Prevalence and factors associated with undernutrition among Dayak children in rural areas of Sarawak, Malaysia

Abstract

Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.

Demographic characteristics are associated with children’s nutritional status: Findings from a pilot study on food insecure households in Simunjan district, Sarawak

“…This finding is consistent with NHMS (2019), where the prevalence of undernutrition (underweight 14.1%; stunting 21.8%; wasting 9.7%) was higher than overnutrition (overweight 5.6%; obese 5.6%) (IPH, 2020). In Sarawak, a study conducted by Rahman, Kiyu & Seling (2021) reported that the proportion of wasting was lower than in the present study, which was 6.9%. The difference in proportion may be due to different demographic characteristics, as the previous study was conducted among the Dayak community and in all divisions of Sarawak.…”

“…Besides that, it might be due to the difference in the proportion of poor households between these two studies. Poor household is one of the factors related to wasting in children (Rahman et al, 2021). Undoubtedly, the proportion of poor households in this study (74.2%) was much higher than the study conducted by Rahman et al (2021), which was 27.3%.…”

“…Poor household is one of the factors related to wasting in children (Rahman et al, 2021). Undoubtedly, the proportion of poor households in this study (74.2%) was much higher than the study conducted by Rahman et al (2021), which was 27.3%. According to the Nutrition Landscape Information System's proposed prevalence thresholds, which are set to map countries based on severity levels, the prevalences of underweight and wasting in this study were categorised as medium and serious public health significance, respectively (de Onis et al, 2019).…”