Background
Methods
Data source
Inclusion/exclusion criteria
Sampling and data collection procedure
Variables
Dependent variables
Independent variables
Variables | Categories (Codes) | n (%) |
---|---|---|
Sex of child | Male (1) | 2576 (51.2) |
Female (2) | 2451 (48.8) | |
Age of child | 0–5 (0) | 548 (10.9) |
6–11 (1) | 489 (9.7) | |
12–23 (2) | 957 (19.0) | |
24–35 (3) | 1028 (20.4) | |
36–47 (4) | 9975 (19.4) | |
48–59 (5) | 1030 (20.5) | |
Birth Order | 1st (0) | 1048 (20.8) |
2–3 (1) | 1692 (33.7) | |
4–5 (2) | 1151 (22.9) | |
6 and more (3) | 1136 (22.6) | |
Multiple birth | Single birth (0) | 4918 (97.8) |
1st of multiple (1) | 61 (1.2) | |
2nd of multiple (2) | 48 (1.0) | |
Residence | Urban (1) | 1157 (23.0) |
Rural (2) | 3870 (77.0) | |
Region | Tigray (1) | 429 (8.5) |
Afar (2) | 561 (11.2) | |
Amhara (3) | 459 (9.1) | |
Oromia (4) | 638 (12.7) | |
Somali (5) | 532 (10.6) | |
Benishangul (6) | 452 (9.0) | |
SNNPR (7) | 591 (11.8) | |
Gambela (8) | 381 (7.6) | |
Harari (9) | 380 (7.6) | |
Addis Ababa (10) | 257 (5.1) | |
Dire Dawa (11) | 347 (6.9) | |
Source of drinking water | unimproved source (0) | 2042 (40.6) |
Improved source (1) | 2986 (59.4) | |
Number of children under-five years in the household | 1 (0) | 1854 (36.9) |
2 (1) | 2301 (45.8) | |
3 or more (2) | 872 (17.3) | |
Husband/partner’s education level | No education (0) | 2766 (55.0) |
Primary (1) | 1569 (31.2) | |
Secondary and above (2) | 692 (13.8) | |
Age of mothers at first birth | < 20 (0) | 3185 (63.4) |
20–34 (1) | 1827 (36.3) | |
35–49 (2) | 15 (0.3) | |
Mother’s current marital status | Married (1) | 4745 (94.4) |
Widowed (2) | 140 (2.8) | |
Divorced (3) | 142 (2.8) | |
Number of living children | 1–4 | 3350 (66.6) |
5–9 | 1618 (32.2) | |
10 and more | 59 (1.2) | |
Place of delivery | Home (1) | 2481 (49.4) |
Health sector (2) | 2546 (50.6) | |
Breastfeeding | yes (1) | 3134 (62.3) |
no (0) | 1409 (28.0) | |
Missing | 484 (9.6) | |
Religion | Orthodox (1) | 1461 (29.1) |
Protestant (2) | 934 (18.6) | |
Muslim (3) | 2532 (50.4) | |
Others (4) | 100 (2.0) | |
Household size | 1–4 (small) (0) | 1368 (27.2) |
5–9 (medium) (1) | 3300 (65.6) | |
10 and more (Large) (2) | 359 (7.1) | |
Household wealth index | Poorest (0) | 1681 (33.4) |
Poorer (1) | 883 (17.6) | |
Middle (2) | 706 (14.0) | |
Richer (3) | 654 (13.0) | |
Richest (4) | 1103 (21.9) |
Statistical analysis
Logistic regression
Multilevel multivariate logistic regression
Covariates | Stunting | p-value | Underweight | p-value | Wasting | p-value | |||
---|---|---|---|---|---|---|---|---|---|
Yes(%) | No(%) | Yes(%) | No(%) | Yes(%) | No(%) | ||||
