Malnutrition among under-five children in amhara and oromia regions, Ethiopia: Continuous time markov multi-state
Dafa Duge Wachifo1, Dereje Danbe Debeko1, Zeytu Gashaw Asfaw2,3
1Department of Statistics, Hawassa University, Ethiopia.
Insights
Most under-five children in Ethiopia experience undernutrition. Maternal education and region significantly impact recovery and transition to malnutrition, highlighting the need for targeted interventions.
Area of Science:
- Public Health
- Global Health
- Child Nutrition
Background:
- Ethiopia has a high prevalence of undernutrition among children under five (U5C).
- This study examines the dynamics of anthropometric failure states in Ethiopian children.
- Focuses on Amhara and Oromia regions, identifying factors influencing nutritional status transitions.
Purpose of the Study:
- To determine the frequency and duration of transitions between Composite Index Anthropometry Failure (CIAF) states in Ethiopian U5C.
- To identify key factors influencing these nutritional status changes.
- To provide evidence for targeted interventions to combat child undernutrition.
Main Methods:
- Utilized longitudinal data from the International Food Policy Research Institute (IFPRI) covering 2018-2021.
- Included 3,044 households with children aged 0-35 months in safety net programs.
- Employed a continuous-time multi-state Markov model to analyze transitions between CIAF states.
Main Results:
- 71% of nourished children transitioned to undernutrition; recovery averaged 41 months.
- Children spent 75% of their lives in an undernourished state.
- Factors like maternal education, region (Oromia), and being female influenced transition probabilities and recovery rates.
Conclusions:
- Undernutrition is highly prevalent and persistent among Ethiopian U5C.
- Maternal education and region are critical determinants of undernutrition risk.
- Interventions should prioritize enhancing maternal education programs to improve child nutritional outcomes.
Background:
Ethiopia faces a high burden of undernutrition prevalence, ranking among the 15 worst-affected nations globally. So, this study aimed to find out how often and how long under-five children (U5C) in Ethiopia's Amhara and Oromia regions move between different states of Composite Index Anthropometry Failure (CIAF) as well as what factors influence these changes.
Methods:
The data used for this study was extracted from the International Food Policy Research Institute. The institute conducted a follow-up survey in three consecutive rounds: February 8, 2018-April 25, 2018; July 25, 2019-October 23, 2019; and February 8, 2021-April 25, 2021, respectively. The inclusion criteria were households that had children between the ages of 0 and 35 months, were participants in the safety net program, and had the mother or primary female caregiver during the baseline survey. A total of 3,044 households having children with at least two complete anthropometric measurements were included. A continuous-time multi-state Markov model was used to estimate transitions and their probability between CIAF's states.
Results:
Nourished children had a 71% probability of becoming undernourished. Time taken to recover from undernourished state for U5C was 41 months on average. 75% of the U5C's life is spent in the undernourished state. Girls had a 1.824 times higher likelihood of recovering from an overnourished state and were less likely to transit from a nourished state to an undernourished state compared to boys (HR: 0.8013). Children older than two years were more likely to recover from undernourished and overnourished states respectively (HR: 1.013 & 1.036), to a nourished state and less likely to transit back to the malnutrition states (HR: 0.9693 & 0.9662). Children of educated mothers and residents in the Oromia region had lower risk of transition from a healthy to an undernourished state respectively (HR: 0.8171& 0.8074).
Conclusion:
Undernutrition will affect most U5Cs. Children whose mothers had no education and live in the Amhara region are more susceptible to undernutrition. The Ministry of Health and other relevant stakeholders should develop a practical intervention to enhance adult and maternal education programs.
More Related Videos
Related Concept Videos
01:24Metabolic States of the Body: Fasting and Starvation
01:25Metabolic States of the Body: The Absorptive State
01:23Mechanistic Models: Compartment Models in Individual and Population Analysis
01:18Metabolic States of the Body: The Postabsorptive State
Initially, glycogen stored in the liver is broken down to release glucose into the bloodstream, while glycogen in the muscles is broken down to supply glucose for energy directly within the muscle cells. As glycogen stores diminish,...
01:14Multicompartment Models: Overview
These models offer a more comprehensive representation of drug behavior in the body than one-compartment models. They accommodate the complexity of drug distribution,...
01:17Clearance Models: Noncompartmental Models
The noncompartmental approach capitalizes on extensive sampling data, correlating the volume of distribution to systemic exposure and the administered dosage. This method enables...