Poor Households Research Articles

Household Food Insecurity and COVID-19 Social Safety Nets in Cavite, Philippines

The COVID-19 restrictions have caused economic losses that affected food availability and accessibility, thereby compromising people’s lifestyles and putting the already existing poor households into severe food insecurity. As such, national government agencies and local government units in the Philippines provided emergency cash assistance and food aid as safety nets during the pandemic to help vulnerable households cope with the impending economic crisis and to improve food security in the country. This cross-sectional study assesses the association of social safety net programs with household food security (i.e., food secure, consistently food insecure, and newly food insecure) in Cavite province, Philippines. Findings show that being beneficiaries of the Pantawid Pamilyang Pilipino Program and the Social Amelioration Program are associated with being consistently and newly food insecure. Furthermore, households that obtained food from the community pantry, a volunteer-led movement during the height of the COVID-19 pandemic are also associated with food insecurity. On the other hand, the households that were provided with food packs, across different socioeconomic conditions, are not significantly associated with food insecurity. The study also affirms that households most vulnerable to food crises in the context of COVID-19 are those who are consistently food insecure and were already exposed to critical food and dietary deprivations before the onset of the pandemic. There is much to be done to improve the safety net programs in the country. The study results can add information and policy recommendations toward strengthening the services for vulnerable population groups to withstand short- and long-term food system disruptions and eventually build food-resilient households and communities.

Differences in Associated Factors of Underweight and Overweight According to Rural-Urban Residence Strata among Ever-Married Non-Pregnant Women of Reproductive Age in Bangladesh.

This study sought to compare the prevalence of underweight and overweight among ever-married, non-pregnant women of reproductive age in Bangladesh by urban or rural residency status. This study used Bangladesh Demographic and Health Survey (BDHS), 2017 data. Cross-sectional study design with two-stage stratified sampling method was employed. A sample of ever-married non-pregnant women of reproductive age was selected and multinomial logistic regression was utilised in analysis. It was found that around half of rural women (45.0%, N = 4,934) and more than half of urban women (60.3%, n = 3,913) were overweight. Nearly one in seven rural women (14.0%, n = 1,537) and 1 in 12 urban women (9.0%, n = 564) were reported as underweight. Our analyses revealed that being overweight was substantially connected with age, husband's occupation, economic status, television access, and division for both urban and rural areas. Women from poor households were significantly more likely to be underweight than women from middle- income households for both urban (P < 0.05; OR: 1.41; 95% CI: 1.03, 1.94) and rural (P < 0.05; OR: 1.23; 95% CI: 1.04, 1.46) areas. Interestingly, women without television access both in urban (P < 0.001; OR = 0.78; 95% CI: 0.67, 0.91) and rural (P < 0.001; OR = 0.75; 95% CI: 0.68, 0.84) areas had an inverse association with overweight/obesity compared to women with television access. In both areas, women in Sylhet and Mymensingh had higher likelihood of being underweight than Barisal division. Additionally, in both residential zones, women in Sylhet had lower likelihood of being overweight than Barisal division. This study reveals that multiple characteristics are linked to both overweight and underweight among ever-married, non-pregnant women of reproductive age in Bangladesh. Addressing these variables should be a priority in public health efforts to combat the dual challenge of malnutrition in Bangladesh.

Strategies For Mobilizing Economic Resources to Cover Healthcare Costs for Poor Households in Vinh City, Nghe An Province

Strategies For Mobilizing Economic Resources to Cover Healthcare Costs for Poor Households in Vinh City, Nghe An Province

Boom and bust: Variegated livelihood pathways among rural households in the banana boom in northern Laos

Crop booms are a significant driver of change for both rural landscapes and smallholder livelihoods. Cavendish bananas have boomed in northern Laos and replaced maize, the previous boom crop, through land leasing contracts between farmers and Chinese companies. This study of two villages in Oudomxay Province explores rural households' participation in this banana boom and the conjunctures that shape variegated livelihood pathways and outcomes. Household participation in the banana boom depended on their assets (land and labour), livelihood context and social pressure. Household income in both villages generally improved, but differentially. The better‐off, and those with a wider array of livelihood options, used income from bananas to move to primarily non‐agricultural livelihoods, while many poorer households became dependent on wage labour in banana production, at the expense of their health. Women reported to be content to escape agricultural labour through land leasing; but many who contributed labour to banana production felt trapped in ongoing heavy labour, with attendant adverse impacts. These outcomes reflect how the conjunctures of different household, community and external elements, and crop boom‐bust cycles, lead to differentiated (‘variegated’) household livelihood trajectories and outcomes for households and for men and women, and suggest points of policy intervention.

