Factors associated with stunting among children below five years of age in Zambia: evidence from the 2014 Zambia demographic and health survey

Abstract

Stunting continues to be a major public health problem globally. Stunting is a manifestation of many factors including inadequate food intake and poor health conditions. However, poor quality nutritional diets during pregnancy, infancy and early childhood lead to inadequate nutrient intake. The prevalence of stunting at 40% remains unacceptably high in Zambia. To better understand factors contributing to the high stunting levels, the 2013/14 Zambia Demographic and Health Survey (ZDHS) data was analysed in order to identify factors that are associated with stunting. Data was extracted using a data extraction tool and analysed using Stata version 13. Sample data of 12, 328 children aged 0-59 months was analysed. Logistic regression was used to analyse risk factors of stunting. From the 4,937 children who were stunted, stunting was higher in male children than female children (42.4% and 37.6% respectively). Other analysis revealed that children whose source of drinking water was piped (33.7%) were less likely to be stunted compared to children whose source of drinking water was from a river/spring (47.7%). The study further showed that stunting was associated with factors such as sex and age of a child, mother’s education and age, residence, wealth, source of drinking water and duration of breastfeeding at 95% CI and p<0.05. For instance, mother’s level of education had an inverse relationship with stunting. Children whose mothers had higher education were 0.35 times less likely to be stunted compared to those whose mothers had no education (AOR=0.35, 95%CI: 0.22, 0.54; p<0.05). Similarly, wealth status also showed an inverse relationship. Children who came from rich households were 0.67 times less likely to be stunted compared to those who came from poor households (AOR=0.68, 95%CI: 0.57, 0.82; p<0.05). The study determined that the major predictors of stunting among children under five years old in Zambia were sex and age of the child, mother’s age and level of education, wealth status, source of drinking water, duration of breastfeeding and residence. Measures targeted at reducing child stunting should, therefore not be taken in isolation but should include a multidimensional approach to influence policy and programmes.