Concordance of Nutritional Status between Mothers and Their Index under Five-Children and Associated Factors in Jimma City Administration, Oromia Region, Ethiopia

Abstract

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