Prevalence and associated factors of undernutrition among under-five children from model and non-model households in east Gojjam zone, Northwest Ethiopia: a comparative cross-sectional study.

BACKGROUND

Developing countries, undernutrition remains significant public health attention, as it was a combined consequence of poor dietary consumption and recurrent infectious illness especially in countries same Ethiopia. Undernutrition is associated with morbidity and mortality among children. This study, therefore, was conducted to assess the prevalence and associated factors of undernutrition among under-five children from the model and non-model households at Eastern Gojjam administrative Zone, northwest Ethiopia.

METHODS

A community-based comparative cross-sectional study was conducted from 1st July 2015 to 30th August 2015 in East Gojjam Zone among 507 households (170 from model-household and 337 from non-model household) selected using a multistage sampling technique. Data were collected using questionnaire and nutritional anthropometric measurement. The Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transition was used to convert raw anthropometric data into Z-scores. The collected data were entered into EpiData, and analysis was conducted using Statistical Package for Social Sciences (SPSS) version 22. The Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transition was used to convert raw anthropometric data into Z scores. Descriptive statistics were used to report the prevalence of outcome variable, undernutrition (intermesh of underweight, stunting, and wasting). In addition, results were presented using narration, tables, and figures including frequency and percentage. Adjusted Odds Ratio (AOR) with its 95% Confidence Interval (CI) was computed. Univariate and multivariate logistic regression analyses were done. A -value less than 0.05 of was considered to declare a result as statistically significant.

RESULTS

This study found that the prevalence of undernutrition explained by stunting (height-for-age Z-score (HAZ) < - 2), underweight (weight-for-age Z-score (WAZ) < - 2) and wasting (weight-for-height Z-score (WHZ) < - 2) were 44.7% [95%CI 41.11, 48.29%]c, 15.3% [95%CI: 12.17, 18.43%] and 10% [95% CI 8.0, 12.0%], and 52.5% [95% CI: 48.62, 56.98%], 24.3% [95% CI: 20.22, 28.38%] and 11.3% [95% CI: 8.45, 14.15%] in under-five children among model household and non-model respectively. Protected water (AOR = 0.08, 95% CI: 0.03, 0.18) and less than three times daily intake of food (AOR = 4.06, 95% CI: 1.53, 10.82) were predictors for undernutrition among under-five model household. Protected source of drinking water (AOR = 0.07, 95% CI: 0.03, 0.13), households that ever-had education on complementary feeding (AOR = 0.19, 95% CI: 0.09, 0.25) and starting complementary feeding on 6 month after birth (AOR = 0.19, 95% CI: 0.09, 0.25) were significant predictors for under-five undernutrition among non-model households.

CONCLUSION

The prevalence of undernutrition explained by stunting, underweight and wasting among under-five children in both model and non-model households were high. The prevalence of all the three parameters (stunting, underweight and wasting) was higher among the non-model households compared to the models, even if the differences were not statistically significant. Use of an unprotected source of drinking water and less than three times daily intake of food were found to be associated with undernutrition among under-five children in the model households. On the other hand, having educational exposure on complementary feeding, using drinking water from protected sources and initiation of complementary feedings at age of 6 months were found to be associated with undernutrition among children in the non-model households. Therefore, the concerned bodies must access safe and adequate water supply, works on information dissemination using mass media on timely initiation of complementary feeding, save water and on meal frequency should be strengthened.