Assessing MDG Achievements Through Under-5 Child Stunting in the East African Community: Some Insights from Urban Versus Rural Areas in Burundi and Rwanda Using DHS2010

Nkunzimana, Tharcisse; Custodio, Estefanía; Pérez-Hoyos, Ana; Francois, Kayitakire

doi:10.1007/978-3-319-30981-1_4

Cited by 4 publications

(5 citation statements)

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“…The global zero hunger target [8], which was also shared by the government of Ethiopia might have contributed to the observed improvements as compared to previous results of Ethiopian DHS[24–26]. Stunting in this study is also lower than that of the results from Burundi 57.5% [27], Malawi 47.1%, Mozambique 42.6%, and Democratic Republic of Congo 42.7%[28–31].…”

Section: Discussionsupporting

confidence: 40%

Poor nutrition for under-five children from poor households in Ethiopia: Evidence from 2016 Demographic and Health Survey

et al. 2019

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BackgroundEthiopia is commonly affected by drought and famine, and this has taken quite a toll on citizens of the country, particularly the under-five children. Undernutrition among under-five children in Ethiopia is a prominent public health concern, and it lacked attention for decades. However, the government of Ethiopia, together with other stakeholders, committed to overcoming the impact of malnutrition through the transformational plan. Here we show the magnitude of undernutrition among under-five children and the factors predicting the achievement of global nutrition targets set for 2025 at the World Health Assembly.MethodsEthiopian Demographic and Health Survey (EDHS) 2016 was used for this study. A total of 9494 child-mother pairs were included in this analysis. The nutritional status indicators (Height-for-age, Weight-for-height and Weight-for-age) of children were measured and categorized based on the World Health Organization child growth standards. A multilevel logistic regression model adjusted for clusters and sampling weights were used to identify factors associated with stunting, underweight, and wasting. The independent variables were assessed by calculating the odds ratios with 95% confidence interval (CI).ResultThe prevalence of stunting was 38.3% (95% CI: 36.4% to 40.2%), under-weight 23.3% (95%CI: 21.9% to 24.9%) and wasting 10.1% (95%, CI: 9.1% to 11.2%). Sex of the child (male), children older than 24 months, recent experience of diarrhea, household wealth index (poorest), and administrative regions (Tigray, Amhara and developing regions) had a higher risk of undernutrition. On the other hand, children born from overweight mothers and educated mother (primary, secondary or higher) had a lower risk of undernutrition.ConclusionThe burden of undernutrition is still considerably high in Ethiopia. Implimentation of strategies and policies that focus on improving the socioeconomic educatiional status of the community need to be sustained. Generally, actions targeted on factors contributing to undernutrition among under-five children demands immediate attention to achieve national and global nutrition target.

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Section: Discussionsupporting

confidence: 40%

Poor nutrition for under-five children from poor households in Ethiopia: Evidence from 2016 Demographic and Health Survey

et al. 2019

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“…The trend of stunting in Burundi has remained stable at 57.5% since it was first measured in 2005; without intervention, no improvements will be achieved and a further deterioration of the situation is inevitable [21]. …”

Section: Discussionmentioning

confidence: 99%

“…Burundi reported the highest prevalence for stunting in the East Africa sub-region with nearly six in ten children under the age of five being stunted in 2010 [ 20 ]. The trend of stunting in Burundi has remained stable at 57.5% since it was first measured in 2005; without intervention, no improvements will be achieved and a further deterioration of the situation is inevitable [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016)

