Multiple anthropometric and nutritional deficiencies in young children in Ethiopia: a multi-level analysis based on a
Nigatu Regassa Geda1, Cindy Xin Feng2,3, Carol J Henry4
1Center for Population Studies, College of Development Studies, Addis Ababa University, Sidist Kilo Campus, PO Box 1176, Addis Ababa, Ethiopia. negyon@yahoo.com.
Insights
Childhood malnutrition and anemia in Ethiopia are critical issues. This study identified key risk factors for multiple nutritional deficiencies, emphasizing the need for improved parental education, wealth, and sanitation.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Child undernutrition and anemia are significant public health challenges in Ethiopia, contributing to increased child morbidity and mortality.
- Despite a decrease in stunting from 50% to 38% between 2000 and 2016, understanding concurrent nutritional deficiencies remains limited.
Purpose of the Study:
- To investigate the magnitude and identify risk factors for multiple nutritional deficiencies in Ethiopian children.
- To analyze the prevalence and determinants of concurrent stunting and anemia (CAS) in children aged 6-59 months.
Main Methods:
- Utilized data from 9218 children (6-59 months) from the 2016 Ethiopian Demographic and Health Survey (EDHS).
- Employed multiple nutrition deficit index and a concurrent stunting and anemia (CAS) index as outcome variables.
- Applied Poisson and Logistic mixed-effects regression models to identify risk factors.
Main Results:
- Prevalence: Stunting (38%), underweight (25.2%), wasting (9.4%), anemia (58%), and concurrent stunting and anemia (24.8%).
- Multiple nutritional problems were associated with child's sex, age, birth order, parental education, household wealth, religion, family structure, hygiene, sanitation, feeding practices, and healthcare utilization.
- Stunting and anemia co-occurrence was linked to child's sex, age, maternal education, household wealth, religion, and hygiene/sanitation.
Conclusions:
- Interventions should focus on enhancing parental education, household wealth, hygiene, sanitation, feeding practices, and healthcare access.
- Nutrition programs must consider individual child characteristics like age, gender, and birth order for effective targeting.
Background:
In Ethiopia, child undernutrition and anemia are major public health concerns, resulting in increased childhood morbidity and mortality. Despite progress made to reduce the prevalence of malnutrition (especially stunting) from 50% in 2000 to 38% in 2016, little is known about the magnitude and risk factors for concurrent nutritional deficiencies in Ethiopia.
Methods:
Analysis for this study was based on a total sample of 9218 children aged 6-59 months drawn from the Ethiopian Demographic and Health Survey (EDHS) conducted in the year 2016. The study used two outcome variables: Multiple nutrition deficit index formed by combining stunting, underweight, wasting and anemia status; and a concurrent stunting and anemia (CAS) index. Two mixed effect regression models, Poisson and Logistic, were used to identify the key risk factors of the two outcome variables, respectively.
Results:
The proportion of children with stunting (length-for-age), underweight (weight-for-age) and wasting children (weight-for-length) was 38%, 25.2% and 9.4%, respectively. About 58% of the children had anemia. The prevalence of children with concurrent stunting and anemia children was 24.8%. Our results showed that the risks of multiple nutritional problems were determined by a range of individual, household and behavioral factors including: sex of the child, age of the child, birth order, parity, parental education, religion, household wealth index and type of family structure. The proximate variables (hygiene and sanitation score, feeding practice, and child health service utilization score) were also found to exert a strong influence on the risk of multiple nutritional deficiencies. The likelihood of co-occurrence of stunting and anemia was determined by certain individual and household factors, including sex of the child, age of the child, maternal education, household asset based wealth, religion and household hygiene and sanitation.
Conclusions:
This study underscores the importance of improving parental education, household wealth, hygiene and sanitation conditions, promoting feeding practice and child health service utilization. Also, any nutrition sensitive and specific intervention should consider a child's characteristics such as his/her age, gender and birth order.
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