Socio-economic Inequality in Stunting among Children Aged 6-59 Months in a Ugandan Population Based Cross-sectional Study
American Journal of Pediatrics
Volume 5, Issue 3, September 2019, Pages: 125-132
Received: Apr. 18, 2019; Accepted: Jun. 14, 2019; Published: Aug. 6, 2019
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Baru Ruth Sharon Apio, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Kampala, Uganda
Ratib Mawa, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Kampala, Uganda
Stephen Lawoko, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Kampala, Uganda
Krishna Nand Sharma, Department of Public Health, Faculty of Health Sciences, Victoria University Kampala, Kampala, Uganda
Socio-economic status is an important predictor of stunting, however published population based studies on socio-economic inequalities in stunting among children under-five years of age is scarce in Uganda. Data from the 2016 Uganda Demographic and Health Survey was used to identify possible socio-economic inequalities in stunting among 3941 children aged 6-59 months. Multivariate binary logistic regression models were fitted to calculate the odds ratios and their corresponding 95% confidence intervals for stunting by maternal formal education and household wealth index. The overall prevalence of stunting among children was 30.1%. The risk of stunting was higher among children whose mothers had no formal education (OR: 4.35; 95% CI, 2.45-7.71), attained primary (OR: 2.74 95% CI, 1.62-4.63) and secondary level education (OR: 2.30 95% CI, 1.34-3.96) compared to those whose mothers attained tertiary level education. Similarly higher risk of stunting was found among children that lived in the poorest (OR: 1.78 95% CI, 1.23-2.59), poorer (OR: 1.88; 95% CI, (1.28-2.74), middle (OR: 1.91, 95% CI, 1.31-2.77) and richer households (OR: 1.60; 95% CI, 1.10-2.32) compared to those in the richest households. Socio-economic differences in stunting among children under-five years of age were found. Targeting stunting prevention interventions to less affluent mother-child dyads and households might be important in reducing social inequalities in stunting among children under-five years of age in Uganda.
Stunting, Children, Socio-economic Status, Inequalities, Uganda
To cite this article
Baru Ruth Sharon Apio, Ratib Mawa, Stephen Lawoko, Krishna Nand Sharma, Socio-economic Inequality in Stunting among Children Aged 6-59 Months in a Ugandan Population Based Cross-sectional Study, American Journal of Pediatrics. Vol. 5, No. 3, 2019, pp. 125-132. doi: 10.11648/j.ajp.20190503.18
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Black, R. E., et al., Maternal and child undernutrition: global and regional exposures and health consequences. The lancet, 2008. 371 (9608): p. 243-260.
Dewey, K. G. and K. Begum, Long‐term consequences of stunting in early life. Maternal & child nutrition, 2011. 7: p. 5-18.
Stunting, C., Context, Causes and Consequences WHO Conceptual Framework. 2013, WHO.
Black, R. E., et al., Maternal and child undernutrition and overweight in low-income and middle-income countries. The lancet, 2013. 382 (9890): p. 427-451.
De Onis, M., M. Blössner, and E. Borghi, Prevalence and trends of stunting among pre-school children, 1990–2020. Public health nutrition, 2012. 15 (1): p. 142-148.
UNICEF, Joint child malnutrition estimates—Levels and trends. 2017.
UNICEF, W., and The World Bank., Levels and trends in child malnutrition: key findings of the 2019 Edition of the Joint Child Malnutrition Estimates. 2019: Geneva.
Yang, Y. Y., et al., Trends and determinants of stunting among under-5s: evidence from the 1995, 2001, 2006 and 2011 Uganda Demographic and Health Surveys. Public health nutrition, 2018. 21 (16): p. 2915-2928.
Statistics, U. B. o. and U. ICF % J Kampala, Uganda demographic and health survey 2016: key indicators report. 2017, UBOS, and Rockville Maryland.
Bank, W., the Uganda Poverty Assessment Report 2016 2016.
Statistics, U. B. o. and ICF, Uganda Demographic and Health Survey 2016: Key Indicators Report. 2017, Uganda Bureau of Statistics (UBOS), and Rockville, MD: UBOS and ICF Kampala.
