menarche status, pubertal development, anaemia, stunting, frequency of consuming fruits and vegetables, frequency of consuming animal-sourced foods, maternal age, household wealth index and size, and the intervention group the girl was assigned to in the trial. Results About 20.1% of adolescent girls were classified as likely depressed, and 70.3% of their households were food insecure, with 22.9% and 18.0% being moderately and severely food insecure, respectively. Compared with girls from food-secure households, those from moderately (adjusted OR (AOR) 2.63, 95% CI (1.35 to 5.12)) and severely (AOR 3.28, 95% CI (1.66 to 6.49)) food insecure households had about three times the odds of being classified as depressed, after controlling for potential confounders. The odds of being likely depressed were about twice for adolescent girls from food-insecure households compared with their peers from food-secure households in both the crude and final adjusted model. Conclusion The study discovered high levels of household food insecurity and depression in adolescent girls in Northern Ghana, with a dose-response association between the two.

Background. Though emerging evidence indicates caesarean section (CS) brings about late initiation of breastfeeding, early cessation of breastfeeding, and a higher risk of developing obesity, little is documented on the association between CS birth and stunted growth. This study assessed caesarean section delivery and the risk of poor postnatal childhood growth. Methods. A retrospective cohort study design was used to collect the requisite data on a sample of 528 mothers having children between the ages of 6 to 24 months. An interviewer-administered questionnaire was used to collect the data. Results. After controlling for potential confounding factors, linear growth as measured by height-for-age Z-score (HAZ) was significantly higher by 0.121 standard units in children born through normal vaginal delivery, compared to their counterparts born through caesarean section (beta coefficients (β) = 0.121, p=0.002). The mode of delivery also had a statistically significant impact on infant feeding practices. Whereas 70.4% of babies delivered via vagina initiated breastfeeding within one hour of delivery, only 52.7% of babies born through CS did the same. Vaginally delivered babies were 2.1 times more likely to initiate breastfeeding within one hour of delivery ((Crude odds ratio (COR) = 2.13, p<0.001). Compared to CS babies, vaginally delivered babies were 3.2 times more likely not to have been fed with prelacteal feeds such as water and sugar solutions. Vagina delivered babies were 1.8 times more likely to receive adequate neonatal feeding than their counterparts who were delivered through CS (COR = 1.76, p=0.003). Conclusions. This study has found an association between CS delivery and stunting, an adverse outcome that clinicians and patients should weigh when considering in particular elective CS that seeks to avoid the pain associated with a vaginal birth.

Background: Despite advances in antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) continue to face heightened susceptibility to opportunistic infections (OIs). Adequate nutrition remains an essential factor that positively influences disease progression and the occurrence of OIs. In Ghana, no study has evaluated the association between dietary diversity and OI occurrence among adults with HIV. This study aimed to evaluate the association between dietary diversity and the presence of OIs among HIV-positive adults receiving ART. Methods: A facility-based cross-sectional study was conducted among 291 HIV-positive adults receiving ART from February 2023 to April 2023 at Kumasi South Hospital, Ghana. The study participants were selected using a convenient sampling method. A pre-tested questionnaire and review of electronic health records were used to collect sociodemographic, nutritional and clinical data. Binary logistic regression analyses were conducted to identify variables significantly associated with the study outcome and hierarchical multivariable logistic regression was used to evaluate the association between dietary diversity and the occurrence of OIs while controlling for confounders at p-value < 0.05. Results: The mean age and dietary diversity were 46.2 ± 10.9 years and 4.0 (IQR: 3.0 to 6.0) food groups, respectively. Out of 291 respondents, 152 (52.2%) had inadequate dietary diversity and 39 (13.4%) had at least one OI. The respondents with inadequate dietary diversity were three times more likely to have an OI than their peers with adequate dietary diversity [AOR 3.03, (95% CI: 1.20 to 7.64), p = 0.019]. Conclusion: This study revealed that inadequate dietary diversity is a significant nutritional problem and dietary diversity was associated with the presence of OIs among PLWHA on ART at the study site. Hence, there is the need to enhance the intake of diversified diets based on locally available foods. This could decrease the occurrence of OIs and eventually reduce HIV-related morbidity/mortality.

Childhood malnutrition is a public health challenge of much interest and concern globally. However, a perturbed gut microbiome (GM) may limit some nutrition interventions’ effects among healthy children with undernutrition. This review aimed to evaluate the effects of GM-targeted nutrition interventions on growth outcomes among children (0–59 mo) using published studies in low- and middle-income countries. The methods were guided by the Cochrane methodology. The literature search was conducted to include articles published from inception to July 2023 in PubMed, Google Scholar, and Cochrane Databases. We identified and included 35 studies among 11,047 children. The analysis was conducted considering various growth parameters in the qualitative synthesis and weight gain (kg) in the meta-analysis. In the qualitative synthesis, 55.6% of prebiotics, 66.7% of probiotics, 71.4% of synbiotics, and 28.6% of “microbiome complementary feed” studies had significant effects on growth outcomes. Also, prebiotics had more studies with significant effects among healthy children, whereas probiotics, synbiotics, and “microbiome complementary feeds” had more studies with significant effects among children with undernutrition. Nineteen studies were included in the meta-analyses, of which 7 (36.8%) measured GM outcomes. The meta-analysis showed that prebiotics exhibited heterogeneity but had significant effects on weight in the intervention as compared with the control (mean difference [MD]: 0.14 kg; 95% CI: 0.02, 0.25; I² = 63%, P = 0.02; 4 studies, n = 932). Probiotics had significant effects on weight in the intervention (MD: 0.15 kg; 95% CI: 0.06, 0.25; I² = 42%, P = 0.05; 8 studies, n = 2437) as compared to the control. However, synbiotics (MD: 0.26 kg; 95% CI: –0.04, 0.56; I² = 41%, P = 0.17; 4 studies, n = 1896] and “microbiome complementary feed” (MD: –0.03 kg; 95% CI: –0.18, 0.11; I² = 0%, P = 0.60; 3 studies, n = 733] had no significant effects on weight in the intervention as compared with control. Although probiotics and synbiotics may be effective at enhancing growth among children, the selection of interventions should be contingent upon health status. This trial was registered at www.crd.york.ac.uk/prospero/ as CRD42023434109.

As a result of the COVID-19 pandemic, schools in Ghana were compelled to suspend routine learning activities and shut down to avert a possible public health crisis. As such, online learning was introduced as a temporary measure to ensure continuity in learning. For nursing and midwifery students who are usually more engaged in face-to-face practical learning, it will be interesting to ascertain how they experienced online learning during the COVID-19 pandemic in a technologically deprived country. Hence, data was collected from March to June 2021 using online methods and a cross-sectional study design among students of nursing and midwifery training colleges in the five regions of Northern Ghana. Logistic regression and descriptive analysis were conducted using SPSS (version 22) to determine the association between (1) socio-demographic factors, (2) internet exposure and accessibility factors, and the outcome variable; students’ experiences. The results for 318 students revealed that pleasant experiences were below average (42.8%) and that reliable college internet connectivity, older age, year of study, and residence in southern Ghana were significant predictors of pleasant experiences. However, high cost of data and home distractions were identified as the main challenges to online learning. Therefore, it is important for nursing and midwifery training colleges in northern Ghana to establish robust information and communication technology infrastructure on their campuses to ensure reliable internet connectivity.