scholarly journals A Decomposition Analysis of Inequality in Malnutrition among Under-Five Children in Iran: Findings from Multiple Indicator Demographic and Health Survey, 2010

2019 ◽  
Author(s):  
Abdollah ALMASIAN KIA ◽  
Sahar GOODARZI ◽  
Heshmatollah ASADI ◽  
Ardeshir KHOSRAVI ◽  
Aziz REZAPOUR
Keyword(s):  
Health Survey ◽  
Maternal Education ◽  
Socioeconomic Inequality ◽  
Demographic And Health Survey ◽  
Decomposition Approach ◽  
Under Five ◽  
Under Five Children ◽  
Multiple Indicator ◽  
The Impact ◽  
Concentration Indices

Background: Nutritional status at the early stages of children’s lives is essential for growth and development not only in infancy but also in adult life. This study aimed to measure the inequality in malnutrition among under-five children in Iran and explore the impact of socioeconomic factors on this inequality using a regression-based decomposition approach. Methods: Data were extracted from Iran's Multiple-Indicator Demographic and Health Survey 2010. The concentration index of stunting, underweight, and wasting were applied in order to measure the magnitude of socioeconomic inequality in child malnutrition. Moreover, the concentration indices were decomposed to understand the contribution of socioeconomic variables in childhood malnutrition inequality. Results: The obtained concentration indices of stunting, underweight, and wasting were respectively -0.177, -0.092, and -0.031. Socioeconomic inequality in stunting and underweight was statistically significant, however this socioeconomic gradient was not observed in wasting. More than 50% of the inequality in stunting and about 63% of the inequality in underweight were influenced by socioeconomic status. Furthermore, maternal education was associated with 19% and 22% of inequality in stunting and underweight respectively. Conclusion: The average reduction of malnutrition indices at the national level hides the burden of malnutrition among children in poor families. If government and policymakers seek to solve this problem, they have to take direct and targeted actions to eliminate the existing inequalities in the socioeconomic determinants associated with malnutrition.  

scholarly journals Spatial distribution and determinants of childhood stunting among under-five children in Ethiopia: evidence from the 2019 Ethiopian demographic and health survey

2021 ◽  
Author(s):  
Delelegn Emwodew ◽  
Binyam Tariku ◽  
Getanew Aschalew ◽  
Elias Seid ◽  
Samuel Hailegebreal ◽  
...  
Keyword(s):  
Health Survey ◽  
Maternal Education ◽  
Demographic And Health Survey ◽  
Community Level ◽  
Feeding Practice ◽  
Under Five ◽  
Factors Associated ◽  
Under Five Children ◽  
The World ◽  
Childhood Stunting

Abstract Background: Childhood stunting is a major challenge to the growth and development of nations by affecting millions of children across the world. Although Ethiopia has made steady progress in reducing stunting, the prevalence of stunting is still one of the highest in the world. This study aims to investigate the spatial variation and factors associated with childhood stunting in Ethiopia.Methods: This study is a secondary data analysis of the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). A total of 4,971 children aged 0–59 months were included in the analysis. The Getis-Ord statistics tool has been used to identify areas with high and low hotspots of stunting. A multilevel logistic regression model was used to identify factors associated with stunting.Results: The prevalence of stunting was found to be 36.86% in Ethiopian under-five children. Statistically significant hotspots of stunting were found in northern parts of Ethiopia. Both individual and community-level factors determined the odds childhood stunting among under-five children. Children in the age group between 24–35 months were more likely to be stunted than children whose age was less than one year [AOR = 3.74; 95 % CI: (3.04–4.59)]. Children with mothers who had completed higher education had lower odds of being stunted compared to children whose mothers had no formal education [AOR = 0.55; 95%CI: (0.38–0.82)]. Children from the poorest wealth quintile had higher odds of being stunted compared to children from the richest wealth quintiles [AOR = 2; 95 % CI: (1.46–2.73)]. Children living in Tigray (AOR =3.64; 95 % CI: 2.17–6.11), Afar (AOR 2.02; 95 % CI 1.19-3.39), Amhara (AOR =2.29; 95 % CI: 1.37–3.86), Benishangul Gumz (AOR=1.87; 95% CI: 1.10-3.17) and Harari (AOR=1.95; 95% CI: 1.17-3.25) regions were more likely to be stunted compared to children living in Addis Ababa.Conclusion: This study showed that both individual and community-level factors were significant predictors of childhood stunting. Improving maternal education, improving the economic status of households, improving age-specific child feeding practice, and providing additional resources to regions with high hotspots of childhood stunting are recommended.

