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Background. Underweight is defined as being below the healthy weight range. Underweight in reproductive age group women not only affects women but also increases the risk of an intergenerational cycle of malnutrition and child mortality. Various factors are linked with underweight among women. However, studies on the prevalence of underweight and its associated factors among women are limited in Ethiopia. Hence, this study aimed to assess the prevalence of underweight and its associated factors among reproductive age group women in Ethiopia. Methods. For this study, data were drawn from the 2016 Ethiopian demographic and health survey (EDHS). From the total, 15,683 women participants of the 2016 EDHS; a subsample of 2,848 participants aged 15-49 years who had a complete response to all variables of interest were selected and utilized for analysis. Data were analyzed using SPSS version 20 software program. Pearson’s chi-squared test was used to assess the frequency distribution of underweight and is presented with different sociodemographic characteristics. Logistic regression models were applied for analysis. A two-sided p value of less than 0.05 was used to declare a statistically significant association between the independent variables and underweight among women. Results. The prevalence of underweight among reproductive age group women in Ethiopia was 17.6%. The majority, 78.3% of underweight women, were rural dwellers. The odds of being underweight was higher among the young aged women, among those residing in rural areas, in those with higher educational status, and in those who have one or more children. On the other hand, the odds of underweight among respondents living in Benishangul, SNNPR, and Addis Ababa were less compared to those living in Dire Dawa. Similarly, the odds of underweight among participants with a higher level of husband or partner educational status and among those who chew Khat were less compared to their counterparts. Conclusion. Underweight among reproductive age group women in Ethiopia is still a major public health problem, particularly among rural dwellers. Underweight was significantly associated with different sociodemographic variables. Hence, context-based awareness creation programs need to be designed on the prevention methods of underweight in Ethiopia, giving especial emphasis to those residing in rural areas.
This cross-sectional study was done based on the 2016 EDHS data. The 2016 EDHS was the fourth survey conducted in Ethiopia next to the 2000, 2005, and 2011 surveys. The main aim of the 2016 EDHS was to provide up-to-date information on fertility, childhood mortality, fertility preferences, awareness, approval, and use of family planning methods; maternal and child health; domestic violence; and knowledge and attitude toward HIV/AIDS and other sexually transmitted infections and the prevalence of HIV among the adult population. The survey included representative samples of women (aged 15–49 years) and men (aged 15–59 years) from the nine regions and two administrative cities of the country [18]. However, the current study involved nonpregnant reproductive age group women only because pregnancy nullifies the values of BMI, and data about BMI was not collected among pregnant women and among women who have had a birth in the 2 months before the survey in the 2016 EDHS [18]. In the 2016 EDHS, a two-stage stratified sampling technique was employed. In the first stage, the regions in the country were stratified into urban and rural areas. Then, a total of 645 enumeration areas were selected in both urban and rural areas. In the second stage, a fixed number of 28 households per enumeration area were selected with the probability sampling technique. All reproductive age group women who were usual members of the selected households or who spent the night before the survey in the selected households were eligible for the female survey. The details of the sampling process are available elsewhere [18]. For this study, from the total 15,683 women participants of the 2016 EDHS, a subsample of 2,848 reproductive age group women aged 15–49 years who had a complete response to all variables of interest were selected and utilized for analysis after excluding women who were pregnant. Five standardized and validated questionnaires were used for the 2016 EDHS. The questionnaires were adapted from the DHS Program’s standard Demographic and Health Survey questionnaires in a way to reflect the population and health issues relevant to Ethiopia. In addition to the use of validated tools in the data collection process, the 2016 EDHS has used well-trained field personnel and followed standardized protocols to ensure data quality. Data were collected from January 18 to June 27, 2016, with a response rate of 95% for the women’s survey [18]. For the purpose of the current study, the women’s data from the 2016 EDHS was utilized. Several independent variables like respondent’s age, education, religion, region, wealth index, and access to media were considered depending on their availability in the 2016 EDHS data. Age was categorized into 3 categories after taking the age group of 15–24 in one group as youth based on the United Nations definition of youth age group [23]. Media access was also classified as yes if the participant had access to at least one of the three public media sources. These are access to magazines/newspapers, listening to the radio and watching television, and no if the participant has no access to all of them. Regarding marital status, according to the 2016 EDHS’s definition, women who reported being married or living together with a partner as though married at the time of the survey are considered as ever married [18]. The operational definition of some other variables is available elsewhere [18]. The dependent variable of interest was underweight among nonpregnant ever-married women aged 15–49 years. The outcome variable of interest was categorized based on the WHO Classification of body mass index for adults as follows: underweight if the BMI is <18.5 kg/m2 and not underweight if it is ≥18.5 kg/m2 [24]. For adolescents aged 15–19 years, the corresponding BMI for age of more than 1 standard deviation below the median of the WHO growth reference for school-aged children and adolescents was used as a cut-off point for underweight [4]. Data analysis started with a summary of the sociodemographic characteristics of women using frequency distribution analysis. Bivariate analysis using Pearson's chi-squared test was used to assess the frequency distribution of the main outcome variable and is presented in relation to different sociodemographic characteristics. Binary logistic regression analysis was done, and variables with a p value of less than 0.25 were fitted into the multivariable logistic regression analysis model [25–27]. Then, a multivariable logistic regression analysis was done to examine the association between underweight and the independent variables. A two-sided p value of less than 0.05 was used to declare statistically significant odds of association between the independent variables and underweight among women in the multivariable regression model. Data were analyzed using the SPSS version 20 software program.
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