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Updated: Jun 24, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Determinants of aggregate anthropometric failure among children under-five years in Ethiopia: Application of
Biniyam Sahiledengle1, Lillian Mwanri2
1Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
Insights
Multiple forms of malnutrition in children under five, measured by the Composite Index of Anthropometric Failure (CIAF) and Composite Index of Severe Anthropometric Failure (CISAF), are linked to male sex, older age groups, and poorer household conditions in Ethiopia.
Area of Science:
- Public Health
- Pediatrics
- Nutritional Epidemiology
Background:
- Undernutrition is a major cause of child mortality and morbidity.
- Conventional markers for malnutrition (stunting, wasting, underweight) are insufficient to capture multiple anthropometric failures.
- The Composite Index of Anthropometric Failure (CIAF) and Composite Index of Severe Anthropometric Failure (CISAF) were developed to address this gap.
Purpose of the Study:
- To identify factors associated with CIAF and CISAF in Ethiopian children aged 0-59 months.
- To provide evidence for targeted interventions against multiple forms of child malnutrition.
Main Methods:
- Utilized data from the 2019 Ethiopia Mini Demographic and Health Survey.
- Included a weighted sample of 5,259 children aged 0-59 months.
- Employed multilevel mixed-effects negative binomial regression to analyze determinants of CIAF and CISAF.
Main Results:
- Male children, older age groups (12-59 months), households with multiple under-five children, poorer households, and earthen floors were associated with higher CIAF.
- Male children, older age groups (6-59 months), households with multiple under-five children, and poorer households were associated with higher CISAF.
- Children aged 6-59 months, male sex, and those from households with multiple children or poor environments were more likely to experience multiple anthropometric failures.
Conclusions:
- Multiple anthropometric failures in Ethiopian children are associated with specific demographic, socioeconomic, and environmental factors.
- Interventions should address these identified risk factors to effectively combat multiple forms of malnutrition.
- The CIAF and CISAF are valuable tools for assessing and monitoring multiple anthropometric failures in young children.
Abstract:
Undernutrition significantly contributes to failure to thrive in children under five, with those experiencing multiple forms of malnutrition facing the highest risks of morbidity and mortality. Conventional markers such as stunting, wasting, and underweight have received much attention but are insufficient to identify multiple types of malnutrition, prompting the development of the Composite Index of Anthropometric Failure (CIAF) and the Composite Index of Severe Anthropometric Failure (CISAF) as an aggregate indicators. This study aimed to identify factors associated with CIAF and CISAF among Ethiopian children aged 0-59 months using data from the 2019 Ethiopia Mini Demographic and Health Survey. The study included a weighted sample of 5,259 children and used multilevel mixed-effects negative binomial regression modeling to identify determinants of CIAF and CISAF. The result showed higher incidence-rate ratio (IRR) of CIAF in male children (adjusted IRR = 1.27; 95% CI = 1.13-1.42), children aged 12-24 months (aIRR = 2.01, 95%CI: 1.63-2.48), and 24-59 months (aIRR = 2.36, 95%CI: 1.91-2.92), those from households with multiple under-five children (aIRR = 1.16, 95%CI: 1.01-1.33), poorer households (aIRR = 1.48; 95%CI: 1.02-2.15), and those who lived in houses with an earthen floor (aIRR = 1.37, 95%CI: 1.03-1.82). Similarly, the factors positively associated with CISAF among children aged 0-59 months were male children (aIRR = 1.47, 95% CI = 1.21-1.79), age group 6-11 months (aIRR = 2.30, 95%CI: 1.40-3.78), age group 12-24 months (aIRR = 3.76, 95%CI: 2.40-5.88), age group 25-59 months (aIRR = 4.23, 95%CI: 2.79-6.39), children from households living with two and more under-five children (aIRR = 1.27, 95%CI:1.01-1.59), and children from poorer households (aIRR = 1.93, 95% CI = 1.02-3.67). Children were more likely to suffer from multiple anthropometric failures if they were: aged 6-23 months, aged 24-59 months, male sex, living in households with multiple under-five children, and living in households with poor environments. These findings underscore the need to employ a wide range of strategies to effectively intervene in multiple anthropometric failures in under-five children.
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