Dietary and non-dietary determinants of linear growth status of infants and young children in Ethiopia: Hierarchical regression analysis

Abstract

Introduction Childhood growth faltering remains a major public health problem in developing countries. We aimed to identify the distal, underlying, and proximal dietary and non-dietary factors associated with length-for-age (LFA) of infants and young children in Ethiopia. Methods We used a nationally representative sample of 2,932 children aged 6-23 months from the Ethiopian demographic and health survey (EDHS) conducted in 2016. Hierarchical regression analysis was done to identify the factors associated with LFA. Findings Pastoral residence (adjusted (a beta) = -0.56, 95 CI = -0.82, -0.31, P< 0.001) and poorest household wealth category (a beta = -0.57, 95 CI = -0.66, -0.48, P< 0.001) were the basic factors negatively associated with LFA. Among underlying factors, maternal wasting (a beta = -0.43, 95 CI = -0.58, -0.28, P< 0.001), and unimproved toilet facility (a beta = -0.48, 95 CI = -0.73, -0.23, P< 0.001) were negatively associated with LFA. Proximal factors found positively associated with LFA were dietary diversity (a beta = 0.09, 95 CI = 0.043, 0.136, P< 0.001), meal frequency (a beta = 0.04, 95 CI = 0.00, 0.08, P = 0.042), and vitamin A supplementation (a beta = 0.16, 95 CI = 0.03, 0.29, P = 0.020). Male sex (a beta = -0.26, 95 CI = -0.39, -0.14, P< 0.001), age (a beta = -0.12, 95 CI = -0.13, -0.10, P = 0.001), small birth size (a beta = -0.45, 95 CI = -0.62, -0.29, P< 0.001), and not currently breastfeeding (a beta = -0.29, 95 CI = -0.47, -0.11, P = 0.003) were negatively associated with LFA. Conclusion LFA was associated with various influences at distal, underlying, and proximal levels. A multi-pronged approach, addressing the various factors comprehensively, would represent an important consideration to promote linear growth in early childhood in Ethiopia.