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Background. Stunting, wasting, and underweight among children are major problems in most regions of Ethiopia, including the Tigray region. The main objective of this study was to assess the risk factors associated with stunting, wasting, and underweight of children in the Tigray region. Methods. The information collected from 1077 children born 5 years before the survey was considered in the analysis. Multivariable binary logistic regression analysis was fitted to identify significant risk factors associated with stunting, wasting, and underweight. Results. Male children and rural born were having a higher burden of both severe and moderate stunting, wasting, and underweight than females and urban born. Among male children, 27.6%, 4.10%, and 14.2% of them were stunted, wasted, and underweight, respectively. Protected drinking water (odds ratio (OR) = 0.68; 95% confidence interval (CI): (0.50, 0.92)) was associated with stunting. Maternal age at birth less than 20 years (OR = 0.66; 95% CI: (0.45, 0.97)) and being male (OR = 2.04; 95% CI: (1.13, 3.68)) were associated with high risk of underweight. No antenatal care follow-up (OR = 2.20; 95% CI: (1.04, 4.64)) was associated with wasting, while the poor wealth index, diarrhea, low weight at birth (<2.5 kg), lower age of a child, and 3 or more under-five children in a household were significantly associated with stunting, wasting, and underweight. Conclusions. Being born in rural, being male, unprotected drinking water, smaller weight at birth, no antenatal follow-ups, diarrhea, and poor household wealth were factors associated with increased stunting, wasting, and underweight. Thus, interventions that focus on utilization of antenatal care services, improving household wealth, and improving access to protected drinking water were required by policymakers to decrease stunting, wasting, and underweight more rapidly.
The Tigray National Regional State is located in the northern part of Ethiopia. According to the 2007 Census, the state's population size was 3,136,267 of which 1,594,102 were females. The urban residents of the region were 468, 478 and its rural residents 2,667,789 [32]. The data onto this study were extracted from the Ethiopian Demographic and Health Survey (EDHS) 2016. The Central Statistics Agency (CSA), the Ministry of Health (MOH), and the Ethiopian Public Health Institute together conducted the survey from January 18, 2016–June 27, 2016, where the United States Agency for International Development (USAID) funded the project. The survey implemented a two-stage sample design. In the first stage, 645 enumeration areas were selected with probability related to size. In the second stage, 28 households per cluster of equal probability systematic were selected from the household list. All women of 15–49 years that were either stable inhabitant or visitors, who lived at least one night in the household before the survey, were eligible for the interview. Data were gathered by conducting face-to-face interviews for women that met the eligibility criteria. Determinants of stunting, wasting, and underweight in this study were selected from the available similar studies on the subject; the main predictors explored for under-five nutritional status were grouped into demographic, socioeconomic, and environmental factors related to mothers and households. Then, the nutritional status of a child was calculated based on the three anthropometric indicators: wasting (weight-for-height), stunting (height-for-age), and underweight (weight-for-age). The dependent variables of this study were stunting, wasting, and underweight among children aged 0–59 months. Data analysis was done using SPSS version 21.0 (2018). The descriptive statistics such as frequencies and proportions were used to summarize the distribution of selected background characteristics of the sample. To estimate the effect of each demographic, socioeconomic, and environmental factors on under-five stunting, wasting, and underweight (odds ratio (OR) with 95% confidence intervals (CI)), logistic regression analysis was fitted. Bivariate analysis based on Pearson chi-square tests was used for testing association with the predictors and outcome variable under-5 stunting, wasting, and underweight. All significant predictor variables (p < 0.05) in the bivariate analysis were included in the multivariate logistic regression analysis. The goodness of fit of the fitted models was checked using the Hosmer and Lemeshow test (HLT).
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