Background
Methods
Survey
Variables
Dependent variable
Independent variables
Analytical framework
Statistical analysis
Results
Descriptive analysis
Characteristics | Sample | Moderate | Severe | Total Stunting(<−2SD) | ||
---|---|---|---|---|---|---|
% | n | Stunting % | Stunting % | % | 95% CI | |
Age |
p < 0.001 | |||||
< 6 months | 10.8 | 976 | 8 | 6.7 | 14.7 | [12.0,17.7] |
6–11 months | 9.8 | 888 | 9.9 | 13.2 | 23.1 | [18.9,27.8] |
12–23 months | 18.9 | 1707 | 21.4 | 17.7 | 39.1 | [35.9,42.3] |
24–35 months | 20.4 | 1840 | 23.4 | 26.8 | 50.2 | [47.1,53.4] |
36–47 months | 19.7 | 1783 | 24.7 | 29.3 | 54.0 | [50.7,57.3] |
48–59 months | 20.4 | 1838 | 23.2 | 28.9 | 52.1 | [48.8,55.3] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Sex |
p < 0.01 | |||||
Male | 50.0 | 4517 | 20.4 | 24.9 | 45.2 | [43.2,47.3] |
Female | 50.0 | 4513 | 20.1 | 20.1 | 40.2 | [38.2,42.2] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Distal factors | ||||||
Mother's education |
p < 0.001 | |||||
None | 19.7 | 1641 | 20.1 | 30.6 | 50.8 | [47.5,54.0] |
Primary | 43.7 | 3632 | 21.3 | 25.8 | 47.1 | [44.8,49.4] |
Secondary | 35.4 | 2945 | 20.1 | 13.1 | 33.2 | [30.9,35.6] |
Higher | 1.2 | 97 | 9.8 | 3.3 | 13.1 | [7.3,22.5] |
Total | 100 | 8315 | 20.5 | 22.0 | 42.5 | [41.0,44.0] |
Wealth quintile |
p < 0.001 | |||||
Richest | 16.1 | 1456 | 14.0 | 9.0 | 22.9 | [20.2,26.0] |
Richer | 18.5 | 1671 | 20.4 | 21.0 | 41.4 | [37.9,45.0] |
Middle | 20.4 | 1843 | 22.3 | 23.5 | 45.8 | [42.6,49.0] |
Poorer | 22.4 | 2018 | 22.2 | 26.1 | 48.3 | [45.1,51.5] |
Poorest | 22.6 | 2042 | 20.8 | 28.8 | 49.7 | [46.9,52.5] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Residence |
p < 0.001 | |||||
Urban | 30.2 | 2728 | 18.7 | 13.8 | 32.5 | [30.3,34.7] |
Rural | 69.8 | 6302 | 20.9 | 26.2 | 47.2 | [45.4,49.0] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Intermediate factors | ||||||
Mothers age at delivery |
p = 0.084 | |||||
< 20 years | 14.5 | 1307 | 24.0 | 22.5 | 46.5 | [43.0,50.1] |
20–34 years | 63.2 | 5704 | 19.9 | 22.0 | 41.9 | [40.1,43.7] |
> =35 years | 22.4 | 2020 | 18.9 | 23.8 | 42.6 | [39.6,45.7] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Mother’s body mass index |
p < 0.001 | |||||
Thin | 11.8 | 944 | 22.7 | 22.8 | 45.4 | [41.0,50.0] |
Normal | 72.6 | 5829 | 20.8 | 23.3 | 44.1 | [42.4,45.9] |
Overweight | 15.6 | 1252 | 17.4 | 15.7 | 33.1 | [29.5,36.8] |
Total | 100 | 8025 | 20.5 | 22.0 | 42.6 | [41.1,44.1] |
Birth interval |
p < 0.001 | |||||
First Birth | 18.1 | 1470 | 21.9 | 19.1 | 41.0 | [37.7,44.4] |
< 24 months | 21.6 | 1755 | 18.9 | 29.4 | 48.3 | [44.9,51.8] |
24–47 months | 47.35 | 3856 | 21.3 | 21.1 | 42.4 | [40.3,44.6] |
