Peer-reviewed article
Prevalence and determinants of stunting and anaemia in children aged 6–23 months: A multilevel analysis from rural Ethiopia
Habtamu Guja, Mariana Belgiu, Kaleab Baye, Alfred Stein ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study collected data from 660 rural households in three agroecological zones of northern Ethiopia to find out what is linked to stunting and anaemia in children aged 6–23 months. About half of the children were stunted (49.1%) and about half were anaemic (49.7%). Stunting was linked to the agroecological zone, the phytate-to-zinc and phytate-to-iron ratios in the diet, crop yield, access to markets and non-farm income, use of health services, diet diversity, child age and mother's age. Anaemia was linked to unimproved water, sanitation and hygiene, younger child age, being a boy, and agroecological zone. The authors suggest that strategies to reduce undernutrition should take agroecological differences into account.
Key points
- 49.1% of children were stunted and 49.7% were anaemic.
- Children in the midland zone were about twice as likely to be stunted as those in the upper highland zone (AOR 1.869; 95% CI 1.147–3.043).
- Stunting risk rose by 16.3% and 41.9% for each unit increase in the phytate-to-zinc and phytate-to-iron molar ratios.
- A 10% increase in mean aggregated crop yield was linked to a 13.6% lower likelihood of stunting.
- Anaemia was more likely in households with unimproved water, sanitation and hygiene, and in children aged 6–11 months and boys; midland children had a 55% lower risk than upper highland children (AOR 0.446; 95% CI 0.273–0.728).
Limitations
The abstract describes associations in a single set of data from northern Ethiopia, so it cannot show that any factor causes stunting or anaemia, or that the findings apply to other regions. It does not describe how the data were collected or measured in detail.
Abstract
AbstractLow‐ and middle‐income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual‐, household‐ and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6–23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147–3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate‐to‐zinc and phytate‐to‐iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non‐farm income‐generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18–23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6–11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273–0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6–23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.