Exploring determinants of under-5 stunting in Malawi using a generalised linear mixed model

Afolabi, Rotimi Felix; Palamuleni, ME

doi:10.7196/sajch.2021.v15i1.01756

Cited by 4 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Supporting this assertion, a Brazilian study found positive correlations between haemoglobin (Hb) levels and HAZ, even after controlling for age [ 30 ], which ultimately led to CAS. Furthermore, Afolabi and Palamuleni reported that the likelihood of stunting was higher among anaemic children [ 31 ]. Likewise, the study identified children born of anaemic mothers and mothers with short/very short stature as being significantly associated with higher odds of childhood CAS.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of Anaemia and Stunting among Children Aged 6–59 Months in Ethiopia: Findings from the Nationally Representative Cross-Sectional Study

Sahiledengle

Mwanri

Petrucka

et al. 2023

IJERPH

View full text Add to dashboard Cite

Introduction: Stunting and anaemia, two severe public health problems, affect a significant number of children under the age of five. To date, the burden of and predictive factors for coexisting forms of stunting and anaemia in childhood have not been well documented in Ethiopia, where both the conditions are endemic. The primary aims of the present study were to: (i) determine the prevalence of co-morbid anaemia and stunting (CAS); (ii) and identify factors associated with these co-morbid conditions among children aged 6–59 months in Ethiopia. Methods: The study was based on data from the Ethiopian Demographic and Health Survey (EDHS 2005–2016). The EDHS was a cross-sectional study that used a two-stage stratified cluster sampling technique to select households. A total weighted sample of 21,172 children aged 6–59 months was included in the current study (EDHS-2005 (n = 3898), EDHS-2011 (n = 8943), and EDHS-2016 (n = 8332)). Children with height-for-age z-scores (HAZ) less than −2 SD were classified as stunted. Anaemia status was measured by haemoglobin level with readings below 11.0 g/deciliter (g/dL) categorized as anaemic. A multilevel mixed-effects logistic regression model was used to identify the factors associated with CAS. The findings from the models were reported as adjusted odds ratios (AOR) with 95% confidence intervals (CIs). Results: Almost half of the children were males (51.1%) and the majority were from rural areas (89.2%). The prevalence of CAS was 24.4% [95% CI: (23.8–24.9)]. Multivariate analyses revealed that children aged 12–23 months, 24–35 months, and 36–59 months, and children perceived by their mothers to be smaller than normal at birth had higher odds of CAS. The odds of CAS were significantly higher among children born to anaemic mothers [AOR: 1.25, 95% CI: (1.11–1.41)], mothers with very short stature [AOR: 2.04, 95% CI: (1.44–2.91)], children from households which practiced open defecation [AOR: 1.57, 95% CI: (1.27–1.92)], children born to mothers without education [AOR: 3.66, 95% CI: (1.85–7.22)], and those who reside in rural areas [AOR: 1.41, 95% CI: (1.10, 1.82)]. Male children had 19% lower odds of having CAS compared to female children [AOR: 0.81, 95% CI: (0.73–0.91)]. Children born to mothers who had normal body mass index (BMI) [AOR: 0.82, 95%CI: (0.73–0.92)] reported lower odds of CAS. Conclusions: One in four preschool-age children in Ethiopia had co-morbid anaemia and stunting, which is a significant public health problem. Future interventions to reduce CAS in Ethiopia should target those children perceived to be small at birth, anaemic mothers, and mothers with short stature.

show abstract

Section: Discussionmentioning

confidence: 99%

Coexistence of Anaemia and Stunting among Children Aged 6–59 Months in Ethiopia: Findings from the Nationally Representative Cross-Sectional Study

Sahiledengle

Mwanri

Petrucka

et al. 2023

IJERPH

View full text Add to dashboard Cite

show abstract

“…The most recent research from Rwanda, Gambia, Ethiopia, India, Uganda [12][13][14][15][16] , and Indonesia 17,18 indicates that the causes of child stunting vary and are multifactorial. Stunting determinants include low birth weight [18][19][20][21][22][23] , food insecurity 19,[23][24][25][26][27] , birth spacing 7,[28][29][30] , child age [31][32][33][34] number of children [35][36][37][38] , and the inability to breastfeed exclusively [39][40][41][42] . Stunting increased significantly in children living in households with three or more children under five years of age, households with 5-7 household members, children whose mothers attended less than four antenatal care services during pregnancy, males, 12-23 months old, and low birth weight 43 .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Determinants Stunting Among Children Under Two Years in Indonesian District

