Understanding Child Wasting in Ethiopia: Cross-sectional Analysis of 2019 Ethiopian Demographic and Health Survey Data Using Generalized Linear Latent and Mixed Models.

Journal: JMIR public health and surveillance

Volume: 9

Issue: 

Year of Publication: 2023

Affiliated Institutions:  Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Southern Nation Nationalities Peoples' Region, Ethiopia. Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Southern Nation Nationalities Peoples' Region, Ethiopia. Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Southern Nation Nationalities Peoples' Region, Ethiopia. Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Southern Nation Nationalities Peoples' Region, Ethiopia. Department of Biomedical Science, School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Southern Nation Nationalities Peoples' Region, Ethiopia.

Abstract summary 

Wasting is an immediate, visible, and life-threatening form of undernutrition in children aged <5 years. Within a short time, wasting causes recurrent sickness, delayed physical and mental growth, impatience, poor feeding, and low body weight. The long-term consequences of wasting and undernutrition are stunting, inability to learn, poor health status, and poor work performance. Wasting remains a public health problem in Ethiopia. According to the World Health Organization, countries have to reduce undernutrition including child wasting to below 5% by 2025. Ethiopia is attempting to attain national and international targets of undernutrition while struggling with many problems.This study aimed to identify the prevalence and associated factors of wasting to provide information for further renewing policy commitments.We used community-based, cross-sectional data from the Ethiopian Mini Demographic and Health Survey. The survey was conducted in 9 regions and 2 city administrations. Two-stage cluster sampling was used to recruit study participants. In the first stage, enumerations areas were selected, and 28-35 households per enumeration area were selected in the second stage. Our analysis included 2016 women with children aged <5 years from the 2019 EMDHS data set. We dropped incomplete records and included all women who fulfilled the eligibility criteria. We used multilevel ordinal regression using Generalized Linear Latent and Mixed Models (GLLAMM) and predicted probability with log-likelihood ratio tests. Fulfilling the proportional odds model's assumption during the application of multilevel ordinary logistic regression was a cumbersome task. GLLAMM enabled us to perform the multilevel proportional odds model using an alternative method.In our analysis, wasting was 7.68% (95% CI 6.56%-8.93%). Around 26.82% of mothers never used antenatal care for their current child. Most mothers (52.2%) did not have formal education, and 86.8% did not have postnatal care for their children. Additionally, half (50.93%) of the mothers have ≥6 household members. Wasting was associated with feeding diverse foods (coefficient 4.90, 95% CI 4.90-4.98), female sex of the household head (-40.40, 95% CI -40.41 to -40.32), home delivery (-35.51, 95% CI -35.55 to -35.47), first (16.66, 95% CI, 16.60-16.72) and second (16.65, 95% CI 16.60-16.70) birth order, female child (-12.65, 95% CI -12.69 to -12.62), and household size of 1 to 3 (10.86, 95% CI 10.80-10.92).According to the target set by World Health Organization for reducing undernutrition in children aged <5 years to below 5% by 2025, child wasting of 7.68% in Ethiopia should spark an immediate reaction from the government and stakeholders. Informed policy decisions, technology-based child-feeding education, and food self-sufficiency support could improve the current challenges. Additional effort is important to improve low maternal education, family planning, awareness of sex preferences, women empowerment, and maternal health services.

Authors & Co-authors:  Gilano Girma G Hailegebreal Samuel S Sako Sewunet S Haile Firehiwot F Gilano Kasarto K Seboka Binyam Tariku BT Kashala Kefita K

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Maleta K. Undernutrition in Malawi. Malawi Med J. 2006;18(4):190–207. doi: 10.4314/mmj.v18i4.10922.
Authors :  7
Identifiers
Doi : e39744
SSN : 2369-2960
Study Population
Women,Female,Mothers
Mesh Terms
Pregnancy
Other Terms
Ethiopia;GLLAMM;Generalized Linear Latent and Mixed Models;factors;under-five children;wasting
Study Design
Cross Sectional Study
Study Approach
Mixed Methods
Country of Study
Ethiopia
Publication Country
Canada