Peer-reviewed article
Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study.
Ayele AW, Gabreyohannes E, Shiferaw YA ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined under-nutrition among children under five years old across urban and rural Ethiopia using data from 4,935 children in the 2019 Ethiopian Mini Demographic and Health Survey. Overall, 39.72% of under-five children were under-nourished, with significantly higher rates in rural areas (43.38%) compared to urban areas (27.56%). The study identified different risk factors between settings: in rural areas, factors included female sex, older child age, lower maternal education and age, and lack of media exposure; in urban areas, lower maternal education, older child age, and larger family size were key factors.
Key points
- Overall under-nutrition prevalence of 39.72% among under-five children, with rural areas showing 43.38% compared to 27.56% in urban areas
- In rural areas, lack of media exposure increased the likelihood of under-nutrition by 25%
- In urban areas, children from families with 6 or more members were 2.25 times more likely to be under-nourished
- Lower maternal education was a significant risk factor in both settings, with no maternal education increasing risk by 93% in urban areas
- High prevalence indicates need for targeted interventions addressing rural-urban disparities and promotion of income-generating activities, education, and media campaigns
Limitations
This is a cross-sectional study, which cannot establish causality or determine the temporal sequence of factors and under-nutrition. The study describes associations at one point in time and cannot track how these relationships change over time or explain the mechanisms through which these factors influence child nutrition.
Abstract
BACKGROUND: Under-nutrition is a major public health concern among under-five children, especially in low- and middle-income countries like Ethiopia. Despite the Ethiopian government’s efforts, it remains a pressing issue among children. Prior studies often overlooked the exploration of under-nutrition across different residential settings and failed to apply composite measures of under-nutrition. Therefore, this study aimed at assessing the prevalence of under-nutrition and its associated factors among under-five children in the urban and rural settings of Ethiopia, using a composite measure of under-nutrition. METHODS: Cross-sectional data from the most recent 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) was used in this study. After appropriate data processing, a total of 4,935 single-birth children aged 0 to 59 months were included. Descriptive statistics were used to summarize the data, while a multivariable binary logistic regression model was employed to identify factors associated with under-nutrition among under-five children. Statistical significance was determined at the p-value < 0.05 for each predictor, and the strength of association was assessed using odds ratios with 95% confidence intervals (CIs). RESULT: In this study, the overall prevalence of under-nutrition among under-five children was 39.72% (95%CI: 38.35, 41.08), with 43.38% (95%CI: 41.80, 44.95) in rural areas and 27.56% (95%CI: 24.96, 30.15) in urban areas. Factors such as being female (AOR = 0.86, 95%CI: 0.75, 0.99), children having higher age, lower preceding birth interval, lower maternal age and education, low wealth status, region and lack of media exposure (AOR = 1.25, 95%CI: 1.05, 1.52) were significantly associated with increased likelihood of under-nutrition in rural areas. In urban areas, having lower maternal education (no education: AOR = 1.93, 95%CI: 1.11, 3.37; primary: AOR = 2.38, 95%CI: 1.45, 3.89), being in the higher age group, and larger family size (6+) (AOR = 2.25, 95%CI: 1.29, 3.93) were associated with increased likelihood of under-nutrition. CONCLUSION: In this study, high prevalence of under-nutrition was observed, with notable disparities between rural and urban areas. Various factors associated with under-nutrition were identified through residential settings. Therefore, concerned stakeholders should address under-nutrition by promoting income-generating activities, initiating educational programs, and running media campaigns on nutrition. Future policies must consider regional and rural-urban disparities to create targeted interventions among children.