Tracking progress in anthropometric failure among under-five children in Ethiopia: a geospatial and multilevel analysis

Binyam Tariku Seboka,Abel Desalegn Demeke,Delelegn Emwodew Yehualashet,Samuel Hailegebreal

doi:10.1186/s13690-021-00615-2

Abstract

BackgroundUndernutrition is a major public health concern among under-five children in many developing countries. This work evaluated the overall prevalence of under-nutrition by using a composite index of anthropometric failure (CIAF), which helps in the detection of children with multiple anthropometric failures. This research also includes the Spatio-temporal distribution of childhood anthropometric failures across time.MethodsSecondary data was obtained from the Ethiopian Demographic and Health Survey for the survey 2005, 2011, and 2016 years. Data included 23,864 samples of children between the ages of 0–59 months, which is a nationally representative sample in Ethiopia. Other than descriptive statistics, the multivariate multilevel logistic regression was used to identify associated factors, and Getis-Ord spatial statistical tools were employed to identify high and low hotspots areas of anthropometric failures.ResultThe prevalence obtained with CIAF in 2005, 2011, and 2016 was, 53.5 %, 51 %, and 46.2 % of children were suffering from under-nutrition respectively. The spatial analysis revealed areas that are at a higher risk of anthropometric failures consistently were found in northern parts of the country, largely in the Amhara, Tigray, and Afar regions. Multilevel logistic regression analysis showed that the risk of anthropometric failure was higher among older children, had low birth weight, had a mother with low BMI, was in a rural area, had mothers and fathers without formal education.ConclusionsIn addition to identifying wasted, stunted, and underweight children, CIAF also identified children with multiple conditions, which are often overlooked in nutritional surveys. As revealed by this composite index, the prevalence of anthropometric failure remains considerably high and its spatial distribution also significantly varied across the regions in the country. The established socio-demographic characteristics and districts with a higher risk of anthropometric failure can be used to develop localized intervention and prevention strategies to improve Ethiopian children’s nutritional status and healthcare.

Highlights

Undernutrition is a major public health concern among under-five children in many developing countries
In addition to identifying wasted, stunted, and underweight children, composite index of anthropometric failure (CIAF) identified children with multiple conditions, which are often overlooked in nutritional surveys
This research aims to add to the body of knowledge by identifying the high-risk areas of childhood anthropometric failures, which can be useful in developing localized strategies and guiding policymakers in developing successful public health interventions to minimize undernutrition-related morbidity and mortality in children

Summary

Introduction

Undernutrition is a major public health concern among under-five children in many developing countries. Under-nutrition in a population of under-five children is commonly measured by three anthropometric indicators, namely stunting (low height for age), wasting (low weight for height), and underweight (low weight for age). Acute and chronic nutritional deficiencies are reflected in stunting and wasting, respectively. In addition, being underweight reflect both acute and chronic nutritional deficiency [1, 2]. Anthropometric deficiencies have both short-term and long-term negative effects. It leads to ill health and mortality among children. In the longterm, it leads to impaired cognitive development, poorer educational achievement, and impeded economic productivity [1, 3]

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