Stunting and Underweight, but not Wasting are Associated with Delay in Child Development in Southwest Ethiopia

Abstract

Background

Stimulating care during childhood is the foundation for optimal health, learning, productivity, and social well-being throughout the life course. In addition, malnutrition is a major public health concern affecting up to half of children under-five years in Ethiopia. However, evidence on the causal contribution of malnutrition to delay in child development is poorly understood in Ethiopia.

Objective

To identify the relationship between different forms of malnutrition and delay in child development among children in Southwest Ethiopia.

Methods

A community-based survey was conducted among 507 randomly selected mother–child pairs in the Guraghe Zone, Southwest Ethiopia. A pretested tool and validated anthropometric measurements were used. Anthropometric indices (WFH, WFA, and HFA) were calculated in Anthros software. The data were summarized in mean, median, standard deviation, tables and charts. Bivariable and multivariable binary logistic regression (stepwise backward regression) models were fitted with nutritional status (wasting, stunting and underweight) and other potential factors associated with delay in child developmental. Adjusted odds ratios with 95% confidence intervals and p-values were reported.

Results

A total of 507 mother–child (12–59 months) pairs were included in the survey (97% response rate). The mean ASQ-3 score was 150 (± 23.4), with a minimum and maximum score of 45 and 270, respectively. A total of 149 (29.4%; 95% CI: 25.4–33.4) children had developmental delays, where 17.2%, 16.8%, 13.4%, 10.8%, and 10.1% had delays in gross motor, communication, problem-solving, personal-social, and fine motor skills, respectively. Children of working mothers (AOR=2.9; 1.8, 4.8), preterm births (AOR=3.2; 1.4, 7.0), early initiation of complementary feeding (AOR=2.5; 1.37, 4.6), stunting (AOR=3.0; 1.9, 4.7), underweight (AOR= 2.3; 1.1, 4.7) and low dietary diversity score (AOR=3.1; 1.3, 7.5), were predictors of developmental delay.

Conclusion

Child development delay is a public health concern and it is strongly associated with stunting, underweight, undiversified dietary consumption, and suboptimal infant and young child feeding practices.

Keywords:

• developmental delay
• nutritional status
• associated factors
• stunting
• children

Abbreviations

A/COR, adjusted/crude odds ratio; ASQ, Age Stage Questionnaire; CI, confidence interval; EDHS, Ethiopian Demographic and Health Survey; HFA, height for age; IYCF, Infant and Young Child Feeding; ; MD, mean difference; VIF, variance inflation factor; WFA, weight for Age; WFH/L, weight for height/length; WHO, World Health Organization.

Data Sharing Statement

All data generated or analyzed during this study are included in the manuscript and supplementary file.

Ethics Approval and Consent to Participate

The research was reviewed and ethically adopted by Wolkite University Institutional Health Research Ethical Review committee. A written informed consent was obtained to collect data from caregivers of children after explaining the purpose and procedures of the study. The study was conducted in accordance with the Declaration of Helsinki.

Acknowledgments

The authors would like to acknowledge the zone and district administrative, data collectors, and supervisor for their kind cooperation and help for the implementation of this study.

Author Contributions

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article was submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

No specific funding was collected for this study. There were no funders and no funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.