Malnutrition is the leading cause of illness and death in children under five [1]. Millions of children around the world are affected, putting their health and future at risk. [2]. Its prevalence is declining, although the decline is inconsistent worldwide. Child malnutrition remains a problem in low- and middle-income countries, particularly in sub-Saharan Africa, with many children still suffering from chronic malnutrition. [3, 4]. The most common symptom of chronic malnutrition in children is inadequate intake of nutrients and energy necessary for growth and development. [5]. Malnutrition, stunting, underweight and wasting are three anthropometric indicators used to assess nutritional deficiencies or imbalances that are the underlying cause of many children’s health problems. [6,7,8]. 3 are well-known indicators of the severity of malnutrition in children [9]. Malnutrition accounts for more than half of under-five mortality in poor countries.Sub-Saharan Africa has very high rates of malnutrition among children under the age of five, and daily mortality rates are rising [7].
Indicators of malnutrition in children include stunting, wasting and underweight. These are, respectively, too short for age (short height for age), too thin for height (low weight for height), and too thin for age (low weight for age). low weight). Height-for-age, weight-for-height, and weight-for-age z-scores are generated using the 2006 WHO Child Growth Criteria. A child whose weight-for-height Z-score (WHZ), height-for-age Z-score (HAZ), or weight-for-age Z-score (WAZ) is less than 2 is called stunted.Exhaustion and underweight, respectively [6]. According to UNICEF, environmental, social and economic factors all play a significant role in childhood malnutrition. [8].
More than half of children under the age of five die each year from malnutrition and its complications. [10]. Malnutrition has been proven to have a significant negative impact on the growth and development of young children. [11]. The adverse effects of childhood malnutrition are both short-term and long-term. [12].Long-term effects of undernutrition include poor educational practices [13]early mortality [11]increased risk of chronic diseases such as diabetes (DM), high blood pressure (HTN) and heart disease. [14, 15].Short-term effects of undernourishment include increased severity of illness [16]delayed recovery from illness [17]delayed physical and mental development in children [18]. In addition, malnutrition adversely affects reproductive health in adolescents. [19, 20]. Malnutrition is so common that it not only negatively impacts human health, it also impacts the economy. Through both direct loss of production due to physical frailty and indirect cognitive and educational impairment, this condition limits economic growth and perpetuates poverty.In addition, an unbalanced diet increases medical costs [21].
In 2020, nearly half of all child deaths were due to malnutrition [22]. In the same year, 12.6% of his children under the age of 5 were underweight, 6.7% wasted and 22% stunted. [22]. In 2020, approximately 149.2 million children under the age of five were affected by stunting, 53% of whom lived in Asia and 30.7% in Africa. [22]. 45.4 million children under the age of five died because of waste.More than two-thirds of all wasted children live in Asia and more than one-fourth in Africa [22]. A more thorough analysis of the distribution of undernourishment on the African continent found that stunting was higher in East Africa (32.6%) than in West Africa (30.9%), North Africa (21.4%) and Southern Africa (23.3%). It happens frequently. [22].
A variety of factors contribute to childhood stunting, wasting, and underweight. Collective causes reported in some studies include the child’s age. [23,24,25,26]child’s gender [27, 28]the child’s birth size [29, 30]child birth order [31, 32]maternal age at first birth and maternal education [32, 33]household wealth index [23, 31, 34]source of drinking water [24, 34]family size [27],residence [27]husband’s education level [31, 34]lactating [35, 36]diarrhea [36, 37]heat [35] and cough [36, 38] Birth type of children born in the last two weeks before the survey [24, 32]the number of children under the age of 5 [30] In East Africa, it has been identified as part of the contributing factors of childhood undernutrition.
Numerous studies of stunting, underweight and wasting have been conducted in East Africa. However, they paid little attention to those relationships and were unable to identify determinants related to anthropometric indicators in East African children under 5 years of age.Studies conducted in Ethiopia, India, and Malawi [9, 39, 40], the association between undernutrition indices was investigated. This association was determined without considering the influence of additional factors related to stunting, underweight and wasting. Other East African and international researchers have independently investigated each indicator of undernourishment and identified corresponding factors. [32, 41,42,43,44]. However, in East Africa there is a paucity of studies, or studies that are being conducted, that identify and extrapolate factors such as stunting, underweight and wasting in indicators of undernutrition in children under five years of age. It has been pointed out that between them. Moreover, cluster effects are rarely considered even though East African populations are heterogeneous in culture, language, and other characteristics. Clustering effects may occur and observational independence may be lost when patient outcomes within comparable groups may be correlated. [45]. Children in the same country are more likely to suffer from similar malnutrition than children in different countries. Thus, ignoring cluster effects results in inappropriate consideration of key determinants of child undernutrition status within and across countries (clusters). Consequently, the aim of this study was to identify and estimate the impact of key factors on indicators of undernourishment.
