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Background <p>Under-nutrition is a major public health concern among under-five children, especially in low- and middle-income countries like Ethiopia. Despite the Ethiopian government’s efforts, it remains a pressing issue among children. Prior studies often overlooked the exploration of under-nutrition across different residential settings and failed to apply composite measures of under-nutrition. Therefore, this study aimed at assessing the prevalence of under-nutrition and its associated factors among under-five children in the urban and rural settings of Ethiopia, using a composite measure of under-nutrition.</p> Methods <p>Cross-sectional data from the most recent 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) was used in this study. After appropriate data processing, a total of 4,935 single-birth children aged 0 to 59 months were included. Descriptive statistics were used to summarize the data, while a multivariable binary logistic regression model was employed to identify factors associated with under-nutrition among under-five children. Statistical significance was determined at the p-value &lt; 0.05 for each predictor, and the strength of association was assessed using odds ratios with 95% confidence intervals (CIs).</p> Result <p>In this study, the overall prevalence of under-nutrition among under-five children was 39.72% (95%CI: 38.35, 41.08), with 43.38% (95%CI: 41.80, 44.95) in rural areas and 27.56% (95%CI: 24.96, 30.15) in urban areas. Factors such as being female (AOR = 0.86, 95%CI: 0.75, 0.99), children having higher age, lower preceding birth interval, lower maternal age and education, low wealth status, region and lack of media exposure (AOR = 1.25, 95%CI: 1.05, 1.52) were significantly associated with increased likelihood of under-nutrition in rural areas. In urban areas, having lower maternal education (no education: AOR = 1.93, 95%CI: 1.11, 3.37; primary: AOR = 2.38, 95%CI: 1.45, 3.89), being in the higher age group, and larger family size (6+) (AOR = 2.25, 95%CI: 1.29, 3.93) were associated with increased likelihood of under-nutrition.</p> Conclusion <p>In this study, high prevalence of under-nutrition was observed, with notable disparities between rural and urban areas. Various factors associated with under-nutrition were identified through residential settings. Therefore, concerned stakeholders should address under-nutrition by promoting income-generating activities, initiating educational programs, and running media campaigns on nutrition. Future policies must consider regional and rural-urban disparities to create targeted interventions among children.</p>

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Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月29日

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  • Amare Wubishet Ayele,
  • Emmanuel Gabreyohannes,
  • Yegnanew A. Shiferaw

摘要

Background

Under-nutrition is a major public health concern among under-five children, especially in low- and middle-income countries like Ethiopia. Despite the Ethiopian government’s efforts, it remains a pressing issue among children. Prior studies often overlooked the exploration of under-nutrition across different residential settings and failed to apply composite measures of under-nutrition. Therefore, this study aimed at assessing the prevalence of under-nutrition and its associated factors among under-five children in the urban and rural settings of Ethiopia, using a composite measure of under-nutrition.

Methods

Cross-sectional data from the most recent 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) was used in this study. After appropriate data processing, a total of 4,935 single-birth children aged 0 to 59 months were included. Descriptive statistics were used to summarize the data, while a multivariable binary logistic regression model was employed to identify factors associated with under-nutrition among under-five children. Statistical significance was determined at the p-value < 0.05 for each predictor, and the strength of association was assessed using odds ratios with 95% confidence intervals (CIs).

Result

In this study, the overall prevalence of under-nutrition among under-five children was 39.72% (95%CI: 38.35, 41.08), with 43.38% (95%CI: 41.80, 44.95) in rural areas and 27.56% (95%CI: 24.96, 30.15) in urban areas. Factors such as being female (AOR = 0.86, 95%CI: 0.75, 0.99), children having higher age, lower preceding birth interval, lower maternal age and education, low wealth status, region and lack of media exposure (AOR = 1.25, 95%CI: 1.05, 1.52) were significantly associated with increased likelihood of under-nutrition in rural areas. In urban areas, having lower maternal education (no education: AOR = 1.93, 95%CI: 1.11, 3.37; primary: AOR = 2.38, 95%CI: 1.45, 3.89), being in the higher age group, and larger family size (6+) (AOR = 2.25, 95%CI: 1.29, 3.93) were associated with increased likelihood of under-nutrition.

Conclusion

In this study, high prevalence of under-nutrition was observed, with notable disparities between rural and urban areas. Various factors associated with under-nutrition were identified through residential settings. Therefore, concerned stakeholders should address under-nutrition by promoting income-generating activities, initiating educational programs, and running media campaigns on nutrition. Future policies must consider regional and rural-urban disparities to create targeted interventions among children.