Sex of child | |||||||||
male | 976 (54.0) | 1600 | 0.002 | 653 (55.7) | 1923 (49.9) | 0.000 | 277 (60.5) | 2299 (50.3) | 0.000 |
female | 831 (46.0) | (49.7) 1620 (50.3) | 519 (44.3) | 1932 (50.1) | 181 (39.5) | 2270 (49.7) | |||
Age of child | |||||||||
0–5 | 87 (4.8) | 461(14.3) | 0.920 | 61 (5.2) | 487 (12.6) | 0.000 | 64 (14.0) | 484 (10.6) | 0.372 |
6–11 | 112 (6.2) | 377 (11.7) | 84 (7.2) | 405 (10.5) | 42 (9.2) | 447 (9.8) | |||
12–23 | 329 (18.2) | 628 (19.5) | 203 (17.3) | 754 (19.6) | 87 (19.0) | 870 (19.0) | |||
24–35 | 463 (25.6) | 565 (17.5) | 298 (25.4) | 730 (18.9) | 91 (19.9) | 937 (20.5) | |||
36–47 | 403 (22.3) | 572 (17.8) | 242 (20.6) | 733 (19.0) | 81 (17.7) | 894 (19.6) | |||
48–59 | 413 (22.9) | 617 (19.2) | 284 (24.2) | 746 (19.4) | 93 (20.3) | 937 (20.5) | |||
Number of children (< 5 yrs) | |||||||||
one | 611 (33.8) | 1243 (38.6) | 0.001 | 392 (33.4) | 1462 (37.9) | 0.003 | 138 (30.1) | 1716 (37.6) | 0.001 |
two | 884 (48.9) | 1417 (44.0) | 544 (46.4) | 1757 (45.6) | 217 (47.4) | 2084 (45.6) | |||
three and more | 312 (17.3) | 560 (17.4) | 236 (20.1) | 636 (16.5) | 103 (22.5) | 769 (16.8) | |||
Residence | |||||||||
Urban | 280 (15.5) | 877 (27.2) | 0.000 | 182 (15.5) | 975 (25.3) | 0.000 | 77 (16.8) | 1080 (23.6) | 0.000 |
Rural | 1527 (84.5) | 2343 (72.8) | 990 (84.5) | 2880 (74.7) | 381 (83.2) | 3489 (76.4) | |||
Region | |||||||||
Tigray | 220 (12.2) | 209 (6.5) | 0.000 | 134 (11.4) | 295 (7.7) | 0.000 | 37 (8.1) | 392 (8.6) | 0.000 |
Afar | 244 (13.5) | 317 (9.8) | 180 (15.4) | 381 (9.9) | 81 (17.7) | 480 (10.5) | |||
Amhara | 201 (11.1) | 258 (8.0) | 126 (10.8) | 333 (8.6) | 39 (8.5) | 420 (9.2) | |||
Oromia | 237 (13.1) | 401 (12.5) | 108 (9.2) | 530 (13.7) | 31 (6.8) | 607 (13.3) | |||
Somali | 167 (9.2) | 365 (11.3) | 163 (13.9) | 369 (9.6) | 117 (25.5) | 415 (9.1) | |||
Benshangul | 185 (10.2) | 267 (8.3) | 132 (11.3) | 320 (8.3) | 29 (6.3) | 423 (9.3) | |||
SNNPR | 222 (12.3) | 369 (11.5) | 119 (10.2) | 472 (12.2) | 35 (7.6) | 556 (12.2) | |||
Gambela | 73 (4.0) | 308 (9.6) | 66 (5.6) | 315 (8.2) | 42 (9.2) | 339 (7.4) | |||
Harari | 128 (7.1) | 252 (7.8) | 68 (5.8) | 312 (8.1) | 17 (3.7) | 363 (7.9) | |||
Addis Ababa | 37 (2.0) | 220 (6.8) | 14 (1.2) | 243 (6.3) | 6 (1.3) | 251 (5.5) | |||
Dire Dawa | 93 (5.1) | 254 (7.9) | 62 (5.3) | 285 (7.4) | 24 (5.2) | 323 (7.1) | |||
Source of drinking water | |||||||||
unimproved | 796 (44.1) | 1246 (38.7) | 0.000 | 565 (48.2) | 1477 (38.3) | 0.000 | 252 (55.0) | 1790 (39.2) | 0.000 |
improved | 1011 (55.9) | 1974 (61.3) | 607 (51.8) | 2378 (61.7) | 206 (45.0) | 2779 (60.8) | |||
