Household-level double burden of malnutrition in Ethiopia: a comparison of Addis Ababa and the rural district of Kersa

Bliznashka, Lilia; Blakstad, Mia M.; Berhane, Yemane; Tadesse, Amare Worku; Assefa, Nega; Danaei, Goodarz; Canavan, Chelsey R.; Hemler, Elena C; Fawzi, Wafaie W.

doi:10.1017/s1368980021003700

Cited by 15 publications

(22 citation statements)

References 44 publications

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“…The existence of a double burden of malnutrition in the same household was reported in different low-income settings such as in Bangladesh [ 16 , 70 ], Indonesia [ 37 ], Kenya [ 22 ], Nepal [ 15 ], and India [ 59 ]. Few studies have also reported Ethiopia's household-level double burden of malnutrition [ 11 , 25 , 26 ]. The observed prevalence of DBM was lower than the finding from a study in Nepal, 6.6% [ 15 ], and studies from Bangladesh, 6·3%, [ 70 ] and, 4.9%, [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

“…This demonstrated that Ethiopia, like other LMICs, is subject to the inevitable consequences of DBM; however, the burden of DBM is still not fully understood [ 25 , 26 ]. So far, a few studies on overweight and undernutrition coexisting at the household level have been reported [ 11 , 25 , 26 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

“…Also, there needs to be more data that have comprehensively examined household-level DBM using a large, pooled dataset in Ethiopia. Previous studies on DBM conducted in Ethiopia have focused on describing the individual-level DBM [ 35 , 49 – 51 ], localized in some areas [ 11 , 35 ], survey specific [ 25 , 26 ], and focus on the coexistence of maternal overweight/obesity and child stunting or anemia [ 52 ]. Considering the above, the aims of the present study were to: (1) determine the prevalence of DBM and (2) examine the association between maternal stature and DBM among mother–child pairs in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study examining the trends of overweight and obesity among women in Africa showed statistically significant increasing trends in several SSA countries [8]. Furthermore, due to the rapid ongoing global nutrition transition, an increasing number of studies demonstrate that the double burden of malnutrition (DBM) is a particular challenge for low-and middleincome countries (LMICs) [1,[9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Earlier estimates on DBM in sub-Saharan Africa reported below 10% prevalence at the household level [21]. However, more recent studies have reported a high prevalence of DBM among mother-child pairs in SSA: overweight/obese mother-stunted child pairs, 13-20% in Kenya [22,23], 10.3% in Nigeria [24], 14% in Egypt [21], and 1.8% to 23% in Ethiopia [11,25,26].…”

Section: Introductionmentioning

confidence: 99%

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Association between maternal stature and household-level double burden of malnutrition: findings from a comprehensive analysis of Ethiopian Demographic and Health Survey

Sahiledengle

Mwanri

Agho

2023

J Health Popul Nutr

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Background Undernutrition among under-five children is one of the intractable public health problems in Ethiopia. More recently, Ethiopia faced a rising problem of the double burden of malnutrition—where a mother may be overweight/obese, and a child is stated as having undernutrition (i.e., stunting, wasting, or underweight) under the same roof. The burden of double burden of malnutrition (DBM) and its association with maternal height are not yet fully understood in low-income countries including Ethiopia. The current analysis sought: (a) to determine the prevalence of double burden of malnutrition (i.e., overweight/obese mother paired with her child having one form of undernutrition) and (b) to examine the associations between the double burden of malnutrition and maternal height among mother–child pairs in Ethiopia. Methods We used population-representative cross-sectional pooled data from four rounds of the Ethiopia Demographic and Health Survey (EDHS), conducted between 2000 and 2016. In our analysis, we included children aged 0–59 months born to mothers aged 15–49 years. A total of 33,454 mother–child pairs from four waves of EDHS were included in this study. The burden of DBM was the primary outcome, while the maternal stature was the exposure of interest. Anthropometric data were collected from children and their mothers. Height-for-age (HFA), weight-for-height (WFH), and weight-for-age (WFA) z-scores < − 2 SD were calculated and classified as stunted, wasting, and underweight, respectively. The association between the double burden of malnutrition and maternal stature was examined using hierarchical multilevel modeling. Results Overall, the prevalence of the double burden of malnutrition was 1.52% (95% CI 1.39–1.65). The prevalence of overweight/obese mothers and stunted children was 1.31% (95% CI 1.19–1.44), for overweight/obese mothers and wasted children, it was 0.23% (95% CI 0.18–0.28), and for overweight/obese mothers and underweight children, it was 0.58% (95% CI 0.51–0.66). Children whose mothers had tall stature (height ≥ 155.0 cm) were more likely to be in the double burden of malnutrition dyads than children whose mothers’ height ranged from 145 to 155 cm (AOR: 1.37, 95% CI 1.04–1.80). Similarly, the odds of the double burden of malnutrition was 2.98 times higher for children whose mothers had short stature (height < 145.0 cm) (AOR: 2.98, 95% CI 1.52–5.86) compared to those whose mothers had tall stature. Conclusions The overall prevalence of double burden of malnutrition among mother–child pairs in Ethiopia was less than 2%. Mothers with short stature were more likely to suffer from the double burden of malnutrition. As a result, nutrition interventions targeting households’ level double burden of malnutrition should focus on mothers with short stature to address the nutritional problem of mother and their children, which also has long-term and intergenerational benefits.

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