Severe acute malnutrition and its associated factors among children under-five years: a facility-based
Umesh Ghimire1, Binod Kumar Aryal2, Ankush Kumar Gupta2
1New ERA, Kalopul, Rudramati Marga, Kathmandu, 44600, Nepal. creationumesh@gmail.com.
Insights
Severe acute malnutrition (SAM) in Nepalese children is linked to larger family size, food insecurity, and younger age. Interventions should focus on improving household food access and maternal health education to reduce child undernutrition.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Child malnutrition remains a significant public health challenge in Nepal despite ongoing interventions.
- This study addresses the critical issue of severe acute malnutrition (SAM) in children aged 6-59 months in two Nepalese districts.
Purpose of the Study:
- To identify key predictors of severe acute malnutrition (SAM) in children aged 6 to 59 months.
- To inform targeted interventions for reducing childhood malnutrition in Nepal.
Main Methods:
- Cross-sectional study utilizing data from Outpatient Therapeutic Care Centers (OTCC).
- Nutritional status assessed via mid-upper arm circumference (MUAC).
- Multivariate logistic regression analysis employed to determine predictors of SAM, with p-value < 0.05 considered significant.
Main Results:
- 5.8% of 398 children exhibited severe acute malnutrition, with a higher prevalence in female children.
- Significant predictors of SAM included larger family size (≥5 members), severe household food insecurity, and younger child age (0-12 months).
- Children from food-insecure households were four times more likely to be severely malnourished.
Conclusions:
- Household size, food access, and child's age are major determinants of severe acute malnutrition.
- Recommendations include promoting kitchen gardening for food security and targeted health education for mothers of young children.
- Interventions aimed at improving household food access and nutrition education are crucial for reducing child undernutrition.
Background:
Despite consistent efforts to enhance child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6 to 59 months in the two districts of Nepal.
Methods:
We used data from a cross-sectional study conducted among 6 to 59 months children admitted to the Outpatient Therapeutic Care Centers (OTCC). The nutritional status of children was assessed using mid-upper arm circumference (MUAC) measurement. To determine which variables predict the occurrence of SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value < 0.05 was considered as significant.
Results:
Out of 398 children, 5.8% were severely malnourished and the higher percentage of female children were malnourished. Multivariate analysis showed that severe acute malnutrition was significantly associated with family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23-12.71). Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Higher odds of SAM were found among younger age-group (AOR: 12.10; 95% CI: 2.06-71.09) children (0-12 vs. 24-59 months).
Conclusions:
The findings of this study indicated that household size, household food access, and the child's age were the major predictors of severe acute malnutrition. Engaging poor families in kitchen gardening to ensure household food access and nutritious diet to the children, along with health education and promotion to the mothers of young children are therefore recommended to reduce child undernutrition.
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