Breast feeding | |||||||||
No | 544 (33.5) | 865 (29.6) | 0.004 | 332 (31.4) | 1077 (30.9) | 0.398 | 132 (30.7) | 1277 (31.0) | 0.465 |
Yes | 1080 (66.5) | 2054 (70.4) | 726 (68.6) | 2708 (69.1) | 298 (69.3) | 2836 (69.0) | |||
Birth order | |||||||||
1st | 335 (18.5) | 713 (22.1) | 0.000 | 218 (18.6) | 830 (21.5) | 0.000 | 86 (18.8) | 962 (21.1) | 0.088 |
2–3 | 579 (32.0) | 1113 (34.6) | 358 (30.5) | 1334 (34.6) | 138 (30.1) | 1554 (34.0) | |||
4–5 | 445 (24.6) | 706 (21.9) | 286 (24.4) | 865 (22.4) | 115 (25.1) | 1036 (22.7) | |||
6 and more | 448 (24.8) | 688 (21.4) | 310 (26.5) | 826 (21.4) | 119 (26.0) | 1017 (22.3) | |||
Multiple birth | |||||||||
Single birth | 1749 (96.8) | 3169 (98.4) | 0.000 | 1132 (96.6) | 3786 (98.2) | 0.001 | 442 (96.5) | 4476 (98.0) | 0.126 |
1st of multiple | 30 (1.7) | 31 (1.0) | 18 (1.5) | 43 (1.1) | 9 (2.0) | 52 (1.1) | |||
2nd of multiple | 28 (1.5) | 20 (0.6) | 22 (1.9) | 26 (0.7) | 7 (1.5) | 41 (0.9) | |||
Religion | |||||||||
Orthodox | 556 (30.8) | 905 (28.1) | 0.000 | 341 (29.1) | 1120 (29.1) | 0.000 | 107 (23.4) 60 | 1354 (29.6) | 0.000 |
Protestant | 277 (15.3) | 657 (20.4) | 152 (13.0) | 782 (20.3) | (13.1) | 874 (19.1) | |||
Muslim | 948 (52.5) | 1584 (49.2) | 654 (55.8) | 1878 (48.7) | 277 (60.5) | 2255 (49.4) | |||
Others | 26 (1.4) | 74 (2.3) | 25 (2.1) | 75 (1.9) | 14 (3.1) | 86 (1.9) | |||
Mothers’ Age at 1st birth | |||||||||
< 20 | 1202 (66.5) | 1983 (61.6) | 0.001 | 792 (67.6) | 2393 (62.1) | 0.001 | 308 (67.2) | 2877 (63.0) | 0.106 |
20–34 | 603 (33.4) | 1224 (38.0) | 379 (32.3) | 1448 (37.48) | 150 (32.8) | 1677 (36.7) | |||
35–49 | 2 (0.1) | 13 (0.4) | 1 (0.1) | 14 (0.4) | 0 (0.0) | 15 (0.3) | |||
Place of delivery | |||||||||
Home | 960 (53.1) | 1521 (47.2) | 0.000 | 676 (57.7) | 1805 (46.8) | 0.000 | 283 (61.8) | 2198 (48.1) | 0.000 |
Health sector | 847 (46.9) | 847 (1699) | 496 (42.3) | 2050 (53.2) | 175 (38.2) | 2371 (51.9) | |||
Total children in the household | |||||||||
1–4 | 1146 (63.4) | 2204 (68.4) | 0.001 | 699 (59.6) | 2651 (68.8) | 0.000 | 272 (59.4) | 3078 (67.4) | 0.003 |
5–9 | 639 (35.4) | 979 (30.4) | 458 (39.1) | 1160 (30.1) | 180 (39.3) | 1438 (31.5) | |||
10 and more | 22 (1.2) | 37 (1.1) | 15 (1.3) | 44 (1.1) | 6 (1.3) | 53 (1.2) | |||
Husband/partner’s education level | |||||||||
No education | 1123 (62.1) | 1643 (51.0) | 0.000 | 781 (66.6) | 1985 (51.5) | 0.000 | 317 (69.2) | 2449 (53.6) | 0.000 |
Primary | 554 (30.7) | 1015 (31.5) | 325 (27.7) | 1244 (32.3) | 108 (23.6) | 1461 (32.0) | |||
Secondary and higher | 130 (7.2) | 562 (17.5) | 66 (5.6) | 626 (16.2) | 33 (7.2) | 659 (14.4) | |||
