Dataset Information

Prevalence and associated factors of stunting among under-five children in Ethiopia: Application of marginal models analysis of 2016 Ethiopian demographic and health survey data.

ABSTRACT:

Background

Stunting, short for age, affects the overall growth and development of the children. It occurs due to chronic under nutrition. Stunting vastly occurs in impoverished regions of the world, including Ethiopia.

Objective

This study aimed to investigate the prevalence and correlates of stunting among under-five children in Ethiopia using marginal models.

Methods

Data were taken from the 2016 Ethiopian Demographic Health Survey, which is a nationally representative survey of children in the 0-59 month age group. For marginal models, generalized estimating equations and alternating logistic regression models were used for the analysis.

Results

The prevalence of stunting among the under-five children was 34.91% in the area. The proportion was slightly higher among male (36.01%) than female (33.76%) child. The Alternating Logistic Regression model analysis revealed that the child's age, the mother's education level, the mother's body mass index, the place of residence, the wealth index, and the previous birth interval were found to be significant determinants of childhood stunting, and the result shows that children born with a lower previous birth interval (less than 24 months) were more likely to be stunted than those born within a higher birth interval. Children in rural Ethiopia were more likely to be stunted than children in urban Ethiopia.

Conclusion

This study found that more than one third of children were stunted in the area. The study also determined that child's age, the mother's education, the mother's body mass index, the place of residence, the wealth index, and birth interval influence stunting. Therefore, it is better enhancing the nutritional intervention programs.

SUBMITTER: Gobena WE

PROVIDER: S-EPMC10617690 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prevalence and associated factors of stunting among under-five children in Ethiopia: Application of marginal models analysis of 2016 Ethiopian demographic and health survey data.

Gobena Woldemariam Erkalo WE Wotale Teramaj Wongel TW Lelisho Mesfin Esayas ME Gezimu Wubishet W

PloS one 20231031 10

<h4>Background</h4>Stunting, short for age, affects the overall growth and development of the children. It occurs due to chronic under nutrition. Stunting vastly occurs in impoverished regions of the world, including Ethiopia.<h4>Objective</h4>This study aimed to investigate the prevalence and correlates of stunting among under-five children in Ethiopia using marginal models.<h4>Methods</h4>Data were taken from the 2016 Ethiopian Demographic Health Survey, which is a nationally representative su ...[more]

PMID: 37906602

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Project description:BackgroundDespite continued efforts to address malnutrition, there is minimal reduction in the prevalence rates of stunting in developing countries, including Ethiopia. The association between nutritional and socioeconomic factors collected from a national survey in Ethiopia and stunting have not been rigorously analyzed. Therefore, this study aims to model the effect of nutritional and socioeconomic predictors using 2016 Ethiopian Demographic Health Survey (EDHS) data.MethodsThis study is a secondary data analysis of the 2016 EDHS survey, which included 7909 children aged 6 to59 months. Descriptive statistics using frequency and percentage for categorical data and mean and standard deviation for metric data were conducted. Linearity, confounding, and multicollinearity were checked. Bivariable and multivariable logistic regression were carried out. The adjusted odds ratio (AOR) and 95% confidence interval (CI) were calculated. A receiver operative curve was built to estimate the sensitivity and specificity of the model.ResultsThe study identified that 39.2% of children included in this analysis were stunted. Furthermore, 76.47, 84.27, and 92.62% of the children did not consume fruits and vegetables, legumes and lentils, or meat and its products, respectively. Children aged 24 months to 59 months were found to be at 9.71 times higher risk of being stunted compared to their younger counterparts aged 6-24 months (AOR: 9.71; CI: 8.07, 11.6 children). Those children weighing below 9.1 kg were at 27.86 odds of being stunted compared to those weighing 23.3 kg and above. Moreover, mothers with a height below 150 cm (AOR: 2.01; CI: 1.76, 2.5), living in a rural area (AOR: 1.3, CI: 1.09, 1.54), and being male (AOR: 1.4; CI: 1.26, 1.56) were factors associated with stunting. The predictive ability of the model was 77%: if a pair of observations with stunted and non-stunted children were taken, the model correctly ranks 77% of such pair of observations.ConclusionThe model indicates that being born male, being from a mother of short stature, living in rural areas, small child size, mother with mild anemia, father having no formal education or primary education only, having low child weight, and being 24-59 months of age increases the likelihood of stunting. On the other hand, being born of an overweight or obese mother decreases the likelihood of stunting.

