Association between household socio-economic status and stunting among under-five children in Zimbabwe

• Main Author: Musakwa-Maravanyika, Nozipho Orykah
• Format: Others
• Language: en
• Published: 2017
• Subjects: Stunting; Stunting Social Class
• Online Access: http://hdl.handle.net/10539/23116

A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the requirements for the degree of Degree of Master of Public Health Johannesburg, June 2017 === Background The disparities in health outcomes between the poor and the rich are increasingly widened, with conditions like stunting still dominating the public health agenda. Policy-makers and researchers need to investigate and inform policies that are aimed at reducing inequities and implement interventions based on available evidence. Objectives The study aimed to investigate the relationship between household socio-economic status and stunting in children younger than five years in Zimbabwe using the 2010 Demographic and Health Survey (DHS). The specific objectives were (i) to describe the different levels of stunting in children under-five years of age; (ii) to determine the association between socio-economic status and stunting in the under-five year age group; and (iii) to determine other factors associated with stunting in children under-five years of age in Zimbabwe. Methods Data from the 2010 Zimbabwe DHS was used for a cross sectional analysis. A modified Poisson regression was used to compute the crude and adjusted prevalence ratios (PR) and the 95% confidence interval (CI) of the association between socio-economic status and stunting. For multivariate models, variables that were identified a priori, those that had a p-value <0.20 in bivariate analyses and inclusion of variables that resulted in a change of 10% or more in the estimate of outcome, were included in the multiple regression models as potential confounders. Results A total of 1,080 children (25.3%; 95% CI: 23.8-26.8 %) of the 4,761 included in the sample were stunted. In univariate analysis, children in the richest households were shown to have a 43% significantly reduced prevalence of stunting as compared to the poorest households [crude PR=0.57, 95% CI (0.45 – 0.72)]. In multivariate analysis, the richer households had less stunted children than the poorest households (adj PR 0.63; 95% CI: 0.47 - 0.84), richer (adj PR 0.79 95% CI: 0.63 - 0.97 ;), middle (adj PR 1.01; 95% CI: 0.87 – 1.17 ;), and poorer (adj PR 0.85; 95% CI: 0.74 – 0.97). Other factors associated with stunting were the child’s anaemia status, age, sex, weight, living with mother or other, the mother’s height and the mother’s body mass index (BMI). Conclusion This study showed that household socio-economic status is associated with stunting in children under the age of five years in Zimbabwe. Stunting is still an immense challenge for most economically unindustrialized nations, Zimbabwe included, and threatens the possibility of many of these countries meeting the Sustainable Development Goals. Therefore there is need for multi-sectoral interventions that include poverty alleviation, social welfare, educational and health policies that will enhance the socio-economic status of the household in order to improve children’s nutritional status in Zimbabwe. === MT2017