Abstract
BackgroundChildhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. However, there is limited evidence showing the association between the planning of birth (PoB) and childhood undernutrition (stunting and underweight). We aimed to investigate the relationship between PoB and childhood undernutrition in the current study.MethodsWe used the Nepal Demographic and Health Survey (NDHS) 2016 data, a nationally representative cross-sectional household survey. We used two anthropometric indicators of childhood undernutrition as the outcome of this study. PoB is the main predictor. We used binary logistic regression with sampling weights to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between the PoB and childhood undernutrition. Unless stated, the significant association between the variables is calculated with p < 0.001.ResultsThe overall prevalence of stunting was 35.8%, and underweight was 27.1% in children under 5 years of age in Nepal. We found a higher rate of stunting (52.7%) and underweight (41.1%) in children with birth order > 3 and < 2 years of the interval between birth and subsequent birth (IBBSB). The association between the children’s birth order and the prevalence of undernutrition had strong statistical significance. Mother’s age at marriage (p = 0.001), underweight mother, mother’s education, father’s education, wealth quintile, no exposure to mass media, children’s age, and place of residence(p = 0.001) were significantly associated with childhood undernutrition. The result of the multiple logistic regression showed that children with birth order one and 12–24 months of the interval between marriage and first birth (IBMFB) had significantly decreased odds of stunting than those children with birth order one and < 12 months of IBMFB (OR 0.6, 95% CI 0.4–0.9).ConclusionThe findings of the study demonstrate that PoB has a protective effect on childhood undernutrition. Delaying of childbirth until 12–24 months after marriage was found to be associated with reduced childhood stunting odds. To mitigate childhood undernutrition, Nepal’s government needs to promote delayed childbearing after marriage while focusing on uplifting the household economics status and wide coverage of and utilization of mass media.
Highlights
Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal
The frequency distribution table shows the highest percentage of order 2–3 children (45.7%), with 35.1% of them having more than 24 months of the interval between birth and subsequent birth (IBBSB). 64.1% of the mothers were married at the age of 15 to 19 years, with a mean age at marriage of 17.7 years
We found that younger age at marriage, poor socioeconomic characteristics of the mother, area of residence were significantly associated with childhood undernutrition
Summary
Childhood undernutrition is a significant public health issue in low-and middle-income countries, including Nepal. It is estimated that among children under 5 years of age, one-third are stunted (178 million), and 112 million are underweight [1]. Childhood undernutrition accounts for more than half of the global deaths in children younger than 5 years of age [2, 3]. It causes a substantial increase in overall disease burden, in low-and middle-income countries, including Nepal [2, 3]. The SUN movement aimed at a 40% reduction in global stunting among children under 5 years of age by 2025 [6]. All the national nutritional targets of Nepal are aligned with the Global Nutrition Targets [4]
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