Disparity in prevalence and predictors of undernutrition in children under five among agricultural, pastoral, and agro-pastoral ecological zones of Karamoja sub-region, Uganda: a cross sectional study
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Date
2022-05-30
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pediatrics
Abstract
Background: Undernutrition accounts for nearly half of under-five child mortality in developing countries where
household nutrition is largely dependent on agriculture. Despite the strong influence of agroecology on agriculture
in those countries, limited information exists on whether undernutrition in children under five varies with agro
ecological location.
Methods: Using Karamoja sub-region of Uganda, one of the most food insecure parts of Eastern Africa as a case area,
and applying a multi-stage sampling procedure, and a structured questionnaire, this study examined in a comparative
manner, the prevalence and predictors of undernutrition in children under five among the agricultural, pastoral,
and agro-pastoral ecological zones. Chi-square test and Kruskal-Wallis test were used to establish the disparity in
prevalence of undernutrition and household contextual characteristics, respectively. Binary logistic regression was
used to determine the predictors of undernutrition in children under five among the three agro-ecological zones. The
level of statistical significance was set at p ≤ 0.05.
Results: The prevalence of underweight, stunting, and wasting ranged from 36 to 58% but varied with agroecology
in terms of the peak age ranging from 6 to 37 months. Child characteristics, feeding practices, household economic
factors, sanitation factors, and caregiver characteristics that predict undernutrition among children under five were
identified (p ≤ 0.05). Caregiver handwashing after using latrine (p = 0.005) and diarrhoea in a fortnight (p < 0.001)
increased the likelihood of stunting in pastoral agroecology only whereas cereal storage in both sacks and granary
in agro-pastoral zone was associated with reduced likelihood of both underweight (p < 0.001 and p = 0.014) and
stunting (p = 0.011 and p = 0.018), respectively. A male child was more likely to be underweight and stunted in
pastoral (p = 0.002 and p = 0.011) and agro-pastoral (p = 0.017 and p = 0.002) agroecology, respectively. Household
expenses reduced the likelihood of both underweight and wasting in pastoral (p = 0.013 and p = 0.005) and
agricultural (p = 0.011 and p = 0.021) agroecology, respectively. Flour storage duration increased the stunting
likelihood in pastoral (p = 0.032) and agro-pastoral (p = 0.006) agroecologies
Conclusion: This study has revealed that, in a food insecure developing country setting such as Karamoja sub-region
of Uganda, undernutrition among children under five varies with agroecology. Thus, nutritional interventions in such
locations should be agroecology specific.
Description
Keywords
Ecology, Food handling, Undernutrition, Children under five
Citation
Okidi, L., Ongeng, D., Muliro, P. S., & Matofari, J. W. (2022). Disparity in prevalence and predictors of undernutrition in children under five among agricultural, pastoral, and agro-pastoral ecological zones of Karamoja sub-region, Uganda: a cross sectional study. BMC pediatrics, 22(1), 316.