Prevalence and determinants of wasting among under-5 Egyptian children: Application of quantile regression

Abstract

Wasting is one of the symptoms of malnutrition that has been connected to the deaths of malnourished children. This study was intended to explain the effect of socio-demographic and economic factors on under-5 wasting by evaluating their conditional effect across the distribution of weight-for-height Z (WHZ) scores using the quantile regression (QR) model. The weighted sample which included 13,680 children under 5 years was taken from the countrywide Egyptian DHS 2014 survey. The results depicted that about 2% of Egyptian children were severely wasted, with the prevalence of wasting being around 8%. It was discovered that across the WHZ distribution, the child's features, maternal characteristics, father's education, and social factors had significant but varied contributions in explaining the wasting status of under-5 children. It was revealed that female children had a significant weight advantage, notably 0.21 standard deviation (SD) higher weight at the 95th quantile over their male counterparts. The WHZ score was also found to be significantly positively associated with both age and household's wealth status at the lower and upper tails of the WHZ distribution, respectively. Moreover, in comparison with children whose mothers were underweight, those whose mothers were normal or overweight had higher WHZ scores, with a 1.45 SD increase in WHZ scores at the 95th quantile for mothers who were normal weights. Furthermore, the children who were breastfed, whose mothers received antenatal care (ANC) services, and/or who had educated parents had an advantage in terms of WHZ scores than their counterparts. In addition, the children with higher birth order and/or who resided in urban areas had weight disadvantages compared to their counterparts. Therefore, in order to improve children's nutritional status and achieve the Sustainable Development Goals (SDGs) by 2030, the government and public-private owner organizations must work together at the community level focusing on vulnerable groups.

Keywords: Egypt; child malnutrition; chi‐square; quantile regression; undernutrition; wasting.

FIGURE 1

Boxplot of the weight‐for‐height Z‐scores (WHZ) of under‐5 children

FIGURE 2

Prevalence of wasting among children region in Egypt

FIGURE 3

Quantile regression estimates for some selected determinants of WHZ score