% Malnutrition (less than -2Z) Socioeconomic Factors Associated With Children’s Oral Health and Malnutrition in Nepal Chloe Tsang, Karen Sokal-Gutierrez, Howard Barkan, Kristine Ronsin, Ashmita Baral BACKGROUND RESULTS RESULTS Childhood Malnutrition Nepal has 41% of its children under 5 stunted Early Childhood Caries Tooth decay is one of the most prevalent chronic conditions, affecting 60-90% of children worldwide Limited Health Care There is only 1 dentist for every 100,000 people Rural and Urban Development Rapid urbanization is shifting traditional nutritional practices towards increased junk food consumption I. Demographics IV. Child Oral Health and Nutrition Status Maternal Total Urban Mothers Rural Mothers Mean age 29.7 years 29.5 years 29.9 years Mean education level* 4.9 years 6.1 years 2.5 years Mean number of children* 2 children 3 children Mean household size* 5 members 6 members Child Oral Health Status Children Total Urban Children Rural Children Mean age* 4.4 years 4.3 years 5.1 years Females 52.2% 44.9% 51.1% Males 46.9% 53.5% 48.9% % Malnutrition (less than -2Z) Total Urban Children Rural Children HAZ* 34.2% 29.5% 42.7% WAZ 14.8% 13.2% 17.6% BMI 2.1% 2.0% ABSTRACT & HYPOTHESIS Despite greater knowledge about oral health and nutrition, greater access to and consumption of junk food drives poor nutritional practices and increased early childhood caries II. Maternal Oral Health and Nutrition Knowledge KNOWLEDGE Dental Caries Oral Health Practices Nutritional Value ACCESS Dental Care Oral Hygiene Products Junk Food Knowledge Total Urban Rural Sweets cause caries 85.5% 84.7% 87.0% Juice/soda causes caries* 5.0% 6.4% 2.3% Not brushing causes caries* 26.1% 29.5% 20.0% Don’t know how caries affect children* 8.0% 6.0% 11.2% Think caries causes pain 74.9% 73.4% 79.5% Think caries affects eating 47.5% 44.9% 52.6% Think caries affects sleep* 17.6% 21.1% 11.6% Think caries harms health* 8.9% 12.4% 0.9% PRACTICES Oral Care Nutrition Bottle feeding OUTCOMES Level of Decay  Weight and Height poor oral health outcomes better oral health outcomes URBAN RURAL RISK FACTORS* -- Knowledge -- Access to dental care -- Access to dental hygiene products -- Access to junk food -- Daily consumption of junk food VI. Summary OBJECTIVES Explore key socioeconomic factors contributing to poor oral health and nutrition through baseline analysis Determine effective interventions to improve children’s oral health and nutrition III. Child Oral Health and Nutrition Practices METHODS CONCLUSION Data Collection: Sampled participants in 10 community health camps, 5 from urban and 5 from rural areas Study Population: 632 mothers interviewed; 836 children aged 0-8 years measured: 532 (63.6%) urban children; 304 (36.4%) rural children Maternal Interviews: Assessed knowledge of oral health and nutrition Oral Health Examinations: De decay=surface enamel decay, Dd=dentin decay, Dp=pulp decay; decayed missing and filled teeth; recurrent caries Nutritional Status Examinations: HAZ=height for age, WAZ=weight for age; BAZ=BMI for age Analysis: SPSS version 22, tested for statistical significance between urban with rural responses and correlations for association analysis Junk food consumption is adversely reshaping traditional practices and reinforcing malnutrition and childhood caries Key interventions include reducing the consumption of junk food and improving overall health knowledge and practices in the household and at school, starting from birth Further analysis will explore the results of our intervention program ACKNOWLEDGEMENTS Many thanks to: the Hasilo Nepal team, volunteer dentists, UC Berkeley, UCSF, UCB Health Research for Action Center; hundreds of participating families and children; supported funding from Global Healing, UC Berkeley Undergraduate Research Apprenticeship Program *statistically significant difference between urban and rural (p<.05) by chi-sq test