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Updated: Mar 7, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Factors Associated With Composite Anthropometric Failures (CIAF) Among Under Five Children in Lesotho: An Insight
Nigussie Adam Birhan1, Denekew Bitew Belay2,3
1Department of Statistics, College of Natural and Computational Science Injibara University Injibara Ethiopia.
Insights
Undernutrition in Lesotho affects 34.68% of children under five, measured by the Composite Index of Anthropometric Failure (CIAF). Factors like age, sex, wealth, and birth status significantly influence this nutritional status.
Area of Science:
- Public Health
- Pediatrics
- Nutrition Science
Background:
- Undernutrition is a critical determinant of child mortality in developing nations.
- The Composite Index of Anthropometric Failure (CIAF) integrates stunting, wasting, and underweight to comprehensively assess child nutrition.
- Assessing nutritional status is vital for targeted interventions and policy development.
Purpose of the Study:
- To identify factors associated with the Composite Index of Anthropometric Failure (CIAF) in children under five in Lesotho.
- To provide data for improving child nutrition strategies in the region.
- To highlight key demographic and socioeconomic predictors of anthropometric failure.
Main Methods:
- Secondary analysis of the Lesotho Demographic and Health Survey 2023-24 data.
- Inclusion of 1089 children under five years old.
- Statistical analysis using descriptive statistics and binary logistic regression to determine predictors of CIAF, estimating adjusted odds ratios (AOR) and 95% confidence intervals.
Main Results:
- The prevalence of CIAF in Lesotho was 34.68%.
- Significant predictors of CIAF included child's age (24-59 months: AOR=2.42), sex (female: AOR=0.54), household wealth (rich: AOR=0.29), multiple births (AOR=12.02), rural residence (AOR=0.56), number of living children (3-4: AOR=2.54), and birth size (larger: AOR=0.38).
- Female children, those from richer households, and those with larger birth size had lower odds of CIAF, while older children, multiple births, rural residence, and higher numbers of siblings had increased odds.
Conclusions:
- Lesotho faces a high prevalence of CIAF among children under five.
- Child's age, sex, birth type, wealth quintile, residence, number of siblings, and birth size are significantly associated with CIAF.
- Recommendations include adopting CIAF for malnutrition assessment, strengthening rural nutrition programs, and informing policy to address child undernutrition in Lesotho.
Abstract:
Under nutrition is the main cause of child death in developing countries. The Composite Index of Anthropometric Failure (CIAF) combines all three forms of anthropometric failures to assess the nutrition status of children. Thus, the objective of this was to identify factors associated with CIAF of under-five children in Lesotho. A secondary analysis of the Lesotho Demographic and Health Survey 2023-24 was conducted, using the data for 1089 children under the age of 5 years. The CIAF was used to classify children based on stunting, wasting, and underweight. Descriptive summary statistics were computed. A binary logistic regression model was employed to identify predictors of CIAF for under-five children. Adjusted odds ratio with 95% confidence interval was estimated. The prevalence of CIAF in Lesotho was 34.68% (95% CI: 31.76-37.73). Female child 0.54 (AOR = 0.54; 95% CI: 0.375, 0.776), age group 24-59 months 2.42 (AOR = 2.42; 95% CI: 1.149, 5.109), rich households 0.29 (AOR = 0.29; 95% CI: 0.151, 0.554), multiple births 12.02 (AOR = 12.02; 95% CI: 1.199, 120.426), rural residence (AOR = 0.56: 95% CI: 0.335, 0.946), living children 3 to 4 were 2.54 (AOR = 2.54; 95% CI: 1.522, 4.226), and larger size at birth were 0.38 (AOR = 0.38; 95% CI: 0.211, 0.683) were found to be significantly associated with CIAF. The prevalence of CIAF among children under five in Lesotho was high. Child's age, child's sex, child's type of birth, wealth tercile, residence, number of living children, and child's birth size were found to be significantly associated with CIAF. We suggest that the government adapt CIAF as a metric for assessing children's nutritional status in order to estimate the overall prevalence of malnutrition and strengthening adequate nutrition intervention programs in rural areas. Furthermore, highlighting the factors influencing child CIAF will help inform future policies and programs designed to approach this major problem in Lesotho.
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