scholarly journals Association Between Household Air Pollution and Infant and Child Mortality in Myanmar: Evidence From The First Demographic and Health Survey

2021 ◽  
Author(s):  
Juwel Rana ◽  
Md Nuruzzaman Khan ◽  
Rakibul M Islam ◽  
Razia Aliani ◽  
Youssef Oulhote
Keyword(s):  
Air Pollution ◽  
Child Mortality ◽  
Health Survey ◽  
Rural Areas ◽  
Demographic And Health Survey ◽  
Household Air Pollution ◽  
Cluster Sampling ◽  
High Exposure ◽  
Under Five ◽  
Under Five Children

Abstract Background: Household air pollution (HAP) from solid fuel use (SFU) for cooking has been considered a public health threat, particularly for women and children in low and middle-income countries (LMICs), with limited evidence. This study was undertaken to investigate the effects of HAP on neonatal, infant, and under-five child mortality in Myanmar. Methods: This cross-sectional study employed data from the Myanmar Demographic and Health Survey (MDHS), the first nationally representative survey conducted in 2016. Data were collected from MDHS based on stratified two-stage cluster sampling design applied in urban and rural areas. The sample consists of 3249 under-five children in the household with a 98% response rate. Exposure measures were HAP (coal and biomass) and level of exposure to HAP (no exposure, moderate and high exposure). The main outcomes were neonatal, infant, and under-five child mortality reported by mothers presented in rates and risk ratios with 95% confidence intervals, accounting for survey weight and cluster variation. Results: The prevalence of SFU was 79.0%. The neonatal, infant and under-five child mortality rates were 26, 45, and 49 per 1,000 live births, respectively. The risks of infant (aRR 2.02; 95% CI: 1.01-4.05) and under-five mortality (aRR 2.16; 95% CI: 1.07-4.36) mortality were higher among children from households with SFU compared to children from households using clean fuel. When applying an augmented measure of exposure to HAP by incorporating SFU and the kitchen's location, the likelihoods of infant and under-five mortality were even higher among moderate and highly exposed children than unexposed children with similar trends. Neonatal mortality was not associated with either HAP exposure or levels of exposure to HAP.Conclusion: Infants and under-five children are at higher risk of mortality from exposure to HAP. Increasing access to cookstoves and clean fuels is imperative to reduce the risk of infant and under-five child mortality in LMICs, including Myanmar.

Geographical disparities and determinants of childhood diarrheal illness in Ethiopia: Further Analysis of 2016 Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
Asmamaw Atnafu ◽  
Malede Mequanent Sisay ◽  
Getu Debalkie Demissie ◽  
Zemenu Tadesse Tessema
Keyword(s):  
Health Survey ◽  
Mixed Model ◽  
Addis Ababa ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Childhood Diarrhea ◽  
Mixed Effect ◽  
Under Five ◽  
Diarrheal Illness ◽  
Under Five Children