48 months or more | 13.1 | 1063 | 17.8 | 17.0 | 34.7 | [30.9,38.8] |
Total | 100 | 8143 | 20.4 | 22.0 | 42.4 | [40.9,43.9] |
Family size |
p = 0.532 | |||||
Small(<4) | 22.3 | 1711 | 21.6 | 20.3 | 41.8 | [38.7,45.1] |
Medium (4–6 members) | 17.0 | 1303 | 19.3 | 21.7 | 41.0 | [37.4,44.6] |
Large (>8 members) | 60.7 | 4660 | 19.2 | 24.0 | 43.2 | [41.2,45.2] |
Total | 100 | 7674 | 19.7 | 22.8 | 42.5 | [41.0,44.06] |
Number of Children |
p < 0.5 | |||||
1 | 20.0 | 1806 | 22.0 | 17.5 | 39.5 | [36.5,42.7] |
2 | 44.6 | 4028 | 20.7 | 23.2 | 43.9 | [41.7,46.1] |
3 | 26.5 | 2394 | 19.2 | 25.5 | 44.7 | [41.9,47.5] |
4 or more | 0.9 | 79 | 17.7 | 21.6 | 39.3 | [34.6,44.2] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Access to safe water | 0 |
p < 0.001 | ||||
No | 70.6 | 6372 | 21.5 | 25.0 | 46.5 | [44.8,48.1] |
Yes | 29.4 | 2658 | 17.3 | 16.4 | 33.8 | [31.4,36.6] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Access to hygienic toilet | 0 |
p < 0.001 | ||||
No | 96.5 | 8717 | 20.6 | 23.1 | 43.7 | [42.2,45.2] |
Hygienic | 3.5 | 313 | 10.1 | 5.5 | 15.6 | [11.0,21.6] |
Total | 100 | 9030 | 20.2 | 22.5 | 42.7 | [41.3,44.2] |
Proximal factors | ||||||
Birth order |
p = 0.113 | |||||
1 | 18.0 | 1476 | 21.9 | 19.1 | 41.0 | [37.7,44.4] |
2 | 16.5 | 1352 | 20.5 | 19.2 | 39.7 | [36.3,43.3] |
> =3 | 65.5 | 5363 | 20.0 | 23.5 | 43.6 | [41.7,45.5] |
Total | 100 | 8192 | 20.5 | 22.1 | 42.5 | [41.0,44.0] |
Had Diarrhoea |
p = 0.441 | |||||
No | 82.4 | 6691 | 20.6 | 22.2 | 42.8 | [41.2,44.5] |
Yes | 17.6 | 1430 | 19.8 | 21.4 | 41.2 | [37.7,44.9] |
Total | 100 | 8121 | 20.5 | 22.0 | 42.5 | [41.0,44.0] |
Breastfeeding within first hour |
p = 0.120 | |||||
No | 55.6 | 4459 | 22.1 | 21.5 | 43.6 | [41.6,45.7] |
Yes | 44.4 | 3566 | 18.3 | 22.9 | 41.2 | [39.0,43.4] |
Total | 100 | 8025 | 20.4 | 22.1 | 42.5 | [41.0,44.1] |
Bivariate analysis
Hierarchical logistic regression analysis
Distal factors
Characteristics | Model 1 | Model 2 | Model 3 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
aOR | 95% CI | aOR | 95% CI | aOR | 95% CI | |||||||
Age | ||||||||||||
< 6 months | 1.00 | 1.00 | 1.00 | |||||||||
6–11 months | 1.89 | 1.12 | 3.19 | * | 1.84 | 1.07 | 3.19 | * | 1.84 | 1.09 | 3.13 | * |
12–23 months | 4.22 | 3.07 | 5.80 | *** | 4.35 | 3.14 | 6.03 | *** | 4.41 | 3.19 | 6.09 | *** |
24–35 months | 6.59 | 4.84 | 8.97 | *** | 6.34 | 4.60 | 8.74 | *** | 6.53 | 4.73 | 9.00 | *** |
36–47 months | 7.93 | 5.77 | 10.89 | *** | 8.78 | 6.41 | 12.03 | *** | 9.60 | 6.97 | 13.21 | *** |
48–59 months | 7.67 | 5.61 | 10.50 | *** | 7.63 | 5.59 | 10.42 | *** | 8.13 | 5.93 | 11.15 | *** |
Sex | ||||||||||||
Male | 1.00 | 1.00 | 1.00 | |||||||||
Female | 0.80 | 0.70 | 0.92 | ** | 0.81 | 0.70 | 0.94 | ** | 0.81 | 0.70 | 0.94 | ** |
