Severe acute malnutrition and its associated factors among under-five children in two districts of Nepal

Abstract

Background: Despite consistent efforts to enhance nutritional child nutrition, poor nutritional status of children continues to be a major public health problem in Nepal. This study identified the predictors of severe acute malnutrition (SAM) among children aged 6-59 months in the two districts of Nepal. Methods: We used data from a cross-sectional study conducted among mothers of 6 to 59 months children admitted to the Outpatient Therapeutic Centres (OTCs). The nutritional status of 398 children was assessed using mid-upper arm circumference (MUAC) measurement. To evaluate associated factors with SAM, adjusted odds ratio was computed using multivariate logistic regression and p-value <0.05 was considered as statistically significant. Results: Among 398 children, 5.8 percent were found to be severely malnourished including under-two years and female children. Family size (five or more members) (Adjusted Odds Ratio [AOR]: 3.96; 95% Confidence Interval [CI]: 1.23 - 12.71) was positively associated with SAM. Children from severely food insecure households (AOR: 4.04; 95% CI: 1.88-10.53) were four times more likely to be severely malnourished. Younger age-group (AOR: 12.10; 95% CI: 2.06 - 71.09) children (0 - 12 vs. 24 - 59 months) were significantly associated with childhood undernutrition. Conclusions: The findings of this study indicated that household size, household food access, and child’s age were the major predictors of severe acute malnutrition. Hence, nutrition health programs should be targeted to improve the nutritional status of children by ensuring household food access by focusing poor families engaging them in kitchen gardening to promote nutritious diet to the children.