The burden and correlates of childhood undernutrition in Tanzania according to composite index of anthropometric failure

Abstract

Background Undernutrition is a public health problem worldwide. Tanzania has made significant achievements in the reduction of childhood undernutrition over the past two decades. However, the exact burden of undernutrition was under-estimated when using conventional indices of stunting, wasting and underweight. The objective of this study was to determine the overall prevalence of undernutrition, describe the trends and examine the correlates associated with undernutrition among children under the age of five years using the composite index of anthropometric failure (CIAF). This study aims to understand the real burden and drivers of undernutrition to improve design, implementation and monitoring of appropriate interventions to emeliorate childhood undernutrition in the country. Methods We retrieved and analyzed the data of mother-child pairs from the Tanzania Demographic and Health Surveys (TDHS) of 1991, 1996, 1999, 2004-05, 2009-10, and 2015-16 using Stata and SPSS software. Data for 1991 to 2015 were used to determine the burden and trends of undernutrition. The recent TDHS surveys of 2004-05, 2010 and 2015-16 were used to determine the correlates of undernutrition. The main outcome of interest was undernutrition measured using CIAF. This is an aggregated index of conventional indices of stunting, wasting and underweight of children aged below 59 months. We used multivariate logistic regression analysis to identify the correlates associated with CIAF, whereby both crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) were determined. Results About one in every three (38.2%) of the surveyed children had anthropometric failure in 2015 compared to half of them (50%) in 1991. The odds of anthropometric failure were significantly higher for boys, older children, living in rural areas, living in poorer households, and being born with non-educated or undernourished mothers. Female-headed households were more likely to have children with anthropometric failure, while age of the household head was negatively associated with anthropometric failure. Children who were born at home, with low birth weight, or having episode of illnesses such as diarhea or fever were most likely to have anthropometric failure. Conclusion One in every three under 5 years old children are suffering from either one or multiple forms of anthropometric failure in Tanzania as revealed by CIAF. Multiple factors including those related to mothers, children and household socio-economic characteristics have the potential to influence childhood anthropometric failure. Efforts to reduce the burden of undernutrition should focus on reducing poverty and raising people’s living standards.

Spatial data analysis of malnutrition among children under-five years in Ethiopia

“…Moreover, children in the youngest age group (in months) had significantly lower CIAF odds than the older age groups. This result is also consistent with different studies [ 14 , 72 – 74 ]. This may be because breastfeeding practices common among mothers who spent much of their time with their children [ 79 ].…”

“…Turning to another evidence in the data, the nonlinear relationship between the age of the child (in months) and CIAF prevalence was similar to that of studies conducted elsewhere [ 72 , 73 ]. Moreover, children in the youngest age group (in months) had significantly lower CIAF odds than the older age groups.…”