Drought, conflict and children’s undernutrition in Ethiopia 2000–2013: a meta-analysis

Tefera Darge Delbiso,Debarati Guha-Sapir,Anne-Françoise Donneau,Niko Speybroeck,Jose Manuel Rodriguez-Llanes

doi:10.2471/blt.16.172700

Tefera Darge Delbiso, Debarati Guha-Sapir + Show 3 more

Open Access

https://doi.org/10.2471/blt.16.172700

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Abstract

ObjectiveTo estimate the prevalence of childhood wasting and to investigate the effects of drought and conflict on wasting in crisis-affected areas within Ethiopia.MethodsWe searched the Complex Emergency Database for nutrition surveys carried out in Ethiopia over the period 2000–2013. We extracted data on the prevalence of wasting (weight-for-height z-scores below –2) among children aged 6–59 months for areas of Ethiopia that had sufficient data available. Data on any conflict events (irrespective of magnitude or impact) and episodes of seasonal drought affecting the survey areas were extracted from publicly available data sources. Random-effects Bayesian meta-analysis was used to synthesize the evidence from 231 small-scale surveys.FindingsFrom the total sample of 175 607 children analysed, the pooled number of children wasted was 21 709. The posterior median prevalence of wasting was 11.0% (95% credible interval, CrI: 10.3–11.7) over the 14-year period. Compared with areas unaffected by drought, the estimated prevalence of wasting was higher in areas affected by moderate levels of drought (posterior odds ratio, OR: 1.34; 95% CrI: 1.05–1.72) but similar in severe drought-affected areas (OR: 0.96; 95% CrI: 0.68–1.35). Although the pooled prevalence of wasting was higher in conflict-affected than unaffected areas, the difference was not plausible (OR: 1.02; 95% CrI: 0.82–1.26).ConclusionDespite an overall declining trend, a wasting problem persists among children in Ethiopia. Conflict events did not have a major impact on childhood wasting. Nutrition interventions should go beyond severe drought-prone areas to incorporate areas where moderate droughts occur.

Highlights

Since 1990, considerable progress has been made towards improving child health in the world.[1,2] worldwide 50 million children younger than five years had acute malnutrition in 20141 and nearly 6 million children died in 2015.2 The burden is heavy in Africa, where conflict, political fragility and drought are more prevalent.[3]
Several small-scale surveys have been conducted by humanitarian organizations in crisis-affected areas, we only found one study which investigated the associations among child undernutrition, conflict and variability in the general ecosystem in East Africa including Ethiopia.[9]
We present estimates of the prevalence of childhood wasting in crisisaffected areas within Ethiopia, using pooled data from 231 small-scale surveys

Summary

Introduction

Since 1990, considerable progress has been made towards improving child health in the world.[1,2] worldwide 50 million children younger than five years had acute malnutrition in 20141 and nearly 6 million children died in 2015.2 The burden is heavy in Africa, where conflict, political fragility and drought are more prevalent.[3] These events affect food security and nutrition by limiting food accessibility, impacting health services and disturbing the care structure within the society.[4,5] Several studies have documented the negative effect of conflict[5,6,7,8,9,10] and drought[7,11] on child health and nutrition. Ethiopia has been affected by drought and starvation on a large scale since the mid-1980s. The problem of undernutrition is worse in crisis-affected areas within the country, where food insecurity is heightened due to climate shocks and conflicts.[10,19]

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