Peer-reviewed article
Coexisting maternal and child undernutrition in Ethiopia: Spatial modeling and multilevel analysis of consecutive EDHS data.
Mekuriaw Nibret Aweke, Habtamu Abebe Getahun, Samuel Teferi Chanie, Gelila Yitageasu, Gebrie Getu Alemu et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzed data from four Ethiopian surveys between 2000 and 2016 to understand where and why mothers and children are undernourished at the same time. About 23% of the households studied had both maternal and child undernutrition. The problem is concentrated in northern regions of Ethiopia. Better maternal education, higher household wealth, antenatal care use, and improved sanitation were all associated with lower rates of coexisting undernutrition.
Key points
- Prevalence of coexisting maternal and child undernutrition was 22.87% across the study population
- Geographic hotspots were concentrated in northern regions including Tigray, Amhara, and Benishangul-Gumuz
- Maternal secondary or higher education reduced the odds of coexisting undernutrition by 62%
- Children aged 12-23 months had nearly 3 times higher odds of coexisting undernutrition
- Antenatal care use and improved sanitation were protective factors against coexisting undernutrition
Limitations
This study is observational and based on cross-sectional survey data, so it cannot establish causation or determine whether the identified associations are causal. The analysis does not provide information about the specific mechanisms linking these factors to undernutrition or about the effectiveness of interventions to address them.
Abstract
INTRODUCTION: Maternal and child undernutrition remains a major public health challenge globally, with the highest burdens observed in low- and middle-income countries. Coexisting maternal and child undernutrition has serious implications for survival, growth, and quality of life.Maternal and child undernutrition is a complex, multifactorial issue influenced by a web of interconnected determinants including health, socio-economic status, education and environmental conditions. OBJECTIVES: To examine the spatial distribution and multilevel determinants of coexisting maternal and child undernutrition in Ethiopia using EDHS data from 2000-2016. METHODS: We analyzed a weighted sample of 33,445 participants from four consecutive EDHS surveys. Spatial autocorrelation, hotspot, and interpolation analyses were conducted using ArcMap 10.8. Multilevel logistic regression was performed in Stata 17. Cluster variability was assessed using ICC, MOR, and PCV. Variables with p < 0.05 were considered statistically significant. RESULT: A total of 33,445 weighted sample was used for this study. The prevalence of coexisting maternal and child undernutrition was 22.87% (95% CI: 22.42, 23.32). Spatial analysis result showed that hot spot areas were concentrated in the northern regions especially Tigray, Amhara, and parts of Benishangul-Gumuz. Multilevel logistics regression analysis result revealed that maternal primary education (AOR = 0.88; 95% CI: 0.78, 0.98), secondary/higher education (AOR = 0.38; 95% CI: 0.29, 0.49), medium household wealth (AOR = 0.85; 95% CI: 0.75, 0.97), high household wealth (AOR = 0.78; 95% CI: 0.69, 0.89), child age 12-23 months (AOR = 2.77; 95% CI: 2.44, 3.16), ANC use (AOR = 0.83; 95% CI: 0.75, 0.92), improved toilet (AOR = 0.83; 95% CI: 0.71, 0.98) and regions. CONCLUSION AND RECOMMENDATIONS: Coexisting maternal and child undernutrition shows marked geographic clustering in northern Ethiopia. Strengthening maternal education, improving household economic conditions, enhancing ANC use, and expanding sanitation services particularly in high-risk regions are essential to reduce the burden.