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Background  Undernutrition in children under 5 years is a major risk factor to child deaths and is related to impaired cognitive development and lower school performance. Underprivileged children such as orphans are at particularly high risk of undernutrition. Little is however known about the nutritional status and dietary diversity of orphan children in Ghana. This study therefore compared the nutritional status and dietary diversity of orphan and non- orphan children.    Methods  An analytical cross – sectional study design was used. Two hundred and forty-six children (123 non- orphan and 123 orphans) were sampled from households (non - orphans) and four orphanages (orphans). Maternal / caregiver and child socio-demographic characteristics and dietary diversity of children was assessed with a semi – structured questionnaire. We measured anthropometric characteristics of children. Stunting, wasting and underweight in children was classified using Height – for – age Z – scores (HAZ), Weight – for – height Z – scores (WHZ) and Weight – for – age Z – scores (WAZ) respectively. Bivariate and multivariate analyses were used to compare the nutritional status and dietary diversity of orphan and non- orphan children.    Results  Majority of the children were male (52.4%). The prevalence of stunting, wasting and underweight was 17.9, 5.3 and 7.7% respectively for all children. There was no difference in the prevalence of stunting (17.1% vs 18.7%) ( p  = 0. 74), wasting (4.9% vs 5.7%) ( p  = 0.78) and underweight (7.3% vs 8.1%) ( p  = 0.81) among non – orphans and orphans. There was also no difference in mean HAZ ( p  = 0.52), WHZ ( p  = 0.27) and WAZ ( p  = 0.12) of non- orphan and orphan children. However, orphans had higher mean dietary diversity score ( p  <  0.001) and minimum dietary diversity (p <  0.001) than non – orphans. After controlling for potential confounders, non – orphans were 7.491 times more likely to have a low dietary diversity [AOR = 7.491; 95% CI (1.851–30.320);  p  = 0.005] compared to orphans.    Conclusion  Present study data show no significant difference in the anthropometric status of orphan and non – orphan children. Orphans were more likely to receive a diversified diet than non – orphans.

Nutritional status and dietary diversity of orphan and non – orphan children under five years: a comparative study in the Brong Ahafo region of Ghana