Geospatial Distribution and Determinants of Undernutrition Among Children Under Five in Oromia Regional State, Ethiopia.

Malnutrition is the leading cause of morbidity and mortality among children under five, with significant regional disparities, particularly in Ethiopia, being very high. This study aims to use Geographic Information Systems (GIS) to identify hotspot areas and associated factors for stunting and wasting among children under five in Oromia Regional State, Ethiopia. A community-based cross-sectional study was conducted. Data were obtained from the 2019 Ethiopian Demographic and Health Survey (EDHS). A total of 653 children under five years old were included in this study. The data were collected using a multistage sampling technique to select the study participants. ArcGis Version 10.7 was used for geospatial analysis. A Bayesian logistic regression model was used to determine the associated factors for undernutrition. A value < 0.05 was considered statistically significant. Overall, the prevalence of stunting and wasting was 36.29% and 4.9%, respectively. In hotspot analysis, both Guji Zone and East Hararge were at high risk of stunting among children under 5 years. Eastern Guji (Gora Dola) and Eastern Hararge (Goro Muti and Meta) areas were at high risk for wasting children under 5 years old. In the adjusted model, being rural residents, mothers who had attended a secondary/above school, children aged 24-35 and 36-47 months, a preceding birth interval > 48 months, using a protected water source, and wealth index were significantly associated with stunting among children under five years. Similarly, mothers aged 25-35 years, rural residents, married women, preceding birth intervals > 48 months, and having more than three children were significantly associated with wasting among children under 5 years. The prevalence of stunting and wasting among children under 5 years remains high in the study setting. These findings suggest that a multifaceted approach addressing education, water access, socioeconomic conditions, and targeted health interventions for high-risk populations is essential to reducing stunting and wasting among children under 5 years old in Oromia Regional State.