Prevalence of Stunting and Associated Factors Among Under Five Years Children in Galkaio Town, Puntland, Somalia 2023: A cross-sectional study design
Abstract
Background: Stunting is a frequent dietary issue that mostly affects less industrialized countries, such as Somalia. Even so, the Somali government has made some progress towards achieving the target for stunting, but still, 25.3% of children under five years old are stunted. If the annual decreasing proportion continues at this rate, Somalia will not be able to meet the established target set by the WHO in 2012, which was to reduce stunting by 40% by 2025. Therefore, this study aimed to assess the prevalence and associated factors of stunting among children aged 6-59 months.
Methods and materials: A cross-sectional study with a community focus was carried out. among 362 children aged 6–59 months matched with mothers and caregivers. Districts served as first-stage units, villages served as second-stage units, and houses served as third-stage units in the multistage sampling technique. A structured questionnaire was used, and the mothers and caregivers were interviewed. Standardized anthropometric measurements were used to measure the child’s height. Version 3.1 of Epi Data was used to enter the data, and SPSS version 20 was used for analysis.
Result: The overall prevalence of stunting among children between the ages of 6 and 59 months in this study was 37.3%, 95% CI (32.6–42.5). Polygamous marriage to father [AOR = 2.824; 95% CI: (1.60, 4.98)], educational status of mother [AOR = 2.502; 95% CI: (1.28, 4.90)], sex of child [AOR = 2.079; 95% CI: (1.27, 3.41)], time to initiation of breastfeeding [AOR = 3.212; 95% CI: (1.95, 5.29)], exclusive breastfeeding [AOR = 1.725; 95% CI: (1.01, 2.96)], minimum dietary diversity score [AOR = 2.579; 95% CI: (1.30, 5.28)], and postnatal care visits of mothers [AOR = 2.688; 95% CI: (1.60, 4.52)] were significantly associated with stunting.
Conclusion: The prevalence of stunting among children aged 6–59 months was higher than that among the national population. The polygamous marriage of the father, educational status of the mother, sex of the child, time for initiation of breastfeeding, exclusive breastfeeding, minimum dietary diversity score, and postnatal care visits of the mother were significantly associated with stunting.
Keywords:
Puntland, Somalia, stunting, associated factors, under five children, Galkaio townDOI
https://doi.org/10.22270/jddt.v14i7.6699References
Olack B ea. Nutritional Status of Under-five Children Living in an Informal Urban Settlement in Nairobi, Kenya. Journal of Health, population, and nutrition. . 2011; 29: 357-63. https://doi.org/10.3329/jhpn.v29i4.8451
CSA. Ethiopian Demographic and Health Survey Findings. Calverton, Maryland, USA: CSA and ICF International. 2016.
FB. MdO. Childhood stunting: a global perspective. Matern and Child Nutrition. 2016.
Stewart CP, Iannotti, L., K. G. Dewey, K. F. Michaelsen, and A. W. Onyango. Contextualising complementary feeding in abroader framework for stunting prevention. Maternal and Child Nutrition. 2013; 9. https://doi.org/10.1111/mcn.12088 PMid:24074316 PMCid:PMC6860787
TA. MJ. Disaster Risk Management and Sustainable Development Department. Bahirdar University. Bahirdar, Ethiopia. 2014.
EDHS. EDHS. 2016.
Prendergast AJaJHH. The stunting syn drome in developing countries. Paediatrics and International Child Health. 2014; 34: 250-65. https://doi.org/10.1179/2046905514Y.0000000158 PMid:25310000 PMCid:PMC4232245
United Nations Children's Fund (UNICEF) WHO, International Bank for Reconstruction and Development/The World Bank. . Levels and trends in child malnutrition: key fndings of the 2021 edition of the joint child malnutrition estimates. Geneva. 2021.
