Undernutrition and associated factors among rural adolescent girls in Daramalo district, Southern Ethiopia: a community-based cross-sectional study

Abstract

Background Undernutrition among adolescent girls is a major public health problem. Despite the adolescence period being a unique opportunity to break the intergenerational cycle of malnutrition, in Ethiopia, particularly in the study area information regarding the nutritional status of adolescent girls is lacking. Therefore, this study aimed to fill this identified gap. Objective To assess the prevalence of undernutrition and associated factors among rural adolescent girls in Daramalo district, Southern Ethiopia. Methods: A community-based cross-sectional study was conducted among 672 adolescent girls from March 11 to April 11, 2021, using a systematic random sampling technique. Anthropometric measurements were analyzed by WHO Anthro plus software for Z-score. The data were entered into Epi data version 3.1 and analyzed with SPSS window version 25.0. Binary logistic regression analysis was used to identify factors associated with undernutrition. Adjusted odds ratio (AOR) and 95% confidence intervals (CI) were used to measure the strength of association and a p-value less than 0.05 was used to declare the level of statistical significance. Results The prevalence of thinness and stunting was 12.6% (95%CI: 10.3%, 15.2%) and 21.1% (95%CI: 18.3%, 24.3%), respectively. Large family size (AOR = 3.23; 95%CI: 1.87, 5.58), ≤ 2 meal frequency (AOR = 3.21; 95%CI: 1.59, 6.45), being non-menstruating (AOR = 4.24; 95%CI: 2.36, 7.61), poor and medium wealth index (AOR = 2.34; 95%CI: 1.15, 4.72) and (AOR = 3.16; 95%CI: 1.61, 6.21), and inadequate dietary diversity (AOR = 2.23; 95%CI: 1.34, 3.68) were factors significantly associated with an increased odds of thinness. Whereas, early adolescence (AOR = 1.54; 95%CI: 1.04, 2.28), large family (AOR = 1.85; 95%CI: 1.24, 2.77), separate decision making on nutrition service by father or mother, (AOR = 3.21; 95%: 1.68, 6.14) and (AOR = 3.01; 95%CI: 1.76, 5.15), inadequate dietary diversity (AOR = 2.12; 95%CI: 1.41, 3.19), and household food insecurity (AOR = 2.24; 95%CI: 1.48, 3.41) were factors significantly associated with an increased odds of stunting. Conclusions Stunting and thinness were found to be high in the study area. Future interventions and programs may consider strategies to improve dietary diversity, food security, wealth status, household decision-making power, meal frequency, and family size through increasing the awareness of the community on the intergenerational effect of adolescent undernutrition and by strengthening community-based adolescent nutrition programs.