Determinants of undernutrition among children under-five years old in southern Ethiopia: does pregnancy intention matter? A community-based unmatched case-control study

Shaka, Mohammed Feyisso; Woldie, Yetayal Birhanu; Mokona, Hirbaye; Olkamo, Kalkidan Yohannes; Tesfaye, Adane

doi:10.1186/s12887-020-2004-7

Cited by 15 publications

(26 citation statements)

References 24 publications

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“…Undesired girls are significantly associated with an increased likelihood of wasted and being underweight, similar to existing studies [ 12 , 51 ]. Shaka et al showed that children from unintended pregnancies were three times more likely to be stunted in southern Ethiopia.…”

Section: Discussionsupporting

confidence: 87%

Is there any association between undesired children and health status of under-five children? Analysis of a nationally representative sample from Bangladesh

Alam

Islam

2022

BMC Pediatr

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Background Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status on childhood morbidity and mortality in Bangladesh. Methods We used the data from the nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2017–18 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (perinatal, early neonatal, neonatal, post-neonatal, infant, child, and under-five mortality), morbidity (fever, diarrhea, cough, and acute respiratory infectious-ARI), nutritional problems (stunting, wasting, underweight, and low birth weight), and treatments (postnatal care, treatment for fever, diarrhea/cough, and vitamin A supplementation). Finally, we utilized the chi-square test and multilevel mixed-effects logistic regression analyses. Results The prevalence of undesired children was 19.2%, 21.5%, 3.7%, and 25.4% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.3% among desired children, almost double (5.4%) among undesired children. The likelihood of under-five mortality was [adjusted odds ratio (aOR): 2.05, p ≤ 0.001] higher among undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was substantial. The undesired girl children were associated with an increased likelihood of moderately wasting (aOR: 1.28, p = 0.072), severely underweight (aOR: 1.41, p = 0.066), and low birth weight (aOR: 1.50, p ≤ 0.05). Moreover, the undesired children were 19% (p ≤ 0.05) more likely to be infected with fever. The undesired children had lower treatment for diarrhea and fever/cough and were less likely to get vitamin A supplementation (aOR: 0.71, p ≤ 0.001). Conclusions The share of childhood morbidity, mortality, and malnutrition were higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition.

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Section: Discussionsupporting

confidence: 87%

Is there any association between undesired children and health status of under-five children? Analysis of a nationally representative sample from Bangladesh

Alam

Islam

2022

BMC Pediatr

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“…Undesired children are signi cantly associated with an increased likelihood of stunting and underweight, similar to existing studies [50,51]. Shaka et al (2020) showed that children from unintended pregnancies were three times more likely to be stunted in southern Ethiopia. We also found the prevalence of overweight was higher among the desired children.…”

Section: Discussionsupporting

confidence: 82%

“…If a woman delivers more than she desires, then the children (either gender) may face a lack of proper caring, and the reluctance towards unwanted children may start from pregnancy. Shaka et al (2020) showed that children from unintended pregnancies were three times more likely to be stunted in Ethiopia. The share of childhood mortality from unintended pregnancies were also larger in sub-Saharan Africa [3].…”

Section: Introductionmentioning

confidence: 99%

Is There Any Association Between Undesired Children and Health Status of Under-five Children? Analysis of Nationally Representative Sample From Bangladesh