Project description:BackgroundThough the consequences of teenage pregnancy and early motherhood has been studied very well, little is known about the magnitude as well as the determinants of adolescent fatherhood. Unlike adolescent motherhood, limited public health programs are working on adolescent fatherhood. Currently, in developed countries, there is an increased work to acknowledge teen fathers in clinical practice and in the research forum, but still, there are more issues that need to be addressed in developing countries including Ethiopia. Therefore, this study aimed to investigate the prevalence and associated factors of adolescent fatherhood in Ethiopia based on the nationally representative survey.MethodsThis study used the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 4455 adolescent men was included for the final analysis. For the associated factors, multilevel logistic regression analysis was conducted to consider the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance (-2LLR) were used for model comparison and for assessing model fitness. The model with the largest adjusted R2, lowest Bayesian Information Criteria (BIC) and the smallest cross-validation prediction error were considered as the best-fitted model. In the multivariable analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the presence of statistically significant factors associated with adolescent fatherhood, and variables with p-value <0.05 were considered as a significant variable.ResultsThe prevalence of adolescent fatherhood in Ethiopia was 6.79% [95%CI; 6.08%, 7.56%]. Adolescent men with contraceptive knowledge [AOR = 4.25; 95%CI = 1.23, 14.69], age in 20 to 24 years [AOR = 7.93; 95%CI = 3.66, 17.27] and being Muslim [AOR = 1.84; 95%CI = 1.02, 3.39] were significantly associated with Higher odds of adolescent fatherhood. Individuals who initiate sex lately [AOR = 0.35; 95%CI = 0.22, 0.54], being in female-headed family [AOR = 0.46; 95%CI; 0.26, 0.82] and being from Amhara region [AOR = 0.35; 95%CI = 0.14, 0.84] were significantly associated with lower odds of adolescent fatherhood.ConclusionIn this study, adolescent fatherhood was a common public health problem in Ethiopia as it is closely linked with poor quality of life and premature death (year of potential life lost). Age of respondent, knowledge of respondent about contraceptive methods, early initiation of sex, religion, sex of household head, and region were significantly associated with adolescent fatherhood. Therefore, program planners and decision-makers should give special attention to adolescent men through enhancing reproductive health services utilization and their knowledge towards it to decrease the incidence of adolescent fatherhood.

Project description:BACKGROUND:Diarrhoea is one of the major contributors to death among under-five children in Ethiopia. Studies conducted in different countries showed that rural children are more severely affected by diarrhoea than urban children. Thus, this study was aimed to identify the socio-demographic, environmental and behavioural associated risk factors of the occurrence of diarrhoea among under-five children in rural Ethiopia. METHODS:Data for the study was drawn from the 2016 Ethiopian Demographic and Health Survey. A total of 8041 under-five children were included in the study. Binary logistic regression was used to assess the association of occurrence of diarrhoea with socio-demographic, environmental and behavioural factors among under-five children. RESULTS:Children aged 6-11?months (AOR:3.5; 95% CI: 2.58-4.87), 12-23?months (AOR: 3.1; 95% CI: 2.33-4.04) and 24-35?months (AOR: 1.7; 95% CI: 1.26-2.34) as compared to >?35?months were significantly associated with an increasing prevalence of diarrhoea. Children in Afar region (AOR: 1.92; 95% CI: 1.01-3.64) and Gambela region (AOR: 2.12; 95% CI: 1.18, 3.81) were significantly associated with an increasing prevalence of diarrhoea, but a decreasing prevalence in Somali region (AOR: .42; 95% CI: (.217-.80) as compared to Tigray region. Increasing prevalence of diarrhoea was also significantly associated with male children (AOR: 1.3; 95% CI: 1.05-1.58); households who shared toilet facilities with other households (AOR: 1.4; 95% CI: 1.09-1.77); fourth birth order (AOR: 1.81; 95% CI: 1.17-2.79), and fifth and above birth order (AOR: 1.85; 95% CI: 1.22, 2.81) as compared to first order; and mother's current age 35-49?years in a household with ?3 under-five children (AOR: 4.7; 95% CI: 1.64-13.45) as compared to those maternal ages of 15-24?years in a household with ?2 under-five children. CONCLUSION:The age of a child, sex of a child, region, birth order, toilet facilities shared with other households and the interaction effect of the number of under-five children with mother's current age are identified as associated risk factors for diarrhoea occurrence among under-five children in rural Ethiopia. The findings show the need for planning and implementing appropriate prevention strategies considering these risk factors for rural under-five children.

