Attending Informal Preschools and Daycare Centers Is a Risk Factor for Underweight, Stunting and Wasting in Children under the Age of Five Years in Underprivileged Communities in South Africa

Abstract

The study objectives were to determine the nutritional status of children between the ages of 12–60 months and to establish the association between attending preschool and the prevalence of undernutrition. This was a cross-sectional survey conducted in health facilities in Tshwane district in South Africa, consisting of both a questionnaire and anthropometric measures of 1256 mothers and their children. Weight-for-age (WAZ), height-for age (HAZ) and BMI-for-age (BAZ) were calculated and bivariate and multivariable analysis was performed to establish association. The results showed that child-related factors, namely birthweight, age, gender, and attending preschool increased the risk of undernutrition. Children over the age of 24 months were likely to be stunted and underweight. Maternal education reduced the odds of underweight. Children who stayed at home had reduced odds of underweight and stunting. High birthweight reduced the odds of wasting and underweight. The risks for undernutrition are multifaceted, but children who attend preschool have an increased risk of undernutrition. The risk of undernutrition increased with age and coincided with the time of cessation of breast-feeding and attendance at daycare or preschool. The complementary role of quality childcare in preschools and daycare centers is vital in alleviating the problem of undernutrition in underprivileged communities.