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Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey
Authors: Nebyu Daniel Amaha and Berhanu Teshome Woldeamanuel
Source: Nutrition Journal , Volume 20, Article number: 18; DOI:
Topic(s): Antenatal care
Child height
Institutional births
Women's autonomy
Women's height
Country: Africa
Published: FEB 2021
Abstract: Background: Stunting or chronic undernutrition is a significant public health problem in Ethiopia. In 2019, 37% of Ethiopian children under-5 were stunted. Stunting results from a complex interaction of individual, household and social (environmental) factors. Improving the mother’s overall care is the most important determinant in reducing the stunting levels in developing countries. We aimed to determine the most important maternal factors associated with stunting and quantify their effects. Methods: This study used data from the nationally representative 2016 Ethiopian Demographic Health Survey (EDHS). Common maternal factors were first selected and analyzed using Pearson’s chi-square of association followed by multiple logistic regression. To quantify the effect of a unit change of a predictor variable a model for the continuous maternal factors was developed. All analyses were carried out using IBM SPSS (c) Version 23. Results: Higher maternal educational level, better maternal autonomy, average or above maternal height and weight, having at least 4 antenatal care (ANC) clinic visits, and delivering in a health facility were significantly associated with lower severe stunting levels. Unemployed mothers were 23% less likely (p = 0.003) to have a stunted child compared with employed mothers. Mothers delivering at home had 32% higher odds of stunting (p = 0.002). We found that short mothers (< 150 cm) were 2.5 more likely to have stunted children when compared with mothers above 160 cm. Every visit to the ANC clinic reduces stunting odds by 6.8% (p < 0.0001). The odds of stunting were reduced by 7% (p = 0.028) for every grade a girl spent in school. A unit increase in Body Mass Index (BMI) reduced the odds of stunting by 4% (p = 0.014) and every centimeter increase in maternal height reduced the odds of stunting by 0.5% (p = 0.01). Conclusion: Maternal education, number of antenatal care visits, and place of delivery appear to be the most important predictors of child stunting in Ethiopia. Therefore, educating and empowering women, improving access to family planning and ANC services, and addressing maternal malnutrition are important factors that should be included in policies aiming to reduce childhood stunting in Ethiopia.