Factors associated with malnutrition among children under five years in Mogadishu, Somalia: A multicenter cross-sectional study

Abstract

Abstract Background: Malnutrition is a major public health problem in low- and middle-income countries, including Somalia. Identifying the unique factors associated with malnutrition in each location helps effective and targeted interventions. We assessed the factors associated with protein-energy malnutrition among children under five years old in Mogadishu, Somalia to provide evidence for its control. Methods: A multicenter cross-sectional study was conducted among 1203 child mother pairs who met the inclusion criteria from selected health facilities in Mogadishu, Somalia. A structured questionnaire and anthropometric measurements were used to obtain information from the child-caregiver pair following the WHO guidelines. The Z scores of weight-for-age, height-for-age, and weight-for-height were calculated using the WHO Anthro. The prevalence of wasting, stunting and underweight were estimated and associated factors were identified using binary logistic regression at a 95% confidence interval. Results: The mean age of the children was 26.1±16.1 months , 59.7% were male and 51.3% were aged 0-23 months. The prevalence of wasting was 66.5% (95%CI: 60.5-72.5) out of which 20.9% (95%CI: 18.3-23.5) were moderately and 45.6% (95%CI: 42.2-49.0) were severely wasted. The prevalence of stunting was 64.8% (95%CI: 58.1-71.5), (25.2%, 95% CI: 22.0-28.4) were moderately and (39.6%, 95% CI: 36.1-43.1) were severely stunted. Similarly, 64.8% (95%CI: 58.5-71.1) were underweight, 21.7% (95%CI: 19.0-24.4) were moderately underweight and 43.1% (95% CI: 39.5-46.7) were severely underweight . Being male (aOR: 1.4, 95%CI:1.07-2.15), mothers attaining tertiary education (aOR: 0.1, 95%CI: 0.01-0.20) were associated with wasting, being male (aOR: 2.0, 95%CI: 1.61-2.96), aged 36-59 months (aOR:3.4, 95%CI: 2.26-5.21), being 5-6 birth order (aOR: 4.6, 95%CI: 2.45-8.74) and being of low-income family (aOR: 1.7, 95%CI: 1.16-2.57) were associated with stunting and being male (aOR: 6.0, 95%CI: 4.28-8.49), mothers age 40-49 years (aOR: 0.2, 95%CI: 0.14-0.37) were associated with underweight among the children. Conclusions: The prevalence of wasting, stunting and underweight was high. Age of the child, birth order, birth intervals, number of children, mother's age at birth, mother's education, father's education, marital status, mother's occupation, father's occupation, family type, and family income were associated with malnutrition.