Determinants of diarrhea prevalence among children under 5 years in semi-arid Ghana

ABSTRACT Despite the Sustainable Development Goal (SDG6) of achieving universal access to clean water and sanitation by 2030, many developing countries still face water, sanitation, and hygiene (WASH)-related health issues such as child mortality caused by diarrhea. This study investigated the factors contributing to diarrhea prevalence in rural children, utilizing a cross-sectional survey (n = 517) of smallholder household representatives from a Risk, Attitudes, Norms, Abilities, and Self-Regulation (RANAS) perspective. Using binary logistic regression, the study found that a high prevalence of diarrhea among children was associated with unsafe/open disposal of child feces, living in the poorest households, poor self-rated health, and residing in the Wa East district. Conversely, children from the Brifo ethnicity and those from larger households were less likely to have a high prevalence of diarrhea. These findings underscore the influence of behavioral, socio-cultural, and socioeconomic factors on the prevalence of diarrhea in rural areas. To achieve SDG6, child-friendly sanitation infrastructure, behavior change communication strategies, and incentivizing WASH infrastructure in Ghana and other regions in Sub-Saharan Africa facing similar conditions are recommended.

Measuring the energy poverty premium in Great Britain and identifying its main drivers based on longitudinal household survey data

Following the consistent hike in energy prices in recent years, energy affordability by low-income households in Great Britain has become a significant concern. These concerns are further compounded by the disproportionate cost of energy that poor households are likely to pay, compared to the non-poor. In this study, we examine the exposure of poor households to energy premiums by measuring the additional costs incurred and identifying the main drivers. We merge household-level data from Understanding Society with energy consumption data from the National Energy Efficiency Data — Framework (NEED). Using the merged dataset and the Theory of Complaints, we propose a new approach to measuring the poverty premium based on the cost per unit of energy incurred by households. Based on a two-stage regression model, our results show that poorer households are likely to pay premiums for energy consumption. Furthermore, among households who incur these energy premiums, poor households pay higher premiums than non-poor households, incurring a cost of between 10%–20% more per unit for both gas and electricity premiums between 2011 and 2019. These relationships are still significant even after addressing the potential endogeneity of poverty, thereby confirming the relationship between energy premiums and poverty. The results also suggest that the other key drivers of electricity and gas premiums are payment methods used, and household characteristics such as the number of adults per household, presence of children, unemployed adults and pensioners.

Vulmob, a new multidimensional indicator of mobility vulnerability

Mobility enables to find jobs, go to school or meet people. However, long distances, high costs, car dependency and poor accessibility are sources of mobility vulnerabilities. The current rise in fuel prices may have a strong impact on mobility, especially for households that rely heavily on their cars. Moreover, the need to reduce air pollution and greenhouse gases emissions requires the implementation of ambitious environmental policies. It is therefore necessary to identify transport poor households, affected by financial issues, as well as vulnerable households whose mobility would be strongly impacted by changes in individual mobility conditions and would have difficulties to adapt to this situation. To this end, we construct VulMob, a multidimensional indicator made up of thirteen individual factors organized in four dimensions: financial resources and transport affordability, work constraints, heavy car use and accessibility and structural constraints. We apply this indicator to the Grenoble area, in France. Our results show that 9.6% are highly vulnerable, meaning that they face at least six vulnerability issues and 5.5% of the households face transport affordability issues. A typology of five profiles of highly vulnerable households shows that some are financially constrained; others are heavy car users, work at night or face public transport accessibility problems.

Navigating Credit Access: Uncovering The Dynamics Within Poor Households in Vietnam

In the context of Vietnam's dynamic but uneven economic landscape, the challenge of credit access for poor households signifies a critical disparity in financial inclusion. This research identifies and addresses a gap in understanding the influence of socioeconomic factors on credit accessibility for economically disadvantaged populations. To explore the impacts of household income stability, financial literacy, social norms, credit history, formal financial identity, and asset ownership, our study employs multivariate linear regression analysis to uncover the nuanced relationships between these factors and credit access. The findings reveal significant positive correlations, highlighting the complex interplay of economic and social elements in facilitating financial inclusion. These results offer valuable insights for policymakers, financial service providers, and development practitioners, suggesting targeted interventions in financial education, income stabilization, and adapting financial services to cultural contexts. Ultimately, this study provides a roadmap for enhancing financial accessibility for Vietnam's poor households, contributing to the broader goal of bridging the gap in financial inclusion within the country.

Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: a serial cross-sectional study.

Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status. Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave). Household questionnaires and blood samples were collected to test for malaria by microscopy and for SARS-CoV-2 using a Luminex assay. Seroprevalence was estimated at both the survey and community level. Mixed-effects logistic regression models assessed the association between individual and household factors and SARS-CoV-2 seropositivity in children, adjusting for household clustering. More households reported disruptions in daily life at baseline compared to follow-up, though economic impacts lingered. By the follow-up survey, 52.7% of adults had received at least one COVID-19 vaccine dose. Overall seroprevalence in children was higher at follow-up compared to baseline (71.6% versus 19.2%, p < 0.001). Seroprevalence in children ranged across communities from 6-37% at baseline and 50-90% at follow-up. At baseline, children from the poorest households were more likely to be infected. Increasing age remained the only consistent risk factor for SARS-CoV-2 seroconversion at both timepoints. Results indicate that a larger number of children were infected by the Delta and Omicron waves of COVID-19 compared to the Alpha wave. This study is the largest seroprevalence survey in children in Uganda, providing evidence that most children were infected with SARS-CoV-2 before the vaccine was widely available to pediatric populations. Pediatric infections were vastly underreported by case counts, highlighting the importance of seroprevalence surveys in assessing disease burden when testing and reporting rates are limited and many cases are mild or asymptomatic.

Are the in-work poor more disadvantaged in urban areas? An analysis of housing affordability in Italy

In Europe, there is growing empirical evidence on the difficulties workers face in making ends meet. High housing costs may compound the picture. This study investigates the housing affordability problems of workers’ households. Drawing on 2019 EU-SILC cross-sectional data for Italy, it examines the extent to which working households’ income results in housing affordability problems, and the differences between cities and rural areas. It considers three groups: in-work poor, low-middle, and high-income households. Results confirm the relevance of the income level as in-work poor households face the lowest housing costs but the highest housing affordability problems. In terms of territorial differences, results show a widespread vulnerability of the in-work poor, especially for tenants: these households have considerable difficulties in coping with housing costs in both urban and rural areas, despite rents being higher in cities. In contrast, the place of living assumes more relevance for low-middle-income households: for them, renting in cities rather than in rural areas is substantially riskier.

Faktor-Faktor yang Mempengaruhi Kemiskinan di Desa Kondamara Kecamatan Lewa

Poverty is a complex problem caused by many interrelated factors. So, this research will analyse the variables that influence poverty in Kondamara Village, Lewa District by analysing important problems that can influence poverty. This research aims to determine the profile and factors that influence poverty in Kondamara Village, Lewa District. The data collection technique uses primary data obtained through distributing questionnaires and direct interviews with poor and non-poor households in Kondamara Village, Lewa District. Meanwhile, the data analysis technique uses binary logistic regression analysis with a Likelihood Ratio approach. The research results show that the income of the head of the household and the number of family dependents have a significant influence on poverty in Kondamara Village, Lewa District.

Analysis of the Elasticity of Rice Demand for Poor Households in Sirimau District, Ambon City in 2024

This study aims to analyze the elasticity of rice demand among poor households in Sirimau District, Ambon City. The main focus of this study is the influence of household income, number of family members, the price of Bulog rice, and the price of premium rice on rice consumption among poor households. The analytical method used involves linear regression to identify the relationships between these variables. The results of the study indicate that household income, number of family members, and the price of Bulog rice have a significant positive effect on rice consumption among poor households. Conversely, the price of premium rice does not show a significant effect on rice consumption in this household group. These findings suggest that Bulog rice pricing policies and increasing the income of poor households can be important factors in boosting their rice consumption. This research provides valuable insights for the formulation of more effective food policies to support the welfare of poor households in Sirimau District, Ambon City.

