Individual and community level factors with a significant role in determining child height-for-age Z score in East Gojjam Zone, Amhara Regional State, Ethiopia: a multilevel analysis

Abstract

BackgroundIn Ethiopia, child undernutrition remains to be a major public health challenge and a contributing factor for child mortality and morbidity. To reduce the problem, it is apparent to identify determinants of child undernutrition in specific contexts to deliver appropriately, targeted, effective and sustainable interventions.MethodsAn agroecosystem linked cross-sectional survey was conducted in 3108 children aged 6–59 months. Multistage cluster sampling technique was used to select study participants. Data were collected on socio-demographic characteristics, child anthropometry and on potential immediate, underlying and basic individual and community level determinants of child undernutrition using the UNICEF conceptual framework. Analysis was done using STATA 13 after checking for basic assumptions of linear regression. Important variables were selected and individual and community level determinants of child height-for-age Z score were identified. P values less than 0.05 were considered the statistical level of significance.ResultsIn the intercept only model and full models, 3.8% (p < 0.001) and 1.4% (p < 0.001) of the variability were due to cluster level variability. From individual level factors, child age in months, child sex, number of under five children, immunization status, breast feeding initiation time, mother nutritional status, diarrheal morbidity, household level water treatment and household dietary diversity were significant determinants of child height for age Z score. Also from community level determinants, agroecosystem type, liquid waste disposal practice and latrine utilization were significantly associated with child height-for-age Z score.ConclusionIn this study, a statistical significant heterogeneity of child height-for-age Z score was observed among clusters even after controlling for potential confounders. Both individual and community level factors, including the agroecosystem characteristics had a significant role in determining child height-for-age Z score in the study area. In addition to the existing efforts at the individual levels to improve child nutritional status, agroecosystem and community WASH related interventions should get more attention to improve child nutritional status in the study area.

Magnitude of prelacteal feeding practice and its association with place of birth in Ethiopia: a systematic review and meta-analysis, 2017

“…The pooled odds ratio of women who gave birth at their home was increased by five folds as compared to those who gave birth at health facilities. This finding is in agreement with a multilevel study in twenty-two Sub Saharan Africa including Ethiopia [ 6 ], and another multilevel study conducted in Ethiopia [ 24 ]. This is due to the fact that home delivery in Ethiopia is usually attended by traditional birth attendants who do not have the knowledge on the benefits of optimum breastfeeding and the harms following prelacteal feeding.…”

Prevalence of Stunting and Its Associated Factors among Children of 6–59 Months in Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia: A Community-Based Cross-Sectional Study

“…Obviously, poverty and economic inequality hinder the financial ability for household food access, inadequate sanitation, and health care utilization, which are the major contributing factors for the development of malnutrition including stunting [34]. In contrary, household wealth had no significant association with stunting in study conducted in East Gojjam, Ethiopia [35]. Appropriate infant and young child feeding has been identified as one of key determinants of child under nutrition particularly stunting [10].…”

A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health

“…In particular, a lack of privacy and security were related to women emptying bags and buckets at night, a behavior that can often increase the exposure of women to the threat of violence or sexual assault (Winter et al, 2019). Generally, studies that compared access to sanitation between men and women found largely unremarkable gender differences (Ugbomoiko et al, 2009;Al-Delaimy et al, 2014;Alemu et al, 2017;Baker et al, 2018). However, one study in rural Ethiopia found that male-headed households were ∼4-fold more likely to use household latrines than female-headed families (Aiemjoy et al, 2017).…”

“…Kwiringira et al, 2014;Sato et al, 2016;Khan et al, 2017;Aluko et al, 2018;Angoua et al, 2018;Budhathoki et al, 2018;Dendup et al, 2018;Desalegn et al, 2018;Lubon et al, 2018;Winter et al, 2019 Gender differences in accessing a latrine were largely unremarkable. Ugbomoiko et al, 2009;Al-Delaimy et al, 2014;Alemu et al, 2017;Baker et al, 2018 Women and girls were burdened by latrines which lacked privacy and security. Kwiringira et al, 2014;O'Reilly and Louis, 2014;Winter et al, 2019 Male-headed households were more likely to have a household latrine.…”