Abstract Background: Childhood diarrheal illness is the second leading cause of child mortality in Sub Saharan Africa, including Ethiopia. Studies hypothesized that there are regional variations. Thus, the study aimed to examine the spatial variations and to identify the determinants of childhood diarrhea in Ethiopia. Methods: Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was analyzed. This nationwide survey involved 10,337 children below 5 years old. The survey was carried out using a two-stage stratified sampling design. Moran’s I and LISA were used to detect the spatial clustering of diarrhea cases and to test for clustering in the data. Descriptive statistics followed by a mixed-effect logistic regression was used to identify the factors associated with the prevalence of diarrhea. Results: Overall, 11.87% of children were experienced childhood diarrheal illness. The study reveals high-risk areas were Southern and central Ethiopia, while eastern and west were indicated as low-risk regions. Younger children were more likely to suffer from childhood diarrhea than their older counterparts: age 6 to 12, 12 to 23, and 24 to 35 months were (AOR = 2.66, (95% CI 2.01, 3.52)), (AOR = 2.45, (95% CI 1.89, 3.17)), and (AOR = 1.53, (95% CI 1.17, 2.01)), respectively. Children living in Tigray (AOR= 1.69 (95% CI, 1.01, 2.83)), Amhara (AOR = 1.80, (95% CI, 1.06, 3.06), SNNPR (AOR = 2.04, 95% CI 1.22, 3.42), and Gambela (AOR = 2.05, (95% CI 1.22, 3.42)), faced greater risk than Addis Ababa city. The odds of getting diarrhea is decreased by 24% among households having ≥3 under-five children as compared to households having only one under-five child (AOR = 0.76 (95% CI: 0.61, 0.94)). The odds of children getting diarrheal illness among working mothers increase by 19% as compared to not working (AOR = 1.19 (95% CI 1.03, 1.38)). Conclusions: childhood diarrheal illness is highly prevalent among under-five children, particularly in SNNP, Gambella, Oromia, and Benishangul Gumuz regions. Capacity building programs with best experience sharing and better household environment may prove effective in reducing the incidence of childhood diarrhea in Ethiopia. Keywords: Spatial statistics, Ethiopia, under-five children, Diarrhea, Generalized Mixed Model

scholarly journals Prevalence of Overweight/Obesity and Associated Factors Among Under-Five Children in Ethiopia: Evidence From the 2019 Ethiopia Mini Demographic and Health Survey (Emdhs); A Multilevel Analysis

2021 ◽  
Author(s):  
Mathewos Alemu Gebremichael ◽  
Melkamu Merid Mengesha ◽  
Samuel Hailegebrea’l ◽  
Hanan Abdulkadir ◽  
Biruk Bogale Wolde
Keyword(s):  
Health Survey ◽  
Low Income ◽  
Associated Factors ◽  
Childhood Overweight ◽  
Overweight And Obesity ◽  
The Body ◽  
Demographic And Health Survey ◽  
Under Five ◽  
Under Five Children ◽  
Childhood Overweight And Obesity

Abstract Background: Childhood overweight and obesity are emerging public health challenges of the 21st century. There was a 24% increase in the number of overweight children under the age of five years in low-income countries. Despite the significant risk of childhood overweight/obesity for non-communicable diseases, premature death, disability, and reproductive disorders in their adult life, little attention has been given. Therefore, we aimed to assess the prevalence of overweight/obesity and associated factors among under-five children. Methods: This study was conducted using data from a nationally representative sample of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS). The Mini EDHS was a community-based cross-sectional study that covered all the administrative regions of Ethiopia. The data collection was conducted between March 21, 2019, to June 28, 2019. Both descriptive and analytic findings were produced using STATA version 14. For associated factors, a multilevel binary logistic regression model was fitted to account for the hierarchical nature of the data. Adjusted odds ratio (aOR) with 95% confidence interval (CI) was reported to show the strength of association and statistical significance. Results: A total 5,164 under-five children were included in this study. The overall prevalence of overweight/obesity was 2.14 % (95% CI; 1.74-2.53) (more than two standard deviations (+2SD) above the median of the reference population) based on the body mass index (BMI) Z-score. The odds of overweight/obesity was higher among children aged less than 6 months (aOR= 5.19; 95%CI: 2.98-9.04), 6-24 months (aOR = 1.97; 95%CI: 1.18-3.29), delivered by caesarean section (aOR = 1.75; 95% CI: 1.84-3.65), living in Addis Ababa city (aOR = 2.16; 95%CI: 1.59-7.81), Oromia region (aOR = 1.93; 95CI: 1.71-5.24), having mothers with the age 40-49 years (aOR = 3.91; 95%CI: 1.90-16.92), uses traditional contraceptive methods (aOR = 2.63; 95%CI: 1.66-10.47), and households headed by male (aOR = 1.71; 95%CI: 1.84-3.48). Conclusion: This study showed that childhood overweight/obesity is the problem in Ethiopia. There was an interplay of several factors that affect childhood obesity including child factors, maternal socio-demography, and healthcare utilization, and geography of residence. Therefore, strategies to reduce childhood overweight and obesity should consider a multitude of contributing factors.

