Stunting and Underweight, but not Wasting are Associated with Delay in Child Development in Southwest Ethiopia

Abstract

Background: Stimulating care during childhood is the foundation for optimal health, learning, productivity, and social well-being throughout the life course. In addition, malnutrition is a major public health concern affecting up to half of children under-five years in Ethiopia. However, evidence on the causal contribution of malnutrition to delay in child development is poorly understood in Ethiopia. Objective: To identify the relationship between different forms of malnutrition and delay in child development among children in Southwest Ethiopia. Methods: A community-based survey was conducted among 507 randomly selected mother-child pairs in the Guraghe Zone, Southwest Ethiopia. A pretested tool and validated anthropometric measurements were used. Anthropometric indices (WFH, WFA, and HFA) were calculated in Anthros software. The data were summarized in mean, median, standard deviation, tables and charts. Bivariable and multivariable binary logistic regression (stepwise backward regression) models were fitted with nutritional status (wasting, stunting and underweight) and other potential factors associated with delay in child developmental. Adjusted odds ratios with 95% confidence intervals and p-values were reported. Results: A total of 507 mother-child (12-59 months) pairs were included in the survey (97% response rate). The mean ASQ-3 score was 150 (± 23.4), with a minimum and maximum score of 45 and 270, respectively. A total of 149 (29.4%; 95% CI: 25.4-33.4) children had developmental delays, where 17.2%, 16.8%, 13.4%, 10.8%, and 10.1% had delays in gross motor, communication, problem-solving, personal-social, and fine motor skills, respectively. Children of working mothers (AOR=2.9; 1.8, 4.8), preterm births (AOR=3.2; 1.4, 7.0), early initiation of complementary feeding (AOR=2.5; 1.37, 4.6), stunting (AOR=3.0; 1.9, 4.7), underweight (AOR= 2.3; 1.1, 4.7) and low dietary diversity score (AOR=3.1; 1.3, 7.5), were predictors of developmental delay. Conclusion: Child development delay is a public health concern and it is strongly associated with stunting, underweight, undiversified dietary consumption, and suboptimal infant and young child feeding practices.

Analysis of Factors that affect Events and Interventions of Stunting through the E-Stunting Android Application

“…The condition of children is at risk of nutritional imbalances and the possibility of nutritional problems including obesity and stunting. This result is in line with the research of Uwiringiyimana et al; Gol et al; Oumer et al; and Pallaluththa et al [24], [30], [38], [39] which explain that the child's ability to choose the type of food is at risk of imbalance in nutritional intake, so assistance and supervision from parents or caregivers are needed.…”

“…Restrictions on the number of types of food trigger disruption of the acceptance of types of food in the body, causing imbalances in the metabolic processes of essential amino acids, choline, and the synthesis of sphingolipids which have an important role in the formation of muscle and bone growth hormone [23], [24], [30].…”

“…Moraeus et al [11], [31], [32], [10], [30], [31], [8], [28], [29], [8], [27], [28] which provides an explanation that eating culture in the family affects minimal dietary diversity so that it reduces the Z score and body mass index of children [8], [27], [28], [29].…”

How Can Nutrition Research Better Reflect the Relationship Between Wasting and Stunting in Children? Learnings from the Wasting and Stunting Project

“…To better understand this for different children in different contexts, we need more data, not only on how anthropometric measures change over time but also on the interlinked and dynamic biological processes and pathways that underlie the spectrum of child weight loss and linear growth faltering in different settings. In particular, there is a need to better understand how these processes differ for infants born stunted and/or wasted compared with infants that develop wasting and/or stunting around 3 to 4 months of age ( 9 , 31 ). This would enable a deeper analysis of relationships between the causes and timing of child weight and linear growth faltering.…”

Analysis of factors that affect health-seeking behavior in parents with stunted and obese children during the pandemic

“…This opinion has been conducted in previous research by Gholampour et al (2020);Vaivada et al (2020);Hailegebriel, (2020);Zhu et al (2021) who explained that government policies in an area affect the model of community behaviour in the realm of early detection, choice of place and decision to go for treatment. Likewise, the research by Ayelign & Zerfu (2021); Ngwira (2020); Oumer et al (2022), stated that the nutritional status of children is strongly influenced by government policies.…”