Why is stunting highest in Western Uganda?

  • Asiimwe John Bosco Makerere University
  • Abel Nzabona Makerere University
  • Richard Tuyiragize Makerere University
  • Christian Kakuba Makerere University
  • Susan Habert Sendege Makerere University
  • Robert Wadada Makerere University
##plugins.pubIds.doi.readerDisplayName##: https://doi.org/10.37284/eajhs.8.1.3061
##share.article##:

Résumé

Stunted children have a high risk of death, and over 30 percent of under-5 children in Sub-Saharan Africa are affected. In Uganda, 29 percent of children under five are stunted, and this has remained high over the last decade but is worse in the Western region of the country. We used pooled Uganda Demographic and Health Survey (UDHS) data from 2001 to 2016, obtained from the measure DHS website, to establish factors that could explain stunting among children aged 24 to 59 months by applying a logistic regression model. Results show that children whose mothers had attained higher levels of education were significantly associated with reduced odds (0.2) of stunting compared to those with no education. Children whose mothers had not received health information were significantly associated with increased odds (1.3) of stunting. Children who had had diarrhoea two weeks before the survey were associated with higher odds (1.5) of stunting compared to those who did not have it. Male children were also significantly associated with increased odds (1.2) of stunting compared to females. Children from empowered mothers were significantly associated with reduced odds (0.7) of stunting compared to those who were not empowered. The findings call for increased education of the girl child, access to health information for mothers, prevention, prompt treatment of diarrhoea, care of the boy-child, and sensitization aimed at empowering women.

##plugins.generic.usageStats.downloads##

##plugins.generic.usageStats.noStats##

Références

Abuya BA, Ciera J, Kimani-Murage E. Effect of mother’s education on child’s nutritional status in the slums of Nairobi. BMC Pediatr. 2012;12:80.

Akombi BJ, Agho KE, Hall JJ, Merom D, Astell-Burt T, Renzaho AMN. Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis. BMC Pediatr. 2017 Dec;17(1):15.

Albu D. The sustainable development goals report 2021. Drept Omului. 2021;115.

Atukunda P, Eide WB, Kardel KR, Iversen PO, Westerberg AC. Unlocking the potential for achievement of the UN Sustainable Development Goal 2–‘Zero Hunger’–in Africa: targets, strategies, synergies and challenges. Food Nutr Res [Internet]. 2021 [cited 2025 Jan 28];65. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8254460/

Berkman D, Lescano A, Gilman R, Lopez S, Black M. Effects of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. The Lacent. 2002;359(9306): P564-571.

Boco AG. Assessing sex differentials in under-five mortality in sub-Saharan Africa: a cross-national comparative analysis. Can Stud Popul Arch. 2014;41(3–4):49–87.

Danaei G, Andrews K, Sudfeld C, Fink G, McCoy D, Peet E, et al. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels. PLoS Med. 2016;13(11).

Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Med. 2016;13(11):e1002164.

Danjin M, Adewoye SO, Sawyerr HO. Prevalence and socio-demographic determinants of stunting among school age children (SAC) in Gombe State, Nigeria. J Adv Med Med Res. 2020;32(3):22–34.

Dewey K, Begum K. Long-term consequences of stunting in early life. Matern Child Nutr. 2011;Suppl 3:5–18.

Fanzo J, Hawkes C, Udomkesmalee E, Afshin A, Allemandi L, Assery O, et al. 2018 Global Nutrition Report: Shining a light to spur action on nutrition [Internet]. 88149; 2018 [cited 2025 Jan 27]. Available from: https://repository.mdx.ac.uk/item/88148

GoU. THE UGANDA FOOD AND NUTRITION POLICY. Kampala, Uganda: Goverment of Uganda; 2003.

Group WMGRS, de Onis M. Assessment of differences in linear growth among populations in the WHO Multicentre Growth Reference Study. Acta Paediatr. 2006;95:56–65.

Handayani F, Siagian A, Aritonang EY. Mother’s Education as A Determinant of StuntingamongChildren of Age 24 to 59 Months in North Sumatera Province of Indonesia. Journal Of Humanities And Social Science. 2017;22(6):58–64.

Keino S, Plasqui G, Ettyang G, Van Den Borne B. Determinants of Stunting and Overweight among Young Children and Adolescents in Sub-Saharan Africa. Food Nutr Bull. 2014 Jun;35(2):167–78.

Kikafunda JK, Agaba E, Bambona A. Malnutrition amidst plenty: an assessment of factors responsible for persistent high levels of childhood stunting in food secure Western Uganda. Afr J Food Agric Nutr Dev. 2014;14(5):2088–113.

Kumar R, Lakhtakia S. Women’s empowerment and child stunting in India: an investigation. Journal of Population and Social Studies [JPSS]. 2021;29:47-66.

