Multivariate Multilevel Analysis On Determinants Of Nutritional Status Of Children In Ethiopia

Abstract

Background: Children malnutrition is a critical public health concern in Ethiopia. Stunting, underweight and wasting reflect poor nutrition and which in children leads to retarded growth. The aim of this study is to determine the factors associated with children nutritional status measures of height-for-age, weight-for-age and weight-for-height z-scores, among children aged under five years in Ethiopia. Methods: The study used secondary data of Ethiopian Demographic and Health Survey 2016 collected by Central Statistical Agency and included 9028 children under-five years of age with complete anthropometric measures. The study used descriptive, multilevel linear regression analyses were used to determine the prevalence and determinants of nutritional status measures’ among under-five children in Ethiopia. Results: The prevalence of stunting was 34.5%, the prevalence of underweight 23.8% and wasting 12.7%. Univariate analysis revealed that the most consistent factors associated with nutritional status z-scores of Height-for-Age, Weight-for-Age, and Height-for-weight are: sex and age of children, combined wealth index of the household, mother’s level of education and Body Mass Index status, drinking water source and type of toilet facilities the household used. Moreover, the multilevel model provided interesting relationships that there were regional disparities means there is a variation of under-five children nutritional status from region to region with regard to HAZ, WAZ and WHZ. It also found that a random Intercept model was the best model of the data-set among multilevel regression models. Conclusions: The study suggests that most of the analyzed factors that accounted for nutritional status in Ethiopian children (such as; combined wealth index of the household, educational level and mothers’ nutritional status measure (Body Mass Index), source of drinking water quality and type of toilet facilities) are controllable and preventable. Therefore, to reduce the burden of children malnutrition government and responsible bodies interventions that can address these factors are required, such as women or female based education, targeted economic development and the health sector should encourage and done to help households adopt improved types of toilet facilities, improved type of drinking water and nutritional interventions.