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Journal of Tropical Pediatrics Advance Access originally published online on October 9, 2008
Journal of Tropical Pediatrics 2009 55(2):109-115; doi:10.1093/tropej/fmn093
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© The Author [2008]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A Multilevel Analysis of Individual and Community Effect on Chronic Childhood Malnutrition in Rural Nigeria

Olalekan A. Uthman

Center for Evidence-Based Global Health, Save the Youth Initiative, Nigeria

Correspondence: Olalekan A. Uthman, Center for Evidence-Based Global Health, Save the Youth Initiative, Nigeria. E-mail <uthlekan{at}cebglobalhealth.org>.


  Abstract

Background: Protein energy malnutrition is the second most important cause of childhood morbidity and mortality in Nigeria after infections. The purpose of this article was to develop and test a model of childhood malnutrition that includes individual-level characteristics along with contextual characteristics defined at the community level.

Design: Multilevel logistic regression analysis.

Subjects and setting: A total of 4007 children resident in 96 rural villages in Nigeria.

Main outcome: Stunting: height-for-age that is less than the international reference value by >2 standard deviations (SDs).

Main results: Independent of other factors, children born to underweight mothers were 1.32-times more likely to be stunted [adjusted odds ratio (aOR) 1.32; 95% confidence interval (CI) 1.07–1.64]. For each additional month of breastfeeding the odds of being stunted increased by 4% (aOR 1.04; 95% CI 1.03–1.06). Each SD increase in the household wealth index and maternal health-seeking behaviour index decreased the odds of being stunted by 16% (aOR 0.84; 95% CI 0.76–0.94) and 29% (aOR 0.71; 95% CI 0.60 –0.82), respectively.

Conclusion: The study has provided evidence that both individual and community characteristics are important predictors of childhood malnutrition in rural Nigeria; and that scholars trying to understand variation in childhood malnutrition should pay attention to the characteristics of both children and place of residence.


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J Trop Pediatr 2009 55: i. [Full Text]  





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