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. 2023 Apr 4;23(1):641.
doi: 10.1186/s12889-023-15488-z.

Spatial distribution and determinants of stunting, wasting and underweight in children under-five in Ethiopia

Kenenisa Abdisa Kuse  1 , Dereje Danbe Debeko  2
Affiliations

Spatial distribution and determinants of stunting, wasting and underweight in children under-five in Ethiopia

Kenenisa Abdisa Kuse et al. BMC Public Health. .

Abstract

Background: The burden of malnutrition in children under five remains an important child health issue where significant regional variations are observed in Ethiopia. The main aim of the current study was to explore the spatial distribution of stunting, wasting, and underweight in children under five in Ethiopia.

Methods: The secondary data from EDHS, 2016, was employed, and a total of 7960 under-five children were included in the analysis. The general spatial analysis was performed to explore the spatial distribution of malnutrition among under-five within and between the regions of Ethiopia. The Spatial Lag and Spatial Error models were used to examine the spatial dependence between stunting, wasting, and being underweight. The Geographically weighted regression analysis was performed to estimate the types and strength of relationships between malnutrition and associated determinant factors across the regions and within the clusters or Zones of each region.

Results: Among the under-five children included in the study, 36.6% were stunted, 12.2% were wasted and 25.2% were underweight. The Global Moran Index's value indicates (Stunting, I = 0.3135, p-value < 0.00001, Wasting, I = 0.1948, p-value < 0.0001 and Underweight, I = 0.5291, p-value < 0.0001) that there was a significant spatial variation of malnutrition across the regions and Zones of Ethiopia. The significant source of spatial variation of malnutrition in children under five was associated with the mother's education level, drinking water facility, toilet facilities, number of children under-five in the household, household's wealth index, breastfeeding duration of the child, child size at birth, Body Mass Index of Mothers (BMI), region, and place of residence.

Conclusions: The spatial association and spatial patterns of stunting, wasting, and being underweight were clustered within and between the regions of Ethiopia. The hotspot areas of stunting, wasting, and being underweight were detected in the regions where there were poor health facilities and limited socioeconomic indicators.

Keywords: Ethiopia; Malnutrition; Spatial analysis; Under-five children.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The decision tree of diagnostic procedures for spatial model selection. Source: Anseline, 2005 [25]
Fig. 2
Fig. 2
Spatial autocorrelation of underweight
Fig. 3
Fig. 3
Spatial autocorrelation of wasting
Fig. 4
Fig. 4
Spatial autocorrelation of stunting
Fig. 5
Fig. 5
Spatial distribution of Hotspots and Cold spots areas of stunted among under-five in Ethiopia
Fig. 6
Fig. 6
Spatial distribution of Hotspots and Cold spots areas of underweight among under-five in Ethiopia
Fig. 7
Fig. 7
Spatial distribution of Hotspots and Cold spots areas of wasting among under-five in Ethiopia
Fig. 8
Fig. 8
Spatial distribution of un-improved toilet facility among households in various Ethiopia regions
Fig. 9
Fig. 9
Spatial distribution of un-improved drinking water sources among households in the various Ethiopia Regions
See this image and copyright information in PMC

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