Poverty dynamics for Ghana during 2005/06–2016/17: An investigation using synthetic panels

Ghana has consistently kept its poverty rate lower than the regional average over the past 25 years, but this positive trend has slowed down recently. Without actual panel data, it would be next to impossible to probe into the dynamic patterns beneath this trend. We offer the first study that examines the dynamics of overall, moderate, and extreme poverty in Ghana during 2005/06–2016/17, addressing the lack of actual panel data by constructing synthetic panel data from three nationally representative cross-sectional rounds of the Ghana Living Standards Surveys (GLSSs).We present a well-defined decomposition framework, which allows us to examine a rich profile of the dynamics among different population groups. Beyond poverty analysis, we further investigate the dynamics of the full consumption expenditure distribution. Although we find considerable conditional chronic (extreme) poverty rates hovering around 50–60%, there was more upward mobility than downward mobility during this period. Poor households were also more likely to have stronger consumption expenditure growth. The findings suggest that factors such as educational attainment, female household headship, urban residence, and nonagricultural work are positively correlated with poverty reduction. Compared to all other correlates, educational attainment appears to be the most effective in pushing households out of poverty and keeping them from falling into poverty. These results contribute to the growing literature on poverty dynamics in developing countries in general and provide new and relevant inputs for policy advice in Ghana in particular, especially since policies that address chronic poverty typically differ from those that tackle transient poverty.

Utilisation Challenges of Public Health Insurance Initiatives: Evidences from Sehat Sahulat Programme (SSP) in Pakistan

EXECUTIVE SUMMARY Healthcare utilisation largely depends on both demand and supply-side factors. On the supply side, health infrastructure could be better to serve the population’s needs, whereas, on the demand side, affordability is the main challenge, especially for poor households. Health insurance provides an opportunity to avail of decent health facilities. The government of Pakistan launched the Sehat Sahulat Programme (SSP) to provide equitable and affordable indoor health services through public-driven health insurance. The current study has analysed the SSP by focusing on the factors that may reduce the in-door utilisation of health services. Besides secondary analysis, we have managed the qualitative and quantitative field survey by conducting in-depth interviews with all the supply and demand side stakeholders. A household survey is also carried out with the beneficiaries. Our analysis found that the programme has been facing the issues of lower utilisation due to various factors, including lack of awareness and a limited number of empanel hospitals. In some districts, there is only one hospital to cater to the needs of 73,000 families. The programme also requires focus to ensure 100 percent enrolment of all the eligible families, as in study districts, the pending cases range from 22 percent to 74 percent, with an average of 39 percent. Around 7 percent of the inpatients are deprived of seeking indoor treatment, either due to lack of hospital or lack of facility in the hospital or denial of services by the empanel hospital. The programme requires improving the environment of the empanel hospital by ensuring the availability of communication material, the 24/7 presence of a front desk person (HFO), and the availability of the operational manual. On the demand side, we found that most beneficiaries need more proper knowledge about various programme features, including where they should go for treatment, package amount, type of treatment covered in the package, and whom to contact for information. Despite the low utilisation rate, a heartening element is the high satisfaction level of the beneficiaries who had received treatment. As a way forward, we recommend the following: First, the programme may ensure every citizen receives in-door health treatment by improving accessibility and availability of health services and easing the documentation requirement. Second, there must be a sufficient number of empanel hospitals, and offered packages against a treatment must be attractive to avoid the ‘pick and choose’ option by the hospitals. The entire government health infrastructure must be on the pool of SSP. It should be mandatory that all private hospitals be a part of the SSP. Third, the authorities must ensure that HFOs should be available in hospitals 24/7. The hospital list should be publicly available through various sources, including the website and dedicated SMS service. Moreover, the programme should introduce some Android applications to find the nearest hospital to a patient. Fourth, there is a need for a grassroots-level communication strategy, especially in districts where the programme is universal. The key messages must be disseminated at the doorsteps of beneficiaries. For this, the programme may involve local notables, education and health departments, and other social safety net departments having a ground-level presence (i.e., BISP, Zakat, Pakistan Bait-ul-Mal, and various provincial social protection/security authorities). Overall, the communication strategy must be heterogeneous, considering the population’s needs.

AS THE IMPOVERISHED GET EVEN POORER: AN ANALYSIS ON THE IMPACT OF PHILIPPINE TRAIN LAW TO THE MINIMUM WAGE EARNER

In the Philippines, the TRAIN Law or tax reform for acceleration and inclusion legislation was put into effect in 2018. This law sought to significantly alter the nation's tax structure in order to increase money for poverty alleviation, healthcare, and infrastructure. One of the features of the law was to increase the income threshold below which minimum wage earners would not be required to pay income tax. But it also resulted in higher costs for goods and services, which had an effect on Metro Manila's level of living. This qualitative research examines the significant data and information based on the participant's experiences with the TRAIN law. Semi-structured questions were used in the in-depth interview to facilitate deeper clarification and additional discussion. The results show that the majority of the impact of the law on the poor is related to basic needs like food, for which they must cut their budget in order to survive because there are other expenses to consider, such as utility bills and debts. Moreover, it impacts an individual's emotional and overall health, including mental health concerns brought on by financial difficulties. Additionally, it has an impact on their social interaction because they tend to engage with others less frequently because they are preoccupied with the things that need significant financial outlays. Thus, it may be inferred that the poor income class households' standard of living declined with the introduction of TRAIN law. KEYWORDS: tax reform law, poverty alleviation, minimum wage earner

