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Ambikapathi, Ramya

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Ambikapathi

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Ramya

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Ambikapathi, Ramya
Author's Publications: search.filters.isAuthorOfPublication.eaaeeb26-ad82-4223-bfc8-4a7529b3456e

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    Associations of land, cattle and food security with infant feeding practices among a rural population living in Manyara, Tanzania
    (BioMed Central, 2018) Hanselman, Bailey; Ambikapathi, Ramya; Mduma, Estomih; Svensen, Erling; Caulfield, Laura E.; Patil, Crystal L.
    Background: Livelihoods strategies and food security experiences can positively and negatively affect infant and young child feeding (IYCF) practices. This study contributes to this literature by exploring how variation in household economics among rural farmers in Tanzania relates to IYCF patterns over the first 8 months of an infant’s life. Methods: These data were produced from a longitudinal study in which a cohort of mother-infant dyads was followed from birth to 24 months. In addition to baseline maternal, infant, and household characteristics, mothers were queried twice weekly and monthly about infant feeding practices and diet. Weekly and monthly datasets were merged and analyzed to assess infant feeding patterns through the first 8 months. Standard statistical methods including survival and logistic regression analyses were used. Results: Aside from breastfeeding initiation, all other IYCF practices were suboptimal in this cohort. Land and cattle ownership were associated with the early introduction of non-breastmilk food items. Food insecurity also played a role in patterning and inadequate complementary feeding was commonplace. Conclusions: Health promotion programs are needed to delay the introduction of animal milks and grain-based porridge, and to achieve a minimum acceptable diet after 6 months of age among smallholder farmers in rural Tanzania. Results highlight that livelihoods-based health promotion interventions, built from a flexible and integrated design, may be an important strategy to address community-level variation in infant feeding practices and promote optimal IYCF practices.
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    Social connectedness is associated with food security among peri-urban Peruvian Amazonian communities
    (Elsevier, 2018) Lee, Gwenyth O.; Surkan, Pamela J.; Zelner, Jon; Paredes Olórtegui, Maribel; Peñataro Yori, Pablo; Ambikapathi, Ramya; Caulfield, Laura E.; Gilman, Robert H.; Kosek, Margaret N.
    Background: Food insecurity is a major global public health issue. Social capital has been identified as central to maintaining food security across a wide range of low- and middle-income country contexts, but few studies have examined this relationship through sociocentric network analysis. Objective: We investigated relationships between household- and community-level social connectedness, household food security, and household income; and tested the hypothesis that social connectedness modified the relationship between income and food security. Methods: A cross-sectional census with an embedded questionnaire to capture social relationships was conducted among eleven peri-urban communities. Community connectedness was related to study outcomes of food security and per-capita income through regression models. Results: Of 1520 households identified, 1383 were interviewed (91.0%) and 1272 (83.9%) provided complete data. Households in the youngest communities had the most total contacts, and the highest proportion of contacts outside of the community. Household income was also associated with more outside-community contacts (0.05 more contacts per standard deviation increase in income, p<0.001). Less food secure households reported more contacts nearby (0.24 increase in household food insecurity access scale (HFIAS) for each additional contact, p<0.001). After adjusting for household-level socioeconomic status, membership in an older, larger, and better-connected community, with a greater proportion of residents engaged in rural livelihood strategies, was associated with greater food security (-0.92 decrease in HFIAS for each one-unit increase in community mean degree, p=0.008). There was no evidence that social connectedness modified the relationship between income and food security such that lower-income households benefited more from community membership than higher-income households. Conclusions: Although households reported networks that spanned rural villages and urban centers, contacts within the community, with whom food was regularly shared, were most important to maintaining food security. Interventions that build within-community connectedness in peri-urban settings may increase food security.