scholarly journals Determinants of Undernutrition among Children under Five Years of Age in Ethiopia

2019 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Proportional Odds ◽  
Children Under Five ◽  
Under Five ◽  
Factors Associated ◽  
Anthropometric Indicators ◽  
Partial Proportional Odds Model

Abstract Background: Child undernutrition is still a persistent health problem in developing country like Ethiopia. Several cross-sectional studies have used the three anthropometric indicators separately to identify the factors associated to undernutrition of children. This study aimed at identifying the factors associated with undernutrition of children using a single composite index of anthropometric indicators. Methods: Ethiopia Demographic and Health Survey of 2016 was used for the analysis. A single composite index of undernutrition indicators was created using principal component analysis and recode into ordinal outcome. For this ordinal outcome, partial proportional odds model was fitted to identify significant determinants of undernutrition and its relative performance was compared with some other ordinal regression models. Results and conclusion: The Brant test of proportional odds model indicated that the null hypothesis that states the model parameters are equal across categories was rejected. Based on Akaike information criterion, partial proportional odds model suggested an improved fit compared to ordinal regression models that do not need parallel regression assumption. Hence, the fitted partial proportional odds model revealed child’s age, maternal education, region, source of drinking water, number of children under five years, wealth index, anemic status of child, multiple birth, child’s sex, fever, mother’s age at birth, body mass index of mother and husband’s education were significantly associated with children undernutrition. Finally, authors recommend that responsible bodies take interventions on improving household wealth index and food security, educating mothers and their partners, improving maternal nutritional status, and increase access to health care Keywords: Stunting; underweight; wasting; partial proportional odds model

scholarly journals Determinants of Undernutrition among Children under Five Years of Age in Ethiopia

2020 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Proportional Odds ◽  
Anthropometric Indices ◽  
Under Five ◽  
Anthropometric Indicators ◽  
Under Nutrition ◽  
Partial Proportional Odds Model

Abstract Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying the factors of child under-nutrition using a single composite index of anthropometric indicators. Methods: Data from Ethiopia’s Demographic and Health Survey (EDHS) 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with Child Growth Standards (WHO, 2006), the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition, partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results and conclusion: In the Brant test of proportional odds model, the null hypothesis that the model parameters were equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. The fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anaemic status, multiple birth, fever, mother’s age at birth, and husband’s education significantly associated with child under-nutrition. It is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access. Keywords: Stunting; underweight; wasting; partial proportional odds model

scholarly journals Determinants of Under-nutrition among Children under Five Years of Age in Ethiopia

2020 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Body Mass Index ◽  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Nutrition Status ◽  
Proportional Odds ◽  
Anthropometric Indices ◽  
Under Nutrition ◽  
Partial Proportional Odds Model

Abstract Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying factors of child under-nutrition using a single composite index of anthropometric indicator. Methods: Data from Ethiopia’s Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with WHO 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition , partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results: The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. A child with mother of body mass index less than 18.5 kg, from poorest family, a husband without education and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion: The authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anemic status, multiple birth, fever before two months of survey, mother’s age at first birth, and husband’s education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access.

scholarly journals Determinants of Under-nutrition among Children under Five Years of Age in Ethiopia

2020 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Body Mass Index ◽  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Nutrition Status ◽  
Proportional Odds ◽  
Anthropometric Indices ◽  
Under Nutrition ◽  
Partial Proportional Odds Model

Abstract Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying factors of child under-nutrition using a single composite index of anthropometric indicator. Methods: Data from Ethiopia’s Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with WHO 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition , partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results: The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. A child with mother of body mass index less than 18.5 kg, from poorest family, a husband without education and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion: The authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anemic status, multiple birth, fever before two months of survey, mother’s age at first birth, and husband’s education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access.

scholarly journals Determinants of Under-nutrition among Children under Five Years of Age in Ethiopia

2020 ◽  
Author(s):  
Gashu Workneh Kassie ◽  
Demeke Lakew Workie
Keyword(s):  
Body Mass Index ◽  
Regression Models ◽  
Composite Index ◽  
Wealth Index ◽  
Proportional Odds Model ◽  
Nutrition Status ◽  
Proportional Odds ◽  
Anthropometric Indices ◽  
Under Nutrition ◽  
Partial Proportional Odds Model

