Exploring determinants of under-five stunting and wasting in Ethiopia

Abstract

Malnutrition remains a major public health problem in Ethiopia, with stunting and wasting causing long-term physical and cognitive harm. Evidence on key determinants is still limited. Unlike previous EDHS studies that ignored data hierarchy, this study uses a generalized linear mixed model to account for clustering and unobserved heterogeneity. Identifying key socioeconomic, maternal, and environmental factors is essential for effective interventions. This study used nationally representative cross-sectional data from the 2016 EDHS, including children aged 0–59 months. Analyses accounted for clustering and stratification. Data were analyzed using STATA 14 with descriptive statistics and cross-tabulations. A generalized linear mixed-effects model with cluster level random intercepts identified factors associated with stunting and wasting. Results were reported as adjusted odds ratios with 95% confidence intervals, and model fit was evaluated using AIC and BIC. The prevalence of stunting was 34.2% (95% CI: 33.65–36.25), while the prevalence of wasting was 12.6% [95% CI: 12.10–13.7]. Female children had lower odds of being stunted compared with male children (AOR = 0.86; 95% CI: 0.79, 0.94). Similarly, children from middle-wealth and rich households had lower odds of stunting (AOR = 0.85; 95% CI: 0.73, 0.99) and (AOR = 0.76; 95% CI: 0.65, 0.89) respectively relative to children from poor households. For wasting, female children also showed reduced vulnerability, compared to males (AOR = 0.78; 95% CI: 0.68, 0.89). In addition, children aged 25–59 months had lower odds of wasting than those aged 0–24 months (AOR = 0.41; 95% CI: 0.35, 0.48). Childhood stunting and wasting in Ethiopia are strongly influenced by maternal education, household socioeconomic status, birth-related factors, and child biological characteristics.