Nigatu Regassa Geda1, Cindy Xin Feng2,3, Carol J Henry4, Rein Lepnurm2, Bonnie Janzen5, Susan J Whiting4. 1. Center for Population Studies, College of Development Studies, Addis Ababa University, Sidist Kilo Campus, PO Box 1176, Addis Ababa, Ethiopia. negyon@yahoo.com. 2. School of Public Health, Health Science E-wing, University of Saskatchewan, 104 Clinic Place, S7N 2Z4, Saskatoon, SK, Canada. 3. Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Canada. 4. College of Pharmacy and Nutrition, University of Saskatchewan, Health Sciences A-wing, 107 Wiggins Road, S7N 5E5, Saskatoon, SK, Canada. 5. Dept of Community Health & Epidemiology, Collège of Medicine, University of Saskatchewan, Saskatoon, Canada.
Abstract
BACKGROUND: In Ethiopia, child undernutrition and anemia are major public health concerns, resulting in increased childhood morbidity and mortality. Despite progress made to reduce the prevalence of malnutrition (especially stunting) from 50% in 2000 to 38% in 2016, little is known about the magnitude and risk factors for concurrent nutritional deficiencies in Ethiopia. METHODS: Analysis for this study was based on a total sample of 9218 children aged 6-59 months drawn from the Ethiopian Demographic and Health Survey (EDHS) conducted in the year 2016. The study used two outcome variables: Multiple nutrition deficit index formed by combining stunting, underweight, wasting and anemia status; and a concurrent stunting and anemia (CAS) index. Two mixed effect regression models, Poisson and Logistic, were used to identify the key risk factors of the two outcome variables, respectively. RESULTS: The proportion of children with stunting (length-for-age), underweight (weight-for-age) and wasting children (weight-for-length) was 38%, 25.2% and 9.4%, respectively. About 58% of the children had anemia. The prevalence of children with concurrent stunting and anemia children was 24.8%. Our results showed that the risks of multiple nutritional problems were determined by a range of individual, household and behavioral factors including: sex of the child, age of the child, birth order, parity, parental education, religion, household wealth index and type of family structure. The proximate variables (hygiene and sanitation score, feeding practice, and child health service utilization score) were also found to exert a strong influence on the risk of multiple nutritional deficiencies. The likelihood of co-occurrence of stunting and anemia was determined by certain individual and household factors, including sex of the child, age of the child, maternal education, household asset based wealth, religion and household hygiene and sanitation. CONCLUSIONS: This study underscores the importance of improving parental education, household wealth, hygiene and sanitation conditions, promoting feeding practice and child health service utilization. Also, any nutrition sensitive and specific intervention should consider a child's characteristics such as his/her age, gender and birth order.
BACKGROUND: In Ethiopia, child undernutrition and anemia are major public health concerns, resulting in increased childhood morbidity and mortality. Despite progress made to reduce the prevalence of malnutrition (especially stunting) from 50% in 2000 to 38% in 2016, little is known about the magnitude and risk factors for concurrent nutritional deficiencies in Ethiopia. METHODS: Analysis for this study was based on a total sample of 9218 children aged 6-59 months drawn from the Ethiopian Demographic and Health Survey (EDHS) conducted in the year 2016. The study used two outcome variables: Multiple nutrition deficit index formed by combining stunting, underweight, wasting and anemia status; and a concurrent stunting and anemia (CAS) index. Two mixed effect regression models, Poisson and Logistic, were used to identify the key risk factors of the two outcome variables, respectively. RESULTS: The proportion of children with stunting (length-for-age), underweight (weight-for-age) and wasting children (weight-for-length) was 38%, 25.2% and 9.4%, respectively. About 58% of the children had anemia. The prevalence of children with concurrent stunting and anemiachildren was 24.8%. Our results showed that the risks of multiple nutritional problems were determined by a range of individual, household and behavioral factors including: sex of the child, age of the child, birth order, parity, parental education, religion, household wealth index and type of family structure. The proximate variables (hygiene and sanitation score, feeding practice, and child health service utilization score) were also found to exert a strong influence on the risk of multiple nutritional deficiencies. The likelihood of co-occurrence of stunting and anemia was determined by certain individual and household factors, including sex of the child, age of the child, maternal education, household asset based wealth, religion and household hygiene and sanitation. CONCLUSIONS: This study underscores the importance of improving parental education, household wealth, hygiene and sanitation conditions, promoting feeding practice and child health service utilization. Also, any nutrition sensitive and specific intervention should consider a child's characteristics such as his/her age, gender and birth order.
Authors: Zulfiqar A Bhutta; Jai K Das; Arjumand Rizvi; Michelle F Gaffey; Neff Walker; Susan Horton; Patrick Webb; Anna Lartey; Robert E Black Journal: Lancet Date: 2013-06-06 Impact factor: 79.321
Authors: Jee Hyun Rah; Aidan A Cronin; Bhupendra Badgaiyan; Victor M Aguayo; Suzanne Coates; Sarah Ahmed Journal: BMJ Open Date: 2015-02-12 Impact factor: 2.692
Authors: Ibironke Olofin; Christine M McDonald; Majid Ezzati; Seth Flaxman; Robert E Black; Wafaie W Fawzi; Laura E Caulfield; Goodarz Danaei Journal: PLoS One Date: 2013-05-29 Impact factor: 3.240