Stunting disparities and its associated factors among preschool children of employed and unemployed mothers in Gondar City: a comparative community-based cross-sectional study

IntroductionA stunted child refers to a child who is too short for his/her age, which is the most common cause of morbidity and mortality in children under five in developing countries. Stunting in preschool children is caused by a multitude of socioeconomic and child-related factors, including the employment status of women. This study aimed to compare the prevalence and factors associated with stunting of preschool children among employed and unemployed mothers in Gondar city, Northwest Ethiopia, in 2021.MethodsFrom 30 February to 30 March 2021, a community-based comparative cross-sectional study was conducted among 770 preschool children of employed and unemployed mothers in Gondar city. A structured questionnaire-based interview with anthropometric measurements was used to collect data. A multi-stage sampling technique was used. Data were entered into EPI Info version 7.22 and transferred to Stata version 14 for further analysis. To identify factors associated with stunting, a binary logistic regression analysis was used. The presence of an association was declared based on a p-value of <0.05 and confidence intervals.ResultsA total of 770 preschool children participated in the study. The overall prevalence of stunting among preschool children was 39.7% (95% CI: 36.3–43.2). The prevalence was higher among preschool children of employed mothers (42.6%) (95% CI: 37.6–47.5) than among unemployed mothers (36.7%) (95% CI: 32.0–41.7). Maternal age [AOR = 2.8, 95% CI: 1.26–6.34] and wealth status [AOR = 0.32, 95% CI: 0.18–0.57] were significantly associated with stunting among unemployed mothers, while family size [AOR = 7.19, 95% CI: 2.95–17.5], number of children under the age of five [AOR = 1.92, 95% CI: 1.12–3.29], and having a home servant [AOR = 0.126, 95% CI: 0.06–0.26] were associated with stunting of preschool children among employed mothers.ConclusionStunting is more common in preschool children of employed mothers than in those of unemployed mothers. As a result, interventions such as raising awareness among employed mothers to devote time and care to their children, as well as concerned bodies assisting women with preschool or under-five children, is required. The nutrition intervention should focus on encouraging dietary diversity to combat the existing nutrition-associated stunting in children. Similarly, further research on the difference between employed and unemployed mothers' child stunting status as well as an investigation of extra variables such as the number of hours worked by an employed mother is also recommended to upcoming researchers

Spatial distribution and determinants of tetanus toxoid immunization among pregnant women in Ethiopia using data from Ethiopian demographic and health survey 2016

Abstract Introduction Tetanus is a major public health problem caused by clostridium tetani. Although it is vaccine-preventable, the case fatality rate among neonates in areas with poor immunization coverage and limited access to clean deliveries reaches 80-100%. Vaccination of pregnant mothers with the tetanus toxoid (TT) vaccine is the most effective way to protect against neonatal tetanus. This study aimed to examine the spatial distribution and determinants of tetanus toxoid immunization among pregnant mothers using the 2016 EDHS data. Method Secondary analysis of the Ethiopia Demographic and Health Survey 2016 was done to assess the spatial distribution and determinants of tetanus toxoid vaccine among pregnant women in Ethiopia. Spatial autocorrelation analysis and hot spot analysis were used to detect spatial dependency and spatial clustering of the tetanus toxoid vaccine in Ethiopia. Spatial interpolation was used to predict the tetanus toxoid vaccine coverage in unsampled areas. The multilevel binary logistic regression model was fitted to identify factors associated with tetanus toxoid vaccination. An adjusted odds ratio with 95% CI was calculated and used as the measure of association and a p-value less than 0.05 were considered statistically significant. Result From the total of 7043 pregnant women, 42.4% of them have taken at least two doses of tetanus toxoid immunization. Spatial clustering of TT immunization was observed in the Northern, Southwestern and Southwestern parts of Ethiopia. Whereas, low TT coverage was observed in the Eastern and Western parts of the country. Increased ANC visits and the richest economic status favored TT immunization, whereas living in Addis Ababa and Dire Dewa cities decreased the TT immunization coverage. Conclusion The finding of this study reveals that TT immunization had spatial dependency, with the highest immunization coverage observed in the Northern, Southwestern and Southeastern parts of the Country. Thus, geographically targeted interventions should be implemented particularly in the eastern and western parts of the country

Regional prevalence of infant mortality in Ethiopia.

Regional prevalence of infant mortality in Ethiopia.</p

Random effect and model fit statistics of infant mortality in Ethiopia.

Random effect and model fit statistics of infant mortality in Ethiopia.</p

Sociodemographic characteristics of live births born five years preceding the survey in Ethiopia.

Sociodemographic characteristics of live births born five years preceding the survey in Ethiopia.</p

Multivariable multilevel logistic regression analysis results of both individual-level and community-level factors associated with infant mortality in Ethiopia.

Multivariable multilevel logistic regression analysis results of both individual-level and community-level factors associated with infant mortality in Ethiopia.</p

Hot spot analysis of infant mortality in Ethiopia, Shapefile source: (Central Statistical agency 2013; URL: https://africaopendata.org/dataset/ethiopia-shapefiles).

Map output: Own analysis using ArcMap 10.8 software.</p

Spatial autocorrelation of infant mortality in Ethiopia.

Spatial autocorrelation of infant mortality in Ethiopia.</p

Interpolation of infant mortality in Ethiopia, Shapefile source: (Central Statistical agency 2013; URL: https://africaopendata.org/dataset/ethiopia-shapefiles).

Map output: Own analysis using ArcMap 10.8 software.</p

Spatial scan statistical analysis of infant mortality in Ethiopia.

Spatial scan statistical analysis of infant mortality in Ethiopia.</p