Abstract Background: Ethiopia is one of the developing countries where child under-nutrition is prevalent. Prior studies employed three anthropometric indicators for identifying factors of children’s under-nutrition. This study aimed at identifying factors of child under-nutrition using a single composite index of anthropometric indicator. Methods: Data from Ethiopia’s Demographic and Health Survey 2016 was the base for studying under-nutrition in a sample of 9494 children below 59 months. A single composite index of under-nutrition was created from three anthropometric indices through principal component analysis recoded into an ordinal outcome. In line with WHO 2006 Child Growth Standards, the three anthropometric indices involve z-score of height-for-age (stunting), weight-for-height (wasting) and weight-for-age (underweight). To identify significant determinants of under-nutrition , partial proportional odds model was fitted and its relative performance compared with some other ordinal regression models. Results: The single composite index of anthropometric indicators showed that 49.0% (19.8% moderately and 29.2% severely) of sampled children were undernourished. In the Brant-test of proportional odds model, the null hypothesis that the model parameters equal across categories was rejected. Compared to ordinal regression models that do not involve parallel regression assumption, and Akaike information criterion, partial proportional odds model showed an improved fit. A child with mother of body mass index less than 18.5 kg, from poorest family, a husband without education and male to be in a severe under-nutrition status was 1.4, 1.8 1.2 and 1.2 times more likely to be in worse under-nutrition status compared to its reference group respectively. Conclusion: The authors conclude that the fitted partial proportional odds model indicated that age and sex of the child, maternal education, region, source of drinking water, number of under five children, mother’s body mass index, wealth index, anemic status, multiple birth, fever before two months of survey, mother’s age at first birth, and husband’s education were significantly associated with child under-nutrition. Thus, it is argued that interventions focus on improving household wealth index, food security, educating mothers and their spouses, improving maternal nutritional status, and increasing mothers’ health care access.

scholarly journals Stunting in children under five years old is still a health problem in the Western Brazilian Amazon: a population-based study in Assis Brasil, Acre, Brazil

2016 ◽  
Vol 21 (7) ◽  
pp. 2257-2266 ◽  
Author(s):  
Saulo Augusto Silva Mantovani ◽  
Alanderson Alves Ramalho ◽  
Thasciany Moraes Pereira ◽  
Fernando Luiz Cunha Castelo Branco ◽  
Humberto Oliart-Guzmán ◽  
...  
Keyword(s):  
Health Problem ◽  
Public Health Problem ◽  
Wealth Index ◽  
Brazilian Amazon ◽  
Population Based ◽  
World Health ◽  
Important Public Health Problem ◽  
Children Under Five ◽  
Under Five ◽  
Factors Associated

Abstract Despite the process of nutritional transition in Brazil, in some places, such as the Amazon region, stunting is still an important public health problem. We identified the prevalence and factors associated with stunting in children under five years old residing in the urban area of Assis Brasil. A survey was conducted in which a questionnaire on socioeconomic, maternal and children’s conditions was applied, and height or length was measured. The children with height for age index below -2 Z-scores were considered stunted, according to the criteria by the World Health Organization. Four hundred and twenty-eight children were evaluated. Of these, 62 were stunted. Factors associated with stunting, according to adjusted models, were: the presence of open sewer, the wealth index for households, the receipt of governmental financial aid and the mother’s height, age and education. Therefore, it was observed that family and the mother’s characteristics as well as environmental and socioeconomic factors were closely related to the occurrence of stunting in the population studied, and such nutritional disturbance is still a health problem in the Brazilian Amazon.

scholarly journals Associated risk factors of underweight among under-five children in Ethiopia using multilevel ordinal logistic regression model

2021 ◽  
Vol 21 (1) ◽  
pp. 362-72
Author(s):  
Nigussie Adam Birhan ◽  
Denekew Bitew Belay
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Proportional Odds Model ◽  
Proportional Odds ◽  
Under Five ◽  
Single Level ◽  
Under Five Children ◽  
Under Nutrition ◽  
Partial Proportional Odds Model ◽  
Associated Risk Factors

Background: Malnutrition is associated with both under nutrition and over nutrition which causes the body to get improp- er amount of nutrients to maintain tissues and organ function. Under nutrition is the result of insufficient intake of food, poor utilization of nutrients due to illnesses, or a combination of these factors. The purpose of this study was to identify associated risk factors and assess the variation of underweight among under-five children of different regions in Ethiopia. Methods: Ethiopian Demography and Health Survey (EDHS-2016) weight-to-age data for under-five children is used. In order to achieve the objective of this study; descriptive, single level and multilevel ordinal logistic regression analysis were used. Results: From a total of 8935 children about 8.1% were severely underweight, 17.1% were moderately underweight and 74.8% were normal. The test of heterogeneity suggested that underweight varies among region and multilevel ordinal model fit data better than single level ordinal model. Conclusion: Educational level of mother, religion, birth order, type of birth, sex of child, mother body mass index, birth size of child, existence of diarrhea for last two weeks before survey, existence of fever for last two weeks before survey, duration of breast feeding, age child and wealth index had significant effect on underweight among under-five children in Ethiopia. The finding revealed that among the fitted multilevel partial proportional odds model, the random intercept model with fixed coefficients is appropriate to assess the risk factors of underweight among under-five children in Ethiopia. The findings of this study have important policy implications. The government should work closely with both the private sector and civil society to teach women to have sufficient knowledge, awareness and mechanisms of improving under-five under- weight for children’s wellbeing. Keywords: Underweight; Partial proportional odds model; Multilevel partial proportional odds model; under-five children.