Garcia Cruz LM, González Azpeitia G, Reyes Súarez D, Santana Rodríguez A, Loro Ferrer JF and Serra-Majem L. Factors associated with stunting among children aged 0 to 59 months from the central region of Mozambique. Nutrients. 2017; 9: 491. https://doi.org/10.3390/nu9050491 PMid:28498315 PMCid:PMC5452221
Dapi Nzefa L MF, Äng C. Undernutrition among children under five in the Bandja village of Cameroon, Africa. South African Journal of Clinical Nutrition. 2019 Apr 3;32(2):46-50. 2019. https://doi.org/10.1080/16070658.2018.1448503
Jude CK CA, Egbuna KO. Under-five malnutrition in a south-eastern Nigeria metropolitan city. . African Health Sciences 2019; 19: 3078-84. https://doi.org/10.4314/ahs.v19i4.29 PMid:32127883 PMCid:PMC7040336
Bank W. Malawi MW: Prevalence of Stunting: Height for Age: % of Children Under 5, Modeled Estimate. 2021.
Mrema JD, Elisaria E, Mwanri AW and Nyaruhucha CM. Prevalence and determinants of undernutrition among 6-to 59-months-old children in lowland and highland areas in Kilosa District, Tanzania: a cross-sectional study. Journal of nutrition and metabolism. 2021; 2021. https://doi.org/10.1155/2021/6627557 PMid:33936812 PMCid:PMC8055427
Hadijah A. Mbwana LM. Prevalence and determinants for poor nutritional status among children in Rural Dodoma Region of Tanzania, 29 September 2022, PREPRINT (Version 1) https://doi.org/10.21203/rs.3.rs-1913873/v1
Mtonga T and Nyaruhucha C. Prevalence and factors associated with undernutrition among under-five children in Gairo district in Morogoro, Tanzania. Tanzania Journal of Health Research. 2022; 23: 1-10. https://doi.org/10.4314/thrb.v23i4.8
Fenta HM, Workie DL, Zike DT, Taye BW and Swain PK. Determinants of stunting among under-five years children in Ethiopia from the 2016 Ethiopia demographic and Health Survey: Application of ordinal logistic regression model using complex sampling designs. Clinical Epidemiology and Global Health. 2020; 8: 404-13. https://doi.org/10.1016/j.cegh.2019.09.011
Dewana Z, Fikadu T, Facha W and Mekonnen N. Prevalence and predictors of stunting among children of age between 24 to 59 months in Butajira town and surrounding district, Gurage zone, Southern Ethiopia. Health Sci J. 2017; 11: 518. https://doi.org/10.21767/1791-809X.1000518
Gebreayohanes M and Dessie A. Prevalence of stunting and its associated factors among children 6-59 months of age in pastoralist community, Northeast Ethiopia: A community-based cross-sectional study. PloS one. 2022; 17: e0256722. https://doi.org/10.1371/journal.pone.0256722
PMid:35113874 PMCid:PMC8812981
Tadele TT, Gebremedhin CC, Markos MU and Fitsum EL. Stunting and associated factors among 6-23 month old children in drought vulnerable kebeles of Demba Gofa district, southern Ethiopia. BMC nutrition. 2022; 8: 1-11. https://doi.org/10.1186/s40795-022-00501-2 PMid:35078514 PMCid:PMC8790906
Yazew T. Risk factors of stunting and wasting among children aged 6-59 months in household food insecurity of Jima Geneti district, western Oromia, Ethiopia: An observational study. Journal of Nutrition and Metabolism. 2022; 2022. https://doi.org/10.1155/2022/3981417 PMid:35070448 PMCid:PMC8776470
Mengesha A, Hailu S, Birhane M and Belay MM. The prevalence of stunting and associated factors among children under five years of age in southern Ethiopia: community based cross-sectional study. Annals of Global Health. 2021; 87. PMid:34824992 PMCid:PMC8603859 https://doi.org/10.5334/aogh.3432
Shine S, Tadesse F, Shiferaw Z, Mideksa L and Seifu W. Prevalence and associated factors of stunting among 6-59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia 2016. J Nutr Disorders Ther. 2017; 7: 2161-0509.1000208. https://doi.org/10.4172/2161-0509.1000208
Eozenou PH-V and Shekar M. Stunting reduction in sub-Saharan Africa. The World Bank, 2017.
