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Contextual factors and spatial trends of childhood malnutrition in Zambia
Journal
PLOS ONE
ISSN
1932-6203
Date Issued
2022-11-03
Author(s)
Million Phiri
David Mulemena
Chester Kalinda
Julius Nyerere Odhiambo
Editor(s)
Inés González-Casanova
DOI
https://doi.org/10.1371/journal.pone.0277015
Abstract
Background
Understanding the national burden and epidemiological profile of childhood malnutrition is central to achieving both national and global health priorities. However, national estimates of malnutrition often conceal large geographical disparities. This study examined the prevalence of childhood malnutrition across provinces in Zambia, changes over time, and identified factors associated with the changes.
Methods
We analyzed data from the 2013/4 and 2018 Zambia demographic and health surveys (ZDHS) to examine the spatial heterogeneity and mesoscale correlates of the dual burden of malnutrition in children in Zambia. Maps illustrating the provincial variation of childhood malnutrition were constructed. Socio-demographic and clinical factors associated with childhood malnutrition in 2013 and 2018 were assessed independently using a multivariate logistic model.
Results
Between 2013/4 and 2018, the average prevalence of stunting decreased from 40.1% (95% CI: 39.2–40.9) to 34.6% (95% CI:33.6–35.5), wasting decreased from 6.0% (95% CI: 5.6–6.5) to 4.2% (95% CI: 3.8–4.7), underweight decreased from 14.8% (95% CI: 14.1–15.4) to 11.8% (95% CI: 11.2–12.5) and overweight decreased from 5.7% (95% CI: 5.3–6.2) to 5.2% (95% CI: 4.8–5.7). High variability in the prevalence of childhood malnutrition across the provinces were observed. Specifically, stunting and underweight in Northern and Luapula provinces were observed in 2013/14, whereas Lusaka province had a higher degree of variability over the two survey periods.
Conclusion
The study points to key sub-populations at greater risk and provinces where malnutrition was prevalent in Zambia. Overall, these results have important implications for nutrition policy and program efforts to reduce the double burden of malnutrition in Zambia.
Understanding the national burden and epidemiological profile of childhood malnutrition is central to achieving both national and global health priorities. However, national estimates of malnutrition often conceal large geographical disparities. This study examined the prevalence of childhood malnutrition across provinces in Zambia, changes over time, and identified factors associated with the changes.
Methods
We analyzed data from the 2013/4 and 2018 Zambia demographic and health surveys (ZDHS) to examine the spatial heterogeneity and mesoscale correlates of the dual burden of malnutrition in children in Zambia. Maps illustrating the provincial variation of childhood malnutrition were constructed. Socio-demographic and clinical factors associated with childhood malnutrition in 2013 and 2018 were assessed independently using a multivariate logistic model.
Results
Between 2013/4 and 2018, the average prevalence of stunting decreased from 40.1% (95% CI: 39.2–40.9) to 34.6% (95% CI:33.6–35.5), wasting decreased from 6.0% (95% CI: 5.6–6.5) to 4.2% (95% CI: 3.8–4.7), underweight decreased from 14.8% (95% CI: 14.1–15.4) to 11.8% (95% CI: 11.2–12.5) and overweight decreased from 5.7% (95% CI: 5.3–6.2) to 5.2% (95% CI: 4.8–5.7). High variability in the prevalence of childhood malnutrition across the provinces were observed. Specifically, stunting and underweight in Northern and Luapula provinces were observed in 2013/14, whereas Lusaka province had a higher degree of variability over the two survey periods.
Conclusion
The study points to key sub-populations at greater risk and provinces where malnutrition was prevalent in Zambia. Overall, these results have important implications for nutrition policy and program efforts to reduce the double burden of malnutrition in Zambia.
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