Post-conflict household structures and underweight: a multilevel analysis of a community-based study in northern Uganda.
Volume: 21
Issue: 15
Year of Publication: 2019
Abstract summary
To examine associations between household-level characteristics and underweight in a post-conflict population.Nutritional status of residents in the Gulu Health and Demographic Surveillance Site was obtained during a community-based cross-sectional study, ~6 years after the civil war. Household-level factors included headship, polygamy, household size, child-to-adult ratio, child crowding, living with a stunted or overweight person, deprived area, distance to health centre and socio-economic status. Multilevel logistic regression models examined associations of household and community factors with underweight, calculating OR, corresponding 95 % CI and intraclass correlation coefficients. Effect modification by gender and age was examined by interaction terms and stratified analyses.Rural post-conflict area in northern Uganda.In total, 2799 households and 11 312 individuals were included, representing all age groups.Living in a female-headed v. male-headed household was associated (OR; 95 % CI) with higher odds for underweight among adult men (2·18; 1·11, 4·27) and girls <5 years (1·51; 0·97, 2·34), but lower odds among adolescent women aged 13-19 years (0·46; 0·22, 0·97). Higher odds was seen for residents living in deprived areas (1·37; 0·97, 1·94), with increasing distance to health services (P-trend <0·05) and among adult men living alone v. living in an average-sized household of seven members (3·23; 1·22, 8·59). Residents living in polygamous households had lower odds for underweight (0·79; 0·65, 0·97).The gender- and age-specific associations between household-level factors and underweight are likely to reflect local social capital structures. Adapting to these is crucial before implementing health and nutrition interventions.Study Outcome
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Statistics
Citations : United Nations High Commissioner for Refugees (2016) Global Trends. Forced Displacement in 2016. http://www.unhcr.org/statistics/unhcrstats/5943e8a34/global-trends-forced-displacement-2016.html (accessed September 2017).Authors : 6
Identifiers
Doi : 10.1017/S1368980018001581SSN : 1475-2727