Factors associated with chronic energy malnutrition among reproductive-age women in Ethiopia: An analysis of the 2016 Ethiopia demographic and health survey data

Determinants of underweight among returnee lactating mothers in Gedeb District, Southern Ethiopia: a case-control study

OBJECTIVE

This study aimed to assess the determinants of underweight among returnees lactating mothers in governmental health facilities of Gedeo zone, Southern Ethiopia.

DESIGN

Case-control study.

SETTING

Gedeb District governmental health facilities.

PARTICIPANTS

A total of 264 returnees lactating mothers (88 cases and 176 controls) were randomly selected from four health institutions of Gedeb District.

OUTCOME MEASURES

Underweight was measured by anthropometric measurement weight/height2. An institutional-based unmatched case-control study was conducted from 11 July 2022 to 20 September 2022. The study involved 264 returnee lactating mothers, with 88 classified as cases (body mass index, BMI<18.5 kg/m²) and 176 as controls (BMI 18.5-24.9 kg/m²). Participants were selected through simple random sampling from public health institutions. Data were collected on sociodemographic, reproductive and nutritional factors using structured questionnaires and anthropometric measurements. Bivariate and multivariable logistic regression analyses were performed to identify significant determinants of maternal underweight.

RESULT

The study identified several key determinants of underweight. Returnee lactating mothers with a short birth interval (<24 months) were significantly more likely to be underweight (adjusted OR (AOR) 4.04, 95% CI 1.68 to 9.74). Unplanned pregnancies (AOR 7.60, 95% CI 3.14 to 18.41), home deliveries (AOR 5.81, 95% CI 2.09 to 16.14) and meals frequency <3 per day (AOR 2.51, 95% CI 1.12 to 5.63) were also strongly associated with increased risk of underweight. Inadequate dietary diversity (AOR 3.92, 95% CI 1.52 to 10.15) and food insecurity (AOR 4.72, 95% CI 1.77 to 12.61) further contributed to the risk. Poor socioeconomic status was associated with a higher likelihood of being underweight (AOR 4.38, 95% CI 1.49 to 12.82).

CONCLUSION

The study highlights significant factors contributing to maternal underweight among returnee lactating mothers. Addressing short birth intervals, unplanned pregnancies, dietary diversity and food insecurity is crucial. Policy-makers should focus on targeted interventions to improve maternal health, with special emphasis on returnee lactating mothers. Enhanced healthcare access, nutritional support and socioeconomic development are essential for mitigating underweight and improving overall health outcomes.

Determinants of underweight among lactating mothers in public health facilities, Siraro District, Southern Ethiopia: unmatched case-control study

BACKGROUND

Ethiopia is reported to have one of the highest prevalence of underweight among lactating mothers in Africa. In our study setting, the nutritional report from the district health office showed a high number of underweight lactating mothers and recurrent malnutrition problems. However, the determinants of underweight among lactating mothers were not well understood in our study setting. The study aimed to assess the determinants of underweight among lactating mothers in public health facilities of Siraro District, Southern Ethiopia.

METHODS

Unmatched case control study was conducted among 390 (130 cases and 260 controls) lactating mothers in public health facilities of Siraro District from April 30 to May 30/2022. Cases were lactating mothers with BMI < 18.5 kg/m2 and controls were mothers whose BMI was ≥ 18.5 kg/m2. To identify the determinants of underweight, bivariate and multivariable binary logistic regression analysis were carried out. The final model was interpreted using adjusted odds ratio (AOR), along with a 95% confidence interval (CI). Significance was declared at p-value < 0.05.

RESULT

Multivariable logistic regression analysis revealed that having; antenatal care visits [AOR = 0.43, 95% CI (0.26,0.72)], latrine availability [AOR = 0.50,95% CI (0.27,0.93)], poor food consumption score [AOR = 5.40, 95% CI (3.15,9.27)], inadequate dietary diversity score [AOR = 1.66, 95% CI (1.20,2.78)], medium [AOR = 3.34, 95% CI (1.52,7.33)] and poor wealth index [AOR = 6.32, 95%CI(3.12,12.81)] were significantly associated with being underweight among lactating mothers.