Project description:BackgroundChildhood under-nutrition is a major global health problem. Although the rate of under-nutrition in Ethiopia has declined in the last decade, but it still remains being the major causes of morbidity and mortality of children under-five years. The problem is even worse in rural areas. The prevalence of underweight among rural children was 25% compared with 13% among urban children. To alleviate this problem, it is necessary to determine the magnitude and determinants of underweight. The study models non-Gaussian data analysis to identify risk factors associated with underweight among under-five children in rural Ethiopia.MethodologyThe data source for this study was secondary data, which was retrieved from EDHS 2016 database. It was analyzed using two model families; one with marginal models (GEE and ALR) in which responses are modeled and marginalized overall other responses, and the other is random effects model (GLMM) which is useful when the interest of the analyst lies in the individual's response profiles as well as to evaluate within and between regional variations of underweight.ResultFrom fitting non-Gaussian data analysis to identify risk factors associated with underweight among under five children in rural Ethiopia, the independent variable which have significant effect on underweight were:-Age of child, birth interval, mothers education, fathers education, wealth index, diarrhea in last two weeks, fever in last two weeks are significant and also father's work status shows that difference in significance among the category.ConclusionChild age, preceding birth interval, mother's education, household's wealth index, fever, diarrhea, father's education and father's work status were associated with child underweight. Furthermore, there is both within and between regional heterogeneity of underweight among children in rural Ethiopia. Therefore, rigorous community-based interventions (such as uplifting mother's education by providing formal education and preventing infectious diseases that cause diarrhea and fever) should be developed and executed throughout the country to improve this grave situation of underweight prevalence in rural areas of Ethiopia.

Project description:Background:Underweight is defined as being below the healthy weight range. Underweight in reproductive age group women not only affects women but also increases the risk of an intergenerational cycle of malnutrition and child mortality. Various factors are linked with underweight among women. However, studies on the prevalence of underweight and its associated factors among women are limited in Ethiopia. Hence, this study aimed to assess the prevalence of underweight and its associated factors among reproductive age group women in Ethiopia. Methods:For this study, data were drawn from the 2016 Ethiopian demographic and health survey (EDHS). From the total, 15,683 women participants of the 2016 EDHS; a subsample of 2,848 participants aged 15-49 years who had a complete response to all variables of interest were selected and utilized for analysis. Data were analyzed using SPSS version 20 software program. Pearson's chi-squared test was used to assess the frequency distribution of underweight and is presented with different sociodemographic characteristics. Logistic regression models were applied for analysis. A two-sided p value of less than 0.05 was used to declare a statistically significant association between the independent variables and underweight among women. Results:The prevalence of underweight among reproductive age group women in Ethiopia was 17.6%. The majority, 78.3% of underweight women, were rural dwellers. The odds of being underweight was higher among the young aged women, among those residing in rural areas, in those with higher educational status, and in those who have one or more children. On the other hand, the odds of underweight among respondents living in Benishangul, SNNPR, and Addis Ababa were less compared to those living in Dire Dawa. Similarly, the odds of underweight among participants with a higher level of husband or partner educational status and among those who chew Khat were less compared to their counterparts. Conclusion:Underweight among reproductive age group women in Ethiopia is still a major public health problem, particularly among rural dwellers. Underweight was significantly associated with different sociodemographic variables. Hence, context-based awareness creation programs need to be designed on the prevention methods of underweight in Ethiopia, giving especial emphasis to those residing in rural areas.

Project description:IntroductionChildhood vaccination is a cost-effective public health intervention to reduce child mortality and morbidity. But, vaccination coverage remains low, and previous similar studies have not focused on machine learning algorithms to predict childhood vaccination. Therefore, knowledge extraction, association rule formulation, and discovering insights from hidden patterns in vaccination data are limited. Therefore, this study aimed to predict childhood vaccination among children aged 12-23 months using the best machine learning algorithm.MethodsA cross-sectional study design with a two-stage sampling technique was used. A total of 1617 samples of living children aged 12-23 months were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 70% and 30% of the observations were used for training, and evaluating the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. All the included algorithms were evaluated using confusion matrix elements. The synthetic minority oversampling technique was used for imbalanced data management. Informational gain value was used to select important attributes to predict childhood vaccination. The If/ then logical association was used to generate rules based on relationships among attributes, and Weka version 3.8.6 software was used to perform all the prediction analyses.ResultsPART was the first best machine learning algorithm to predict childhood vaccination with 95.53% accuracy. J48, multilayer perceptron, and random forest models were the consecutively best machine learning algorithms to predict childhood vaccination with 89.24%, 87.20%, and 82.37% accuracy, respectively. ANC visits, institutional delivery, health facility visits, higher education, and being rich were the top five attributes to predict childhood vaccination. A total of seven rules were generated that could jointly determine the magnitude of childhood vaccination. Of these, if wealth status = 3 (Rich), adequate ANC visits = 1 (yes), and residency = 2 (Urban), then the probability of childhood vaccination would be 86.73%.ConclusionsThe PART, J48, multilayer perceptron, and random forest algorithms were important algorithms for predicting childhood vaccination. The findings would provide insight into childhood vaccination and serve as a framework for further studies. Strengthening mothers' ANC visits, institutional delivery, improving maternal education, and creating income opportunities for mothers could be important interventions to enhance childhood vaccination.

