Modelling Factors Associated with Malnutrition and Anemia in Children under Five Years in Angola, Senegal, and Malawi by using a Joint Model

Abstract

Background: In Sub-Saharan Africa, malnutrition and anemia contribute a higher percentage to infant morbidity. Malnutrition is known as the dearth of proper nutrition in the human body and it is an important risk factor for the burden of diseases. The lack of hemoglobin and red cells in the human body is known as anemia, and it is divided into three groups. This paper aims to identify the determinants of anemia and malnutrition in Angola, Senegal and Malawi. The novelty of this study includes creating a sample that will be jointly modelled to identify determinants of anemia and malnutrition. Methods: This paper used 2016 information from Angola, Senegal and Malawi Demographic and Health Survey to conduct a secondary data analysis. To create a pool sample for the analysis, the Angola, Malawi and Senegal Demographic and Health Survey data were combined. The joint model under the generalized linear mixed model was employed to identify the determinants of malnourishment and anemia among children under five years in Angola, Senegal, and Malawi. Results: The analysis of the data was performed in SAS 9.4. The results of the covariance components indicated a positive correlation between nutritional status and anemia status. Joint generalized linear mixed model results revealed that children under five years residing with a mother that has attained a primary level of education are 2.995 times more likely to be malnourished when compared to children under five years residing with a mother that have attained a higher level of education. Children under five years residing in the rural setting of Angola, Senegal, and Malawi are 1.473 times more likely to be malnourished when compared to children under five years residing in the urban setting of Angola, Senegal and Malawi. Conclusion: Based on the joint generalized linear mixed model results, type of residence, sex of the child, age of the child, mother's level of education, birth interval and wealth index are the correlates of malnourishment and anemia in Angola, Senegal and Malawi. There is a greater need for partnership and collaboration among the studied countries to achieve the SGD target.