High-risk fertility behaviour and undernutrition among children under-five in sub-Saharan Africa: a cross-sectional
Abdul-Aziz Seidu1,2, John Elvis Hagan Jnr3,4, Eugene Budu5
1Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana.
Insights
High-risk fertility behaviors, including early maternal age and short birth intervals, significantly increase under-five undernutrition in sub-Saharan Africa. Addressing these factors is crucial for meeting global nutrition targets.
Area of Science:
- Public Health
- Pediatrics
- Demography
Background:
- Childhood undernutrition remains a critical public health issue in sub-Saharan Africa (SSA).
- High-risk fertility behaviors are suspected contributors to undernutrition but require further investigation in the SSA context.
Purpose of the Study:
- To examine the association between high-risk fertility behaviors and undernutrition among children under five years old in sub-Saharan Africa.
Main Methods:
- Cross-sectional analysis of Demographic and Health Surveys from 32 SSA countries.
- Included 110,522 mother-child pairs.
- Multilevel binary logistic regression used to assess associations, with results presented as adjusted odds ratios (aOR) and 95% confidence intervals (CIs).
Main Results:
- Pooled prevalence of stunting was 31.3%, wasting 8.1%, and underweight 17.0%.
- Mothers younger than 18 and those with short birth intervals had children with higher odds of stunting, wasting, and underweight.
- High parity was associated with increased odds of stunting and wasting, while maternal age over 34 was linked to lower odds of underweight.
Conclusions:
- Early maternal age at birth, high parity, and short birth intervals are significant risk factors for under-five undernutrition in SSA.
- Interventions targeting these fertility behaviors are essential for achieving global nutrition goals, including reducing stunting and wasting by 2025.
Objective:
The study examined high-risk fertility behaviour and its association with under-five undernutrition in sub-Saharan Africa (SSA).
Design:
We conducted a cross-sectional analysis of data from 32 sub-Saharan African countries' Demographic and Health Surveys. A weighted sample of 110 522 mother-child pairs was included in final analysis. Multilevel binary logistic regression was used to examine the association between high-risk fertility behaviour and undernutrition. The results were presented using adjusted odds ratio (aOR) with their respective 95% confidence intervals (CIs).
Setting:
Thirty-two countries in SSA.
Outcome Measure:
Stunting, wasting, and underweight.
Results:
The pooled prevalence of stunting was 31.3%, ranging from 15.0% in Gabon to 51.7% in Burundi. Wasting was highest among children from Burkina Faso (19.1%) and lowest among those from South Africa (1.6%). The overall prevalence of wasting was 8.1%. The prevalence of underweight was 17.0%, with the highest among children in Niger (37.1%) and lowest in South Africa (4.8%). Mothers who gave birth at the age less than 18 years and those with short birth interval were more likely to have their children being stunted, wasted, and underweight. The odds of stunting and wasting were high among children born to women with high parity. However, maternal age at birth more than 34 was associated with lower odds of childhood underweight as against those with age at birth less than 34.
Conclusion:
Countries in SSA are encouraged to address the issue of maternal age at birth less than 18, high parity, and shorter birth intervals in order to meet the Global Nutrition targets, which aim to achieve a 40% reduction in the number of stunted children under the age of 5 and to reduce and maintain childhood wasting to less than 5% by 2025.
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