Child Wasting in Emergency Pockets: A Meta-Analysis of Small-Scale Surveys from Ethiopia.

Chiara Altare,Debarati Guha-Sapir,Tefera Delbiso

doi:10.3390/ijerph13020178

Abstract

Child undernutrition is a major public health concern in Ethiopia (stunting national prevalence: 44%; wasting: 10%), despite the overall improvement in child health status during the last decade. Hundreds of small-scale surveys are conducted in Ethiopia’s emergency pockets under ENCU’s supervision. We reviewed the evidence from small-scale surveys conducted between 2008 and 2013 with two objectives: to provide a summary estimate of wasting prevalence from emergency pockets and to examine reasons for variation in prevalence estimates. We created a dataset by combining data from the Complex Emergency Database, the Famine Early Warning System Network and the Armed Conflict Location Event Data. We conducted a meta-analysis of small-scale surveys using a random effects model with known within-study heterogeneity. The influence of survey covariates on estimated prevalence was investigated with meta-regression techniques. We included 158 surveys in the analysis. A high degree of heterogeneity among surveys was observed. The overall estimate of wasting prevalence was 10.6% (95% CI 9.8–11.4), with differences among regions and between residents and refugees. Meta-regression results showed that vaccination coverage, child mortality, diarrhea prevalence and food insecurity are significantly associated with wasting prevalence. Child care and displacement status were not. Aggregated analysis of small-scale surveys provides insights into the prevalence of wasting and factors explaining its variation. It can also guide survey planning towards areas with limited data availability.

Highlights

Child undernutrition is a major public health concern in Ethiopia, despite the overall improvement in child health during the last decade
We conducted a meta-analysis of more than 150 small-scale nutrition surveys collected over a six-year period to summarize evidence from Ethiopian emergency pockets, thereby exploiting a valuable source of recent data
Over the same period, we identified a dozen published studies investigating factors associated with wasting that could have been included in a similar meta-analysis [7,9,10,25,26,27,28,29,30,31,32,33]

Summary

Introduction

Child undernutrition is a major public health concern in Ethiopia, despite the overall improvement in child health during the last decade. Between 2000 and 2011, infant mortality declined from 97 deaths per 1000 live births to 59 and child mortality from 77 down to 31. Ethiopia still ranks worst among Eastern African countries as far as both stunting and wasting are concerned [1]. Ethiopia is facing a chronic crisis with a high prevalence of stunting and developmental challenges. It has emergency pockets, where wasting threatens child survival. According to WHO’s classification of the severity of malnutrition [2], a prevalence of acute malnutrition of 10% is considered as serious.

Objectives

Methods

Results

Discussion

Conclusion