Project description:BackgroundThe perinatal mortality rate in Ethiopia is among the highest in Sub Saharan Africa. The aim of this study was to identify the spatial patterns and determinants of perinatal mortality in the country using a national representative 2016 Ethiopia Demographic and Health Survey (EDHS) data.MethodsThe analysis was completed utilizing data from 2016 Ethiopian Demographic and Health Survey. This data captured the information of 5 years preceding the survey period. A total of 7230 women who at delivered at seven or more months gestational age nested within 622 enumeration areas (EAs) were used. Statistical analysis was performed by using STATA version 14.1, by considering the hierarchical nature of the data. Multilevel logistic regression models were fitted to identify community and individual-level factors associated with perinatal mortality. ArcGIS version 10.1 was used for spatial analysis. Moran's, I statistics fitted to identify global autocorrelation and local autocorrelation was identified using SatSCan version 9.6.ResultsThe spatial distribution of perinatal mortality in Ethiopia revealed a clustering pattern. The global Moran's I value was 0.047 with p-value <0.001. Perinatal mortality was positively associated with the maternal age, being from rural residence, history of terminating a pregnancy, and place of delivery, while negatively associated with partners' educational level, higher wealth index, longer birth interval, female being head of household and the number of antenatal care (ANC) follow up.ConclusionsIn Ethiopia, the perinatal mortality is high and had spatial variations across the country. Strengthening partner's education, family planning for longer birth interval, ANC, and delivery services are essential to reduce perinatal mortality and achieve sustainable development goals in Ethiopia. Disparities in perinatal mortality rates should be addressed alongside efforts to address inequities in maternal and neonatal healthcare services all over the country.

Project description:BackgroundUnderweight is one form of indicators of under-nutrition, which results from the poor nutrient intake and underlying health problems. Its impact is beyond an individual and extends to a country level. It has been known from the literature that underweight has a negative effect on income and development of a country. In the context of Ethiopia, factors predicting underweight remain unknown and there is a paucity of evidence on geographical distribution of underweight among individuals aged 15-49 years. Therefore, the aim of this study was to examine the geographic distribution of underweight and its associated factors among individuals aged 15-49 years in Ethiopia.MethodsSecondary data analysis was done on a data set consisting of 28,450 individuals and obtained from the Ethiopian Demography and Health Survey (EDHS) 2016. The spatial distribution of underweight across the country was identified by ArcGIS software. Hotspots analysis was done using Getis-Ord Gi* statistic within ArcGIS. In SaTScan software, the Bernoulli model was fitted by Kulldorff's methods to identify the purely spatial clusters of underweight. A binary logistic regression was applied to determine factors associated with being underweight.ResultIn Ethiopia, the spatial distribution of underweight was clustered with Global Moran's I = 0.79 at p-value < 0.0001. The highest underweight clusters were observed in Tigray, Gambella, eastern part of Amhara, and western and central part of Afar regions. Male individuals [AOR = 1.21; 95% CI: (1.15 1.28)], never married [AOR = 1.14; 95% CI: (1.05, 1.24)], rural residents [AOR = 1.32; 95% CI: (1.18, 1.47)], rich [AOR = 0.85; 95% CI: (0.76, 0.94)], cigarette smoking [AOR = 1.25; 95% CI: (1.07, 1.46)], drinking treated water [AOR = 0.91; 95% CI: (0.83, 0.99)] and open filed defecation [AOR = 1.17; 95% CI: (1.08, 1.26)] were found to have a significant association with being underweight.ConclusionsThere was a significant clustering of underweight among individuals aged 15-49 years. Gender, age, marital status, place of residence, wealth index, cigarette smoking, using untreated water and types of toilet were the significant factors of being underweight. Therefore, effective public health interventions like building safe and supportive environments for nutrition, providing socio-economic protection and nutrition-related education for poor and rural resident would be better to mitigate these situations and associated risk factors in hot spot areas. In addition, policymakers should strengthen and promote nutrition sensitive policies and activities in order to alleviate the underlying and basic causes of underweight.

Dataset Information

Prevalence and associated factors of stunting among under-five children in Ethiopia: Application of marginal models analysis of 2016 Ethiopian demographic and health survey data.

Background

Objective

Methods

Results

Conclusion

Publications

Prevalence and associated factors of stunting among under-five children in Ethiopia: Application of marginal models analysis of 2016 Ethiopian demographic and health survey data.

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