Nambuusi, B. B., et al., The effects and contribution of childhood diseases on the geographical distribution of all-cause under-five mortality in Uganda. Parasite Epidemiology and Control, 2019: p. e00089.
Achadi, E., et al., Global Nutrition Report: From Promise to Impact: Ending Malnutrition by 2030. 2016: International Food Policy Research Institute.
Marmot, M., et al., Fair society, healthy lives. 2008.
Adekanmbi, V. T., G. A. Kayode, and O. A. Uthman, Individual and contextual factors associated with childhood stunting in Nigeria: a multilevel analysis. Maternal & child nutrition, 2013. 9 (2): p. 244-259.
Mawa, R. and S. Lawoko, Malnutrition Among Children Under Five Years in Uganda. American Journal of Health Research, 2018. 6 (2): p. 56-66.
Dake, S. K., et al., Predictors of stunting among children 6–59 months of age in Sodo Zuria District, South Ethiopia: a community based cross-sectional study. 2019. 5 (1): p. 23.
Akombi, B., et al., Stunting, wasting and underweight in sub-Saharan Africa: a systematic review. 2017. 14 (8): p. 863.
Casale, D., G. Espi, and S. A. J. P. h. n. Norris, Estimating the pathways through which maternal education affects stunting: evidence from an urban cohort in South Africa. 2018. 21 (10): p. 1810-1818.
Mawa, R. and S. J. A. J. o. H. R. Lawoko, Malnutrition Among Children Under Five Years in Uganda. 2018. 6 (2): p. 56-66.
Abuya, B., et al., Influence of maternal education on child immunization and stunting in Kenya. 2011. 15 (8): p. 1389-1399.
Keino, S., et al., Determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa. 2014. 35 (2): p. 167-178.
Howe, L. D., J. R. Hargreaves, and S. R. Huttly, Issues in the construction of wealth indices for the measurement of socio-economic position in low-income countries. Emerging themes in epidemiology, 2008. 5 (1): p. 3.
Mensch, B. S., et al., Evidence for causal links between education and maternal and child health: Systematic review. Tropical Medicine & International Health, 2019.
Habaasa, G. J. B. p., An investigation on factors associated with malnutrition among underfive children in Nakaseke and Nakasongola districts, Uganda. 2015. 15 (1): p. 134.
Kikafunda, J. and J. Tumwine, Diet and socio-economic factors and their association with the nutritional status of pre-school children in a low income suburb of Kampala City, Uganda. East African medical journal, 2006. 83 (10): p. 565-574.
Prentice, A. M. J. N. and G. Yearbook, Stunting in Developing Countries. 2019. 119: p. 171-183.
Wamani, H., et al., Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. 2007. 7 (1): p. 17.
Schoenbuchner, S. M., et al., The relationship between wasting and stunting: a retrospective cohort analysis of longitudinal data in Gambian children from 1976 to 2016. The American journal of clinical nutrition, 2019.
Foundation, N., The HUNGaMA Survey Report 2011.
Abuya, B. A., J. Ciera, and E. J. B. p. Kimani-Murage, Effect of mother’s education on child’s nutritional status in the slums of Nairobi. 2012. 12 (1): p. 80.
Fikadu, T., S. Assegid, and L. Dube, Factors associated with stunting among children of age 24 to 59 months in Meskan district, Gurage Zone, South Ethiopia: a case-control study. BMC Public Health, 2014. 14 (1): p. 800.
Jolliffe, I. T. and J. Cadima, Principal component analysis: a review and recent developments. Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences, 2016. 374 (2065): p. 20150202.
Habaasa, G., An investigation on factors associated with malnutrition among underfive children in Nakaseke and Nakasongola districts, Uganda. BMC pediatrics, 2015. 15 (1): p. 134.
Mistry, S. K., et al., Individual-, maternal-and household-level factors associated with stunting among children aged 0–23 months in Bangladesh. Public health nutrition, 2019: p. 1-10.
Sharaf, M. F., E. I. Mansour, and A. S. Rashad, child nutritional status in egypt: a comprehensive analysis of socioeconomic determinants using a quantile regression approach. Journal of biosocial science, 2019. 51 (1): p. 1-17.