Laksono AD, Wulandari RD, Amaliah N, Wisnuwardani RW. Stunting among children under two years in Indonesia: Does maternal education matter? Plos One. 2022;17(7):e0271509.

Margatot DI, Huriah T. The effectiveness of women empowerment in preventing stunting in children aged 6-59 months. Bali Med J. 2021;10(3):1230–4.

MoH. Annual Health Sector Perfomance Report 2020/21. Kampala, Uganda: Ministry of Health; 2021.

Monteiro CA, Benicio MH, Conde WL, Konno S, Lovadino AL, Barros AJ, et al. Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974–2007. Bull World Health Organ. 2010;88(4):305–11.

Musbah E, Worku A. Influence of Maternal Education on Child Stunting in SNNPR, Ethiopia. Central African Journal of Public Health. 2016;2(2):71–82.

Oh C, Keats EC, Bhutta ZA. Vitamin and mineral supplementation during pregnancy on maternal, birth, child health and development outcomes in low-and middle-income countries: a systematic review and meta-analysis. Nutrients. 2020;12(2):491.

Pomeroy-Stevens A, D’Agostino A, Adero N, Merchant HF, Muzoora A, Mupere E, et al. Prioritizing and funding the Uganda nutrition action plan. Food Nutr Bull. 2016;37(4_suppl):S124–41.

Pongou R. Why is infant mortality higher in boys than in girls? A new hypothesis based on preconception environment and evidence from a large sample of twins. Demography. 2013;50(2):421–44.

Puett C, Guerrero S. Barriers to access for severe acute malnutrition treatment services in Pakistan and Ethiopia: a comparative qualitative analysis. Public Health Nutrition. 2014;18(10):1873–82.

Quamme SH, Iversen PO. Prevalence of child stunting in Sub-Saharan Africa and its risk factors. Clin Nutr Open Sci. 2022;42:49–61.

Remans R, Flynn DF, DeClerck F, Diru W, Fanzo J, Gaynor K, et al. Assessing nutritional diversity of cropping systems in African villages. PloS One. 2011;6(6):e21235.

Svedberg P. Undernutrition in Sub‐Saharan Africa: Is there a gender bias? J Dev Stud. 1990;26(3):469–86.

Thompson A. L. Greater male vulnerability to stunting? Evaluating sex differences in growth, pathways and biocultural mechanisms. Annals of human biology. 2021;18(48(6)):466–73.

Uganda Bureau of Statistics (UBOS) and ICF International Inc. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS and Calverton, Maryland: ICF International Inc.; 2012.

Uganda Bureau of Statistics (UBOS) and Macro International Inc. Uganda Demographic and Health Survey 2006. Calverton, Maryland, USA: UBOS and Macro International Inc; 2007.

Uganda Bureau of Statistics (UBOS) and ORC Macro. 2001. Uganda Demographic and Health Survey 2000-2001. Calverton, Maryland, USA: UBOS and ORC Macro; 2001.

Uganda Bureau of Statistics (UBOS), ICF. Uganda Demographic and Health Survey 2016. 2018 Jan p. Kampala, Uganda and Rockville, Maryland, USA: UBOS and ICF.

UNICEF, WHO W. Levels and trends in child malnutrition: key findings of the 2019 Edition of the Joint Child Malnutrition Estimates. Geneva World Health Organ. 2020;

Vecchio AL, Conelli ML, Guarino A. Infections and chronic diarrhea in children. Pediatr Infect Dis J. 2021;40(7):e255–8.

Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian S. The association of parental education with childhood undernutrition in low- and middle-income countries: comparing the role of paternal and maternal education. Int J Epidemiol. 2017;46(1):312–23.

Wamani H, Åstrøm AN, Peterson S, Tumwine JK, Tylleskär T. Boys are more stunted than girls in sub-Saharan Africa: a meta-analysis of 16 demographic and health surveys. BMC pediatrics. 2007;7.

Wassie EG, Tenagashaw MW, Tiruye TY. Women empowerment and childhood stunting: evidence from rural northwest Ethiopia. BMC pediatrics. 2024;24(1):30.

Wheeler T, Von Braun J. Climate Change Impacts on Global Food Security. Science. 2013 Aug 2;341(6145):508–13.

WHO. Global nutrition targets 2025: Stunting policy brief. World Health Organization; 2014.

WHO. Guideline: Vitamin A supplementation in infants and children 6–59 months of age. Geneva, Switzerland: World Health Organization; 2011.

Wulandari RD, Laksono AD, Kusrini I, Tahangnacca M. The targets for stunting prevention policies in Papua, Indonesia: What mothers’ characteristics matter? Nutrients. 2022;14(3):549.

Publiée
29 mai, 2025