Determinants of stunting among children aged 6-59 months at Kindo Didaye woreda, Wolaita Zone, Southern Ethiopia: Unmatched case control study

Abstract

BackgroundStunting is a well-established risk marker of poor child development. Globally in 2017, 155 million children under 5 were estimated to be stunted. While different activities are being done to reduce the burden of stunted growth, the problem is overwhelming in Africa; it was increased by 24%. Therefore, identifying determinants of stunting among children aged 6–59 would help to set priorities for action and to the design of stunting reduction plan at a grassroots level.MethodsThe unmatched case-control study was conducted in randomly selected 8 rural kebeles of Kindo Didaye woreda, Ethiopia from February to April, 2016 to identify the determinants of stunting among children aged 6–59 months. The sampling frame was identified by enumeration of 6–59 months of age children in the entire households of the study area. From which 155 as cases and 310 as controls were chosen using anthropometric measurement based on the median of WHO 2006 reference population. The anthropometric data were analyzed by WHO Anthro 2010 software to generate Z-score values. Odds Ratio along with 95% confidence interval was estimated to identify determinants of stunting using the multivariable logistic regression.ResultsDrinking water from unsafe source (AOR = 7.06, 95% CI; 4.40–20.42),occasionally eating animal source food (AOR = 0.51, 95% CI; 0.02–0.68), ARI in the past two weeks (AOR = 3.04, (95% CI; 1.04–13.35), late initiation of breastfeeding after one hours after birth (AOR = 5.16, 95% CI; 2.24–15.90) and lack of vaccination (AOR = 6.38, 95% CI; 2.54–17.10)were significantly associated with stunting.ConclusionsFactors like exposure to diarrhea disease, exposure to acute respiratory infection, late initiation of breast milk after child breath, squeeze out of 1st breast milk, lack of vaccination, animal source of food, and unsafe source of water for drinking could be used to set priorities for action and to the design of Kindo Didaye woreda plan for stunting reduction down to grassroots level. Therefore, zonal health department and Kindo Didaye woreda health office should promote the importance of colostrums feeding. Drinking water should be decontaminated. Expansion of vaccination program to enhance herd immunity at the community level is important.

<p>Level of Undernutrition and Its Determinants Among Children Aged 12–59 Months in Wolaita District, Ethiopia</p>

“…Children living in households that use unprotected water for drinking were about four times more likely to be stunted than those who use protected water. The finding is in line with the study from one woreda in Wolaita 16 Haramaya district 10 and in Tanzania. 17 This might be because those children who use unprotected sources of drinking water might be exposed to repeated diarrhea, intestinal parasites, and other infections.…”

Faktor Risiko Stunting pada anak di Negara Berkembang

“…Berdasarkan hasil penelitian di daerah miskin dan pedesaan bahwa penyakit infeksi menular seperti diare berisiko terhadap stunting 51 hasil penelitian di Ethiopia menunjukkan anak yang menderita diare berisiko 6,3 kali mengalami stunting 52 hasil penelitian Hywot Yisak et al bahwa anak yang mengalami diare berisiko 2,4 kali mengalami stunting 33 , penelitian Blessing et al menyatakan bahwa balita yang mengalami diare 2 minggu terakhir menjadi determinan terjadinya stunting 53 dan beberapa penelitian membuktikan bahwa penyakit infeksi menjadi faktor risiko terjadinya stunting. 24,33,52,54 Selanjutnya dapat di lihat beberapa perbedaan hasil penelitian tentang faktor risiko stunting di Indonesia dan negara berkembang lainnya di bawah ini Jika dilihat berdasarkan kerangka konsep WHO menunjukkan peninjauan yang menyeluruh terhadap artikel-artikel tentang determinan terjadinya stunting pada anak di Indonesia dan Negara berkembang lainya, dari hasil literature review yang kami lakukan diperoleh secara konsisten untuk variable tinngi badan ibu, kelahiran premature, BBLR, panjang badan lahir, pendidikan ibu yang rendah, penyakit infeksi, social ekonomi keluarga merupakan faktor risiko terjadinya stunting di Indonesia 55 , belakangan ini telah dilakukan penelitian cross sectional menunjukkan bahwa variable penyapihan ASI dini, tinggi badan ayah, konsumsi air minum yang tidak diolah, lingkungan kumuh berisiko terjadinya stunting 56 , sedangkan penelitian di Pulau Madura diperoleh bahwa pemberian makanan pendamping ASI terlalu dini berisiko mengalami stunting pada anak 57 .…”

Promoting Children Growth and Development: A community‐based cluster randomized controlled trial in rural areas of Indonesia

“…Other factors such as safe drinking water, sanitation facilities and adequate hygiene (Adhikari, Khatri, Paudel, & Poudyal, ; WHO, ), and sufficient energy, and protein intake (Laurus et al, ) directly influence nutritional status in children. Related social factors are the age of the child, occupation of head of household, family size, father's education, diarrhea, acute respiratory infections, late breastfeeding initiation, first lactation squeeze, and lack of vaccination (Batiro, Demissie, Halala, & Anjulo, ; Geberselassie, Abebe, Melsew, Mutuku, & Wassie, ).…”