Abstract
Stunting is a significant public health problem in low- and middle-income countries. This study assessed the prevalence of stunting and associated risk factors of stunting among preschool and school-going children in flood-affected areas of Pakistan. A cross-sectional study was conducted by visiting 656 households through multi-stage sampling. Respondent's anthropometric measurements, socio-demographic information and sanitation facilities were explored. A logistic regression model was used to determine determinants of stunting, controlling for all possible confounders. The overall prevalence of stunting in children was 40.5%, among children 36.1% boys and 46.3% of girls were stunted. The prevalence of stunting in under-five children was 50.7%. Female children (OR=1.35, 95% CI:0.94-2.0), children aged 13-24 months (OR=6.5, 95% CI: 3.0-13.9), mothers aged 15-24 years (OR=4.4, 95% CI: 2.6-7.2), joint family (OR=2.1, 95% CI: 1.4-3.0) did not have access to improved drinking water (OR=3.3, 95% CI: 1.9-5.9), and the toilet facility (OR=2.8, 95% CI, 1.9-4.3), while the children from district Nowshera (OR=1.7, 95% CI: 0.9-3.2) were significantly (P<0.05) associated in univariate analysis. The regression model revealed that child age, maternal age, family type, quality of water, and toilet facility, were the significant (P<0.05) factors contributing to child stunting in the flood-hit areas. Identification of key factors might be helpful for policymakers in designing comprehensive community-based programs for the reduction of stunting in flood-affected areas. In disasters such as flood, the detrimental consequences of the stunting problem could be even more on children. Evidence-based education and care must be provided to the families in the flood-affected regions to reduce the stunting problem. The determinants of stunting should be targeted by making comprehensive policies regarding proper nutrition, livelihood, clean water, and sanitation facilities in flood-hit regions.
Highlights
Malnutrition is a primary cause of mortality and morbidity of children, leading to 45% of under-5 deaths (Gbogbo and Thonneau, 2019)
We explored the prevalence of stunting in preschool and school-going children’s in the target population and its associated socioeconomic and demographic risk factors. 266 (40.5%) were globally stunted, whereas 27.6% (181/656) were severely stunted
Age of the child, age of mother, family type, type quality of water, and toilet facility, are the significant factors contributing to stunting-based child malnutrition in the flood-affected areas of Pakistan
Summary
Malnutrition is a primary cause of mortality and morbidity of children, leading to 45% of under-5 deaths (Gbogbo and Thonneau, 2019). 159 million under-5 children are stunted globally (Schrijner and Smits, 2018). Malnutrition has become a severe problem in underdeveloped countries and natural disaster affected regions (Jaspars and Young, 1995). Chronic under‐nutrition is pervasive in most low-income countries, hit by a natural disaster (Evans and Bassani, 2018), resulting in low levels of human performance. Stunting is an important anthropometric measure used for assessing child undernutrition in developing countries (Stevens et al, 2012). In 2005, approximately 178 million children under five years of age in low- and middle-income countries were stunted (Monteiro et al, 2010)
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