Abstract
BackgroundStunting and anemia are long-standing public health challenges which adversely affects the cognitive development and physical wellbeing of children in low income settings. The aim of this study was to assess the prevalence and associated factors of stunting and anemia among 6–23 months old children in Damot Sore District, Southern Ethiopia.MethodsCross-sectional survey was conducted among 477 children aged 6–23 months, which were living in Damot Sore District, in April 2017. A multistage sampling technique was used. Villages were randomly selected and systematic random sampling method was used to select study participants. Data on socio-demographic, anthropometric, dietary, blood samples for hemoglobin were collected. Data were entered into EPI Data V. 3.1 and exported into SPSS Version 21.0 for analysis. A principal component analysis (PCA) was done to generate wealth score of households. Binary logistic regression model was used to identify factors associated with the outcome variables (stunting and anemia) separately, those variables having less than a p-value of 0.25 were chosen as candidate for multivariable analyses and finally multivariable logistic regression model was used to identify independent variables of each outcomes, with statistical significance set at p < 0.05 (95% confidence interval (CI)).ResultsOut of 477 children studied, 31.7% were stunted and 52% were anemic. In the multivariable analyses, the number of under five children within a household (AOR = 4.18, 95% CI: 2.65–6.57), drinking water from unsafe source (AOR = 4.08, 95% CI: 1.33–12.54) and anemia (AOR = 3.13, 95% CI 2.00–4.92) were factors significantly associated with stunting. On the other hand, independent variables of anemia were early initiation of complementary feeding (AOR = 2.96, 95% CI: 1.23–4.85), poor dietary diversity (AOR = 2.95, 95% CI: 1.78–4.91), poor breast feeding practice (AOR = 2.94, 95% CI: 1.63–5.32) and stunting (AOR = 3.65, 95% CI: 2.15–6.19).ConclusionThis study revealed higher level of stunting and anemia among children aged 6–23 months than WHO (world health organization) criteria of public health importance. Sustainable promotion of diversified diet, optimal complementary feeding, optimal and complementary breast feeding practices, improving sanitation infrastructure are measures needed to tackle these severe public health challenges.
Highlights
Introduction time of complementary feedingEarlier than 6 months Just at 6 monthsBreast feeding practice Poor GoodNever breast feed at all Source of drinking waterPiped inside compound PublicProtected well/spring ToiletNo facility/bush/field
Socio-demographic characteristics of children and mothers From a total of 498 children participated in the study, 477 children were involved in the study yielding a response rate of 95.78%
This study indicated that out of 477 sampled children aged 6–23 months old, 31.7% were stunted and 52% were anemic, which could be described as severe public health challenge according to the World Health Organization (WHO) criteria [13]
Summary
Children exposed to lower dietary diversity were 2.95 times more anemic as compared to their counterparts exposed to a higher dietary diversity This is in line with a study conducted in Wag-Himra, northern Ethiopia, in which poor micronutrient bioavailability related with anemia was observed [31]. Significances of early life experiences to subsequent health outcomes are main public health concerns and increasingly gaining attention in the scientific literature [1] Nutritional malignancies such as stunting and anemia have been suggested to cause irreversible health effects of later life courses such as acute and chronic diseases, non-communicable diseases, cognitive development and economic productivity of individuals and the society [1, 2]. Inadequate access to and affordability of quality and sufficient complementary foods, frequent disease episodes, poor sanitation and hygiene practice have been identified as the main causes of malnutrition [2,3,4,5]
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