Determinants of Under-nutrition among Children under Five Years of Age in Ethiopia

Abstract

Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying factors of child under-nutrition using a single composite index of anthropometric indicator. Methods: Data from Ethiopia’s Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with WHO 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition , partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results: The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. A child with mother of body mass index less than 18.5 kg, from poorest family, a husband without education and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion: The authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anemic status, multiple birth, fever before two months of survey, mother’s age at first birth, and husband’s education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access.

Determinants of Stunting Prevention among Mothers with Children Aged 6–24 Months

“…Knowledge itself is influenced by many factors, one of which is the level of education and age [26]. This research is in line with the research conducted by Aridiyah and Rohmawati [27] and Kassie and Workie [28]. The studies stated that one of the factors that influence the occurrence of stunting in children is the mother's education and knowledge.…”

Determinants of Acute Malnutrition among Children 6-59 Months of Age Visiting Public Health Facilities in Dawe Kachen District, East Bale Zone, Oromia, Ethiopia: A Case Control Study.

“…Children whose mothers/caregivers had not received IYCF counselling were eight times more likely to have acute malnutrition than were children whose mothers/caregivers had received IYCF counselling. These ndings coincide with those of Gambella town, Southwest Ethiopia (24). This could be attributed to the fact that counselling mothers/caregivers on infant and young child feeding increases awareness of optimal child feeding and caring practices.…”

Risk Assessment and Control of Stunting in Makassar City, Indonesia

“…Mothers with better knowledge of children's nutritional health and prevention of infectious diseases will have awareness in providing better health care for their children and better prevention treatment of infective diseases. It can be concluded that the better the mother knows about the health status of her child, the lower the stunting rate in her child [9]. Increased knowledge of infectious diseases in housewives can be obtained from various sources such as posyandu activities which are one of the means for mothers of toddlers to increase their knowledge.…”