Kinyoki DK BJ, Moloney GM, Kandala NB, Noor AM. . Predictors of the risk of malnutrition among children under the age of 5 years in Somalia. . Public Health Nutr 2015; 18: 3125-33. https://doi.org/10.1017/S1368980015001913 PMid:26091444 PMCid:PMC4697134
De Onis M BE, Arimond M, Webb P, Croft T, Saha K. Prevalence thresholds for wasting, overweight and stunting in children under 5 years. . Public Health Nutr 2019; 22: 175-9. https://doi.org/10.1017/S1368980018002434 PMid:30296964 PMCid:PMC6390397
Nayak BSea. Risk factors for malnutrition among preschool children in rural Karnataka: A case-control study. . BMC Public Health 2018; 18: 1-8. https://doi.org/10.1186/s12889-018-5124-3 PMid:29482540 PMCid:PMC5828120
Khan S, Zaheer, S. & Safdar, N. F. . Determinants of stunting, underweight and wasting among children< 5 years of age: Evidence from 2012-2013 Pakistan demographic and health survey. . BMC Public Health. 2019; 19: 1-15. https://doi.org/10.1186/s12889-018-6343-3 PMid:30606151 PMCid:PMC6318918
Dewey KG BK. Long-term consequences of stunting in early life. . Matern Child Nutr. 2011; 7: 5-18. https://doi.org/10.1111/j.1740-8709.2011.00349.x PMid:21929633 PMCid:PMC6860846
UNICEF. The State of the World's Children, UNICEF, NewYork, NY, USA, 2017. 2017.
Donkor WE, Mbai J, Sesay F, et al. Risk factors of stunting and wasting in Somali pre-school age children: results from the 2019 Somalia micronutrient survey. BMC Public Health. 2022; 22: 1-11. https://doi.org/10.1186/s12889-021-12439-4 PMid:35139826 PMCid:PMC8827289
Kahssay M, Woldu E, Gebre A and Reddy S. Determinants of stunting among children aged 6 to 59 months in pastoral community, Afar region, North East Ethiopia: unmatched case control study. BMC nutrition. 2020; 6: 1-8. https://doi.org/10.1186/s40795-020-00332-z PMid:32153979 PMCid:PMC7050729
Blossner M, De Onis M and Prüss-Üstün A. Malnutrition: quantifying the health impact at national and local levels. World Health Organization, 2005.
Berkman DS LA, Gilman RH, Lopez SL, Black MM. Effects of stunting, diarrheal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. The Lancet. 2012; 359: 564-71. https://doi.org/10.1016/S0140-6736(02)07744-9 PMid:11867110
Adair LS FC, Osmond C, Stein AD, Martorell R, Ramirez-Zea M, COHORTS Group. Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies. . Lancet 2013; 382: 525-34. https://doi.org/10.1016/S0140-6736(13)60103-8 PMid:23541370
Leroy JL RM, Habicht J-P, Frongillo EA. . Linear growth defcit con tinues to accumulate beyond the frst 1000 days in low-and middle income countries: global evidence from 51 national surveys. J Nutr. 2014;144(9):1460-6. https://doi.org/10.3945/jn.114.191981 PMid:24944283
Black RE VC, Walker SP, Bhutta ZA, Christian P, De Onis M. Maternal and child undernutrition and overweight in low-income and middle-income countries. The lancet. 382(9890):427-51. 2013. https://doi.org/10.1016/S0140-6736(13)60937-X PMid:23746772
Keino S PG, Ettyang G, van den Borne B. Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa. Food Nutr Bull. 35(2):167-78. 2014. https://doi.org/10.1177/156482651403500203 PMid:25076764
H. G. Food Security and Nutrition in the context of the Global Nutrition Transition. Rome, Italy: Food and Agriculture Organization. 2014.