Distal factors
| ||||||||||||
Mother's education | ||||||||||||
None | 1.00 | 1.00 | 1.00 | |||||||||
Primary | 1.03 | 0.88 | 1.21 | 1.02 | 0.86 | 1.21 | 0.99 | 0.83 | 1.18 | |||
Secondary | 0.80 | 0.67 | 0.96 | * | 0.84 | 0.68 | 1.03 | 0.83 | 0.67 | 1.04 | ||
Higher | 0.45 | 0.22 | 0.93 | * | 0.64 | 0.31 | 1.32 | 0.63 | 0.31 | 1.28 | ||
Wealth quintile | ||||||||||||
Richest | 1.00 | 1.00 | 1.00 | |||||||||
Richer | 2.14 | 1.57 | 2.92 | *** | 1.92 | 1.32 | 2.79 | ** | 1.91 | 1.32 | 2.76 | ** |
Middle | 2.84 | 1.98 | 4.07 | *** | 2.30 | 1.51 | 3.50 | *** | 2.38 | 1.56 | 3.62 | *** |
Poorer | 3.28 | 2.23 | 4.83 | *** | 2.43 | 1.54 | 3.82 | *** | 2.48 | 1.57 | 3.92 | *** |
Poorest | 3.93 | 2.70 | 5.72 | *** | 2.81 | 1.78 | 4.44 | *** | 2.90 | 1.83 | 4.57 | *** |
Ethnicity | ||||||||||||
Bakongo | 1.00 | 1.00 | 1.00 | |||||||||
Bas-kasai et kwilu-kwngo | 0.93 | 0.52 | 1.67 | 0.82 | 0.45 | 1.49 | 0.92 | 0.51 | 1.66 | |||
Cuvette central | 0.77 | 0.41 | 1.45 | 0.60 | 0.31 | 1.14 | 0.65 | 0.34 | 1.24 | |||
Ubangi et itimbiri | 1.02 | 0.53 | 1.96 | 1.07 | 0.53 | 2.17 | 1.11 | 0.54 | 2.24 | |||
Uele lac albert | 1.08 | 0.52 | 2.24 | 0.99 | 0.45 | 2.18 | 1.05 | 0.48 | 2.30 | |||
Basele-k, man. et kivu | 0.96 | 0.45 | 2.05 | 0.91 | 0.41 | 2.01 | 0.93 | 0.41 | 2.11 | |||
Kasai, katanga, Tanganyika | 1.00 | 0.54 | 1.85 | 0.94 | 0.49 | 1.79 | 1.08 | 0.57 | 2.05 | |||
others (lunda/pygmy/foreign) | 1.28 | 0.62 | 2.68 | 1.23 | 0.60 | 2.50 | 1.61 | 0.83 | 3.13 | |||
Residence | ||||||||||||
Urban | 1.00 | 1.00 | ||||||||||
Rural | 0.92 | 0.74 | 1.15 | 0.90 | 0.69 | 1.18 | 0.89 | 0.68 | 1.16 | |||
Province (New) | ||||||||||||
Kinshasa | 1.00 | 1.00 | ||||||||||
Kwango | 1.81 | 0.93 | 3.50 | 1.62 | 0.78 | 3.36 | 1.42 | 0.69 | 2.91 | |||
Kwilu | 1.29 | 0.73 | 2.27 | 1.41 | 0.74 | 2.67 | 1.29 | 0.69 | 2.43 | |||
Mai-ndombe | 1.07 | 0.59 | 1.92 | 1.12 | 0.61 | 2.03 | 1.02 | 0.56 | 1.84 | |||
Kongo central | 2.09 | 0.97 | 4.48 | 1.64 | 0.72 | 3.72 | 1.77 | 0.84 | 3.77 | |||
Equateur | 0.58 | 0.27 | 1.24 | 0.60 | 0.26 | 1.40 | 0.55 | 0.24 | 1.28 | |||
Mongala | 0.96 | 0.52 | 1.79 | 0.84 | 0.41 | 1.73 | 0.79 | 0.39 | 1.61 | |||
Nord-ubangi | 1.22 | 0.60 | 2.51 | 1.33 | 0.61 | 2.91 | 1.23 | 0.56 | 2.69 | |||
Sud-ubangi | 1.22 | 0.62 | 2.42 | 1.00 | 0.48 | 2.08 | 0.95 | 0.46 | 1.96 | |||
Tshuapa | 1.71 | 0.86 | 3.41 | 2.54 | 1.24 | 5.18 | * | 2.33 | 1.15 | 4.72 | * | |
Kasai | 2.82 | 1.60 | 4.97 | *** | 3.05 | 1.65 | 5.61 | *** | 2.75 | 1.49 | 5.07 | ** |
Kasai-central | 1.89 | 1.02 | 3.49 | * | 1.74 | 0.88 | 3.46 | 1.48 | 0.74 | 2.96 | ||
Kasai-oriental | 1.80 | 1.03 | 3.15 | * | 2.05 | 1.14 | 3.70 | * | 1.86 | 1.04 | 3.33 | * |
