Predictors of acute undernutrition among children aged 6 to 36 months in east rural Ethiopia: a community based nested case - control study

Background: Child undernutrition is one of the major public health problems in the developing countries having a devastating effect on the lives of many children under five years of age. However, its causes are multitude and not uniformly understood enough across the various parts of the world and that a thorough understanding of these causes is required to design appropriate intervention. The objective of this study was to identify the predictors of acute child undernutrition in east rural Ethiopia. Methods: An unmatched community based nested case - control study was carried on 2199 (241 cases and 1958 controls) cohorts of children aged between 6-36 months with their respective mothers from July/August, 2010 to January/February, 2011. The data were collected by using a pre-tested structured questionnaire and anthropometric measuring instruments which are recommended by UNICEF, after the standardization. Odds Ratio along with 95% confidence interval was estimated to identify determinants of wasting using the multivariable logistic regression. Results: Wasting was associated with poor [AOR (95% CI) = 1.49 (1.02, 2.20)] and middle [AOR (95% CI) = 1.52 (1.05, 2.20)] households' socio- economic positions, individual based decision - making on the care or treatment of the ill child [AOR (95% CI) = 1.62 (1.20, 2.20)], lack of maternal access to health facility [AOR (95% CI) = 1.56 (1.14, 2.20)], narrow birth interval [AOR (95% CI) = 1.65 (1.23, 2.20)], and non - exclusive breast feeding [AOR (95% CI) = 1.43 (1.05, 1.94)]. Conclusions: Wasting was significantly associated with the households' poverty, poor access to health services, lack of mutual decision - making on the care or treatment of their sick child between biological parents, closer birth interval, and poor exclusive breastfeeding practice. Thus, an organized effort should be made at all levels to improve infant and young child feeding, health services, child birth spacing behavior, and exclusive breastfeeding practice of the poor rural population particularly mothers to curb the problems of child undernutrition.