Co-occurrence of maternal anemia and child undernutrition in Ethiopia: multilevel analysis of analysis of EDHS data (2005-2016).

INTRODUCTION

Approximately half of people worldwide suffer from micronutrient deficiencies and maternal and child undernutrition. Maternal and child undernutrition is a critical public health issue in low- and middle-income countries characterized by the coexistence of both conditions, which pose severe health challenges. Maternal micronutrient deficiency elevates the risk of malnutrition in children negatively affecting their health and development. The trends and determinants of the co-occurrence of maternal anemia and child undernutrition in Ethiopia is not well understood.

OBJECTIVES

This study aims to assess the trends and determinants of the co-occurrence of maternal anemia and child undernutrition in Ethiopia using data from the Ethiopian Demographic and Health Surveys (EDHS) conducted between 2005 and 2016.

METHODOLOGY

We conducted a community-based cross-sectional study using data from the 2005-2016 Ethiopia Demographic and Health Surveys. A total of 21,531 women-child pairs were included in the analysis, which was weighted to represent 23,210 pairs at the national level. All analyses were performed using Stata version 17. To assess variability between clusters we calculated the intraclass correlation coefficient. We used the median odds ratio to quantify unexplained heterogeneity and the proportional change in variance to evaluate model improvement across different regression models. Variables with a p-value less than 0.20 in the bivariable analysis were entered into the multivariable logistic regression model. Statistical significance was determined at a p-value less than 0.05 with 95% confidence level.

RESULT

This study included weighted samples of 23,210 mothers with under-five children. The overall prevalence of CMACU in Ethiopia was found 12.41% (95% CI: 11.99, 12.84). Significant factors associated with CMACU included maternal education (primary: AOR = 0.82, 95% CI: 0.73, 0.92; secondary or higher: AOR = 0.69, 95% CI: 0.53, 0.90), household wealth (high-income: AOR = 0.78, 95% CI: 0.68, 0.89), birth interval (> 36 months: AOR = 0.83, 95% CI: 0.76, 0.90), child age (12-23 months: AOR = 2.82, 95% CI: 2.43, 3.27), birth type (multiple births: AOR = 1.53, 95% CI: 1.17, 2.00), contraceptive use (AOR = 0.64, 95% CI: 0.56, 0.72), maternal nutritional status (not undernourished: AOR = 0.72, 95% CI: 0.66, 0.79), media exposure (AOR = 0.90, 95% CI: 0.82, 0.99), residence (rural: AOR = 1.28, 95% CI: 1.05, 1.57), and region.

CONCLUSION AND RECOMMENDATION

The prevalence of CMACU in Ethiopia was notably high. Variables significantly associated with CMACU were included maternal education, wealth index, birth interval, type of birth, child age, contraceptive use, maternal nutritional status, ANC visit, media exposure, place of residence, and region. To reduce CMACU in Ethiopia, it is essential to focus on educating mothers, improving their economic status, promoting family planning, raising awareness, and targeting high-risk regions for interventions during program and policy development.