et al. 2017

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BackgroundSub-Saharan Africa has one of the highest levels of child malnutrition globally. Therefore, a critical look at the distribution of malnutrition within its sub-regions is required to identify the worst affected areas. This study provides a meta-analysis of the prevalence of malnutrition indicators (stunting, wasting and underweight) within four sub-regions of sub-Saharan Africa.MethodsCross-sectional data from the most recent Demographic and Health Surveys (2006–2016) of 32 countries in sub-Saharan Africa were used. The countries were grouped into four sub-regions (East Africa, West Africa, Southern Africa and Central Africa), and a meta-analysis was conducted to estimate the prevalence of each malnutrition indicator within each of the sub-regions. Significant heterogeneity was detected among the various surveys (I2 >50%), hence a random effect model was used, and sensitivity analysis was performed, to examine the effects of outliers. Stunting was defined as HAZ<-2; wasting as WHZ<-2 and underweight as WAZ<-2.ResultsStunting was highest in Burundi (57.7%) and Malawi (47.1%) in East Africa; Niger (43.9%), Mali (38.3%), Sierra Leone (37.9%) and Nigeria (36.8%) in West Africa; Democratic Republic of Congo (42.7%) and Chad (39.9%) in Central Africa. Wasting was highest in Niger (18.0%), Burkina Faso (15.50%) and Mali (12.7%) in West Africa; Comoros (11.1%) and Ethiopia (8.70%) in East Africa; Namibia (6.2%) in Southern Africa; Chad (13.0%) and Sao Tome & Principle (10.5%) in Central Africa. Underweight was highest in Burundi (28.8%) and Ethiopia (25.2%) in East Africa; Niger (36.4%), Nigeria (28.7%), Burkina Faso (25.7%), Mali (25.0%) in West Africa; and Chad (28.8%) in Central Africa.ConclusionThe prevalence of malnutrition was highest within countries in East Africa and West Africa compared to the WHO Millennium development goals target for 2015. Appropriate nutrition interventions need to be prioritised in East Africa and West Africa if sub-Saharan Africa is to meet the WHO global nutrition target of improving maternal, infant and young child nutrition by 2025.

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“…On the other hand, Burundi has the highest rate of stunting in East Africa, reaching in 2010 the highest percentage of stunted children in the last two decades (58%)[7], which declined to 56% in 2016 [8]. In both countries, the underlying and basic causes of malnutrition are poor socio-economic and education status of the household with very low purchasing power, agricultural market dysfunctions, poor infrastructures, decline of the per capita food production and other institutional and organizational failures [4,5,9].…”

Section: Introductionmentioning

confidence: 99%

Children’s dietary diversity and related factors in Rwanda and Burundi: A multilevel analysis using 2010 Demographic and Health Surveys

et al. 2019

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BackgroundOne of the reported causes of high malnutrition rates in Burundi and Rwanda is children's inadequate dietary habits. The diet of children may be affected by individual characteristics and by the characteristics of the households and the communities in which they live. We used the minimum dietary diversity of children (MDD-C) indicator as a proxy of diet quality aiming at: 1) assess how much of the observed variation in MDD-C was attributed to community clustering, and 2) to identify the MDD-C associated factors.MethodsData was obtained from the 2010 Demographic and Health Surveys of Burundi and Rwanda, from which only children 6 to 23 months from rural areas were analysed. The MDD-C was calculated according to the 2007 WHO/UNICEF guidelines. We computed the intra-class coefficient to assess the percentage of variation attributed to the clustering effect of living in the same community. And then we applied two-level logit regressions to investigate the association between MDD-C and potential risk factors following the hierarchical survey structure of DHS.ResultsThe MDD-C was 23% in rural Rwanda and 16% in rural Burundi, and a 29% of its variation in Rwanda and 17% in Burundi was attributable to community clustering. Increasing age and living standards were associated with higher MDD-C in both countries, and only in Burundi also increasing level of education of the mother's partner. In Rwanda alone, the increasing ages of the head of the household and of the mother at first birth were also positively associated with it. Despite the identification of an important proportion of the MDD-C variation due to clustering, we couldn't identify any community variable significantly associated with it.ConclusionsWe recommend further research using hierarchical models, and to integrate dietary diversity in holistic interventions which take into account both the household's and the community's characteristics the children live in.

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Assessing MDG Achievements Through Under-5 Child Stunting in the East African Community: Some Insights from Urban Versus Rural Areas in Burundi and Rwanda Using DHS2010

Cited by 4 publications

References 18 publications

Poor nutrition for under-five children from poor households in Ethiopia: Evidence from 2016 Demographic and Health Survey

Poor nutrition for under-five children from poor households in Ethiopia: Evidence from 2016 Demographic and Health Survey

Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016)

Children’s dietary diversity and related factors in Rwanda and Burundi: A multilevel analysis using 2010 Demographic and Health Surveys

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