Household size | |||||||||
1–4 | 457 (25.3) | 911 (28.3) | 0.063 | 275 (23.5) | 1093 (28.4) | 0.001 | 105 (22.9) | 1263 (27.6) | 0.003 |
5–9 | 1222 (67.6) | 2078 (64.5) | 796 (67.9) | 2504 (65.0) | 305 (66.6) | 2995 (65.6) | |||
10 and more | 128 (7.1) | 231 (7.2) | 101 (8.6) | 258 (6.7) | 48 (10.5) | 311 (6.8) | |||
Wealth index | |||||||||
poorest | 674 (37.3) | 1007 (31.3) | 0.000 | 519 (44.3) | 1162 (30.1) | 0.000 | 246 (53.7) | 1435 (31.4) | 0.000 |
poorer | 360 (19.9) | 523 (16.2) | 235 (20.1) | 648 (16.8) | 74 (16.2) | 809 (17.7) | |||
middle | 293 (16.2) | 413 (12.8) | 161 (13.7) | 545 (14.1) | 43 (9.4) | 663 (14.5) | |||
richer | 239 (13.2) | 415 (12.9) | 116 (9.9) | 538 (14.0) | 40 (8.7) | 614 (13.4) | |||
richest | 241 (13.3) | 862 (26.8) | 141 (12.0) | 962 (25.0) | 55 (12.0) | 1048 (22.9) | |||
Marital Status | |||||||||
Married | 1720 (95.2) | 3025 (93.9) | 0.108 | 1109 (94.6) | 3636 (94.3) | 0.752 | 432 (94.3) | 4313 (94.4) | 0.484 |
Divorced | 39 (2.2) | 101 (3.1) | 29 (2.5) | 111 (2.9) | 10 (2.2) | 130 (2.8) | |||
Widowed | 48 (2.7) | 94 (2.9) | 34 (2.9) | 108 (2.8) | 16 (3.5) | 126 (2.58) |
Ethics approval
Results
Variables | Categories (codes) | n (%) |
---|---|---|
Stunting | yes (1) | 1816 (36.0) |
no (0) | 3234 (64.0) | |
underweight | yes (1) | 1177 (23.3) |
no (0) | 3873 (76.7) | |
wasting | yes (1) | 460 (9.1) |
no (0) | 4590 (90.9) |
Underweight | Total | |||||
---|---|---|---|---|---|---|
yes | no | |||||
Stunting | yes | Wasted | yes | 767 | 860 | 1627 |
no | 180 | 0 | 180 | |||
no | Wasted | yes | 154 | 124 | 278 | |
no | 71 | 2871 | 2942 | |||
Total | 1172 | 3855 | 5027 |
Undernutrition category | frequency (%) |
---|---|
Nourished | 2871 (57.1) |
Wasting only | 124 (2.5) |
Underweight only | 71 (1.4) |
Stunting and Wasting | 860 (17.1) |
Stunting and Underweight | 180 (3.6) |
Underweight and Wasting | 154 (3.0) |
Stunting, Wasting, and Underweight | 767 (15.3) |
Stunting, Underweight | Stunting, Wasting | Underweight, Wasting | |
---|---|---|---|
OR | 14.66 | 1.17 | 11.99 |
Variables | Stunting | Underweight | Wasting | |||
---|---|---|---|---|---|---|
est.(sd.err) | OR (95% CI) | est.(sd.err) | OR (95% CI) | est.(sd.err) | OR (95% CI) | |
Intercept | −1.606 (0.313) | 0.201(0.109,0.370) | −0.872(0.353) | 0.418(0.209,0.835) | −0.300(0.048) | 0.741(0.291,1.882) |
Sex | ||||||
male(a) | 0.000 | 0.000 | 0.000 | |||
female | −0.212(0.065) | 0.809(0.712,0.920) | −0.299(0.073) | 0.741(0.642,0.856) | −0.446(0.105) | 0.640(0.521,0.786) |
Age of child | ||||||
0–5 (a) | 0.000 | 0.000 | 0.000 | |||
6-11 t | 0.455(0.162) | 1.577(1.148,2.166) | 0.529(0.184) | 1.697(1.184,2.433) | −0.303(0.211) | 0.739(0.488,1.118) |
