Predictors of Stunting among 6–35 Months Old Children in Assosa Zone, Northwest Ethiopia: Unmatched Case–Control Study

Abstract

Background. In 2020, globally, 149.2 million under 5 years old children were stunted. In Africa, 61.4 million and 79 million under 5 years old children in Asia were also stunted in 2020. Stunting is a major public health problem in Ethiopia, where more than 5.5 million children under 5 years old are stunted. Stunting has irreversible and intergenerational health consequences, including impaired cognitive and physical growth, poor learning capacity, and reduced work productivity. Efforts to end stunting need comprehensive and context identification of risk factors. For this reason, this study aims to identify the predictors of stunting among children 6–35 months of age in Northwest Ethiopia. Method. A community-based, unmatched case–control study was employed in the Assosa zone, Benishangul Gumuz, west Ethiopia. A multistage and simple random sampling technique was used to select the study participants. Data were collected through interviewer-administered questionnaires using validated structured questionnaires and anthropometric measurements. Data were entered into Epidata version 3.1 and exported to SPSS 25.0 statistical software for analysis. Bivariate and multivariate analyses were computed. Finally, an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to identify independent predictors of stunting using a multivariable logistic regression model. Result. The study included 544 mother–child pairs (181 cases and 363 controls), with a 100% response rate. The majority of the mothers, 85 (47.0%) in the case and 153 (42.1%) in the control group, were in the 25- to 29-year-old age group. This study revealed that mothers who had no formal education (AOR = 2.5, 95% CI (1.436, 4.180)), short maternal height (<150 cm) (AOR = 4.25, 95% CI (2.714, 6.663)), exclusive breastfeeding for less than 6 months (AOR = 3.16, 95% CI (1.97, 5.10)), minimum dietary diversity (AOR = 3.09, 95% CI (1.97, 5.01)), additional food during pregnancy (AOR = 2.26, 95% CI (1.44, 3.5)) and food security (AOR = 3.08, 95% CI (1.79, 5.26)) were found to be independently statistically associated with child stunting. Conclusion and Recommendation. This study revealed that the predictors of stunting among children aged 6–35 months were multifactorial, which calls for an integrated and multisectoral intervention to reduce or eliminate stunting. Mothers’ factors, educational status, additional food during pregnancy, and child feeding, including dietary diversity and exclusive breastfeeding, were modifiable predictors of child stunting. Therefore, we call for promoting mothers’ education, creating awareness among mothers about optimum infant and young child feeding, specifically exclusive breastfeeding, and promoting mothers’ practices of dietary diversity feeding.