Determinants of Severe Acute Malnutrition Among Children 6-36 Months in Kalafo District, Riverine Context, Ethiopia. Unmatched Case Control With Qualitative Study.

Abstract

Background: Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries.Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia.Methods: Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition(SAM) among children between 6 to 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6-36 months using multivariate logistic regression.Results: The Odds of Severe Acute Malnutrition was 2.28(1.22,4.26); 4.68(2.29,9.58); 2.85(1.26,6.45); 2.39(1.16,4.96) and 3.262(1.46,7.31) and 3.237(1.45,7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past two weeks, their mothers had not nutrition counselling during pregnancy, Children’s age between 6-11 and 12-17 months as compared to controls.Conclusion: The finding of this study reveals that the main determinants of severe acute malnutrition in riverine context are multi-level. On top of poor childcare and polygamy in qualitative finding, Diarrhea and inadequate dietary intake under the category of immediate cause of malnutrition. Having more than (≥3) under-five children, young age (6-11 and 12-17months) and not having nutrition counseling during pregnancy were also among basic determinants of severe acute malnutrition in riverine context. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.

Barriers and facilitators of severe acute malnutrition management at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, North West Ethiopia, descriptive phenomenological study

“…These include underlying illnesses, poverty, and local superstitions or taboos. Poor awareness of appropriate feeding, illiteracy, and poor breastfeeding practices were almost unanimously mentioned as major causes of SAM, which has similar findings in studies conducted in different regions [28][29][30][31][32].…”