12–23 | 1.134(0.139) | 3.108(2.366,4.084) | 0.897(0.160) | 2.452(1.791,3.359) | −0.257(0.180) | 0.773(0.543,1.100) |
24–25 | 1.578(0.139) | 4.845(3.688,6.364) | 1.277(0.158) | 3.587(2.630,4.891) | −0.358(0.182) | 0.699(0.489,0.999) |
36–47 | 1.446(0.143) | 4.245(3.210,5.614) | 1.101(0.163) | −3.008(2.187, 4.137) | −0.367(0.188) | 0.693(0.479,1.000) |
48–59 | 1.307(0.150) | 3.696(2.755, 4.957) | 1.131(0.169) | 3.100(2.224,4.321) | −0.381(0.200) | 0.684(0.462,1.010) |
No. of children (< 5 yr) | ||||||
one(a) | 0.000 | 0.000 | 0.000 | |||
two | 0.170(0.084) | 1.185(1.006, 1.396) | −0.064(0.094) | 0.938(0.780, 1.128) | 0.056(0.137) | 1.058(0.808,1.384) |
three or more | 0.074(0.116) | 1.0765(0.858,1.351) | −0.032(0.127) | 0.968(0.754, 1.242) | −0.026(0.178) | 0.975(0.687,1.382) |
Residence | ||||||
Rural(a) | 0.000 | 0.000 | 0.000 | |||
Urban | 0.105(0.121) | 1.111(0.876,1.409) | −0.286(0.138) | 0.751(0.573,0.984) | −0.411(0.191) | 0.663(0.456,0.965) |
Source of drinking water | ||||||
Unimproved(a) | 0.000 | 0.000 | 0.000 | |||
Improved | −0.008(0.073) | 0.992(0.859,1.146) | −0.065(0.081) | 0.937(0.800,1.098) | −0.223(0.114) | 0.800(0.640,1.002) |
Breast Feeding | ||||||
No(a) | 0.000 | 0.000 | 0.000 | |||
Yes | 0.082(0.076) | 1.085(0.935,1.259) | 0.210(0.085) | 1.233(1.043,1.458) | 0.0105(0.123) | 1.011(0.794,1.286) |
Birth Order | ||||||
1st (a) | 0.000 | 0.000 | 0.000 | |||
2–3 | 0.032(0.102) | 1.033(0.845,1.261) | −0.120(0.115) | 0.887(0.709,1.111) | −0.232(0.165) | 0.793(0.575,1.100) |
4–5 | 0.145(0.137) | 1.156(0.884,1.512) | −0.311(0.156) | 0.732(0.540,0.994) | −0.427(0.224) | 0.652(0.421,1.011) |
6 and more | 0.234(0.174) | 1.263(0.899,1.775) | −0.384(0.194) | 0.681(0.466,0.996) | −0.543(0.276) | 0.581(0.338,0.998) |
Multiple Birth | ||||||
Single birth(a) | 0.000 | 0.000 | 0.000 | |||
1st of multiple | 0.547(0.148) | 1.727(1.292,2.310) | 0.508(0.149) | 1.663(1.242,2.225) | 0.330(0.197) | 1.391(0.946,2.044) |
2nd of multiple | 0.547(0.148) | 1.727(1.292,2.310) | 0.508(0.149) | 1.663(1.242,2.225) | 0.330(0.197) | 1.391(0.946,2.044) |
Religion | ||||||
Orthodox(a) | 0.000 | 0.000 | 0.000 | |||
Protestant | −0.568(0.105) | 0.567(0.462,0.696) | −0.579(0.123) | 0.560(0.440,0.713) | −0.268(0.184) | 0.765(0.533,1.096) |
Muslim | −0.195(0.083) | 0.823(0.700,0.968) | −0.100(0.092) | 0.905(0.755,1.083) | 0.079(0.136) | 1.082(0.829,1.412) |
Others | −0.819(0.253) | 0.441(0.268,0.723) | −0.225(0.263) | 0.798(0.477,1.336) | 0.446(0.322) | 1.561(0.830,2.935) |
Mother’s age at 1st birth | ||||||
< 20 (a) | 0.000 | 0.000 | 0.000 | |||
