Determinants of Severe Acute Malnutrition Among 6-59 Months Children in Nutritional Care Centers of Lumbini Province, Nepal: A Facility-Based Cross-Sectional Study

Abstract

BACKGROUND Malnutrition results in the most visible form of undernutrition, ultimately leading to Severe Acute Malnutrition (SAM). Globally, undernutrition is observed as a significant contributor to the global burden of disease and a leading cause of child mortality. AIM To assess the epidemiological determinants of SAM among children visiting Out-Patient Therapeutic Centers (OTCs) and Nutrition Rehabilitation Homes/centers (NRH) in Lumbini Province, Nepal. METHODS A facility-based cross-sectional study design was conducted in randomly selected OTCs and NRHs. Face-to-face interviews were conducted among mothers of children visiting the facilities using structured questionnaire, and anthropometric measurements of children were done using standardized equipment. Descriptive statistics were used to assess the socio-demographic information of the participants whereas, inferential statistics were applied to test the significance of the association between independent and dependent variables. RESULTS Socio-demographic characteristics showed that 53.2% participants were male, 55.8% resided in rural municipalities with two-thirds being from _Madhesi/terai _ethnic background. Children of age group 6-11 months, and 12-23 months were found to have lower odds of SAM with aORs 0.21[95% CI: (0.09-0.52)] and aORs 0.20[95% CI: (0.10-0.45)] respectively whereas mother’s age at childbirth had higher odds of SAM with aOR 2.77[95% CI: (1.33-5.77)]. CONCLUSION The facility-based SAM prevalence of Lumbini Province was 34.9% whereby the child’s age and mother’s age at childbirth were observed as significant predictors of SAM. Implementing school and community-based training programs on behavior change communication regarding the need for proper nutrition pre and post-maternity and its outcome, could possibly be vital in reducing malnutrition as a whole.