Exploring the Fundamental Risk Factors of Child Malnutrition: An Application of Proportional Odds Model (POM)

Abstract

Background: This study was designed with the objective to evaluate the fundamental risk factors of malnutrition among children in Lahore city and its outskirts, Pakistan. Methods: Data of four hundred and five children with age group less than 5 years was collected from Children hospital and Jinnah hospital, Lahore. We used weight-for-height anthropometric index, designed by World Health Organization (WHO), to measure the nutritional status of children. Preliminary analysis was performed by using Pearson Chi-square and Gamma statistics to check the association between factors (demographic, socio-economic and health related variables) and response variable i.e., nutritional status. Then, proportional odds model (POM) was fitted to the information collected. Results: Of 405 children included in the study, 33% (135) were found malnourished, whereas, approximately 67% (270) were found nourished. Findings of the study revealed that child’s age, maternal education level, socio-economic status, maternal age at the birth of child, low birth spacing, status of antenatal-postnatal care, incomplete vaccinations, exclusive breastfeeding, prevalence of fever, cough and recurrent episodes of diarrhea were the significant risk factors of malnutrition. Prevalence of acute respiratory infection (ARI) was turned out to be insignificant risk factor.  In this study, parallel lines assumption was satisfied and proportional odds model was fitted well with p-value greater than 5% level of significance. Conclusion: This paper highlights the significant risk factors that are affecting the child’s health. Recognizing and understanding the identified risk factors would be very helpful in prevention of malnutrition in Pakistan.