Gender, Feeding Practices and Hygiene Factors Linked to Early Stunting in Iringa, Tanzania: Paradox of Food Abundance

Abstract

Aim: Stunting, defined as low height-for-age, impairs growth, cognitive development and contributes to long-term poverty through poor school performance and health outcomes. In Tanzania, 28% of children under 5 are stunted, with Iringa Region showing the highest prevalence (57%). It is unclear why such high incidences occur despite the region being a leading food producer.

Methods: To explore underlying factors, a community-based cross-sectional survey was conducted in four districts of Iringa in September-October 2024, involving children under 2 years. Data were collected using household questionnaires covering feeding practices, water, sanitation and hygiene (WaSH), vaccination, illness and socio-demographic factors.

Results: The median age was 14 months and 205 (51%) were male. Overall, out of 397, 59% were stunted, though most had normal underweight (89%) and wasting status (97.5%). Additionally, 94% met minimum dietary diversity, confirming diet alone does not explain the high stunting rate. Bivariate analysis identified nine significant variables: gender, underweight status, toilet sharing, child hand wash before and after feeding, continued breastfeeding, measles vaccination, vitamin A supplementation and feeding diversity, of which five (5) remained significant in multivariate analysis. Multivariate analysis showed male children had 2.2 times higher odds of stunting; risk also increased among underweight children but was lower in those under 1 year. Continued breastfeeding after 6 months reduced odds of stunting by 61%. Children in households sharing toilets had almost half the odds.

Conclusion: Findings highlight the need to promote breastfeeding beyond 6 months, strengthen nutrition and WaSH programs and target interventions for male and underweight children.

Keywords: Iringa; WaSH; child nutrition; feeding practices; stunting.