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Determinants of severe acute malnutrition among children under 5 years of age in Nepal: a community-based

Nilesh Kumar Pravana1, Suneel Piryani1, Surendra Prasad Chaurasiya1

  • 1Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.

BMJ Open
|August 31, 2017
PubMed

Insights

Low socioeconomic status, maternal age, short birth intervals, and father's illiteracy are key factors contributing to severe acute malnutrition (SAM) in Nepalese children. Addressing these determinants is crucial for child survival.

Area of Science:

  • Pediatrics
  • Public Health
  • Nutritional Epidemiology

Background:

  • Severe acute malnutrition (SAM) is a major cause of child mortality in low- and middle-income countries, including Nepal.
  • The prevalence of SAM has risen in Nepal, yet its specific determinants remain under-researched.
  • Children with SAM face a ninefold higher mortality risk compared to well-nourished children.

Purpose of the Study:

  • To investigate the factors contributing to severe acute malnutrition (SAM) in children aged 6-59 months.
  • To identify key determinants for targeted interventions in the Bara district of Nepal.

Main Methods:

  • A community-based case-control study was conducted in 12 randomly selected Village Development Committees (VDCs) in Nepal's Bara district.
  • A sample of 292 children (146 cases, 146 controls) aged 6-59 months were analyzed.
  • Statistical analysis identified significant risk factors associated with SAM.

Main Results:

  • The prevalence of SAM was found to be 4.14% among children under five.
  • Significant determinants included low socioeconomic status (AOR 17.13), maternal age outside 20-35 years (AOR 3.21), birth interval <24 months (AOR 4.09), illiterate father (AOR 3.65), bottle feeding (AOR 2.19), and delayed complementary feeding (AOR 2.91).
  • Maternal education, breastfeeding initiation, colostrum feeding, and exclusive breastfeeding were not significantly associated with SAM.

Conclusions:

  • Maternal age, birth interval, socioeconomic status, father's education, and timely complementary feeding are critical determinants of SAM.
  • A multi-sectoral strategy is necessary for effective SAM management and prevention.
  • Further research should also encompass moderate acute malnutrition.
Abstract

Keywords:
Nepalcase-control studychildren under five year of agesevere acute malnutrition

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