Multilevel Analysis of Determinants of Stunting Prevalence among Children under Age Five in Ethiopia
DOI:
https://doi.org/10.6000/1929-4247.2021.10.03.5Keywords:
Children under age five, Stunting, Multilevel logistic regression, Ethiopian Demographic, Health SurveyAbstract
Background: Stunting is a well-established child health indicator of chronic malnutrition related to environmental and socio-economic circumstances. In Ethiopia, childhood stunting is the most widely prevalent among children under the age of five years.
Objective: To estimate the prevalence of stunting and model the determinants of stunting prevalence among children under age five in Ethiopia.
Methods: Data were extracted from 2016 EDHS, and samples of 8487 children under age five were used in this study. The sample was selected using a two-stage stratified sampling process, and a multilevel logistic regression model was used to determine the factors associated with childhood stunting in Ethiopia.
Results: This study revealed that the prevalence of stunting among children under age five years in Ethiopia was around 39.39%. The multilevel binary logistic regression analysis was performed to investigate the variation of predictor variables of stunting prevalence among children under age five. Accordingly, it has been identified that the ages of the child above 12 months, male gender, children from poor households, and no mother education significantly affect the prevalence of stunting in Ethiopia. It is found that variances related to the random term were statistically significant, implying a variation in the prevalence of stunting across Ethiopia's regional states.
Conclusion: The current study confirmed that the prevalence of stunting among children under aged five years in Ethiopia was a severe public health problem. Therefore, governmental or stakeholders should pay attention to all the significant factors mentioned in this study's analysis.
References
World Health Organization. WHO Child Growth Standards based on length/height, weight, and age. Acta Paediatrica 2006; Supplement 450: 76-85. https://doi.org/10.1111/j.1651-2227.2006.tb02378.x DOI: https://doi.org/10.1111/j.1651-2227.2006.tb02378.x
Amy LR, Lisa S, Adnan H, Robert EB. Malnutrition as an underlying cause of childhood deaths associated with infectious diseases in developing countries. Bulletin of the World Health Organization 2000; 78(10): p. 1207.
Ramoteme LM, Marianne A, Nelia PS, Delemarre-van de Waal HA, Naomi SL. Prevalence and determinants of stunting and overweight in 3 -year-old black South African children are residing in the Central Region of Limpopo Province, South Africa. Journal of Public Health Nutrition 2005; 8: 501-8. https://doi.org/10.1079/PHN2005786 DOI: https://doi.org/10.1079/PHN2005786
Berkman DS, Lescano AG, Gilman RH, Lopez SL, Black MM. Effects of stunting, diarrheal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. Lancet 2002; 359: 564-57. https://doi.org/10.1016/S0140-6736(02)07744-9 DOI: https://doi.org/10.1016/S0140-6736(02)07744-9
SCUK. A life free from hunger: tackling child malnutrition London save the children fund UK 2012.
Dewey K. Reducing stunting by improving maternal, infant, and young child nutrition in regions such as South Asia: evidence, challenges, and opportunities. Matern Child Nutr 2016; 12(Suppl. 1): 27-38. https://doi.org/10.1111/mcn.12282 DOI: https://doi.org/10.1111/mcn.12282
United Nations Children's Fund, World Health Organization, International Bank for Reconstruction and Development/The World Bank. Levels and trends in child malnutrition: key findings of the 2019 edition of the joint child malnutrition estimates. Geneva: World Health Organization 2019 Licence: CC BY-NC-SA 3.0 IGO.
CSA (Ethiopian Central Statistical Agency). Demographic and health survey, Ethiopia 2011.
Christiaensen L, Alderman H. Child malnutrition in Ethiopia: can maternal knowledge augment the role of income? Econ Dev Cult Change 2004; 52(2): 287-312. https://doi.org/10.1086/380822 DOI: https://doi.org/10.1086/380822
UNICEF. UNICEF annual report Ethiopia 2017.
World Health Organization. Global nutrition targets 2025: Stunting policy brief. World Health Organization 2014.
Diggle PJ, Liang KY, Zeger SL. Analysis of longitudinal data. New York: Oxford University Press 1994; vol. 253: p. 17.
Central Statistical Agency [Ethiopia] and ICF International. Ethiopia Demographic and Health Survey, 2016. Addis Ababa, Ethiopia, and Calverton, Maryland, USA 2016.
Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The global Syndetic of obesity, under nutrition, and climate change: the lancet commission report. Lancet. London: England 2019. DOI: https://doi.org/10.1016/S0140-6736(18)32822-8
McCarthy JJ, Canziani OF, Leary NA, Dokken DJ, White KS, editors. Climate change 2001: impacts, adaptation, and vulnerability: contribution of Working Group II to the third assessment report of the Intergovernmental Panel on Climate Change. London: Cambridge University Press 2001.
Pelletier DL, Deneke K, Kidane Y, Haile B, Negussie F. The food-first bias and nutrition policy: lessons from Ethiopia. Food Policy 1995; 20(4): 279-98. https://doi.org/10.1016/0306-9192(95)00026-7 DOI: https://doi.org/10.1016/0306-9192(95)00026-7
Ezeh A, Oyebode O, Satterthwaite D, Chen Y-F, Ndugwa R, Sartori J, et al. The history, geography, and sociology of slums and the health problems of people who live in slums. Lancet 2017; 389(10068): 547-58. https://doi.org/10.1016/S0140-6736(16)31650-6 DOI: https://doi.org/10.1016/S0140-6736(16)31650-6
García Cruz LM, González Azpeitia G, Reyes Súarez D, Santana Rodríguez A, Loro Ferrer JF, Serra-Majem L. Factors associated with stunting among children aged 0 to 59 months from the central region of Mozambique. Nutrients 2017; 9(5): 491. https://doi.org/10.3390/nu9050491 DOI: https://doi.org/10.3390/nu9050491
Solomon D, Amare W. Magnitude and factors associated with malnutrition in children 6-59 months of age in the pastoral community of Dollo Ado district, Somali region, Ethiopia. Science Journal of Public Health 2013; 1(4): 175-183. https://doi.org/10.11648/j.sjph.20130104.12 DOI: https://doi.org/10.11648/j.sjph.20130104.12
Ahmed A, Sakineh S, Shahabeddin R, Kurosh D. Nutritional status of under-five children in Ethiopia: a systematic review and meta-analysis. Ethiopian Journal of Health Sciences 2017; 27(2): 175-188. https://doi.org/10.4314/ejhs.v27i2.10 DOI: https://doi.org/10.4314/ejhs.v27i2.10
Tebeje NB, Bikes GA, Abebe SM, Yesuf ME. Prevalence and major contributors of child malnutrition in developing countries: systematic review and meta-analysis, Journal of Childhood Obesity 2017; 2(4): 2572-5394.
Dejen DD, Ayele TG. Nutritional status of under-five children in Hawassa Zuria district, Southern Ethiopia. American Journal of Health Research 2015; 3(5): 286-292. https://doi.org/10.11648/j.ajhr.20150305.14 DOI: https://doi.org/10.11648/j.ajhr.20150305.14
Kimani-Murage EW, Muthuri SK, Oti SO, Mutua MK, van de Vijver S, Kyobutungi C. Evidence of a double burden of malnutrition in poor urban settings in Nairobi, Kenya. PLoS One 2015; 10(6). https://doi.org/10.1371/journal.pone.0129943 DOI: https://doi.org/10.1371/journal.pone.0129943
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