Prevalence and factors associated with undernutrition among 15–49- year-old women in Sierra Leone: A secondary data analysis of Sierra Leone Demographic Health Survey of 2019

Abstract

Background: Undernutrition of non-pregnant women of childbearing age is pertinent for maternal and offspring health. This study aimed to determine the prevalence and factors associated with undernutrition, underweight, and stunting, among women of reproductive age (15-49 years) in Sierra Leone using secondary data analysis of the 2019 Demographic Health Survey. Methods: Anthropometric measurements and maternal characteristics were obtained from the Sierra Leone Demographic Health Survey (SLDHS) of 2019. The heights and weights of women were measured, and BMI in kg/m2 was calculated. Based on the World Health Organization's recommendations, stunting was defined as having heights <145cm, and underweight as BMI <18 kg/m2. Multivariable logistic regression analyses were conducted to identify correlates of undernutrition, with a significance level of p<0.05. Results: A total of 7,514 women of reproductive age, 15-49 years, participated in this study. The prevalence of stunting and underweight was 1.5% (113/7514) and 6.7%(502/7,514), respectively. Women with primary education had a 47% lower likelihood of stunting (adjusted Odds Ratio [aOR]=0.53, 95% Confidence Interval [CI]: 0.30-0.94;p=0.029) than secondary education. Similarly, women in the poorest wealth index had a 51% lower likelihood of stunting (aOR=0.49,95%CI:0.27-0.88;p=0.017) than middle wealth index. However, underweight was 1.48 times more likely among women with a parity of one-to-four (aOR=1.48,95% CI:1.08-2.03;p=0.015) than women who had never given birth. Additionally, underweight was 1.41 times more likely among women who listened to radios (aOR=1.41,95% CI:1.14-1.74;p=0.002) than those who did not. Notably, age groups of 15-19 years and 40-49 years had a 54% (aOR=0.46,95%CI:0.34-0.62;p<0.001) and 34% (aOR=0.66,95%CI:0.45-0.97;p=0.035) lower likelihood of underweight, respectively, than 20-29-year age group. Women with primary education had a 26% lower likelihood of underweight (aOR=0.74,95%CI:0.56-0.99;p=0.042) than secondary education. However, none of the wealth indices were significantly associated with underweight. Conclusion: The prevalence of underweight and stunting among women of reproductive age, 15-49 years, in Sierra Leone was lower compared to regional and world data. This study highlights similarities and differences in this population's prevalence and correlates of stunting and underweight. Primary education was less likely in both underweight and stunting, while parity of one-to-four and listening to radios were significantly associated with underweight. Further trend studies using DHS data from 2010, 2014, and 2019 are warranted to understand the dynamics of undernutrition in Sierra Leone.