A multilevel analysis of factors associated with wasting in children one to two years old in Hamadan city.

The study aimed to identify risk factors for childhood wasting in 1-2 year-olds in Hamadan city, focusing on this age group due to infection and malnutrition risks. Unlike previous cross-sectional studies on children under 5 years old, this longitudinal study tracked weight-to-height changes over time. Data were analyzed from 455 mother-child pairs, aged 1-2 years, collected from health centers and recorded in the Integrated Electronic Health System (SIB). The weight-for-height index, an ordinal response with three categories (wasting, normal, and overweight), was measured several times. A two-level longitudinal ordinal model was used to identify factors associated with wasting. The analysis of data from 230 girls and 225 boys identified several factors associated with wasting: lower birth weight (Adjusted Odds Ratio (AOR) = 0.77), age 12-15 months (AOR = 1.15), lack of health insurance (AOR = 3.09), mother-child residence (AOR = 3.80), maternal height (AOR = 0.92), and age at pregnancy < 24 years (AOR = 4.71). The results of this study showed that most of the factors contributing to childhood wasting can be controlled and prevented. Therefore, implementation of targeted policies and appropriate interventions for mothers before, during, and after pregnancy could reduce the burden of childhood wasting.