Comparison of Chi-Square Automatic Interaction Detector (CHAID) and Random Forest Methods in the Classification of Household Poverty Status in Central Java

Central Java was in second position as the province with the highest number of poor people in Indonesia in March 2020. Poverty alleviation efforts have been carried out, but many are still not yet on target. The purpose of this study was to model the classification of household poverty status in Central Java using CHAID and random forest methods and compare the two methods. The data used in this study is data from the 2020 National Socioeconomic Survey (SUSENAS) conducted by the Central Bureau of Statistics (BPS) for Central Java. The number of poor households is much less than non-poor households. Therefore, Synthetic Minority Oversampling Technique (SMOTE) was performed to handle unbalanced data. The random forest method produced better classification performance than the CHAID method with accuracy, sensitivity, specificity, and AUC of 93,95%, 98,43%, 89,92%, and 0,9417, respectively. The important variables that build the random forest model are the floor area of the house, the age of the head of the household, cooking fuel, the place for the final disposal of feces, and ownership of the place to defecate.

Associations between childhood malnutrition, socioeconomic inequalities and sanitation in the coastal regions of Bangladesh

This study aimed to identify critical risk factors for childhood malnutrition and inform targeted interventions. Childhood malnutrition remains a pressing concern in the coastal regions of Bangladesh. Data were extracted from the latest Bangladesh Demographic and Health Survey 2017–2018 and children aged 0–59 months and their mothers aged 15–49 years from 17 coastal districts were included as study population in this study. We performed multivariable logistic regression model to determine the risk factors and a total 2153 children were eligible for the analysis. Stunting, wasting and underweight prevalence was 31.4%, 8.5% and 21.1% respectively. Stunting was more common in children aged 24–35 months with compared to their younger counterparts [adjusted odds ratio (AOR) = 3.32, 95% confidence interval (CI): 2.35–4.67]. Children to mothers with higher education exhibited 69% (AOR = 0.31, 95% CI: 0.18–0.52) lower risk of stunting compared to those with no education. Similarly, children in poorest and poorer households had 2.2 and 1.83 times higher odds of stunting respectively than those in the richest households. Children born to obese mothers (compared to normal) were 34% less likely to be stunted (AOR = 0.66, 95% CI: 0.51–0.85). Children who had fever and underweight mothers reported wasting. Increasing child age, low maternal education, poorest wealth index, unimproved toilet facilities and childhood morbidity were identified as significant risk factors for underweight. Results support the requirement of effective and appropriate interventions for this particular region considering the identified risk factors to reduce childhood malnutrition in Bangladesh.

Emission inequality: Comparing the roles of income and wealth in Belgium and the United Kingdom

Many studies have investigated the distribution of greenhouse gas emissions associated with household consumption, highlighting that richer households have a substantially larger carbon footprint than poorer households. While these studies have typically used income or household expenditures as a proxy of households’ living standards, the association between emissions and wealth has hardly been studied. Wealth is not just an important component of households’ material living standards, known to be imperfectly correlated with income and expenditures, but it is also a very relevant dimension for climate policies. For instance, affluent households have more scope to invest in reducing emissions (e.g. insulation of their homes). Therefore, in this paper, we compare the inequality of emissions over wealth groups as well as groups defined by other living standard concepts such as income, expenditure and the joint distribution of income and wealth to add a focus on wealth to the analysis of emission inequality. Our study focuses on Belgium and the United Kingdom, which differ considerably in their level of wealth inequality. Our results highlight that the social distribution of emissions varies between expenditures, income, wealth and the joint distribution of income and wealth, with per capita emissions being more strongly associated with the joint distribution of income and wealth than with income alone. We also show that a significant share of households has both low income and low wealth, and may thus be lacking the means to prepare for a carbon-neutral future. Although increasing wealth taxation could provide much-needed revenues for low carbon investments, our results suggest that it would have a lower direct impact on the level of emissions and emission inequality compared to increasing taxes on high incomes.