Abdifitah S. Child Care Practices and Nutritional Status of Young Children Admitted at Gaalkacyo General Hospital, Somalia. University of Nairobi, 2021.
Nutrition G. Global Nutrition Report. Available on: https://globalnutritionreport.org/resources/nutrition-pdf. 2022.
Strategy SN. Target based on the Ministry of Health and Human Services Federal Republic of Somalia, Localization of Health Related, Sustainable Develop ment Goals 2030 for Somalia. 2020.
UNWFP. United Nations World Food Programme. Food Market and Supply Situ ation in Southern Somalia. Rome UN-WFP; Available from: https://documents.wfp.org/stellent/groups/public/documents/ena/wfp255737. 2011.
Kinyoki DK BJ, Moloney GM, Kandala NB, Noor AM. . Predictors of the risk of malnutrition among children under the age of 5 years in Somalia. Public health nutrition. 2015 Dec;18(17):3125-33. 2015. https://doi.org/10.1017/S1368980015001913 PMid:26091444 PMCid:PMC4697134
Bank. UWW. UNICEF/WHO/World Bank. Joint Child Malnutrition Estimates Expanded Database: Stunting, Wasting and Overweight. Published online May 2022. Available at: https://data.unicef.org/resources/dataset/malnutrition-data. Accessed 16 November 2022. 2022.
DNS. Directorate of National statistics of Somalia. 2017.
WHO. Nutrition Landscape Information System (NLIS) country profile indicators: interpretation guide. World Health Organization. 2010.
Afework E, Mengesha S and Wachamo D. Stunting and associated factors among under-five-age children in West Guji Zone, Oromia, Ethiopia. Journal of Nutrition and Metabolism. 2021; 2021. https://doi.org/10.1155/2021/8890725 PMid:33614170 PMCid:PMC7878078
B. C. Anthropometric Indicators Measurement Guide. 2003.
WHO. World Health Organization, Indicators for Assessing Infant and Young Child Feeding Practices, WHO Press, Geneva,Switzerland. 2010.
Noora Shrestha. Detecting Multicollinearity in Regression Analysis. American Journal of Applied Mathematics and Statistic. 2020; 8: 39-42. https://doi.org/10.12691/ajams-8-2-1
Fagerland MW and Hosme D. A Generalized Hosmer-Lemeshow Goodness-of-Fit Test for Multinomial Logistic Regression Models. The Stata Journal Promoting communications on statistics and Stata. 2012; 12: 447-53. https://doi.org/10.1177/1536867X1201200307
Wali N AK, Renzaho AM. Factors associated with stunting among children under 5 years in five South Asian countries (2014-2018): Analysis of demographic health surveys. Nutrients. 2020 Dec 18;12(12):3875. 2020. https://doi.org/10.3390/nu12123875 PMid:33352949 PMCid:PMC7767090
Rachmi CN AK, Li M, Baur LA. Stunting, underweight and overweight in children aged 2.0-4.9 years in Indonesia: prevalence trends and associated risk factors. PloS one. 2016 May 11;11(5):e0154756. 2016. https://doi.org/10.1371/journal.pone.0154756 PMid:27167973 PMCid:PMC4864317
Moges B, Feleke A, Meseret S, and and Doyore F. Magnitude of Stunting and Associated Factors Among 6-59 Months Old Children in Hossana Town, Southern Ethiopia. 2015.
