Factors affecting child malnutrition in Ethiopia
Ashenafi Argaw Yirga1, Henry G Mwambi1, Dawit Getnet Ayele2
1School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Pietermaritzburg, Private Bag X01, Scottsville, 3209, South Africa.
Insights
Child malnutrition in Ethiopia is linked to birth weight, mother's BMI, and region. These factors are key to developing strategies for improving child nutrition and health outcomes in developing countries.
Area of Science:
- Public Health
- Biostatistics
- Demography
Background:
- Child malnutrition is a significant public health issue in developing nations.
- Assessing the nutritional status of children under five is crucial for monitoring child health.
- This study investigates malnutrition risk factors in Ethiopian children using national survey data.
Purpose of the Study:
- To identify key risk factors associated with child malnutrition in Ethiopia.
- To apply the proportional odds model for analyzing ordinal nutritional status.
- To inform public health strategies aimed at reducing child malnutrition.
Main Methods:
- Utilized the 2016 Ethiopian Demographic and Health Survey data.
- Categorized child nutrition status into four ordinal levels: underweight, normal, overweight, and obese, based on weight-for-height Z-scores.
- Employed an ordinal logistic regression (OLR) proportional odds model (POM) to analyze the data, considering complex survey design.
Main Results:
- Model fitting that accounts for complex survey design yields more appropriate estimates and standard errors.
- Significant risk factors for under-five malnutrition in Ethiopia include child's birth weight, mother's age, mother's Body Mass Index (BMI), mother's marital status, and region of residence.
- Specific regions (Afar, Dire Dawa, Gambela, Harari, Somali) showed significant associations with nutritional status.
Conclusions:
- Child's age, sex, birth weight, mother's BMI, and region are significant determinants of malnutrition in Ethiopian children under five.
- These identified determinants can guide the development of targeted interventions to combat child malnutrition.
- The ordinal logistic regression proportional odds model is confirmed as suitable for assessing malnutrition determinants in ordinal nutritional status data.
Background:
One of the public health problems in developing countries is child malnutrition. An important factor for children's well-being is good nutrition. Therefore, the malnutrition status of children under the age of five is an important outcome measure for children's health. This study uses the proportional odds model to identify risk factors associated with child malnutrition in Ethiopia using the 2016 Ethiopian Demographic and Health Survey data.
Methods:
This study uses the 2016 Ethiopian Demographic and Health Survey results. Based on weight-for-height anthropometric index (Z-score) child nutrition status is categorized into four levels namely- underweight, normal, overweight and obese. Since this leads to an ordinal variable for nutrition status, an ordinal logistic regression (OLR)proportional odds model (POM) is an obvious choice for analysis.
Results:
The findings and comparison of results using the cumulative logit model with and without complex survey design are presented. The study results revealed that to produce the appropriate estimates and standard errors for data that were obtained from complex survey design, model fitting based on taking the survey sampling design into account is better. It has also been found that for children under the age of five, weight of a child at birth, mother's age, mother's Body Mass Index (BMI), marital status of mother and region (Affar, Dire Dawa, Gambela, Harari and Somali) were influential variables significantly associated with underfive children's nutritional status in Ethiopia.
Conclusion:
This child's age of a child, sex, weight of child at birth, mother's BMI and region of residence were significant determinants of malnutrition of children under five years in Ethiopia. The effect of these determinants can be used to develop strategies for reducing child malnutrition in Ethiopia. Moreover, these findings show that OLR proportional odds model is appropriate assessing thedeterminants of malnutrition for ordinal nutritional status of underfive children in Ethiopia.
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