scholarly journals Socio-demographic, environmental and behavioural factors of diarrhoea among under-five children in Rural Ethiopia: further analysis of the 2016 Ethiopian demographic and health survey

2020 ◽  
Author(s):  
Melkamu Molla Ferede
Keyword(s):  
Birth Order ◽  
Health Survey ◽  
Associated Factors ◽  
Binary Logistic Regression ◽  
Study Data ◽  
Demographic And Health Survey ◽  
Under Five ◽  
Under Five Children ◽  
Rural Ethiopia ◽  
Behavioural Factors

Abstract Background: Diarrhoea is one of the major contributors to deaths among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are highly affected by diarrhoea than urban children. Thus, the purpose of this study was to identify the socio-demographic, environmental and behavioural associated factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. Methods: Data for the study was drawn from the 2016 Ethiopia Demographic and Health Survey. A total of 8,041 under-five children were included in the study. Data was analysed using SPSS version 23. Binary logistic regression was used for the analysis of the data to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural associated factors among under-five children. Results: Children aged 6-11 months (AOR: 3.5; 95% CI: 2.58-4.87), 12-23 months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35 months (AOR: 1.7; 95% CI: 1.26-2.34) were significantly associated with diarrhoea. Diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58), children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64), Somali region (AOR: .42; 95% CI: (.217-.80), Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81), households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77), fourth birth order (AOR: .1.81; 95% CI: 1.17-2.79), fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) and the interaction of older mothers with three or more under-five children (AOR: 4.7; 95% CI: 1.64-13.45). Conclusion: The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of number of under-five children with mother’s current age are identified as associated factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings carry implications for the need for planning and implementing appropriate prevention strategies that target rural under-five children.

scholarly journals Poor nutrition for under-five children from poor households in Ethiopia: Evidence from 2016 Demographic and Health Survey

PLoS ONE ◽  
2019 ◽  
Vol 14 (12) ◽  
pp. e0225996
Author(s):  
Habtamu Kebebe Kasaye ◽  
Firew Tekle Bobo ◽  
Mekdes Tigistu Yilma ◽  
Mirkuzie Woldie
Keyword(s):  
Health Survey ◽  
Demographic And Health Survey ◽  
Under Five ◽  
Under Five Children ◽  
Poor Households ◽  
Poor Nutrition

scholarly journals Association of sickle cell disease with anthropometric indices among under-five children: evidence from 2018 Nigeria Demographic and Health Survey

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mohammad Redwanul Islam ◽  
Md Moinuddin ◽  
Ayeda Ahmed ◽  
Syed Moshfiqur Rahman
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Health Survey ◽  
Indirect Effect ◽  
Hemoglobin Level ◽  
Demographic And Health Survey ◽  
Cell Disease ◽  
Anthropometric Indices ◽  
Under Five ◽  
Under Five Children