CONCLUSION

Antenatal care visits, latrine availability, poor food consumption scores, inadequate dietary diversity score, medium and poor wealth index were the determinants of underweight. A multi-sectoral approach focusing on latrine construction, economic empowerment and food diversification, as well as ongoing awareness creation, is essential to increase the nutritional status of lactating mothers and break the vicious cycle of malnutrition.

Multi-Level Correlates of the Nutritional Status of Nigerian Women of Reproductive Age

Poor nutrition compromises the capacity of women to perform their vital roles as mothers and productive workers in their families, communities and society. Using a conceptual framework developed by the United Nations Children's Fund, this study determines individual-, household- and community-level factors associated with the nutritional status of Nigerian women of reproductive age. A secondary analysis of pooled data from the Nigeria Demographic and Health Survey (NDHS) for 2003, 2008, 2013 and 2018 was conducted involving 82,734 non-pregnant women aged 15-49 years. Multinomial logistic regression was used to determine predictors of nutritional status. Study results show that a significant proportion of the women had poor nutritional status; the prevalence of underweight, overweight and obesity were 12.1%, 16.8% and 7.2% respectively. Statistically significant factors associated with poor nutritional status were found at all three levels, highlighting the need for effective multidimensional, multisectoral policy interventions to address the double burden of malnutrition among women in Nigeria.

Rural-urban disparities in nutritional status among women in Ethiopia based on HIV serostatus: a cross-sectional study using demographic and health survey data

BACKGROUND

Ethiopia is one of the sub-Saharan African countries most affected by the human immunodeficiency virus (HIV) epidemic and also by severe undernutrition, which is particularly prevalent among women. HIV infection, reproductive biology, and their role in society increase the vulnerability of women to malnutrition. Various factors including urbanization could cause differences in the nutritional status of rural and urban residents. In this study, we aimed to assess rural-urban disparities in nutritional status among women of reproductive age based on HIV serostatus in Ethiopia.

METHOD

Data from the Ethiopian Demographic and Health Survey (EDHS) conducted in 2016 were used. Among 15,683 women included in the survey, 8822 non-pregnant women aged 15-49 years, including those who gave birth two months before the DHS survey were included in this study. Multinomial logistic regression was used to determine the relative risk ratios (RRR) for the associations between study variables.

RESULTS

Generally, the prevalence of underweight among women of reproductive age was higher in rural residents (28.9%) than in urban residents (12.3%) in Ethiopia. Being overweight was more prevalent among urban women than rural women, (35.1% vs. 4.8%). About 32% of HIV-positive women were underweight in both rural and urban areas. About 29% of HIV-positive urban women were overweight compared to 3.4% of HIV-positive rural women. Among urban residents, HIV-positive women were about 4 times more likely to be underweight than their HIV-negative counterparts, RRR 3.8 (95% CI: 1.58, 9.26). However, there was no significant difference in nutritional status between HIV-positive and HIV-negative women living in rural areas. Anemic women were more likely to be underweight while, wealthy women were less likely to be underweight in both rural and urban areas. Women aged 25-49 years were generally more likely to be overweight/obese and less likely to be underweight compared to younger women aged [Formula: see text]years.

CONCLUSION

Malnutrition was more prevalent among HIV-positive women living in urban Ethiopia. Targeted nutritional interventions for HIV-positive women of reproductive age living in urban areas could be considered. Furthermore, efforts should be made to improve the nutritional status of women of reproductive age across the country.

The association of intimate Partner violence and decision making power on nutritional status of married women in Ethiopia: a multilevel mixed-effect analysis

BACKGROUND

A growing body of research has established a link between intimate partner violence (IPV) and decision-making autonomy on women's mental, physical, and reproductive health consequences, as well as child nutritional status. However, there is a scarcity of research on the effects of IPV and decision-making autonomy on women's nutritional status. To date, no research has been conducted in Ethiopia to investigate the impact of IPV and decision-making autonomy on women's nutritional status. Therefore, the purpose of this study was to investigate the relationship between IPV and decision-making power at both the individual and community levels on women's nutritional status.

