Prevalence and Factors Associated with Stunting among Public Primary School Pupils in Kasulu District, Western Tanzania

Background: Underfeeding of a child in the first 2 years of life results in irreversible growth damage. Globally, stunting has declined from 39.7% in 1990 to 26.7% in 2010 while in Africa has remained at 40% since 1990. However, stunting is little known in primary pupils.This study estimated the prevalence of stunting and contributing factors among public primary school pupils in Kasulu District.Method: Cross-sectional study was conducted among public primary pupils. Systematic random sampling was used to select study participants and then stratified to 5-7 and 8-12 years. Socio-economic factors, dietary practices, water, sanitation, and hygiene behaviours; school performance/attendance data were collected using a pretested questionnaire. Measurements were standardised to the World Health Organization HAZ-Scores for both girls and boys. Descriptive statistics, bivariate, and multivariable logistic regression were used to generate results.Results: A total of 400 pupils (100%RR) were recruited into the study, mean age of 7.51 (STD= 1.54) years and a half (50.3%) were boys. The prevalence of stunting was 127 (31.8%) (95% CI: 27.2%–36.6%), with no sex difference (63 (31.7%) – girls vs. 64 (31.8%) – boys; p = 0.969). Household wealth influenced stunting; lowest quintile (AOR= 28; 95% CI: 3.64 – 214.6; p<0.001) 2nd quintile (AOR = 17; 95%CI: 2.20 – 138.5; p<0.01), the 3rd quintile (AOR = 8.0; 95%CI: 0.99 – 64.67; p = 0.051) and 4th quintile (AOR = 4.2; 95%CI: 0.49 – 36.75; p = 0.191) when compared to 5th (highest) wealthquintile. Food insecurity (AOR = 10.6; 95%CI: 4.60 – 24.60; p< 0.001), less protein in meal were the risk for stunting (AOR = 14.6; 95%CI: 4.07 – 52.42; p<0.001).Inappropriate hand wash after toilets both at school, (AOR=3.5; 95%CI:1.62–7.58; p=0.001), and home (AOR = 13.0; 95%CI: 2.73 – 61.76; p = 0.001) were the risk for stunting. Stunted pupils had irregular school attendance (AOR = 9.4;95%CI: 4.42 – 19.93; p<0.001) and poor performance (AOR = 23.6; 95%CI: 10.24 –54.19; p<0.001). Food insecurity influenced poor performance (AOR = 3.9; 95%CI:1.67–8.92; p<0.01) and irregular school attendance (AOR=5.4, p=0.000).Conclusion: Stunting among public primary school pupils is very high despite the prevention effort. Low wealth, food insecurity, poor hand hygiene, and lack of protein in a meal significantly influence stunting. Also, it affects the pupils’ academic performance and attendance, availability of food in both quantity and quality, community nutritio

A Qualitative Exploration on Perceived Socio-Cultural Factors Contributing to Undernutrition Among Under-Fives in the Southern Highlands of Tanzania

open access articleObjective: Under nutrition especially among under-fives is a major public health challenge in Tanzania. However, the contribution of cultural practices to child under nutrition is often overlooked. This study aimed to explore the perceived socio-cultural factors contributing to the persisting under nutrition among under-fives in Tanzania. Methods: The study applied focus group discussion (FDGs) with forty practitioners to examine the sociocultural factors contributing to under nutrition during early childhood. The study participants were purposively selected and thematic analysis was used to identify themes within the data. Results: This study revealed that, under nutrition for under-fives is caused by a number of socio-cultural factors including existence of gender inequality related to dietary practices and qualities, women’s excessive workload, patriarchy social-norm, excessive alcohol use and cultural taboos prohibiting women and girls from eating certain types of nutrient dense foods. Conclusion: The study highlights the multiplicity of factors including socio-cultural perspectives contributing to under nutrition among under-fives, and calls for a concerted efforts in developing and implementing issue-specific and culturally sensitive strategies towards elimination of child under nutrition