Abstract Background Malnutrition continues to affect under-five children in Africa to an overwhelming proportion. The situation is further compounded by the burden of sickle cell disease (SCD). However, association of SCD with stunting, wasting, and underweight in a nationally representative sample of under-five children remains unexplored. We aimed to describe prevalence of undernutrition by sickle cell status, to evaluate its association with growth faltering ascertained by anthropometric indices, and to explore mediating role of hemoglobin. Methods We availed data from the 2018 Nigeria Demographic and Health Survey (DHS) and the sample comprised 11,233 children aged 6–59 months who were successfully genotyped for SCD. The DHS employed a two-stage, stratified sampling strategy. SickleSCAN rapid diagnostic test was used for SCD genotyping. Z-scores of length/height-for-age (HAZ), weight-for-height (WHZ), and weight-for-age (WAZ) were computed against the 2006 World Health Organization Child Growth Standards. We fitted logistic regression models to evaluate association of SCD with stunting, wasting, and underweight. Mediation analysis was performed to capture the indirect effect of and proportion of total effect mediated through hemoglobin level in SCD-anthropometric indices association. Results Prevalences of stunting, wasting, and underweight among children with SCD were 55.4% (54.5–56.4), 9.1% (8.6–9.7), and 38.9% (38.0–39.8), respectively. The odds of stunting were 2.39 times higher (adjusted odds ratio (aOR) 2.39, 95% CI: 1.26–4.54) among sickle children than those with normal hemoglobin. SCD was also significantly associated with underweight (aOR 2.64, 95% CI: 1.25–5.98), but not with wasting (aOR: 1.60, 95% CI 0.85–3.02). Association of SCD with all three anthropometric indices was significantly mediated through hemoglobin level: for SCD-HAZ, the adjusted indirect effect (aIE) was − 0.328 (95% CI: − 0.387, − 0.270); for SCD-WHZ, the aIE was − 0.080 (95% CI: − 0.114, − 0.050); and for SCD-WAZ, the aIE was − 0.245 (95% CI: − 0.291, − 0.200). Conclusion We presented compelling evidence of the negative impact of SCD on anthropometric indices of nutritional status of under-five children. Integration of a nutrition-oriented approach into a definitive SCD care package and its nationwide implementation could bring promising results by mitigating the nutritional vulnerability of children with SCD.

scholarly journals Prevalence of malnutrition and associated risk factors among under-five children in Amhara Region, Ethiopia: evidence from 2016 Ethiopian Demographic and Health Survey

2020 ◽  
Author(s):  
Damitie Kebede Mengesha ◽  
Yidnekachew Merkeb
Keyword(s):  
Health Survey ◽  
Household Head ◽  
Binary Logistic Regression ◽  
Demographic And Health Survey ◽  
Binary Logistic Regression Analysis ◽  
Amhara Region ◽  
Under Five ◽  
Childhood Malnutrition ◽  
Under Five Children ◽  
Associated Risk Factors

Abstract Background Childhood malnutrition is the most widely prevalent among under-five children in Amhara Region, Ethiopia. This study intended to explore the major determinants of malnutrition and its association with anemia among under-five children in Amhara Region, Ethiopia.Methods The data from the 2016 Ethiopian Demographic and Health Survey were used. A total of 977 under-five children were included in this analysis. A multivariable binary logistic regression analysis was used at a 5% level of significance to determine the individual- and community-level factors associated with childhood malnutrition. Results The prevalence of stunting, wasting, and underweight were 46.3%, 9.8%, and 28.4%, respectively. About 23.1% of children were both stunting and underweight, 7.3% were both underweight and wasting, and only 4.5% of children had all the three conditions. Among the factors considered in this study, Age of child in months, size of child at birth, mother highest education level, sex of household head, sources of drinking water, and type of toilet facility were significantly associated with malnutrition in Amhara Region. Conclusion Malnutrition among under-five children was one of the public health problems in the Amhara Region. The influence of these factors should be considered to develop strategies for reducing malnutrition in Amhara Region. Finally improving the living standards of the children is important to get better health care, to enhance the child’s nutritional status, and reduce child mortality.

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