Abstract:
ABSTRACT
Background: Malnutrition is associated both under nutrition and over nutrition which causes of
the body gets un proper amount of nutrients to maintain tissues and organ function. Malnutrition
and diet are the biggest risk factors for the global burden of disease.
Objective: To determine associated factors to underweight among under-five year children in
Ethiopia.
Method: The data source for analysis was the 2016 EDHS data from under-five children weightto-
age
anthropometric
index
(Z-score)
child
underweight
divided
in
to
three
categories:
severely
underweight
(Z-score<-3.00), moderately underweight and
normal ( ). In order to achieve our objective descriptive, cross-tabulation,
standard ordinal logistic regression and multilevel ordinal logistic regression analysis were used.
Thus several ordinal models such as POM, GOM, PPOM, ACM, CRM and SLM models were
fitted.
Result: The descriptive result revealed that about 7.08% of children were severely underweight
and 16.72% were moderately underweight while 76.19% were normal. Among the fitted model,
PPOM fits the data better than other models. The test of heterogeneity suggested that, the
underweight varies among region and multilevel ordinal model fit data better than single level
ordinal model. For selected multilevel PPOM shows that mother education, wealth index of
family, religion of mother, birth order, birth type, sex of child, birth size of child, diarrhea two
weeks before the survey, fever two weeks before the survey, mother BMI, age of child and
duration of breast feeding were significant determinants of underweight among under-five
children.
Conclusion: In order to reduce severity of underweight, awareness creation efforts have to
improve their economic status, improve the level of education of mothers. It is recommended that
design and implement primary health care and nutrition programs which would fit the features of
each region to safeguard children from nutritional deficiency.
Key words: underweight, partial proportional odds model, multilevel partial proportional odds
model, under-five year children, Ethiopia