Rural and Urban Correlates of Stunting Among Under-Five Children in Sierra Leone: A 2019 Nationwide Cross-Sectional Survey

Abstract

Background: Undernutrition accounts for at least 50% of the annual global under-five mortality burden. Although disparities in the childhood stunting between urban and rural areas in Sierra Leone have been documented, information on factors associated with these differences is lacking. We aimed to determine rural-urban correlates of stunting among children under the age of 5 in Sierra Leone. Methods: We analyzed data from 2019 Sierra Leone demographic and health survey (SLDHS) focusing on under-five children. We conducted multivariable logistic regression to examine rural-urban factors associated with childhood stunting. Results: Prevalence of stunting was 31.6% (95% CI 29.8-33.2) in rural areas and 24.0% (95% CI 21.6-26.1) in urban areas. Within the rural areas, children of stunted mothers (aOR = 2.37; 95% CI 1.07-5.24, P < .05), younger mothers aged 15 to 19 years (aOR = 2.08; 95% CI 1.17-3.69, P < .05), uneducated mothers (aOR = 1.87; 95% CI 1.28-2.71, P < .01), as well as older children (24-59 months) (aOR = 1.83; 95% CI 1.48-2.27, P < .001), and boys (aOR = 1.37; 95% CI 1.12-1.66, P < .01) were more likely to be stunted compared to those of non-stunted, older, post-primary education mothers and those who were less than 24 months and girls respectively. While urban children whose fathers had lower education (aOR = 1.94; 95% CI 1.10-3.42, P < .05), whose mothers were more parous (para 2-4) (aOR = 1.74; 95% CI 1.03-2.95, P < .05), and boys (aOR = 1.48; 95% CI 1.06-2.08, P < .05) were more likely to be stunted compared to their counterparts with fathers that had tertiary education, mothers of low parity and girls, respectively. Conclusions: Stunting is more prevalent in the rural areas compared to the urban areas. Sex of the child was the only significant factor in both rural and urban areas. Our study findings suggest that programs designed to reduce stunting should aim for integrated yet context specific interventions in rural and urban areas.

Stunting among kindergarten children in China in the context of COVID-19: A cross-sectional study

“…The present study shows that the risk of boys suffering from childhood stunting is 1.07 times that of girls, the same as many results from China (20,21,39,40) and other regions (41,42), probably due to the interaction of biological and socio-cultural factors. We also found differences between boys and girls in growth trajectories and immune function beginning prenatally (43,44).…”

Revenue and Expenditure Budgets and Village Development Index to Reduce Stunting: A Case Study from Indonesian Provinces

“…Source: Indonesian Ministry of Health (Khairani, 2020) Figure 1. Stunting in Indonesia Several studies addressed stunting instances in Indonesia and other developing countries, on children under the age of five, which is relatively high in rural areas (Cordeiro et al, 2021;Indriastuty & Kusnadi, 2019;Sserwanja et al, 2021). These findings are consistent with basic health research findings, which show that the prevalence of stunting in children under the age of five in Indonesia is 34.9% in rural areas and 27.3% in urban areas (Ministry of Health, 2018).…”

“…These findings are consistent with basic health research findings, which show that the prevalence of stunting in children under the age of five in Indonesia is 34.9% in rural areas and 27.3% in urban areas (Ministry of Health, 2018). The high risk of stunting in rural areas may be due to a lack of access to food and health services, as well as maternal knowledge (Cordeiro et al, 2021;Sserwanja et al, 2021). This is comparable to the WHO model, which claims that community and socioeconomic factors influence stunting.…”

Neonatal characteristics and conditions contributed to stunting

“…Neonatal characteristics and conditions contributed to stunting: A systematic review and meta-analysis. International Journal of Health Sciences,6(3) Ramli et al, 2009;Shinsugi et al, 2015;Siswati, 2019;Sserwanja et al, 2021;Sunguya et al, 2019;Tafesse et al, 2021;Tariku et al, 2017;Tiwari et al, 2014;Torlesse et al, 2016;Vonaesch et al, 2017Vonaesch et al, , 2021Wali et al, 2020;Widyaningsih et al, 2022;Yang et al, 2018) Of them 1 study were done in Armenia (A Balalian et al, 2017), 1 in Burundi (Nkurunziza et al, 2017), 2 in Central African Republic (Vonaesch et al, 2017(Vonaesch et al, , 2021, 1 in Democratic Republic of Congo (Kismul et al, 2017), 5 in Ethiopia (Ayelign & Zerfu, 2021;Berhe et al, 2019;Gonete et al, 2021;Tafesse et al, 2021), 5 in . Neonatal characteristics and conditions contributed to stunting: A systematic review and meta-analysis.…”