Alam¹,

Islam²

2020

Preprint

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Introduction: Child health, especially childhood mortality, is one of the critical indicators of human development. No child mortality is desirable, but it is still high in Bangladesh. We aimed to assess the effect of the child's desired status of mothers on childhood morbidity and mortality of Bangladesh. Data and Method: We used the data from nationally representative cross-sectional Bangladesh Demographic and Health Survey (BDHS) 2014 and restricted the analyses to children born in the past five years preceding the survey. We estimated the undesired status (excess in boy, girl, both, and parity) by subtracting an ideal number of children from the total live birth. We measured childhood mortality (neonatal, infant, and under-five mortality), morbidity (fever, diarrhea, cough, and ARI), and nutritional problems (stunting, wasting, and underweight). Finally, we utilized the chi-square test and multilevel logistic regression analyses. Findings: The prevalence of undesired children was 20.7%, 23.2%, 4.9%, and 30.3% for boys, girls, both boys and girls, and parity, respectively. Age, education, residence, division, and household wealth index were significantly associated with undesired children. The prevalence of under-five mortality was 3.1% among desired children, almost double (5.9%) among undesired children. The likelihood of under-five mortality was 85% (AOR) to 97% (COR) higher among undesired children than the desired one. Childhood malnutrition (stunting and underweight except wasting) was also higher and significantly associated with undesired children. We also found 17% (AOR: 0.83; 95% CI: 0.72, 0.96) lower postnatal checkup for undesired children. Despite lower under-five mortality among higher socioeconomic status, the relative contribution of undesired children to under-fiver mortality was larger. Conclusion: The share of childhood mortality and malnutrition was higher among undesired children. Every child should be wanted, and no unwanted pregnancies are desirable; thereby, the government should reemphasize the proper use of family planning methods to reduce child mortality and malnutrition.

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“…15,16,20,23 However, un-intended pregnancy increases the odds of chronic undernutrition (stunting) among under-five children. 36 Whereas; fathers and mothers literacy, and higher wealth index decrease the odds of under-nutrition among under-five children. 10, 36, The trends of severe acute malnutrition in Kalafo district of Shebele zone remains high according to the routine therapeutic feeding program reports (TFP).…”

Section: Introductionmentioning

confidence: 99%

Determinants of Severe Acute Malnutrition Among Children 6-36 Months in Kalafo District, Riverine Context, Ethiopia. Unmatched Case Control With Qualitative Study.

Ahmed¹,

Elmi²,

Abas³

et al. 2020

Preprint

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Background: Malnutrition remains prevalent and existing health problem globally. Particularly Undernutrition is a major public health issue in developing countries.Globally the causes of severe acute undernutrition varies across context. The aim of this study was to identify the determinants of severe acute malnutrition to uncover contextual factors based on UNICEF conceptual framework, as there was no study done in a similar context in Ethiopia.Methods: Health facility based (health post) un-matched case control study with Key informant interview was conducted to identify determinant factors of severe acute malnutrition(SAM) among children between 6 to 36 months. 246 children (82 cases and 164) with their mothers or care takers participated the study which was conducted between December 20, 2019 to January 20, 2020 in Kalafo district in Shebele River. Odds ratio with 95% confidence interval was calculated to identify the determinants of SAM among children aged 6-36 months using multivariate logistic regression.Results: The Odds of Severe Acute Malnutrition was 2.28(1.22,4.26); 4.68(2.29,9.58); 2.85(1.26,6.45); 2.39(1.16,4.96) and 3.262(1.46,7.31) and 3.237(1.45,7.23); respectively for mothers with three or more under five children, Children with inadequate dietary diversity, experienced diarrhea in past two weeks, their mothers had not nutrition counselling during pregnancy, Children’s age between 6-11 and 12-17 months as compared to controls.Conclusion: The finding of this study reveals that the main determinants of severe acute malnutrition in riverine context are multi-level. On top of poor childcare and polygamy in qualitative finding, Diarrhea and inadequate dietary intake under the category of immediate cause of malnutrition. Having more than (≥3) under-five children, young age (6-11 and 12-17months) and not having nutrition counseling during pregnancy were also among basic determinants of severe acute malnutrition in riverine context. Decisive and multi-sectoral approach is required to addressing SAM in the riverine area.

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Determinants of undernutrition among children under-five years old in southern Ethiopia: does pregnancy intention matter? A community-based unmatched case-control study

Cited by 15 publications

References 24 publications

Is there any association between undesired children and health status of under-five children? Analysis of a nationally representative sample from Bangladesh

Is there any association between undesired children and health status of under-five children? Analysis of a nationally representative sample from Bangladesh

Is There Any Association Between Undesired Children and Health Status of Under-five Children? Analysis of Nationally Representative Sample From Bangladesh

Determinants of Severe Acute Malnutrition Among Children 6-36 Months in Kalafo District, Riverine Context, Ethiopia. Unmatched Case Control With Qualitative Study.

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