Abstract
BackgroundIn 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.MethodsAnalysis 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.ResultsThe 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.ConclusionsThis 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.
Highlights
In Ethiopia, child undernutrition and anemia are major public health concerns, resulting in increased childhood morbidity and mortality
The present study aims to examine the risk factors of co-occurrence of undernutrition and anemia among children of age 6–59 months in Ethiopia based on nationally representative data
The prevalence of child undernutrition was much higher in rural areas, and the difference was more pronounced for stunting and underweight
Summary
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. Worldwide undernutrition restricts fetal growth causing stunting and wasting; micronutrient deficiencies are responsible for the annual death of 3.1 million children under five years of age (under-5) [1]. Stunting is a chronic form of malnutrition, a result of long-term nutritional deprivation. It is defined as height-for-age < -2 standard deviation (SD) of the World Health Organization’s growth standard median [2]. In Sub-Saharan Africa, the prevalence of underweight, stunting and wasting in children under-5 was 21%, 40% and 9%, respectively [3]
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