Pooled prevalence of stunting and associated factors among children aged 6–59 months in Sub-Saharan Africa countries: A Bayesian multilevel approach

Abstract

Background Over 155 million children under five suffer from stunting, and it is responsible for over one million deaths and 54.9 million Disability Adjusted Life Years (DALYS) of under-five children worldwide. These predominantly occurred in low-and middle-income countries like sub-Saharan Africa. Stunted children begin their lives at a marked disadvantage. Some of these are; poor cognition and educational performance, low adult wages, lost productivity and, when accompanied by excessive weight gain later in childhood, an increased risk of nutrition-related chronic diseases in adult life and the devastating effects of stunting can last a lifetime and even affect the next generation. Despite this, its magnitude rises in the past 25 years in sub-Saharan Africa. Studies that capture the pooled prevalence and associated factors of stunting among children aged 6–59 months in sub-Saharan Africa are limited. Therefore, this study was carried out on the basis of the Bayesian approach to determine the pooled prevalence and predictors of stunting among children aged 6–59 months in Sub-Saharan Africa. Objective To assess the pooled prevalence of stunting and associated factors among children aged 6–59 months in Sub-Saharan Africa Methods For this study a total of 173,483 weighted samples from the demography and health survey data set of 35 sub-Saharan African countries from 2008 to 2020 were used. After checking Variation between cluster by computing Intraclass Correlation Coefficient, binary logistic regression model was conducted based on hierarchical Bayesian statistical approach to account the hierarchical nature of demography and health survey data and to get reliable estimates by using additional information from the prior distribution. Adjusted odds ratio with 95% credible interval of the best fitted model was used to ascertain the predictors. Results The pooled prevalence of stunting in Sub-Saharan Africa was about 35% (95%CI: 34.87, 35.31). Of the sub-regions, the highest prevalence of stunting was in East Africa, 37% (95%, CI: 36.96, 37.63) followed by Central Africa, 35% (95%CI: (34.93, 35.94). Being male (AOR = 1.27, 95% CrI 1.25, 1.30), small birth size (AOR = 1.29, CrI 1.25, 1.32), home delivery (AOR = 1.17, CrI 1.14, 1.20), and no education of mothers (AOR = 3.07, CrI 2.79, 3.39) were some of the significant predictors of stunting of children. Conclusion and recommendation The prevalence of stunting of children in sub-Saharan Africa is among the highest in the world. Predictors such as being male, being small at birth, a child delivered at home, and, low level of maternal education were some of the predictors of childhood stunting. Stakeholders and non-governmental organizations should consider those contributing factors of stunting when they plan and design nutritional improvement programs.

Population-Modifiable Risk Factors Associated With Childhood Stunting in Sub-Saharan Africa

“…First, the study’s reliance on cross-sectional data made it difficult to clearly establish a temporal relationship between some putative exposures and the outcome. However, the modifiable risk factors identified align with previous studies conducted in SSA countries . Second, our findings may have been limited due to the absence of unmeasured modifiable risk factors, such as household food security and sociocultural factors, in the DHS data sets used.…”

Determinants of stunting among children under age five in Burundi: Evidence from the 2016–2017 Burundi Demographic and Health Survey (BDHS 2016–17)

“…In Africa, however, the number of stunted children has increased by more than 15% over the same period (UNICEF et al, 2020). Prevalence of stunting was estimated to be 35% of children under age five in sub‐Saharan Africa, while the eastern African region had with 37% the highest prevalence (Takele et al, 2022).…”

“…Prevalence of stunting was estimated to be 35% of children under age five in sub-Saharan Africa, while the eastern African region had with 37% the highest prevalence (Takele et al, 2022).…”

Co-existence of maternal overweight/obesity, child undernutrition, and anaemia among mother-child pairs in Ethiopia

“…Sub‐Saharan Africa (SSA) has been identified as the most affected region with childhood undernutrition [ 8 ]. The latest estimate showed that the pooled prevalence of stunting among under-five children in SSA was 35% [ 9 ], and six in every ten (60.2%) children aged 6–59 months were affected by anaemia [ 10 ]. Of the sub-regions, the highest prevalence of stunting (37%) was in East Africa, where Ethiopia is located [ 9 ].…”

“…The latest estimate showed that the pooled prevalence of stunting among under-five children in SSA was 35% [ 9 ], and six in every ten (60.2%) children aged 6–59 months were affected by anaemia [ 10 ]. Of the sub-regions, the highest prevalence of stunting (37%) was in East Africa, where Ethiopia is located [ 9 ]. In Ethiopia, the burden of childhood stunting (37%), wasting (21%), and being underweight (7%) have been reported [ 11 ], with national prevalence of anemia estimated to be 56% among children under the age of 5 years [ 12 ], indicative of a severe public health problem [ 13 ].…”