Peer-reviewed article

Nutritional status and associated factors among school age children in Southeast Ethiopia using a bayesian analysis approach.

Girma Beressa, Garumma Tolu Feyissa, Mary Murimi, Abduljewad Hussen Muhammed, Adem Abdulkadir et al. · 6 Jul 2025

Abstract

Undernutrition among school-age children is a major public health concern in sub-Saharan Africa. This study aimed to assess the nutritional status and associated factors among school-age children in the hard-to-reach pastoral communities in Southeast Ethiopia. We conducted a school-based cross-sectional study among 395 randomly selected schoolchildren aged 7-14 years in pastoral communities in Bale Zone. We employed a hybrid of multistage sampling and systematic random sampling to select the respondents. We used the Z scores of height for age (HAZ) and body mass index for age (BAZ) based on the World Health Organization (WHO) guidance to classify nutritional status of the school-age children. We conducted a Bayesian linear regression analysis estimation using Markov chain Monte Carlo (MCMC). We calculated the mean, along with a 95% Bayesian credible interval (BCI), to identify factors associated with nutritional status. The overall prevalence of stunting and thinness among school-age children 7-14 years was 26.6% (95% CI: 21.8, 31.4%) and 28.9% (95% CI: 24.3, 33.2%), respectively. The mean and SD of HAZ and BAZ scores were -0.82 (2.13) and -0.87 (1.73), respectively. A unit increment in the age of the child and a unit increment in dietary diversity score were associated with an increment in HAZ scores by 0.122 and 0.120 units, respectively. Travelling to school for more than 30 min and more (compared to travelling less than 30 min) and being a child of a literate father (compared to being a child of an illiterate father) were associated with a decrement in the mean HAZ scores by 0.81 and 0.675 units, respectively. Children who come from rich families had BAZ scores, which are about 0.50 units higher when compared to those children coming from poor families. The high burden of stunting and thinning among the hard-to-reach pastoral communities underscores the importance of strengthening nutrition intervention programs such as school feeding and multisectoral collaboration and economic empowerment to improve accessibility of diversified food among school-age children in the hard-to-reach pastoral communities. Younger school children, children from poor families and children who have less access to school and diverse diets should be prioritised during school based nutritional interventions.