https://repository.ju.edu.et//handle/123456789/3911 2026-04-04T23:38:45Z https://repository.ju.edu.et//handle/123456789/10170 Impact of Household Air Pollution on Childhood Linear Growth and Health, in Jimma Town, Oromia Region, Ethiopia Elias Mulat Gessese; Kalkidan Hassen Abate; Dessalegn Tamiru Background: Stunting, defined as impaired linear growth and development in children, remains a significant public health challenge, particularly in low- and middle-income countries. It is commonly attributed to factors such as chronic undernutrition, recurrent infections, and poor overall health conditions. While inadequate diet and illness have traditionally been identified as the primary causes of stunting, recent evidence highlights the growing role of environmental factors especially household air pollution in contributing to growth impairments. Exposure to indoor air pollutants has been associated with multiple adverse health outcomes, including childhood stunting and risk of multimorbidity. The leading cause of household air pollution is the widespread use of biomass fuels such as wood, charcoal, and dung for cooking. This practice is particularly prevalent in resource-constrained settings and has emerged as a pressing global health concern. According to the World Health Organization (WHO), more than three billion people worldwide rely on polluting fuels, with approximately 95% of them residing in low- and middle-income countries. The relative contribution of household air pollution to childhood linear growth impairments and the risk of multimorbidity in Ethiopia remains underexplored. While some global studies have highlighted the adverse health effects of indoor air pollution on young children, there is a scarcity of context-specific evidence from Ethiopia that quantifies this relationship, particularly in urban settings like Jimma town. Therefore, this study aims to investigate the impact of household air pollution on linear growth and the risk of multimorbidity in children under five years of age in Jimma town, Ethiopia. Objectives: The main objective of this study is to investigate the impact of household air pollution on the linear growth and health of under-five children in Jimma town, Ethiopia. Methods: To synthesize the global and local evidence on the impact of household air pollution on childhood linear growth, this study employed a combination of systematic review and meta analysis, comparative cross-sectional analysis, and a prospective cohort design. A total of 280 under-five children, with 140 residing in households that use solid fuels (exposed group) and 140 in households that use clean fuels (unexposed group) were involved for the primary studies. The children's height and height-for-age Z scores (HAZ) were measured and compared over a 12 month follow-up period to assess differences in linear growth between the two groups. Environmental exposure was evaluated by measuring real-time concentrations of indoor air pollutants. These included particulate matter (PM₂.₅ and PM₁₀), carbon monoxide (CO), carbon dioxide (CO₂), and volatile organic compounds (VOCs), using Laser PM2.5 Meter-5800D/5800E and Aeroqual’s TM Series 500 portable air quality monitors, respectively. Additionally, data on childhood morbidity were collected using the Ethiopian Demographic and Health Survey (EDHS) morbidity questionnaire, administered to mothers to capture information on common illnesses experienced by their children. Analytically, difference-in-differences estimators were used to compare changes in height and HAZ scores between baseline and endline across the two groups. A multivariable linear regression model was applied to assess the independent effect of solid fuel use on HAZ scores. Furthermore, multiple logistic regression was employed to explore the association between household solid fuel use and the likelihood of childhood multimorbidity, xii while Poisson regression was used to examine whether exposure to solid fuels increased the number of reported morbidities. Statistical significance was determined at a p-value of less than 0.05 with corresponding 95% confidence intervals Results: The results of systematic review and meta-analysis indicate that exposure to household air pollution was significantly associated with increased odds of child stunting [pooled estimate: Odds Ratio = 2.42, (95% CI: 1.45, 4.03), P < 0.0010]. Likewise, children who were exposed to household air pollution from cooking with solid fuels had significantly lower HAZ scores than children who lived in households where cleaner fuels were used [Standardized Mean Difference = 0.41, (95% CI: 0.12, 0.71), p < 0.001] (Chapter 4). The findings of quantitative measurements of Household Air Pollution showed that the mean (SD) and median concentrations of pollutants in all measured households were: PM2.5; 455 (386) and 294 µg/m3, PM10; 819 (829) and 270 µg/m3, CO2; 787 (488) and 577 mg/m3, CO; 12 (13.9) and 7.9 mg/m3, and VOC; 1154 (861) and 1077 mg/m3. Households using solid fuels had significantly higher concentration of PM2.5 (U = 53.0, Z = -14.436, p < 0.001), PM10 (U =63.0, Z = -14.502, p < 0.001), CO2 (U = 3519.50, Z = -7.273, p < 0.001), CO (U = 3246.0, Z = -4.445, p < 0.001) and VOC (U = 2073.0, Z = -11.40, p < 0.001) than households using clean fuel (Chapter 5). The results of the assessment of the Impact of Indoor Air Pollution on the Linear Growth of Children, compared with the clean fuel type, revealed that in an unadjusted model (Model 1), the mean difference in the height-for-age Z score of children in households using solid fuel was lower by 0.54 (-0.54, 95% CI -0.97, -0.12, P = 0.011). The beta coefficient remained negative after adjusting for age and sex (Model 2 -0.543, 95% CI -1.373, -0.563) and sociodemographic variables (Model 3: -0.543, 95% CI -1.362, -0.575). In the final model (Model 4), which adjusted for wealth quantile, dietary practice, water, sanitation and hygiene status and household food insecurity access scale, the beta coefficient held the same and significant (beta: -0.543, 95% CI -1.357, 0.579, P < 0.001) (Chapter six). In the findings of the investigation of Exposure to Household Air Pollution and Childhood Multimorbidity Risk, the overall prevalence of childhood multimorbidity was 34.3% [95% CI: 0.29–0.40]. Among these cases, 23.9% was among children from solid fuel user households, whereas about 10.4% was from clean fuel user households. Adjusted for all possible covariates, children living in solid fuel user households had more than three times the odds of childhood multimorbidity compared to children living in clean fuel user households (AOR = 3.14, 95% CI [1.42–6.95], p < 0.001). Moreover, household air pollution from solid fuel use was positively associated with an increased number of individual morbidity conditions, with an adjusted β coefficient of 0.46 (IRR = 1.58, 95%CI [1.17-2.13], p = 0.003) (Chapter 7). In conclusion, indoor air pollution was negatively associated with childhood linear growth, and solid fuel use independently predicted morbidity risk. Addressing this requires public education on health risks and promoting better kitchen ventilation and improved cooking stoves to reduce child growth impairments and multimorbidity (Chapter 8). 2025-07-18T00:00:00Z https://repository.ju.edu.et//handle/123456789/10163 Eating Behaviors and Associated Factors among Under Five Years Children at Jimma Town, Jimma, Ethiopia Tsegaye Girma; Dessalegn Tamiru; Radiet Kidane Background: Early childhood is the ideal time to establish healthy eating habits as well as a critical time for complete physical and mental development. Eating behaviors evolve during the first years of life; children learn what, when, and how much to eat through direct experiences with food and by observing the eating behaviors of others. It is important to keep an eye on children's eating habits to prevent any nutritional deficiencies, which have been linked to a higher risk of developing diseases including obesity, type2diabetes, and other conditions. However, there is no study and evidence about eating behavior and associated factors among under five years’ children in the Jimma town, Ethiopia. Objective: This study is aimed to assess eating behaviors and associated factors among under- five years children at Jimma town, Oromia regional state, Ethiopia, 2025. Methods: A community-based cross-sectional study was conducted among under-five years children in Jimma town from February 05, 2025 to March 20, 2025. A systematic random sampling technique was used to select the study participants. A total of 576 participants included in this study by using a structured questionnaire. Epi-data manager 4.6 for data entry and Statistical Package for Social Sciences (SPSS) version 25 was used for data analysis. Logistic regression model was used to identify the association between the outcome variable and explanatory variables. The strength of association between dependent and independent variable was determined by (AOR) with 95% confidence intervals and statistically significant association was declared at P-values < 0.05. Results: The prevalence of poor eating behaviors among under-five children in Jimma Town was 45.0% (95%CI: 40.8-49.2). Mothers who have Diploma or higher education (AOR = 2.31; 95% CI: 1.04–5.14), Mothers experienced illness during pregnancy (AOR = 1.86; 95% CI: 1.05 3.33),Children whose mothers did not attend postnatal visits (AOR = 1.69; 95% CI: 1.16 2.46),Children aged 6–11 months (AOR = 1.59; 95% CI: 1.01–2.52), children with a previous history of illness (AOR = 3.71; 95% CI: 1.16–11.9), and children from poor wealthy households (AOR = 1.85; 95% CI: 1.05–3.25) were identified as factors associated with poor eating behaviors among under five years old children in Jimma town. I Conclusion: Nearly half of the under-five children in Jimma Town exhibited poor eating behaviors. Low maternal education, maternal illness during pregnancy, lack of postnatal care, younger child age, previous illness in the child, and low household wealth were identified as factors associated with poor eating behaviors among under- five years old children in Jimma town. 2025-06-11T00:00:00Z https://repository.ju.edu.et//handle/123456789/10161 Concordance of Nutritional Status between Mothers and Their Index under Five-Children and Associated Factors in Jimma City Administration, Oromia Region, Ethiopia Tariku Kumera; Tefera Belachew; Aderajew Nigusse Background: Malnutrition remains a pressing public health concern in Ethiopia, particularly among vulnerable groups such as under-five children and women’s of reproductive age. The nutritional status of mother and their children is often interlinked. Reflecting shared dietary practice. Socioeconomic condition and health behaviors within households. Concordance in nutritional outcomes. Whether under nutrition or overweight-between mothers and their index under-five children can signal broader systematic challenges. Including food security, limited access to health services, and gaps in nutritional knowledge. Despite growing attention to maternal and children nutrition; few studies have explored the extent and determinants of nutritional concordance in urban Ethiopia setting. Investigating this relationship in Jimma city Administration a rapidly urbanization area in Oromia Region. Offers critical insights for designing integrated, family-centered nutritional intervention and informing local policy responses. Objective: To determine the Concordance of Nutritional Status Between Mothers and Their Index Under-Five Children and Associated Factors in Jimma city Administration, Oromia Region, Ethiopia Method: A community-based cross-sectional study was conducted from December 1 to 30 2024; among 401 mother-under-five child pairs selected from five purposively chosen kebeles with in Jimma City Administration Oromia Region.. A multi-stage sampling technique was employed to identify the study participants. The sampling frame was derived from family folders maintained at health posts in each kebele and eligible mother-child pairs were selected using a simple random sampling method. Dietary diversity was assessed using the World Health Organization (WHO) seven foods group classification for child and FANTA/FAO (2016) ten foods group classification for mothers. Data were analyzed using SPSS for windows version 25 and Microsoft Excel. Concordance in nutritional status was evaluated using Cohen’s Kappa statistics, and multivariable logistics regression was applied to identify factors associated with maternal child nutritional concordance. Results: Out of the 403 planned mother–child pairs (mothers aged 15–49 years and children under five), 401 participated in the study, yielding a response rate of 99.5%. A fair level of concordance in dietary diversity scores between mothers and their index children was observed, with a Cohen’s Kappa value of 0.25. Among the participants, only 107 mothers (26.7%) - 1 - consumed five or more food groups, while 160 children (39.9%) met the minimum dietary diversity threshold by consuming four or more food groups. Multivariable logistic regression analysis identified several factors significantly associated with mother–child dietary diversity concordance. These included: Mothers with no formal education were more likely to show concordance (AOR = 2.20; 95% CI: 0.363–2.944). Similarly, being daily laborers had higher odds of concordance (AOR = 3.19; 95% CI: 0.630–7.818). Likewise, socioeconomic status was associated with increased concordance (AOR = 4.23; 95% CI: 0.095–0.557), concordance was more likely when both consumed diverse diets (AOR = 2.10; 95% CI: 1.245–5.253) and mothers with low dietary diversity were less likely to show concordance (AOR = 0.48; 95% CI: 0.209 1.148). Conclusion: This study found that 78.02% of mother–under-five child pairs exhibited discordance in dietary diversity, with 