A thesis submitted to the department of epidemiology, college of Public health and medical science, jimma university, in partial Fulfillment for the requirements for the degree of master of Public health in epidemiology (mphe).

Abstract

Introduction: Malnutrition is major public-health problem throughout the developing world and is an underlying factor in over 50% of the 10–11 million children under 5 years of age who die each year. Although the prevalence of malnutrition is generally high in Ethiopia, its predictors have to do with socio-culture bound child feeding and caring practices that are subject to variability based on the specific cultural practices surrounding child feeding. As there was no enough documented the predictors in North Shoa Zone of Oromiya Region, documentation of the predictors of acute malnutrition is important for designing appropriate intervention strategies. Objective: To identify predictors of acute malnutrition among 6 - 23 months in Hidhabu Abote Woreda, Oromiya Regional State, Ethiopia Methods: Community based unmatched case-control study design was utilized. Children of 6-23 months in the woreda were screened by weight for height and 288 children (144 cases and 144 controls) were selected by simple random sampling technique. Data were collected using structured questionnaire after training was given for data collectors and supervisors. Variables that were found statistically significant under bivariate analysis were identified and entered into multivariate logistic regression and finally p value less than 0.05 was considered as statistically significant for all the independent factors of outcome variables. Results: The mean age of the cases and controls were 13.38 (+ 4.68) and 14.41 (+ 5.44) month respectively. There were more males in the cases 68 (47.5%) than in the controls 58 (40.5Cases with malnutrition were more likely to: have mothers who did not graduate as model by the health extension program (AOR= 7.246), have spring and /or river as source of drinking water (AOR= 5.349), initiate breastfeeding late (AOR= 4.248), not exclusively breastfed (AOR= 4.586), not given colostrum (AOR=2.706), be bottle fed (AOR=3.111) and have illness during the last two weeks before the survey (AOR=4.136) compared to controls. Conclusion: the findings showed that independent predictors of acute malnutrition were suboptimal child feeding practices that are not according the recommendation of the national infant and youth child feeding guidelines, mothers did not graduated by health extension program, illness of the child during the past two weeks before the survey and using unclean water source (spring/river). Interventions for improving the nutritional status of children should target behavior change communications on optimal child feeding practices based on the final guideline and improving water and sanitation including home based treatment of water using ‘Wuha’ Agar.