Tariku A, Biks GA, Derso T, Wassie MM and Abebe SM. Stunting and its determinant factors among children aged 6-59 months in Ethiopia. Italian journal of pediatrics. 2017; 43: 1-9. https://doi.org/10.1186/s13052-017-0433-1 PMid:29258578 PMCid:PMC5735819
Birhanu A, Mekonen S, Atenafu A and Abebaw D. Stunting and associated factors among children aged 6-59 months in Lasta woreda, North East Ethiopia, 2015: a community based cross sectional study design. J Fam Med. 2017; 4: 1112. https://doi.org/10.26420/jfammed.2017.1112
Geberselassie SB, Abebe SM, Melsew YA, Mutuku SM and Wassie MM. Prevalence of stunting and its associated factors among children 6-59 months of age in Libo-Kemekem district, Northwest Ethiopia; A community based cross sectional study. PloS one. 2018; 13: e0195361. https://doi.org/10.1371/journal.pone.0195361 PMid:29723280 PMCid:PMC5933689
Siddiqa M ZA, Kamal A, Ijaz M, Abushal T. . Prevalence and associated factors of stunting, wasting and underweight of children below five using quintile regression analysis (PDHS 2017-2018). Scientific Reports. 2022 Nov 25;12(1):20326. 2022. https://doi.org/10.1038/s41598-022-24063-2 PMid:36434025 PMCid:PMC9700674
Okanda J, Otieno G, Kinuthia J, Kohler P and John-Stewart G. Higher likelihood of 6-months exclusive breastfeeding among HIV infected than uninfected mothers: a household survey in Kenya. International Breastfeeding Journal. 2018; 13: 1-7. https://doi.org/10.1186/s13006-018-0190-9 PMid:30519276 PMCid:PMC6264028
Tessema F, Asefa M and Ayele F. Mothers' health services utilization and health care seeking behaviour during infant rearing: a longitudinal community based study, south west Ethiopia. Ethiopian Journal of Health Development. 2002; 16: 51-8. https://doi.org/10.4314/ejhd.v16i4.9789
Dake SK, Solomon FB, Bobe TM, Tekle HA and Tufa EG. Predictors of stunting among children 6-59 months of age in Sodo Zuria District, South Ethiopia: a community based cross-sectional study. BMC nutrition. 2019; 5: 1-7. https://doi.org/10.1186/s40795-019-0287-6 PMid:32153936 PMCid:PMC7050694
Muldiasman M, Kusharisupeni K, Laksminingsih E and Besral B. Can early initiation to breastfeeding prevent stunting in 6-59 months old children? Journal of Health Research. 2018. https://doi.org/10.1108/JHR-08-2018-038
Tadesse SE and Mekonnen TC. Prevalence and associated factors of stunting among children aged 6-59 months in Delanta District; North East Ethiopia. Nutrition and Dietary Supplements. 2020; 12: 41. https://doi.org/10.2147/NDS.S237407
Chirande L, Charwe D, Mbwana H, et al. Determinants of stunting and severe stunting among under-fives in Tanzania: evidence from the 2010 cross-sectional household survey. BMC pediatrics. 2015; 15: 1-13. https://doi.org/10.1186/s12887-015-0482-9 PMid:26489405 PMCid:PMC4618754
Giashuddin MS, Kabir M, Rahman A and Hannan M. Exclusive breastfeeding and nutritional status in Bangladesh. The Indian Journal of Pediatrics. 2003; 70: 471-5. https://doi.org/10.1007/BF02723136 PMid:12921314
Khamis AG, Mwanri AW, Ntwenya JE and Kreppel K. The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC pediatrics. 2019; 19: 1-9. https://doi.org/10.1186/s12887-019-1897-5 PMid:31881999 PMCid:PMC6935228
Motbainor A, Worku A and Kumie A. Stunting is associated with food diversity while wasting with food insecurity among underfive children in East and West Gojjam Zones of Amhara Region, Ethiopia. PloS one. 2015; 10: e0133542. https://doi.org/10.1371/journal.pone.0133542 PMid:26285047 PMCid:PMC4540277
Published
Abstract Display: 685 
PDF Downloads: 538 PDF Downloads: 319 How to Cite
Issue
Section
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
.