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The Determinants of Stunting in Children under Five in Madagascar
Author(s) -
Rakotomanana Hasina,
Gates Gail,
Hildebrand Deana,
Stoecker Barbara J.
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1149.11
Subject(s) - malnutrition , psychological intervention , poverty , medicine , environmental health , logistic regression , population , under five , demography , developing country , bivariate analysis , pediatrics , biology , ecology , pathology , psychiatry , sociology , economics , economic growth , statistics , mathematics
Maternal and child undernutrition plays an important role in the cyclical process of poverty through its negative economic and health consequences on individuals, on the community and ultimately on the nation. Madagascar is among the countries where the prevalence of stunting is dramatically high in children under 5 years old. Despite the fact that nutrition interventions are more successful when they are targeted to specific areas and/or to specific populations, there is limited knowledge about the determinants of child undernutrition in Madagascar. The purpose of this study was to investigate determinants of child stunting in the country. Using the latest Demographic and Health Survey (2009), bivariate and multivariate logistic regressions were performed to determine the variables associated with stunting. A cut‐off at 24 months was used to separate the population into two groups. Data concerning individual, maternal and household characteristics from a total of 4881 children under five years were analyzed. In 2009, 39% of the 1914 children aged 0–23 months and 53% of the 2967 children aged 24–59 months were stunted contributing to the 43.23% total prevalence in the country. The highest prevalence of stunting was observed in the region of Matsiatra Ambony (64.12%) and the lowest in Sofia (18.46%). The model showed that infants of 0–23 months who were severely anemic (OR=3.453), and males (OR=0.717 for girls) were more likely to be stunted. Increasing age among 0–23 month‐olds was significantly associated with stunting (OR=1.068) and length‐for‐age Z scores were also different by regions. Similar results with anemia level (OR=4.054), age (1.018) and region of residence were found in the older group. Additionally, children perceived as small at birth (OR=1.579) and whose parents’ worked on family‐owned land (OR=1.414) were significantly more likely to be stunted. The quality of the home was associated with better height‐for‐age Z scores in children 24–59 months (OR=0.375 compared to rudimentary construction). The results confirmed that determinants of stunting were different for the two age groups. Thus, interventions aiming to address stunting should be different for children aged 0–23 months and 24–59 months. Support or Funding Information Supported by Fulbright Program for Foreign Students