Wealth index and other behavioral and sociodemographic characteristics associated with body mass index in Ethiopia

BMC Pregnancy Childbirth

Muluneh

2022

Self Cite

Background Globally, the estimated recurrent childbirth of one forth of women happens every two years or fewer. Next to Nigeria, Ethiopia is the second populist country in Africa and the first populist country in sub-Saharan Africa which consists of over 114 million population. There are prevalent short successive birth intervals problems in underdeveloped nations such as Ethiopia that contributes to adverse effects on mother and child health. However, studies that explore recurrent birth events and associated factors are very limited. Thus, this study aimed to explore and model the recurrent birth event by considering its subsequent within a mother and identifying its important determinants. As a result, the research findings of this study will be one of the preliminary research papers on the recurrent birth events that take into account the subsequent event and enable to be input for the policymakers, health institutions, and future researchers. Methods A total of 4676 mothers with their 16833 corresponding children were involved in this study. The data was obtained from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). In this study, extended cox regression models such as Andersen-Gill (AG), Prentice, Williams, and Peterson total time (PWP-TT) model, PWP-gap time (PWP-GT) model, and Frailty model were employed. These all models are used to consider recurrent events within mothers and determine the potential determinants. AG, PWP-TT, and PWP-GT estimate the effect of covariates by considering the correlation between event times for a person can be explained by past events given the covariates, kth event since the entry time, kth event since the time from the previous event, respectively. Results Among mothers who have first and ninth recurrent birth events, 75.5% and 80.1% of them respectively were rural residents while 57.6% and 70.6% of them respectively were a place of delivery in the health sector. The highest prevalence of first recurrent births (44.3%) was obtained from Muslim mothers. Mothers' education level (HR: 1.210; 95%CI: 1.010, 1.460), mothers' age at first birth (HR: 0.713; 95% CI: 0.614, 0.828), household wealth index (HR: 0.776; 95% CI: 0.625, 0.965), child mortality (HR: 0.673; 95%CI: 0.514, 0.881), household size (HR: 1.914; 95%CI:1.539,2.381) and sex of child (HR:0.836; 95%CI = 0.755,0.926) were important determinants of recurrent birth event. This indicates mothers’ education level and household size were positively associated with recurrent birth events. Whereas mothers’ age at first birth, household wealth index, child mortality, and sex of the child was negatively associated with recurrent birth events. Conclusion The WHO recommends a minimum of 33 months between two consecutive births, which is longer than the Ethiopian recurrent birth intervals observed in this study. The highest recurrent birth occurred during the age of fewer than twenty years old of mothers at first birth as compared to mothers whose age was older at first birth. Mothers, children, and household characteristics had significant effects on recurrent birth events. We authors would like to recommend communities, governmental and non-governmental stakeholders consider the associated factors of frequent recurrence of birth noticed in this study. Besides, we would also like to recommend women start birth while they got mature in age to reduce frequent recurrent birth and its corresponding adverse effects.

Section: Discussionmentioning

confidence: 99%

Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019

BMC Pregnancy Childbirth

Muluneh

2022

Self Cite

“…Numerous studies ( 3 , 10 , 11 ) demonstrated factors, mainly wealth index, contributing to malnutrition among under-five children and have been stable to date in developing countries in particular. However, the contribution of the wealth index to malnutrition may be mediated by other socioeconomic, demographic, behavioral, and biological factors despite little attention being given.…”

Section: Introductionmentioning

confidence: 99%

Potential mediators of the link between wealth index and anthropometric indices of under-five children in Ethiopia

Woya

2022

Front. Public Health

BackgroundMalnutrition of under-five children has adverse effects on child's health and development, such as growth failure and muscle wasting. The household wealth index has a direct contribution to child malnutrition despite little attention being given to its indirect effect through other factors. This study aimed to identify the potential mediators of the link between wealth index and malnutrition.MethodsIn this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS), which consists of a total of 3,918 under-five children. Mediation analysis of structural equation (SEM) was implemented to determine and estimate the effects of potential mediators of the link between wealth index and under-five children malnutrition.ResultsAmong 3,918 under-five children involved in this study, 51.4% were male children and 20.2% were from urban areas. The place of delivery of the majority of mothers (56.1%) was at home, and the majority of children were from the poorest household (36.4%). The estimated effects of height-for-age of female children were higher (1.31:95% CI = 0.45, 0.200), indicating that female children had a lower likelihood of stunting than males. As compared to children in an urban area, children from rural areas were more likely to be stunted (−0.269; 95%CI = −0.388, −0.135). The estimated total indirect effects of wealth index on stunting and underweight was 0.69 (95% = 0.045, 0.094) and 0.036 (95% = 0.013, 0.054), respectively, and significant (p-value of <0.05).ConclusionEnvironmental, maternal, biological, and behavioral factors were the potential mediators of the link between the wealth index and the anthropometric indices. Besides, the total effects of the household wealth index had a significant effect on stunting, underweight, and wasting in which children from a household with low economic status were more likely to be malnourished.

“…Breast feeding and mothers age at first birth have also a significant effect on underweight and wasting respectively. The lower wealth index of the household highly associated with higher risk of underweight and wasting among under five children as it is also supported in [ 7 ].…”

Section: Discussionmentioning

confidence: 73%

“…Based on 2018 WHO global reports, the prevalence of anthropometric indicators stunting, underweight and wasting in under five children were 24.7%, 15.1%, and 7.8%, respectively [ 6 , 7 ]. Even if these problems are common all over the world, it is most dominant in low and middle income countries like Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Multilevel multivariate analysis on the anthropometric indicators of under-five children in Ethiopia: EMDHS 2019

Dessie

2022

BMC Pediatr

Self Cite

Background Undernutrition is the main cause of morbidity and mortality of children aged under five and it is an important indicator of countries’ economic and health status. Limited attention is given to research papers conducted in Ethiopia that identified and estimates the determinants of under-five anthropometric indicators by considering their association and clustering effect. Therefore, this study aimed to identify and estimate the effects of important determinants of anthropometric indicators by taking into account their association and cluster effects. Methods In this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) consists a total of 5027 under-five children. A multilevel multivariate logistic regression model was employed to estimate the effect of the determinants given their association of anthropometric indicators and clustering effect. Results Among 5027 children considered in the study 36.0, 23.3, and 9.1% of them were stunted, underweight, and wasted, respectively. Whereas the total number of undernourished (stunting, underweight and/or wasting) children was 42.9%. More than half of the children (51.2%) were males and 77.0% lived in rural area. The estimated odds of children from households with secondary and above education levels being stunted was 0.496 (OR = 0.496) times the estimated odds of children from households with no education. Whereas children from the richest households were less likely to be stunted as compared to children from the poorest households (OR = 0.485). The estimated odds of children from urban areas being underweight and wasting were lower by 24.9 and 33.7% of estimated odds of children from rural areas respectively. Conclusion The prevalence of anthropometric indicators of stunting, underweight, and wasting in Ethiopia was increased. The children underweight has significant dependency with both stunting and wasting. The sex of the child, wealth index, and education level of a household are the common important determinants of stunting, underweight and wasting. The undernourished status of children was more alike within the region and differences between regions.