Factors associated with malnutrition among children under five years of age in Zimbabwe 2010/2011

[摘要] Background: There is evidence suggesting a considerably high prevalence of malnutrition in Zimbabwe. However, there is little evidence available to suggest the factors that may be associated with malnutrition in the local context.Objectives: This study investigates the distribution of malnutrition and the factors associated with each of three types of malnutrition (stunting, wasting and underweight) among Zimbabwean children aged 0-59 months for the period 2010/2011Methods: The study makes use of the Zimbabwean Demographic and Health Survey (ZDHS) data from the 2010/11 survey. SaTScan software was used to identify clustering of malnutrition outcomes at the time of data collection. Binary Logistic regression for survey data was used to determine factors associated with each type of malnutrition, while unconstrained Generalised Ordered Logistic (GOLOGIT) regression for survey data was used to determine the factors associated with a four-level ordinal malnutrition variable, generated by summing up all the types of malnutrition a child had at the time of data collection. Bayesian hierarchical spatial models were built in INLA to incorporate spatial autocorrelation in the modelling of malnutrition.Results: Factors associated with at least two types of malnutrition in this study were mother’s body mass index (BMI), mother’s breastfeeding status, child’s sex, age group, birth weight category and twin status as well as household’s wealth index. There was a consistent observation that female children were at a less risk for malnutrition than males and also that higher birth weight was protective of malnutrition. There was no clustering of malnutrition outcomes. The spatial random components that were added to the Bayesian hierarchical models did not improve any of the models.Conclusion: The findings from this study are consistent with findings from other researches and identify the factors associated with each of the common types of malnutrition. In addition the study reveals that there was no particular spatial distribution of malnutrition outcomes at the time of data collection. The study suggests further investigation of the effects of dietary diversity and mothers’ decision making power on malnutrition. Zimbabwean policy makers can make use of the findings from this study to provide evidence on which to base nutritional programmes in the country.

[发布机构] University of the Witwatersrand