scholarly journals Risk Factors Associated with Malnutrition among Children Under-Five Years in Sub-Saharan African Countries: A Scoping Review

2020 ◽  
Vol 17 (23) ◽  
pp. 8782
Author(s):  
Phillips Edomwonyi Obasohan ◽  
Stephen J. Walters ◽  
Richard Jacques ◽  
Khaled Khatab
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
Children Under Five ◽  
Contextual Risk ◽  
Under Five ◽  
Factors Associated ◽  
Anthropometric Indicators ◽  
Sub Saharan

Background/Purpose: Malnutrition is a significant global public health burden with greater concern among children under five years in Sub-Saharan Africa (SSA). To effectively address the problem of malnutrition, especially in resource-scarce communities, knowing the prevalence, causes and risk factors associated with it are essential steps. This scoping review aimed to identify the existing literature that uses classical regression analysis on nationally representative health survey data sets to find the individual socioeconomic, demographic and contextual risk factors associated with malnutrition among children under five years of age in Sub-Sahara Africa (SSA). Methods: The electronic databases searched include EMBASE (OVID platform), PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Web of Science (WoS) and Cochrane Library. Only papers written in the English language, and for which the publication date was between 1 January 1990 and 31 July 2020, were included. Results: A total of 229 papers were identified, of which 26 were studies that have been included in the review. The risk factors for malnutrition identified were classified as child-related, parental/household-related and community or area-related. Conclusions: Study-interest bias toward stunting over other anthropometric indicators of malnutrition could be addressed with a holistic research approach to equally address the various dimension of the anthropometric indicators of malnutrition in a population.

scholarly journals Bivariate binary analysis on composite index of anthropometric failure of under-five children and household wealth-index

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Demeke Lakew Workie ◽  
Lijalem Melie Tesfaw
Keyword(s):  
Logistic Regression ◽  
Composite Index ◽  
Binary Logistic Regression ◽  
Wealth Index ◽  
Household Wealth ◽  
Education Level ◽  
Multiple Birth ◽  
Under Five ◽  
Under Five Children ◽  
Study Results

Abstract Background Malnutrition is the most common cause of mortality and morbidity of children in low and middle income countries including Ethiopia and household wealth index shares the highest contribution. Thus, in this study it is aimed to conduct bivariate binary logistic regression analysis by accounting the possible dependency of child composite index anthropometric failure and household wealth index. Methods In this study the data from Ethiopian Demographic and Health Survey (EDHS) 2016 involved 9411 under five children was considered. Child Composite Index Anthropometric Failure (CIAF) measures the aggregate child undernourished derived from the conventional anthropometric indices (stunting, underweight and wasting). The correlation between CIAF and wealth index was checked and significant correlation found. To address the dependency between the two outcome variables bivariate binary logistic regression was used to analyze the determinants of child CAIF and household wealth index jointly. Results Study results show that region, place of residence, religion, education level of women and husband/partner, sex of child, source of drinking water, household size and number of under five children in the household, mothers body mass index, multiple birth and anemia level of child had significant association with child CIAF. Female children were 0.82 times less likely to be CIAF compared to male and multiple birth children were more likely to be CIAF compared to single birth. Children from Oromia, Somalie, Gambela, SNNPR, Harari and Addis Ababa region were 0.6, 0.56, 0.67, 0.52, 0.6 and 0.44 times less likely to be CIAF compared to Tigray. A household from rural area were 15.49 times more likely poor compared to a household. The estimated odds of children whose mothers attended primary, and secondary and higher education was 0.82, and 0.52 times respectively the estimated odds of children from mothers who had never attended formal education. Conclusion The prevalence of children with composite index anthropometric failure was high and closely tied with the household wealth index. Among the determinants, region, religion, family education level, and anemia level of child were statistically significant determinants of both CIAF and household wealth index. Thus, the authors recommend to concerned bodies and policymakers work on household wealth index to reduce the prevalence of child composite anthropometric failure.

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