METHODS

We analyzed data from the 2016 Ethiopian demographic and health survey. Our study focused on 3,660 married non-pregnant women of reproductive age. We used the chi-squared test and spearman correlation coefficients for bivariate analysis. The relationship between IPV and decision making power with nutritional status was evaluated using multilevel binary logistic regression models while controlling other determinants.

RESULTS

Around 28% of women reported at least one of the four types of IPV. Approximately 32% of women had no decision-making power at home. About 27.1% of women were underweight (BMI < 18.5), while 10.6% were overweight/obese (BMI ≥ 25). Women who had sexual IPV had a higher chance of being underweight (AOR = 2.97; 95% CI: 2.02-4.38) than women who had no sexual IPV. While women who had decision-making power at home were at lower odds of being underweight (AOR = 0.83; 95% CI: 0.69-0.98) than their counterparts. The findings also revealed a negative relationship between being overweight/obese and community-level women's decision-making autonomy (AOR = 0.75; 95% CI 0.34-0.89).

CONCLUSIONS

Our findings show the presence of a significant association between IPV & decision-making autonomy with women's nutritional status. Therefore, effective policies and programs to end violence against women and encourage women to participate in decision-making are required. This will help to improve the nutritional status of women as well as the nutritional outcomes of their families. This study suggests that efforts to achieve Sustainable Development Goal (SDG5) may have an impact on other SDGs particularly SDG2.

Anaemia, anthropometric undernutrition and associated factors among mothers with children younger than 2 years of age in the rural Dale district, southern Ethiopia: A community‐based study

Mothers in resource‐poor settings are affected by different forms of undernutrition. However, the nutritional status of mothers in rural areas, particularly after delivery, is not well documented. This study assessed haemoglobin levels and body mass index (BMI) of mothers with children below 2 years of age in a rural district of southern Ethiopia. Factors associated with low haemoglobin levels and low BMI were analysed. A community‐based cross‐sectional study was conducted among 931 mother‐child pairs. Structured and standard questionnaires were used to collect data on background information, 24 h dietary recalls, and household food insecurity. Anthropometric and haemoglobin level assessments were performed. Anaemia was defined as haemoglobin levels below 12.0 g/dl, and anthropometric undernutrition was defined as a BMI <18.5 kg/m². Multilevel linear regression was used to determine associations. Out of 931 mothers, 12.8% were anaemic and 12.6% had a BMI <18.5 kg/m². The prevalence of minimum dietary diversity was 37.8%. The majority (78.5%) of the households were food insecure. Weight (β 0.02; 95% CI: 0.003−0.03), dietary diversity (β 0.08; 95% CI: 0.03−0.12) and secondary school attendance (β 0.34; 95% CI: 0.08−0.59) were associated with the mothers' haemoglobin level. Dietary diversity (β 0.08; 95% CI: 0.01−0.16) and household's wealth (β 0.6; 95% CI: 0.27−0.94) were associated with the mothers' BMI. Findings suggest that education and community‐based nutrition interventions must be strengthened to ensure household food security. Implementation of the national food‐based strategies should be considered, to improve the dietary diversity and nutritional status of mothers.

Anaemia and underweight were less prevalent among mothers with young children in the rural Dale district, southern Ethiopia, than the national report of the Ethiopian Demographic and Health Survey in 2016.

Dietary diversity is positively associated with haemoglobin level and body mass index among mothers with children younger than 2 years of age.

The existing nutrition interventions such as the Productive Safety Net Programme need strengthening, to improve the sustained food access to rural households.

Planing and implementing community‐based small‐scale activities, such as school gardening, and fish and poultry farming, to ensure the availability and affordability of nutritious foods.