Predictors of Chronic Under Nutrition (Stunting) Among Children Aged 6-23 Months in Kemba Woreda, Southern Ethiopia: A Community Based Cross-Sectional Study

Abstract

Background: Stunting is a public health problem in developing countries. Stunting (deficit in height/length for age of at least-2 Z score) affects close to 195 million children under five years of age in the developing world. Chronic under nutrition is a major cause of disability preventing children who survive from reaching their full developmental potential. Objective: To assess chronic under nutrition (Stunting) and associated factors among Children aged 6-23 months in Southern Ethiopia. Methods: Community based cross-sectional study was carried out among 562 mothers who have young child from 6-23 months in 2014/15 in Kemba Woreda by using pre tested and structured questioners. Bivariate and multivariate analyses were conducted by SPSS version 20 and finally result was interpreted, compared and discussed with different recently published scientific journal. Results: The study revealed that out of 562 children, 18.7%; 95% C.I (15.6-22.1) of children were stunted, or chronically undernourished (i.e. HAZ ≤ 2Z-score). In multiple logistic regressions, boys [AOR: 2.50; 95% CI(1.60-4.01)],older mothers [AOR: 2.60; 95% CI (1.07-6.35)], mothers who have no formal education [AOR: 2.76; 95% CI (1.63-4.69)], mothers who work as daily workers [AOR: 3.06; 95% CI (1.03-9.12)] and have Private work activity(merchant, farmers) [AOR: 2.39; 95% CI (1.61-3.53)], mothers who have no post natal follow up [AOR: 1.64; 95% CI (1.05-2.55)] and maternal illness encountered after delivery [AOR: 1.56; 95% CI (1.05-2.32)] were identified as significant independent predictors of childhood stunting. Conclusion and Recommendation: A significant number of young child develop chronic malnutrition in this critical periods. Stunting was significantly associated with the illiterate mothers, mothers who work as daily workers and Private work, those has no post natal follow up and maternal illness encountered after delivery. An organized effort should be made at all levels to solve the problems of chronic under nutrition (stunting) in children.

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

“…Although stunting often begins in utero, several research studies have identified socio-demographic, socioeconomic [11][12][13][14][15][16], environmental [17,18], dietary [12,18,19], parasitic infection and other related illness [11,20], and psychological [19] correlations with stunting. One of the psychological factors that might be associated with children stunting is unintended pregnancy, either unwanted (the parent did not desire any or any more children) or mistimed (the pregnancy occurred earlier than desired) [16,21,22].…”

Nutritional status and its concomitant factors among pre-school children in Malda, India: A micro-level study using a multilevel approach

“…Study based in India showed that maternal age is positively associated with stunting among children (58), while some studies showed that stunting is inversely related with maternal age (63,64). Many studies have documented that with the increase of maternal education, the chances of stunting decrease among children (44,54,(65)(66)(67)(68). Mother's body mass index that is negatively associated with stunting among children, also another important risk factor of stunting among children as evidenced by the previous studies (28,44,67).…”

Drivers of stunting reduction in Ethiopia: a country case study

“…Much literature exists on the reasons behind the stunting decline in Ethiopia, and findings point to several key drivers: parental education ( 16–33 ); health care interventions, such as delivery by a skilled birth attendant (SBA) ( 17 , 34–36 ), antenatal care ( 16 , 17 , 26 , 34 , 37–44 ), and postnatal care ( 45 , 46 ); improvements in water, sanitation, and hygiene (WASH), including access to improved water sources ( 21 , 32 , 37 , 39 , 40 , 45 , 47–58 ), reduced distance to fetch water ( 59 ), access to improved sanitation ( 17 , 20 , 21 , 23 , 27 , 29 , 39 , 40 , 45 , 51 , 60–63 ), and reductions in open defecation ( 19 , 27 ); and child feeding indicators ( 19 , 30 , 37 , 38 , 60 , 64–70 ) ( Panel 1 , Supplemental Appendix 2 ) ( 16–98 , 99–118 , 119–142 ). Although we found a wealth of national and subnational studies exploring factors related to stunting in Ethiopia, the overwhelming majority were cross-sectional in design which precludes causality.…”

“…The majority of studies in our review found that childhood immunizations have a protective effect against stunting outcomes ( 28 , 39 , 40 , 50 , 93–95 ), although some found no association ( 23 , 38 , 45 , 51 , 97 , 98 ). Health care interventions such as delivery by an SBA ( 17 , 34–36 ), antenatal care ( 16 , 17 , 26 , 34 , 37–44 ), and postnatal care ( 45 , 46 ) have been found to be associated with reduced stunting outcomes in most studies, although some found no association ( 16 , 19 , 22 , 27 , 30 , 35 , 42 , 45 , 49 , 60 , 64 , 71 , 86 ). Vitamin A supplementation is a promising initiative shown to be associated with a decreased risk of stunting, although variation in findings exists ( 40 , 60 , 61 , 67 , 99–102 ).…”

“…Studies examining access, distance or time to a health facility typically found that these were not strongly related to stunting ( 17 , 32 , 33 , 41 , 52 , 83 , 100 , 101 , 104 ). There is substantial evidence in the literature that rural residence confers a higher likelihood of stunting than urban residence ( 18 , 20 , 22 , 25 , 28 , 31 , 37 , 39 , 48 , 53 , 72 , 77 , 80 , 85 , 105–107 ), although some studies found no association ( 16 , 21 , 23 , 26 , 27 , 32 , 34 , 37 , 46 , 60 , 64 , 68 , 109 ), whereas 1 found that rural-living children were protected ( 24 ). Improvements in WASH indicators such as access to improved water sources ( 21 , 32 , 37 , 39 , 40 , 45 , 47–58 ), distance to fetch water ( 59 ), access to improved sanitation ( 17 , 20 , 21 , 23 , 27 , 29 , 39 , 40 , 45 , 51 , 60–63 ), and open defecation ( 19 , 27 ) have been generally found to be positively associated with stunting outcomes although some did find nonsignificant resul...…”