Social protection as a strategy for HIV prevention, education promotion and child marriage reduction among adolescents: a cross-sectional population-based study in Lesotho

BackgroundLesotho’s government has shown consistent efforts to implement social protection programmes. However, while recent evidence established a positive causal relationship between some of these programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho.Methods and FindingsThe study uses cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey. Our research examined the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people (13–24 years) living in poverty. We employed multivariate logistic regression controlling for age, orphanhood, HIV status and sex. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Additionally, we fitted a marginal effects model by sex. Among the 3,506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use (aOR 1.64, 95% CI 1.17–2.29), educational attainment (aOR 1.79, 95% CI 1.36–2.36), and school enrolment (aOR 2.19, 95% CI 1.44–3.34). Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females (aOR 0.59, 95% CI 0.42–0.83) and higher odds of educational attainment and school enrolment among males (aOR 2.53, 95% CI 1.59–4.03 and aOR 3.11, 95% CI 1.56–6.19, respectively).ConclusionsOur study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. Implementing and expanding such social protection initiatives could prove instrumental in improving the well-being of vulnerable adolescents.ContributionsSocial protection programs have been increasing in sub-Saharan African countries, playing a pivotal role in poverty reduction, with Lesotho being no exception. Despite the optimistic outlook brought about by the implementation of the National Social Protection Strategy Lesotho I (2014-19) and II (2021–2031), the impact of these programs on some specific outcomes that concern the lives of the most vulnerable adolescents in Lesotho remains to some extent unexplored. Additionally, Lesotho grapples with high rates of HIV, adolescent pregnancy, child marriage and early school dropout, which can further contribute to poor long-term health and social outcomes among adolescents. In this study, we used data from the 2018 Lesotho Violence Against Children and Youth Survey (VACS) to examine the association between receiving social protection and multiple adolescent outcomes: educational, sexual and reproductive. The findings revealed that social protection programs, particularly the existing government-provided cash transfers, are significantly associated with multiple better outcomes among adolescents living in the poorest households in Lesotho. Such cash transfer schemes in Lesotho are associated with improved sexual and reproductive health outcomes for adolescent females, including reduced child marriage rates, and improved educational outcomes for males. These findings indicate that government-led social protection programmes are positively associated with favourable outcomes that can improve the quality of life for adolescents in resource-limited settings.

Determinants of aggregate anthropometric failure among children under-five years in Ethiopia: Application of multilevel mixed-effects negative binomial regression modeling.

Undernutrition significantly contributes to failure to thrive in children under five, with those experiencing multiple forms of malnutrition facing the highest risks of morbidity and mortality. Conventional markers such as stunting, wasting, and underweight have received much attention but are insufficient to identify multiple types of malnutrition, prompting the development of the Composite Index of Anthropometric Failure (CIAF) and the Composite Index of Severe Anthropometric Failure (CISAF) as an aggregate indicators. This study aimed to identify factors associated with CIAF and CISAF among Ethiopian children aged 0-59 months using data from the 2019 Ethiopia Mini Demographic and Health Survey. The study included a weighted sample of 5,259 children and used multilevel mixed-effects negative binomial regression modeling to identify determinants of CIAF and CISAF. The result showed higher incidence-rate ratio (IRR) of CIAF in male children (adjusted IRR = 1.27; 95% CI = 1.13-1.42), children aged 12-24 months (aIRR = 2.01, 95%CI: 1.63-2.48), and 24-59 months (aIRR = 2.36, 95%CI: 1.91-2.92), those from households with multiple under-five children (aIRR = 1.16, 95%CI: 1.01-1.33), poorer households (aIRR = 1.48; 95%CI: 1.02-2.15), and those who lived in houses with an earthen floor (aIRR = 1.37, 95%CI: 1.03-1.82). Similarly, the factors positively associated with CISAF among children aged 0-59 months were male children (aIRR = 1.47, 95% CI = 1.21-1.79), age group 6-11 months (aIRR = 2.30, 95%CI: 1.40-3.78), age group 12-24 months (aIRR = 3.76, 95%CI: 2.40-5.88), age group 25-59 months (aIRR = 4.23, 95%CI: 2.79-6.39), children from households living with two and more under-five children (aIRR = 1.27, 95%CI:1.01-1.59), and children from poorer households (aIRR = 1.93, 95% CI = 1.02-3.67). Children were more likely to suffer from multiple anthropometric failures if they were: aged 6-23 months, aged 24-59 months, male sex, living in households with multiple under-five children, and living in households with poor environments. These findings underscore the need to employ a wide range of strategies to effectively intervene in multiple anthropometric failures in under-five children.