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Meta-Analysis
. 2023 Nov 29;18(11):e0294689.
doi: 10.1371/journal.pone.0294689. eCollection 2023.

Pooled prevalence and its determinants of stunting among children during their critical period in Ethiopia: A systematic review and meta-analysis

Amare Kassaw  1 , Yohannes Tesfahun Kassie  2 , Demewoz Kefale  1 , Molla Azmeraw  3 , Getachew Arage  1 , Worku Necho Asferi  4 , Tigabu Munye  5 , Solomon Demis  4 , Amare Simegn  6 , Muluken Chanie Agimas  7 , Shegaw Zeleke  5
Affiliations
Meta-Analysis

Pooled prevalence and its determinants of stunting among children during their critical period in Ethiopia: A systematic review and meta-analysis

Amare Kassaw et al. PLoS One. .

Abstract

Background: Stunting is a major public health concern, particularly in low and middle-income countries. Globally, nearly 149 million under-five children are suffering from stunting. Despite it can occur in all age groups, the impact is more severe among children age less than 24 months as this period is critical time of very rapid growth and development. Therefore, this review aimed to determine the pooled prevalence and determinants of stunting among children during this critical period in Ethiopia.

Methods: The literature search was conducted using international electronic data bases (pumed, Google scholar, CINHAL, Hinari, open Google) and the hand search of reference lists of eligible articles. The presence of heterogeneity between studies was evaluated using Cochrane Q-test and I2 test statistics and sensitivity analysis was also checked. Small study effect was checked through graphical and statistical test. Sub-group analysis was performed to handle heterogeneity.

Results: This study included 14 studies with a total sample size of 8,056 children. The overall pooled estimate of stunting was 35.01(95% CI: 24.73-45.28, I2 = 98.98%) in the country with the highest prevalence in Amhara region. Increased Child's age (OR = 3.83; 95% CI: 2.47-5.18, I2 = 97.76%), no maternal education (OR = 2.90; 95%CI: 1.59-4.20, I2 = 89.73%), no maternal postnatal follow up (OR = 1.81; 95% CI:1.51-2.10) less than four food diversity of the child (OR = 2.24;95%CI; 1.94-2.55,I2 = 21.55%), low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were significant factors of stunting.

Conclusion and recommendations: The pooled prevalence of stunting among children during their critical time is high. Increased Child's age, no maternal education and no maternal postnatal follow up, less than four food diversity of the child, low maternal body mass index, failure to colostrum and exclusive breast feeding, two and more under five children in the household and poor wealth index of the family were determinants of stunting. Therefore, providing continuous maternal postnatal follow up, increase awareness of mothers on importance of colostrum and exclusive breast feeding, feeding of children the recommended variety of foods and at large to improve the wealth status of the households are crucial interventions to meet national and international targets of zero stunting in children less than 2 years.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram of article selection for systematic review and meta-analysis of the prevalence of stunting among children during critical period and its determinants in Ethiopia.
Fig 2
Fig 2. Pooled prevalence of stunting among children during critical period in Ethiopia.
Fig 3
Fig 3. Funnel plot to test publication bias of the 12 studies.
Fig 4
Fig 4. Forest plot showing the association between stunting and child age.
Fig 5
Fig 5. Trim and fill analysis funnel plot for maternal education status.
Fig 6
Fig 6. Forest plot representing the association between stunting and maternal education status.
Fig 7
Fig 7. Forest plot representing the association between stunting and child food diversity score.
See this image and copyright information in PMC

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