20–34 | −0.067(0.072) | 0.935(0.812,1.077) | −0.113(0.081) | 0.893(0.763,1.046) | −0.145(0.115) | 0.865(0.691,1.083) |
35–49 | −0.659(0.785) | 0.517(0.111,2.409) | −0.710(1.018) | 0.491(0.067,3.611) | −15.590(0.206) | 0.001(0.000,0.125) |
Mother’s current marital status | ||||||
Married (a) | 0.000 | 0.000 | 0.000 | |||
Divorced | −0.010(0.214) | 0.990(0.651,1.507) | 0.126(0.233) | 1.134(0.717,1.792) | 0.064(0.343) | 1.067(0.544,2.088) |
Widowed | −0.209(0.214) | 0.811(0.533,1.235) | 0.017(0.229) | 1.017(0.650,1.592) | 0.340(0.294) | 1.405(0.790,2.499) |
Place of delivery | ||||||
Health Sector(a) | 0.000 | 0.000 | 0.000 | |||
Home | 0.172(0.078) | 1.187(1.019,1.383) | 0.036(0.086) | 1.037(0.875,1.229) | −0.072(1.250) | 0.930(0.728,1.189) |
Total children in the HH | ||||||
1–4(a) | 0.000 | 0.000 | 0.000 | |||
5–9 | −0.295(0.124) | 0.744(0.584,0.948) | 0.173(0.138) | 1.189(0.907,1.559) | 0.283(0.198) | 1.328(0.901,1.956) |
10 and more | −0.617(0.352) | 0.539(0.270,1.076) | −0.379(0.406) | 0.685(0.309,1.516) | 0.168(0.506) | 1.183(0.438,3.190) |
Education levels of women | ||||||
No education(a) | 0.000 | 0.000 | 0.000 | |||
Primary | −0.080(0.082) | 0.923(0.785,1.084) | −0.191(0.092) | 0.827(0.690,0.991) | −0.311(0.137) | 0.733(0.560,0.959) |
Secondary and above | −0.702(0.135) | 0.496(0.380,0.646) | −0.845(0.168) | 0.430(0.309,0.600) | −0.546(0.235) | 0.580(0.366,0.919) |
Household Size | ||||||
Small (1–4)(a) | 0.000 | 0.000 | 0.000 | |||
Medium (5–9) | 0.004(0.096) | 1.004(0.832,1.211) | 0.077(0.109) | 1.080(0.872,1.334) | 0.157(0.156) | 1.170(0.861,1.589) |
10 and more | 0.015(0.166) | 1.015(0.733,1.406) | 0.270(0.180) | 1.310(0.921,1.864) | 0.421(0.242) | 1.523(0.948,2.447) |
Wealth Index | ||||||
Poorest(a) | 0.000 | 0.000 | 0.000 | |||
Poorer | 0.058(0.097) | 1.059(0.877,1.280) | −0.146(0.104) | 0.864(0.704,1.060) | −0.465(0.153) | 0.628(0.466,0.847) |
Middle | 0.118(0.109) | 1.125(0.910,1.392) | −0.283(0.122) | 0.754(0.594,0.957) | −0.700(0.192) | 0.496(0.341,0.723) |
Richer | −0.052(0.117) | 0.949(0.755,1.195) | −0.558(0.138) | 0.572(0.437,0.749) | −0.621(0.201) | 0.538(0.362,0.798) |
Richest | −0.723(0.149) | 0.485(0.362,0.651) | −1.046(0.174) | 0.351(0.250,0.494) | −0.961(0.247) | 0.383(0.236,0.621) |
Random effect | σˆrs2 (sd.err) | P-value | σˆru2 (sd.err) | P-value | σˆrw2 (sd.err) | P-value |
Region | 3.890 (0.158) | 0.001 | 3.360 (0.122) | 0.015 | 3.450 (0.544) | 0.032 |
Association | Odds Ratio(OR) | P-value | ||||
Underweight and Stunting | 13.490 | 0.0001 | ||||
Underweight and Wasting | 15.220 | 0.0001 | ||||
Stunting and wasting | 1.110 | 0.169 |