Lomami | 1.97 | 1.11 | 3.50 | * | 1.92 | 1.00 | 3.68 |
P = 0.05 | 1.64 | 0.86 | 3.11 | |
Sankuru | 2.49 | 1.32 | 4.69 | ** | 3.11 | 1.54 | 6.30 | ** | 2.87 | 1.41 | 5.82 | ** |
Haut-katanga | 2.84 | 1.72 | 4.69 | *** | 2.55 | 1.46 | 4.46 | ** | 2.19 | 1.26 | 3.81 | ** |
Haut-lomami | 1.77 | 0.95 | 3.30 | 1.28 | 0.63 | 2.57 | 1.13 | 0.57 | 2.25 | |||
Lualaba | 1.60 | 0.85 | 2.99 | 1.33 | 0.62 | 2.85 | 1.09 | 0.47 | 2.49 | |||
Langanyka | 1.92 | 1.04 | 3.57 | * | 1.57 | 0.78 | 3.17 | 1.32 | 0.67 | 2.62 | ||
Maniema | 1.70 | 0.79 | 3.63 | 1.42 | 0.61 | 3.34 | 1.37 | 0.55 | 3.43 | |||
Nord-kivu | 2.49 | 1.29 | 4.79 | ** | 2.04 | 0.97 | 4.29 | 2.09 | 0.98 | 4.47 | ||
Bas-uele | 1.30 | 0.68 | 2.50 | 1.48 | 0.65 | 3.37 | 1.07 | 0.47 | 2.47 | |||
Haut-uele | 1.41 | 0.60 | 3.32 | 1.56 | 0.62 | 3.91 | 1.40 | 0.55 | 3.52 | |||
Ituri | 1.53 | 0.77 | 3.07 | 1.33 | 0.61 | 2.89 | 1.37 | 0.64 | 2.93 | |||
Tshopo | 1.19 | 0.56 | 2.50 | 1.25 | 0.54 | 2.92 | 1.17 | 0.51 | 2.68 | |||
Sud-kivu | 3.10 | 1.45 | 6.61 | ** | 2.57 | 1.15 | 5.73 | * | 2.54 | 1.11 | 5.83 | * |
Intermediate factors
| ||||||||||||
Mothers age at delivery | ||||||||||||
< 20 years | 1.00 | 1.00 | ||||||||||
20–34 years | 0.78 | 0.59 | 1.03 | 0.70 | 0.52 | 0.94 | * | |||||
> =35 years | 0.76 | 0.54 | 1.06 | 0.65 | 0.45 | 0.94 | * | |||||
Mother’s body mass index | ||||||||||||
Thin | 1.00 | 1.00 | ||||||||||
Normal | 0.96 | 0.73 | 1.26 | 0.97 | 0.74 | 1.28 | ||||||
Overweight | 0.73 | 0.49 | 1.10 | * | 0.73 | 0.48 | 1.09 | |||||
Mother’s height | 0.99 | 0.99 | 1.00 | *** | 0.60 | 0.53 | 0.68 | *** | ||||
Birth interval | ||||||||||||
First Birth | 1.00 | 1.00 | ||||||||||
< 24 months | 1.17 | 0.86 | 1.59 | 1.38 | 1.06 | 1.79 | * | |||||
> 24 months | 1.05 | 0.79 | 1.40 | 1.23 | 0.95 | 1.59 | ||||||
Family size | ||||||||||||
Small(<4) | 1.00 | 1.00 | ||||||||||
Medium (4–6 members) | 0.91 | 0.69 | 1.19 | 0.92 | 0.70 | 1.21 | ||||||
Large (>8 members) | 1.26 | 1.00 | 1.58 |
P = 0.05 | 1.18 | 0.93 | 1.48 | |||||
Number of Children | ||||||||||||
1 | 1.00 | 1.00 | ||||||||||
2 | 1.08 | 0.87 | 1.35 | 1.09 | 0.88 | 1.36 | ||||||
3 | 1.21 | 0.93 | 1.59 | 1.21 | 0.92 | 1.58 | ||||||
4 or more | 0.98 | 0.69 | 1.39 | 0.99 | 0.70 | 1.41 | ||||||
Access to safe water | 0.92 | 0.69 | 1.23 | 0.89 | 0.67 | 1.19 | ||||||
Access to hygienic toilet | 0.80 | 0.49 | 1.31 | 0.80 | 0.48 | 1.31 | ||||||
Proximal factors
| ||||||||||||
Birth order | ||||||||||||
1 | 1.00 | |||||||||||
2 | 0.74 | 0.49 | 1.13 | |||||||||
> =3 | 1.01 | 0.64 | 1.57 | |||||||||
Had diarrhea | ||||||||||||
No | 1.00 | |||||||||||
Yes | 1.11 | 0.89 | 1.39 | |||||||||
Breastfeeding within first hour | ||||||||||||
No | 1.00 | |||||||||||
Yes | 0.82 | 0.70 | 0.95 | ** |