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. 2017 Aug 1;18(1):74.
doi: 10.1186/s12889-017-4621-0.

Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013-14

Hallgeir Kismul  1 , Pawan Acharya  2 , Mala Ali Mapatano  3 , Anne Hatløy  4
Affiliations

Determinants of childhood stunting in the Democratic Republic of Congo: further analysis of Demographic and Health Survey 2013-14

Hallgeir Kismul et al. BMC Public Health. .

Erratum in

  • Erratum to: BMC Public Health, Vol. 18.
    [No authors listed] [No authors listed] BMC Public Health. 2017 Sep 22;17(1):736. doi: 10.1186/s12889-017-4709-6. BMC Public Health. 2017. PMID: 28938882 Free PMC article. No abstract available.

Abstract

Background: Prevalence of child stunting in the Democratic Republic of Congo (DRC) is among the highest in the world. There is a need to systematically investigate how stunting operates at different levels of determination and identify major factors contributing to the development of stunting. The aim of this study was to look for key determinants of stunting in the DRC.

Methods: This study used data from the DRC Demographic Health Survey 2013-14 which included anthropometric measurement for 9030 under 5 year children. Height-for-Age Z score was calculated and classified according to the WHO guideline. The association between stunting and bio-demographic characteristics was assessed using logistic regression.

Results: Prevalence of stunting was much higher in boys than girls. There was a significant rural urban gap in the prevalence of stunting with rural areas having a larger proportion of children living with stunting than urban. Male children, older than 6 months, preceding birth interval less than 24 months, being from lower wealth quintiles had the highest odds of stunting. Several provinces had in particular high odds of stunting. Early initiation of breastfeeding, mother's age more than 20 years at the time of delivery had lower odds of stunting. The taller the mother the less likely the child was to be stunted. Similarly, mother's BMI, access to safe water, access to hygienic toilet, mother's education were found negatively correlated with child stunting in the bivariate logistic regression, but they lost statistical significance in multivariate analysis together with numbers of children in the family and place of residence.

Conclusions: Child stunting is widespread in the DRC and increasing prevalence is worrisome. This study has identified modifiable factors determining high prevalence of stunting in the DRC. Policy implementation should in particular target provinces with high prevalence of stunting and address modifiable determinants such as reducing socioeconomic disparity. Nutrition promotion intervention, including early initiation of breastfeeding should be an immediate priority.

Keywords: Child health; Chronic malnutrition; DHS; Growth disorders; Health status disparities; Social determinants; Stunting; The Democratic Republic of Congo.

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Conflict of interest statement

Ethics approval and consent to participate

This study was based on the secondary data from Demographic and Heath Survey, DRC (2013–14). The survey was approved by Ethics Committee of the School of Public Health (ESP) of the University of Kinshasa and the ICF International Institutional Review Board. Informed consent was obtained from the respondent to participate in the survey before the interview was conducted. A special statement was included in the beginning of the household and the individual questionnaire. This statement explained the purpose of the study. Participation in the survey was completely voluntary and the respondents were informed that they had the right to refuse to answer any questions or stop the interview at any point. The informed consent statement was read exactly as it was written before the respondents were asked to participate in the interview. Then the interviewer signed their names attesting to the fact that he/she read the consent statement to the respondent. No written consent was obtained because the information requested was neither controversial nor sensitive. Measure DHS program permitted access to the secondary data for this study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Multistage sampling procedure, DRC DHS 2013-14
Fig. 2
Fig. 2
Conceptual framework for hierarchial regression modeling of determinants of child nutritional status
Fig. 3
Fig. 3
Prevalence of child stunting according to age (DRC 2013/14)
Fig. 4
Fig. 4
Prevalence of child stunting across the regions (DRC 2013/14)
See this image and copyright information in PMC

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