| dc.description.abstract | Introduction: The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation
conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of
overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous
children remains worrying. The First National Survey of Indigenous People’s Health and Nutrition in Brazil,
conducted in 2008–2009, was the first study to evaluate a nationwide representative sample of indigenous peoples.
This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in
Brazil.
Methods: A multi-stage sampling was employed to obtain a representative sample of the indigenous population
residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a
stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in
sampled villages were selected by census or systematic sampling depending on the village population. The survey
evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers.
Results: Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of
stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for
confounding, the prevalence rates of underweight and stunting were higher among children in the North region,
in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with
low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for
underweight was observed for children under 12 months.
Conclusions: The elevated rate of stunting observed in indigenous children approximates that of non-indigenous
Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence
rates of undernutrition were associated with socioeconomic variables including income, household goods,
schooling, and access to sanitation services, among other variables. Providing important baseline data for future
comparison, these findings further suggest the relevance of social, economic, and environmental factors at different
scales (local, regional, and national) for the nutritional status of indigenous peoples. | |
