Persistent Malnutrition and Associated Factors among Children under Five Years Attending Primary Health Care Facilities in Limpopo Province, South Africa
Open Access
- 19 October 2020
- journal article
- research article
- Published by MDPI AG in International Journal of Environmental Research and Public Health
- Vol. 17 (20), 7580
- https://doi.org/10.3390/ijerph17207580
Abstract
Despite years of interventions intended to reduce child malnutrition in South Africa, its negative effects, stunting in particular, persist mainly among children under five years old living in under-resourced regions. A cross-sectional study was conducted to determine the prevalence of malnutrition and associated factors among 404 children under age five attending childcare services with their mothers in selected healthcare facilities of Limpopo Province, South Africa. Anthropometry, socio-demographics and obstetric history were collected. Height-for-age, weight-for-age and body mass index-for-age Z-scores were used to determine stunting, underweight and thinness among children, respectively. Logistic regression analyses were performed to generate the factors associated with malnutrition. Stunting (45.3%) was the prevalent form of malnutrition among children under age five, affecting boys (51.7%) more than girls (38.8%) and children aged 12–23 months (62.4%) more than those p = 0.004) and underweight (AOR = 2.17, 95% CI: 1.32–3.57, p = 0.002) than girls. Children aged 12–23 months were more likely to be stunted (AOR = 4.79, 95% CI: 2.36–9.75, p ≤ 0.0001) than children aged ≤11 months. Delayed introduction of solid foods increased the odds of stunting (AOR = 5.77, 95% CI: 2.63–12.64, p ≤ 0.0001) and underweight (AOR = 2.05, 95% CI: 1.08–3.89, p = 0.028). Children with normal birth weight were less likely to be thin (AOR = 0.42, 95% CI: 0.19–0.92, p = 0.029) and underweight (AOR = 0.34, 95% CI: 0.17–0.68, p = 0.003) than children who had low birth weight. Children whose mothers had obtained secondary school education (AOR = 0.39, 95% CI: 0.16–0.97, p = 0.044), and Grade 12 or post-Grade 12 education (AOR = 0.32, 95% CI: 0.12–0.83, p = 0.020) were less likely to be stunted than were children of mothers who had only primary school education. Suboptimal complementary feeding predisposed children to stunting and underweight. National nutrition programs should be context-specific to improve the introduction of complementary foods among children, especially in the remote and poor areas.This publication has 49 references indexed in Scilit:
- Malnutrition in Sub-Saharan Africa: burden, causes and prospectsPan African Medical Journal, 2013
- Early cessation of breastfeeding amongst women in South Africa: an area needing urgent attention to improve child healthBMC Pediatrics, 2012
- Determinants of inappropriate complementary feeding practices in young children in India: secondary analysis of National Family Health Survey 2005–2006Maternal & Child Nutrition, 2011
- Determinants of inappropriate complementary feeding practices in young children in Nepal: secondary data analysis of Demographic and Health Survey 2006Maternal & Child Nutrition, 2011
- Malnutrition in developing countriesPaediatrics and Child Health, 2011
- Socioeconomic inequality in malnutrition in developing countriesBulletin of the World Health Organization, 2008
- 'No sister, the breast alone is not enough for my baby' A qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern ZambiaInternational Breastfeeding Journal, 2008
- Developmental potential in the first 5 years for children in developing countriesThe Lancet, 2007
- Food Insecurity and the Risks of Depression and Anxiety in Mothers and Behavior Problems in their Preschool-Aged ChildrenPEDIATRICS, 2006
- Effects of early extra fluid and food intake on breast milk consumption and infant nutritional status at 5 months of age in an urban and a rural area of Burkina FasoEuropean Journal of Clinical Nutrition, 2003