3.7% of mothers identified as positive deviants who buffered their children’s nutritional intake, while 74.3% were negative deviants. Overall, a fair concordance was observed between maternal and child dietary diversity scores. However, the majority of both mothers and children failed to meet the minimum recommended dietary diversity, indicating widespread nutritional inadequacy in the study area. The findings suggest that improving maternal dietary diversity could have a positive influence on children's nutritional outcomes. Key modifiable factors associated with low concordance included maternal occupation (daily labor), lack of formal education, low socioeconomic status, and poor child dietary diversity. Addressing these determinants through targeted nutrition education, social support, and inclusive policy interventions may enhance dietary practices and promote better maternal–child nutritional alignment 2024-05-11T00:00:00Z https://repository.ju.edu.et//handle/123456789/10160 Predictors of Overweight and Obese Among Postpartum Women in Seka Chekorsa District Jimma Zone Southwest Ethiopia, 2024 Solomon Yines; Yabsra Melaku Dubale Introduction: Postpartum women in Ethiopia are increasingly facing the challenge of over nutrition and its associated metabolic risks, including chronic diseases like diabetes and heart disease. This excessive weight gain is particularly concerning as it impacts the long-term health of both mothers and their children, potentially increasing the child's future risk of metabolic disorders. Understanding the specific factors contributing to over nutrition in this population is crucial for developing targeted interventions to promote healthy dietary practices and reduce metabolic complications. Objective: To assess the magnitude and identify the predictors of overweight and obesity in the postpartum period among women in Seka Chekorsa district, Jimma zone, Ethiopia, in 2024. Methods: This community-based cross-sectional study was conducted among postpartum mothers in Seka Chekorsa district. Postpartum mothers who had resided in selected kebeles for at least six months were included. A multistage sampling technique was used to select 604 participants. The sample size was determined using a single population proportion formula based on a 4% marginal error, 95% confidence interval, and an estimated prevalence of 35.4% for overweight/obesity among postpartum women, adjusted for a 10% non-response rate. A structured, pre-tested, and translated questionnaire collected socio-demographic, behavioral, and anthropometric data (weight and height using standardized techniques). Data quality was ensured through rigorous training, supervision, and daily cross-checking. Data were analyzed using descriptive statistics and binary logistic regression to identify factors associated with overweight and obesity. Results: The prevalence of overweight and obesity among postpartum women in Seka Chekorsa District was found to be 24.83% of the 604 postpartum women studied (75% rural, 25% urban), significant predictors of overweight and obesity included older maternal age (35+ years, AOR=1.90), high socioeconomic status (AOR=1.80), and higher parity (5+ pregnancies, AOR=2.20). Dietary factors were crucial, with primary consumption of processed foods (AOR=2.40) and frequent sugary drink intake (AOR=7.50) increasing the odds, while consuming 2-4 daily servings of fruits and vegetables (AOR=0.60) was protective. Engaging in moderate-intensity physical activity for 1-2 days (AOR=0.58) and 3-4 days (AOR=0.55) per week were associated with lower odds of overweight and obesity compared to no activity. Higher health literacy was also associated with lower odds. Notably, compared to those very dissatisfied with their body image, postpartum women reporting less dissatisfaction or more satisfaction had significantly lower odds of being overweight/obese. Urban residence showed a non-significant trend towards increased odds (p=0.063). Conclusion: This study in Seka Chekorsa District, Jimma Zone, identifies older maternal age, higher socioeconomic status, and increased parity as significant socio-demographic risk factors for overweight and obesity among postpartum women in this specific region of Southwest Ethiopia. Behavioral factors such as high consumption of processed foods and sugary drinks, and low fruit/vegetable intake increased the odds, while moderate physical activity and higher health literacy were protective. Furthermore, postpartum women who reported greater satisfaction or less dissatisfaction with their body image had lower odds of overweight/obesity. 2025-06-11T00:00:00Z