Organizations Affiliated to the Authors:Ethiopian Public Health Institute enter for Food Science and Nutrition, Addis Ababa University, Addis Ababa, Ethiopia National Information Platforms for Nutrition (NIPN), International Food Policy Research Institute, Addis Ababa, Ethiopia United Nations Children's Fund (UNICEF), Addis Ababa, Ethiopia
Status:Open Access Open Access
DOI:https://doi.org/10.1111/mcn.13392
Abstract:
The prevention of wasting should be a public health priority as the global burden of
acute malnutrition is still high. Gaps still exist in our understanding of context‐
specific risk factors and interventions that can be implemented to prevent acute
malnutrition. We used data from the four rounds of the Ethiopia Demographic and
Health Survey (2000–2016) to identify risk factors that have contributed to the
change in weight‐for‐height z‐score (WHZ) among children under 5 years of age. We
performed a pooled linear regression analysis followed by a decomposition analysis
to identify relevant risk factors and their relative contribution to the change in WHZ.
Modest improvements in WHZ were seen between 2000 and 2016. The sharpest
decrease in mean WHZ occurred from birth to 6 months of age. Perceived low
weight at birth and recent diarrhoea predicted a decline in WHZ among children
aged 0–5, 6–23 and 23–59 months. Less than 50% of the change in WHZ was
accounted for by the change in risk factors included in our regression decomposition
analysis. This finding highlights data gaps to identify context‐specific wasting risk
factors. The decline in the prevalence of recent diarrhoea (15% of the improvement),
decline in low birth size (7%–9%), and an increase in wealth (15%–30%) were the
main risk factors that accounted for the explained change in WHZ. Our findings
emphasize the importance of interventions to reduce low birthweight, diarrhoea and
interventions that address income inequities to prevent acute malnutrition