Hafid,

Ansar,

Nasrul

et al. 2023

JIK

View full text Add to dashboard Cite

The study aims to analyze the prevalence and determinants of stunting in children under two years of age in Tojo Una-Una District, Indonesia as focus location of stunting. The method is Cross-sectional study design, the sample of 300 children aged 0-23 months, stratified random sampling technique. Data collection in June-July 2022. Stunting data was obtained by measuring body length using the length measuring board. The WHO-Antro 2005 software was used to determine the Z-Score height per age. Univariate, bivariate, and multivariate analyzes used SPSS version 22.00. The Results of this research show that 33.7% of children under the age of two are stunted. Stunting in children under the age of two is associated with child age, birth weight, and food insecurity. In addition to a history of low birth weight (AOR=2.7, 95% CI: 1.2-5.7) and experiencing food insecurity (AOR=1.9, 95% CI: 1.1-3.5), children aged 12-23 months (AOR=3.5, 95% CI: 1.7-7.2) have a higher tendency to experience stunting than those who are not. The Conclusion is the prevalence of stunting which is more than 20 percent is a priority health problem that must be resolved by 2024. Interventions to reduce stunting by reducing the incidence of low birth weight, reducing food insecurity, managing birth spacing > 3 years, number of children less than 3, and breastfeeding.

show abstract

“…In addition to nutritional and other environmental factors, genetic causes of anaemia are common in children of Malawi (Linnemayr & Alderman, 2008). The study investigating the determinants of stunting among under five years children in Malawi by (Afolabi & Palamuleni, 2021) showed that Children who were female from wealthier households whose mothers were overweight/obese aged 25 -34 years had at least a secondary level education were less likely to be stunted. Anaemia in Angola, Malawi and Senegal was found to be associated with the mothers' level of education, household wealth status and child's age, whereas, malnutrition was found to be associated with type of residence, household wealth status, mother's level of education and child's age .…”

Section: Introductionmentioning

confidence: 99%

Statistical study on childhood malnutrition and anaemia in Angola, Malawi and Senegal.

Khulu

View full text Add to dashboard Cite

Malnutrition and anaemia continue to be a concern to the future of developing countries. This thesis aimed to examine the risk factors associated with malnutrition and anaemia among under five-year-old children in Angola, Malawi and Senegal. Statistical models and techniques have improved over the years to give more insight into malnutrition and anaemia, in terms of demographic, socio-economic, environmental, and geographic factors. This thesis also assessed the spatial epidemiological overlaps between childhood malnutrition and anaemia diseases which can lead to various advantages in intervention planning, monitoring, controlling and total elimination of such diseases, especially in high-risk regions. This is a secondary data analysis where national representative data from the three countries was used. The Demographic and Health Survey data from Angola, Malawi and Senegal were merged to create a pooled sample which was then used for all the analyses conducted in this study. The relationship between exploratory variables to malnutrition and anaemia was assessed to obtain variables that explain the two outcomes. Consequently, a generalized linear mixed model was used to investigate the significance of the child-level, community-level and household-level factors to malnutrition and anaemia separately. The relationship between the two diseases was further examined using the three joint modelling approaches: (1) a joint generalised linear mixed model; (2) a structural equation model, and (3) a bivariate copula geo-additive model. For each model employed, the significant factors of both malnutrition and anaemia were identified. The GLMM results on malnutrition revealed that children’s place of residence, age, gender, mother’s level of schooling, wealth status, birth interval and birth order significantly explain malnutrition at the 5% level of significance. Whereas, the GLMM results on anaemia revealed that children‘s age, gender, mother’s level of schooling, wealth status and nutritional status significantly explain anaemia at 5% level of significance. The findings of copula geo-additive modelling of malnutrition and anaemia indicated that there is an association between malnutrition and anaemia. There was a strong association observed between malnutrition and anaemia in the north-west districts of Angola when compared to other districts. The results imply that the policymakers of Angola, Senegal and Malawi can control anaemia through the intervention of malnutrition controlling. The overall findings of this study provide meaningful insight to the policymakers of Angola, Malawi and Senegal which will lead to the implementation of interventions that can assist in achieving the Sustainable Development Goal (SDG) of 25 deaths per 1 000 live births by 2030. To properly eradicate all the causes of malnutrition and anaemia, programs such as parental education, financial education, children's dietary focus programs and mobile health facilities could add a significant value. The results also highlighted the national priority areas related to child-related factors, household factors and environmental factors for childhood malnutrition and anaemia morbidity control. It also provided policy makers with valuable geographical information for developing and implementing effective intervention. There is a greater need for partnership and collaboration among the studied countries to achieve the SGD target.

show abstract

Exploring determinants of under-5 stunting in Malawi using a generalised linear mixed model

Cited by 4 publications

References 30 publications

Coexistence of Anaemia and Stunting among Children Aged 6–59 Months in Ethiopia: Findings from the Nationally Representative Cross-Sectional Study

Coexistence of Anaemia and Stunting among Children Aged 6–59 Months in Ethiopia: Findings from the Nationally Representative Cross-Sectional Study

Prevalence and Determinants Stunting Among Children Under Two Years in Indonesian District

Statistical study on childhood malnutrition and anaemia in Angola, Malawi and Senegal.

Contact Info

Product

Resources

About