Abstract:
Background: Childhood stunting is one of the most significant impediments to human development. Aside from detecting stunting reduction, epidemiological data is insufficient to determine whether the reduction was due by community behavioral change or community decomposition change.
Objective: To assess changes in the prevalence rate of stunning, factors associated with stunting and changes in the prevalence rate among under five children in Ethiopia.
Methods: A further analysis of the four consecutive Ethiopian demographic health surveys (2005 – 2019) that were collected using a stratified two-stage cluster sampling method was carried out. A total of 26048 children aged 0-5 years were included in the analysis. Multilevel logistic regression model was fitted to identify individual and community level factors. The models were compared using deviance information criteria (DIC). Multivariate decomposition logistic regression analysis was also carried out to assess the role of compositional characteristics and behavioral change for declined in stunting prevalence rate among under-five children in Ethiopia. All through the analysis a p-value < 0.05 was determined to be statistically significant.
Results: Over the study period, the prevalence rate of stunting in under five children decreased from 47 % to 37% in 2019. Differences in behavioral change among children under the age of five account for 76.69% of the overall decline in stunting prevalence rate in the years 2005-2011, 86.53% in the years 2005-2016, 98.9% in the years 2005-2019, 70.34% in the years 2011-2016, and 73.77% in the years 2011-2019. The remaining variation in stunting prevalence rate in each combination was related to differences in child compositional characteristics. Behavioral adjustments among breast feed children, diet diversity, place of delivery, ANC follow-up, and region have all had a major effect on stunting prevalence rate. The wealth index, parenteral education, child's age in months, length of breast feeding, and area were among the compositional change factors.
Conclusion: A large percentage of children under the age of five remain stunted in Ethiopia. Stunting was associated to alterations in the compositional and behavioral characteristics of children. Stimulating existing nutritional measures, as well as raise the wealth index, will have a significant impact to further reduce stunting on Ethiopian children under the age of five.
Keywords: Change; Stunting; under five children; Ethiopia;