Speaker
Description
Background: Despite efforts to mitigate malnutrition, wasting remains a prominent public health challenge for children aged 6-59 months in East Africa. It is a critical predictor of impaired growth and cognitive development, and is strongly associated with child morbidity and mortality. However, there is still a lack of comprehensive and up-to-date information on severity of wasting among children in the region.
Objective: The primary objective of this study is to assess the severity level of wasting and identify key contributing factors at both the individual- and community-levels among children aged 6-59 months in East Africa.
Methods: The study used available data from a standard Demographic and Health Survey (DHS) collected between 2012-2022 across East African countries. A total of 42, 413 children aged from 6-59 months were included in this study. A multilevel proportional odds model was employed for analysis, after checking it’s assumption. In the final model, adjusted odds ratios with 95% confidence intervals were reported to highlights statistically significant associations (p < 0.05) between the severity of wasting and its contributing factors at both the individual- and community-level. Sampling weights were applied to ensure the representativeness at regional and national levels.
Results: Overall, in East Africa, 7.2% of children aged 6-59 months are affected by wasting. Among them, 5.7% experience moderate wasting (MAM), while 1.5% are affected by severe wasting (SAM). Within the region a higher prevalence of wasting was recorded in Ethiopia (11.7%), followed closely by Comoros (10.8%), and Madagascar (7.7%). In contrast, Rwanda reported a notably low wasting prevalence of 1.1%, followed by Uganda with a prevalence of 3.5%. The higher severity of wasting was linked with several individual-level factors such as children whose mother had not visited health facility in the past 12 months, mother who were not currently employed, mothers who were underweight, small size of child during birth, child who had recent fever, larger number of under-five children in the households, improved toilet facility in the households and children coming from poor households. At the community level, higher severity was associated low maternal education at the community-level. In contrast, lower severity of wasting was connected to individual factors like child being female, overweight mother, as well as the community factor of living in rural areas.
Conclusion: The study underscores the multifaceted and interconnected nature of individual and community-level factors contributing to the severity of wasting among children in East Africa. Interventions aiming to combat wasting on maternal empowerment through education, enhancing maternal and child health services, promoting the health and nutrition programs regionally and nationally, especially in resource-limited and conflict-affected settings, is essential to reduce intergenerational effect of malnutrition and ensuring the survival and development of children across East Africa.
