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      Understanding correlates of child stunting in Ethiopia using generalized linear mixed models

      research-article
      1 , , 2 , 3
      BMC Public Health
      BioMed Central
      Random effect, Cluster effect, GLMM, Under five, AIC

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          Abstract

          Background

          Stunting is an indicator of the devastating result of malnutrition in early childhood. The effects of childhood stunting are irreparable physical and cognitive harm. It is an issue of the great public health importance throughout Sub-Saharan African countries including Ethiopia. Therefore, identification of the risk factors of child stunting from recent data is very important for timely intervention.

          Methods

          The 2016 Ethiopian Demographic and Health Survey data were used for this study. A generalized linear mixed model which is an extension of the general linear model was employed to identify socioeconomic, demographic, environmental and health related risk factors for stunted under-five children.

          Results

          The result shows that the age and sex of the child, preceding birth interval, mother’s body mass index, household wealth index, mother’s education level, breastfeeding period, type of toilet facility, use of internet and source of drinking water were the major determinants of stunting of under-five children in Ethiopia.

          Conclusion

          The study indicated that children from undernourished mothers, who are not breastfeeding, from poor households, households that have no toilet facilities, who are male, older age (between 12 to 59 months), who have illiterate mother and short birth spacing were associated with stunting problems. Therefore, family planning education and policy is required for the country to improve on under-five age stunting problems.

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          Most cited references11

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Long-term consequences of stunting in early life.

            This review summarizes the impact of stunting, highlights recent research findings, discusses policy and programme implications and identifies research priorities. There is growing evidence of the connections between slow growth in height early in life and impaired health and educational and economic performance later in life. Recent research findings, including follow-up of an intervention trial in Guatemala, indicate that stunting can have long-term effects on cognitive development, school achievement, economic productivity in adulthood and maternal reproductive outcomes. This evidence has contributed to the growing scientific consensus that tackling childhood stunting is a high priority for reducing the global burden of disease and for fostering economic development. Follow-up of randomized intervention trials is needed in other regions to add to the findings of the Guatemala trial. Further research is also needed to: understand the pathways by which prevention of stunting can have long-term effects; identify the pathways through which the non-genetic transmission of nutritional effects is mediated in future generations; and determine the impact of interventions focused on linear growth in early life on chronic disease risk in adulthood. © 2011 Blackwell Publishing Ltd.
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              Prevalence of undernutrition and associated factors among children aged between six to fifty nine months in Bule Hora district, South Ethiopia

              Background More than one-third of deaths during the first five years of life are attributed to undernutrition, which are mostly preventable through economic development and public health measures. To alleviate this problem, it is necessary to determine the nature, magnitude and determinants of undernutrition. However, there is lack of evidence in agro-pastoralist communities like Bule Hora district. Therefore, this study assessed magnitude and factors associated with undernutrition in children who are 6–59 months of age in agro-pastoral community of Bule Hora District, South Ethiopia. Methods A community based cross-sectional study design was used to assess the magnitude and factors associated with undernutrition in children between 6–59 months. A structured questionnaire was used to collect data from 796 children paired with their mothers. Anthropometric measurements and determinant factors were collected. SPSS version 16.0 statistical software was used for analysis. Bivariate and multivariate logistic regression analyses were conducted to identify factors associated to nutritional status of the children Statistical association was declared significant if p-value was less than 0.05. Results Among study participants, 47.6%, 29.2% and 13.4% of them were stunted, underweight, and wasted respectively. Presence of diarrhea in the past two weeks, male sex, uneducated fathers and > 4 children ever born to a mother were significantly associated with being underweight. Presence of diarrhea in the past two weeks, male sex and pre–lacteal feeding were significantly associated with stunting. Similarly, presence of diarrhea in the past two weeks, age at complementary feed was started and not using family planning methods were associated to wasting. Conclusion Undernutrition is very common in under-five children of Bule Hora district. Factors associated to nutritional status of children in agro-pastoralist are similar to the agrarian community. Diarrheal morbidity was associated with all forms of Protein energy malnutrition. Family planning utilization decreases the risk of stunting and underweight. Feeding practices (pre-lacteal feeding and complementary feeding practice) were also related to undernutrition. Thus, nutritional intervention program in Bule Hora district in Ethiopia should focus on these factors.
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                Author and article information

                Contributors
                kastake10@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                22 May 2019
                22 May 2019
                2019
                : 19
                : 626
                Affiliations
                [1 ]ISNI 0000 0004 0620 2260, GRID grid.10818.30, African Center of Excellence in Data Science, , University of Rwanda, ; Kigali, Rwanda
                [2 ]ISNI 0000 0001 0723 4123, GRID grid.16463.36, School of Mathematics, Statistics and Computer Sciences, , University of KwaZulu-Natal, ; Durban, South Africa
                [3 ]ISNI 0000 0004 0620 2260, GRID grid.10818.30, College of Science and Technology, , University of Rwanda, ; Kigali, Rwanda
                Author information
                http://orcid.org/0000-0001-6127-7300
                Article
                6984
                10.1186/s12889-019-6984-x
                6532125
                31118013
                82d1c4c2-78f6-415c-9c5f-3e03c4b56780
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 February 2019
                : 15 May 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Public health
                random effect,cluster effect,glmm,under five,aic
                Public health
                random effect, cluster effect, glmm, under five, aic

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