Abstract
We present prevalence estimates and secular trends of stunting, wasting, underweight, and anaemia among children under 5 years of age and low birth weight (LBW) over the period 1985-2019 in West Africa (WA). Analysis of Demographic and Health Survey (DHS) and World Bank data. DerSimonian-Laird random effect model with the Knapp-Hartung adjustment to the standard error was used to derive overall prevalence estimates. We used fixed effect ordinary least square regression models with cluster robust standard error to conduct time trends analyses. West Africa. Children aged 0 to 59 months. Three distinct periods (1986-1990, 1993-1996 and 1997-2000) of sharp increases in prevalence of all outcomes was observed. After the year 2000, prevalence of all outcomes except LBW started to decline with some fluctuations. LBW prevalence showed a steady increase after 2000. We observed a decline in prevalence of stunting (β = -0·20 %; 95 % CI -0·43 %, 0·03 %), log-wasting (β = -0·02 %; 95 % CI -0·02 %, -0·01 %), log-underweight (β = -0·02 %; 95 % CI -0·03 %, -0·01 %) anaemia (β = -0·44; 95 % CI -0·55 %, -0·34 %), and an increase in LBW (β = 0·06 %; 95 % CI -0·10 %, 0·22 %) in WA over the period. Pooled prevalence of stunting, wasting, underweight, anaemia and LBW in WA for the period 1985-2019 was 26·1 %, 16·4 %, 22·7 %, 76·2 % and 11·3 %, respectively. Child undernutrition prevalence varied greatly between countries and the year cohorts. We observed marginal reductions in prevalence of all outcomes except anaemia where the reductions were quite striking and LBW where an increase was noted. There is the need for more rigorous and sustained targeted interventions in WA.
Highlights
MethodsData sources We assembled data from 60 Demographic and Health Survey (DHS) (https://dhsprogram. com/) reports and the World Bank data repository (https://databank.worldbank.org/home.aspx) from 1985 to 2019 in 14 West African countries
Prevalence estimates of low birth weight (LBW), stunting, wasting, underweight and anaemia during the period were extracted from the Demographic and Health Survey (DHS) reports and the World Bank data repository to create a dataset with a maximum of 60 data points from 14 countries
The results of the trend analysis from the fixed effect ordinary least square regression model with cluster robust standard error showed a decline in prevalence of log-wasting (β = –0·02 %; 95 % confidence interval (CI) –0·02 %, –0·01 %), log-underweight (β = –0·02 %; 95 % CI –0·03 %, –0·01 %) and anaemia (β = –0·44 %; 95 % CI –0·55 %, –0·34 %) among children under 5 years of age
Summary
Data sources We assembled data from 60 DHS (https://dhsprogram. com/) reports and the World Bank data repository (https://databank.worldbank.org/home.aspx) from 1985 to 2019 in 14 West African countries. Prevalence estimates of LBW, stunting, wasting, underweight and anaemia during the period were extracted from the DHS reports and the World Bank data repository to create a dataset with a maximum of 60 data points from 14 countries. The time period for the conduct of DHS surveys varied across the 14 countries within a time interval of 5 years. We complemented the DHS data with the yearly estimates from the World Bank repository where necessary. For the meta-analysis, only estimates from the DHS reports were used. This is because the DHS reports had information on the weighted and unweighted sample of children interviewed and the prevalence estimates were reported with their corresponding standard errors and 95 % confidence interval (CI). The World Bank repository estimates, had no such information to complement the point estimates
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