Prevalence and determinants of under-and over-nutrition among adult Kenyan women; evidence from the Kenya demographic and health survey 2008-09

Objective: To analyze the prevalence and determinants of over- and under-nutrition among Kenyan adult women with data from the Kenya Demographic and Health Survey (KDHS) (2008-09)Methods: A nationally representative sample of 5,916 women aged 20 to 49 years in 2008-2009 DHS data was analyzed. The dependant variable was women’s nutritional status determined as Body Mass Index (BMI). A BMI <18.5 was considered underweight, above 24.9 was considered overweight and a BMI above 29.9 was considered obese.Results: The mean age was 31.9 ± (8.4 SD) years while the mean BMI was 23.4 ± (4.6 SD) kg/m2. Three quarters of the women lived in rural areas and Rift valley province contributed a majority of the participants (26.9%). More than half of the women (54.7%) had achieved primary level of education, 68.5% were married at the time of the survey while 27% were working in agricultural sector. Thirty percent of Kenyan women had over-nutrition as measured by overweight and obesity while 11% were underweight. Regional differentials existed in the distribution of women’s nutritional status. Those living in Eastern province were 2 times significantly more likely to be undernourished compared to those living in Nairobi (OR: 2.0, CI; 1.0 – 4.2; p=0.045). Women living in households of lower, lowest and middle wealth quintiles were 80%, 70% and 50% respectively less likely to have over-nutrition compared to those from the highest wealth index households (p<0.001). Women who are married were 1.9 times (CI 1.2 to 3.2) more likely to have over-nutrition compared to those who were not married (p=0.007).Conclusion: The burden of over-nutrition was higher than under-nutrition among Kenyan women in the 2008- 09 DHS survey. The key determinants of under-nutrition include; household wealth, province of residence and education achievement. The key determinants of over-nutrition were; women’s age, marital status, smoking status and partner’s educational status

Stunting and severe stunting among children under-5 years in Nigeria: A multilevel analysis

Background Stunting has been identified as one of the major proximal risk factors for poor physical and mental development of children under-5 years. Stunting predominantly occurs in the first 1000 days of life (0–23 months) and continues to the age of five. This study examines factors associated with stunting and severe stunting among children under-5 years in Nigeria. Methods The sample included 24,529 children aged 0–59 months from the 2013 Nigeria Demographic and Health Survey (NDHS). Height-for-age z-scores (HFAz), generated using the 2006 World Health Organisation (WHO) growth reference, were used to define stunting (HFAz \u3c −2SD) and severe stunting (HFAz \u3c −3SD). Multilevel logistic regression analyses that adjusted for cluster and survey weights were used to determine potential risk factors associated with stunting and severe stunting among children under-5 years in Nigeria. Results The prevalence of stunting and severe stunting were 29% [95% Confidence interval (Cl): 27.4, 30.8] and 16.4% [95%Cl: 15.1, 17.8], respectively for children aged 0–23 months, and 36.7% [95%Cl: 35.1, 38.3] and 21% [95%Cl: 19.7, 22.4], respectively for children aged 0–59 months. Multivariate analysis revealed that the most consistent significant risk factors for stunting and severe stunting among children aged 0–23 months and 0–59 months are: sex of child (male), mother’s perceived birth size (small and average), household wealth index (poor and poorest households), duration of breastfeeding (more than 12 months), geopolitical zone (North East, North West, North Central) and children who were reported to having had diarrhoea in the 2 weeks prior to the survey [Adjusted odds ratio (AOR) for stunted children 0–23 months = 1.22 (95%Cl: 0.99, 1.49)];[AOR for stunted children 0–59 months = 1.31 (95%Cl: 1.16, 1.49)], [AOR for severely stunted children 0–23 months = 1.31 (95%Cl: 1.03, 1.67)]; [AOR for severely stunted children 0–59 months = 1.58 (95%Cl: 1.38, 1.82)]. Conclusions In order to meet the post-2015 sustainable development goals, policy interventions to reduce stunting in Nigeria should focus on poverty alleviation as well as improving women’s nutrition, child feeding practices and household sanitation