RISK FACTORS ASSOCIATED WITH STUNTING AND WASTING LEVELS AMONG UNDER FIVE CHILDREN IN ETHIOPIA
Keywords:
Stunting and wasting, Proportional odds model, partial proportional odds model.Abstract
Introduction: Childhood stunting is one of the most significant impediments to human development. Stunting is a major health problem in children under-five years in many low and middle income countries around the world. Wasting is sometimes referred to as acute malnutrition because it is believed that episodes of wasting have a short duration, in contrast to stunting, which is regarded as chronic malnutrition.
Method: The data for the study were taken from Ethiopian Demographic Health Survey (EDHS) of year 2011. For stunting levels parallel line assumption of proportional odds model is violated. Thus, Partial proportional odds model was preferred over proportional odds model, generalized ordered logit model and multinomial logistic regression based on Akaike's Information Criterion evidence. Proportional odds model is used to analyze wasting levels since the parallel assumption of proportional odds model is not violated.
Result: This study revealed that the relative frequency distributions of the stunting and wasting status of child. 16.5% are severely stunted, 20.6% are moderately stunted and 62.9% are not stunted and also shows that 1.4% of children are severely wasted, 9% are moderately wasted and 89.6% are not wasted. The result indicates that age of child in month, region, place of residence, wealth index, mothers BMI, birth order of child, incidence of diarrhea for two weeks preceding the survey, incidence of fever for two weeks before survey, mothers and husband/partner educational levels are significantly associated with stunting levels. The result also shows that age of child, wealth index, mothers nutritional status, sex of child, incidence of diarrhea and fever for two weeks before survey, type of toilet, husbands/partner and employment status of mothers are significantly associated with wasting levels.
Conclusions: PPOM fitted the data adequately in predicting severity status of stunting because of POM assumption is violated but POM is appropriate for wasting status. Children younger than 11 months had low risk of stunting and wasting status than other age groups. This could be because of breastfeeding in the early stages of child growth. Children in rural areas are more likely to be stunted than children in urban areas.
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