Maternal risk factors for underweight among children under-five in a resource limited setting: A community based case control study.

Previous studies conducted in Nepal have not identified the potential maternal risk for underweight among children under-five years of age in resource-poor settings. Therefore, to identify these risk factors for being underweight among children under-five years old, a community-based case-control study was conducted in a rural village in the Chitwan District in Nepal. Cases were defined as children who were diagnosed as underweight based on low weight per age, whereas controls were the children with normal weight for their age. Mothers of 93 cases and 186 controls were invited for an interview to collect the data. More than half of underweight children were female (51.6%) and nearly one third of them (31.2%) were aged 13-24 months. Nearly, 30% of the cases belonged to families in the lowest wealth quintile and 82% of cases were from food insecure families. Logistic regression analysis showed that children of mothers who were illiterate had 1.48 times the odds of being underweight compared to whose mothers were not illiterate (95% Confidence Interval [CI]: 1.53-3.07)). Children whose mother had not completed their postnatal care (PNC) were 3.16 more times likely to be underweight compared to children of mothers who completed PNC (95% CI: 1.24-8.03). The children who received care from other family members besides their mothers were 6.05 times more likely to be underweight (95% CI: 1.44-25.42); the children having mothers who had no income at all had 5.13 times the odds of being underweight (95% CI: 1.27-20.71) and children with diarrhea episodes within one month were 2.09 times more likely to be underweight (95% CI:1.02-4.31) compared to those children without any diarrhea episodes within one month. Women should be encouraged to take care of their children themselves, seek PNC services and take precautions to protect their children from diarrhea. Also, enabling factors such as education and improved income for women can help to reduce malnutrition among children.