Department of Demography, College for Health, Community & Policy, The University of Texas at San Antonio, San Antonio, TX, USA.
Institutional Research, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, USA.
Food Nutr Bull. 2023 Mar;44(1):27-38. doi: 10.1177/03795721231158503. Epub 2023 Feb 23.
Stunting has been a major concern in sub-Saharan Africa. However, little evidence exists on the spatiotemporal variations in under-five stunting within a national context.
This paper examines the spatiotemporal variations in under-five stunting and determinants using data from the Ethiopia Demographic and Health Surveys (2000-2016).
Spatial autocorrelation and multilevel logistic regression models were used to conduct the analyses.
The stunting prevalence has decreased from 51% to 37%, while the prevalence of severe stunting has decreased by more than half (from 28% to 12%). Wide regional variations in stunting have been consistently observed over the years, which exhibited a higher level of stunting in Tigray (48%), Afar (42%), and Amhara (42%). The results show considerable local and regional variations in under-five stunting levels with diverse patterns of improvements in regional stunting levels over time. Stunting levels were associated with child-level factors such as the sex of a child, birth size, age of a child, birth order, preceding birth interval, and place of birth. Maternal educational attainment, nutritional status, household wealth, toilet facility type, and place of residence were linked to under-five stunting. The regional-level infant mortality rate was associated with under-five stunting.
Specially tailored policies and interventions should be devised to address persistent spatial inequalities in stunting by focusing on higher risk populations.
发育迟缓一直是撒哈拉以南非洲地区的一个主要问题。然而，在国家范围内，关于五岁以下儿童发育迟缓的时空变化的证据很少。
本文利用埃塞俄比亚人口与健康调查（2000-2016 年）的数据，研究五岁以下儿童发育迟缓及其决定因素的时空变化。
使用空间自相关和多水平逻辑回归模型进行分析。
发育迟缓的患病率已从 51%降至 37%，而严重发育迟缓的患病率已下降一半以上（从 28%降至 12%）。多年来，发育迟缓在区域间存在广泛的差异，提格雷（48%）、阿法尔（42%）和阿姆哈拉（42%）的发育迟缓程度较高。结果显示，五岁以下儿童发育迟缓水平存在相当大的地方和区域差异，区域发育迟缓水平的改善模式也各不相同。发育迟缓水平与儿童自身的因素有关，如儿童的性别、出生体重、儿童的年龄、出生顺序、前次出生间隔和出生地点。母亲的教育程度、营养状况、家庭财富、厕所设施类型和居住地与五岁以下儿童发育迟缓有关。区域婴儿死亡率与五岁以下儿童发育迟缓有关。
应制定专门的政策和干预措施，针对高风险人群，解决发育迟缓方面持续存在的空间不平等问题。
