Stunting and its predictors among children aged 6-59 months in Ethiopia: a systematic review and meta-analysis

Stunting is a major public health problem in many developing countries. Despite the availability of the studies conducted on stunting, most of the studies were single-centered and with small sample sizes and showed significant variation. Hence this review was conducted to assess the pooled prevalence of stunting and its predictors among 6-59 months of age children.

The relevant studies were identified by electronic database searching methods. Data were extracted by employing a data extraction format developed in Microsoft Excel. Inverse variance (I²) test was employed to evaluate the heterogeneity within the included studies. Begg's and Egger's regression tests were utilized to evaluate publication bias. Moreover, predictors of stunting were also assessed. All statistical analyses were performed using STATA™ Version-14 software.

A total of 43 papers were combined in the review. The pooled prevalence of stunting was found to be 39.9% (95%CI:37.1-42.83) with a substantial level of heterogeneity (I² = 97.5%; p < 0.001). The highest prevalence of stunting was found in Amhara region (48.14%) and the lowest prevalence was in Sidama (14.7%). Being 25-59 months of age (POR = 1.36, 95%CI: 1.12-1.64), being male (POR = 1.20, 95%CI:1.05, 1.37), rural residence (POR = 1.91, 95%CI: 1.58-2.31), lack of maternal formal education (POR = 1.55, 95%CI:1.33, 1.81), living with family size of ≥ 5 (POR = 1.32, 95%CI:1.07-1.64), having more than two under five children in the household (POR = 1.78, 95%CI:1.36-2.32), poor household wealth index (POR = 1.80, 95%CI: 1.51-2.13), absence of ANC follow-up (POR = 2.24, 95%CI:1.54-3.26), home delivery (POR = 1.66, 95%CI:1.29-2.13), diarrhea in the last two weeks (POR = 2.20, 95%CI:1.52-3.19), absence of PNC (POR = 2.08, 95%CI:1.63-2.67), non-exclusive breastfeeding (POR = 2.48, 95%CI:1.36-4.54), early or late complementary feeding initiation (POR = 1.53, 95%CI:1.04-2.27), household dietary diversity score of < 4 (POR = 1.75, 95%CI:1.28-2.41), birth order 2 or more) (POR = 1.44, 95%CI:1.06-1.97), and absence of immunization (POR = 2.62, 95%CI:1.61-4.28) were predictors of stunting among 6-59 months of children.

Nearly two out of five children were stunted, Hence strategies to limit family size, to improve the living standard, delivery at health facilities, perinatal care, exclusive breastfeeding in the first six month, and timely initiation of complimentary feeding should be encouraged to combat stunting among 6-59 months of children.