Analysis of Malnutrition among Children under Five Years across Contrasting Agroecosystems of Northwest Ethiopia: Application of Structural Equation Modeling.

Child malnutrition remains a public health challenge in developing countries, but a comprehensive understanding of its burden and its determinants in specific local contexts is generally lacking. This study examined the prevalence of malnutrition and its determinants among children aged <5 years across contrasting agroecosystems in northwest Ethiopia. A community-based cross-sectional study involving 400 respondents was employed. Data were collected through semi-structured questionnaires and anthropometric measurements, complemented with focus group discussions and key informant interviews. The direct and indirect effects of the determinants of malnutrition were examined using structural equation modeling (SEM). The overall prevalence of child malnutrition, measured using the Composite Index of Anthropometric Failure, was 49%, with notable variation across agroecosystems (from 36.1% [midland with red soil] to 59% [lowland and valley fragmented]). Disease experience had significant positive direct effects on malnutrition. Dietary intake had negative and significant total (direct and indirect) effects on malnutrition, partially mediated through disease experience. Serial mediation in SEM analysis revealed significant indirect relationships between malnutrition and food security, feeding and care practices, household environment, health services, maternal diet, maternal empowerment, household wealth, and nutrition-sensitive agricultural practices. In conclusion, child malnutrition was highly prevalent and higher among children in the lowland and valley fragmented agroecosystem, characterized by unfavorable agro-climatic conditions, lower wealth status, poor health services access, and higher disease (particularly malaria) exposure. This study demonstrates the dynamics and multifaceted nature of malnutrition, highlighting the importance of considering geographical differences when planning interventions for childhood malnutrition and its determinants.

Undernutrition and associated factors among lactating mothers in rural Yilmana Densa District, Northwest Ethiopia: A community-based cross-sectional study.

Undernutrition is continued to be significant public health problem worldwide. The extra calories and nutrients required to support breastfeeding make lactating mothers at higher risk of malnutrition than general population. Undernourished lactating mothers have also been found to influence both the quantity and quality of breast milk and then the nutritional and health status of their offspring. Different evidence showed that undernutrition among lactating mothers is a serious public health problem in Ethiopia in which one of every four lactate mothers are undernourished. Despite this fact, the prevalence of undernutrition among lactating women in Ethiopian was not well investigated and very limited number of studies are conducted. This study aims to assess the prevalence of undernutrition and associated factors among lactating mothers in rural Yilmana Densa District, Northwest Ethiopia. A community-based cross-sectional study was conducted among 428 lactating mothers. The data were collected by using interviewers administered structured questionnaire; and also, anthropometric measurements were taken from the study participants. Binary logistic regression model was undertaken to identify significantly associated factors with undernutrition. The prevalence of undernutrition among lactating mothers was 22.6%. Household income, food security status, dietary diversity score, number of meals, potable water source, and latrine facility were found to be significantly associated with undernourishment of lactating mothers. A significant proportion of lactating mothers in the district suffered from undernutrition and hence, to improve nutritional status of lactating mothers, strategies should focus on nutrition counseling, advancing diversified production and consumption, improvement of access to potable water and latrine, as well as effective household food security interventions.