Determinants of underweight among under- five children in Zambia - evidence from 2001, 2007 and 2014 Zambia demographic and health surveys.

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Nakawala, Tamika S.
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The University of Zambia
Over the past ten years, underweight levels in Zambia have remained static at 15%. Literature has shown that the mortality risk of children who are even mildly underweight is increased and this risk increases for those children who are severely underweight. The main objective of the study was to assess the determinants of underweight in under-five children over the last two decades in Zambia. This was a cross sectional study using data from the 2001, 2007 and 2013-14 Zambia Demographic and Health Survey’s. The study included a pooled estimate of about 26,735 under-five children, 6877 in the 2001 survey, 6401 in the 2007 survey and 13, 457 children in the 2013-14 survey. Multiple logistic regression showed that female children were 25% less likely to be underweight than male children [0R=0.75, 95% CI (0.69-0.82), p˂0.0001]. Children from rural areas had reduced odds of being underweight than those from urban areas [OR=0.77, 95%CI (0.68-0.89), p˂0.0001], Children aged 13-24 and 25-36 months had increased odds of being underweight [OR=1.71, 95% CI (1.48-1.98), p˂0.0001] and [OR=1.90, 95% CI (1.64-2.20), p˂0.0001] respectively than children aged 0-12 months. Having had diarrhoea [OR=1.33, 95% CI (1.18-1.50), p˂0.0001] or fever [OR=1.19, 95% CI (1.07-1.32), P=0.001] increased the odds of a child below five being underweight. The odds of underweight in under-five children reduced with an increase in the mother’s education and wealth index. Children whose mothers had tertiary education, came from the richest wealth quintile and children who were large at birth had the lowest odds of being underweight [OR=0.41 95% CI (0.27-0.64), p˂0.0001], [OR=0.40, 95%CI (0.32-0.50), p˂0.0001] and [OR=0.38, 95%CI (0.33-0.44), p˂0.0001] respectively. The study established that mothers with higher education, from the richest wealth index, an average sized child at birth, being female and residing in rural area were protective factors for underweight in children. On the other hand having had diarrhoea and fever was a disadvantage to the child as this promoted being underweight. In addition, older children were more likely to be underweight.
Thesis of Master of Science in Epidemiology.