Chronic Malnutrition Among Under Five Children of Ethiopia May Not Be Economic. A Systematic Review and Meta-Analysis

Abstract

Background: Ethiopia is one of the four low income countries  in achieving MDG4, however, minimizing child under- nutrition became critical undertaking thus far. This review  aimed at identifying the predictors of under-5 children  nutrition in Ethiopia.
Methods: Databases searched were Med Line, HINARY,  MedNar and Embase. Furthermore, gray literatures were  also sought. All papers selected for inclusion in the review  were subjected to a rigorous critical appraisal using  standardized critical appraisal instruments from the Joanna  Briggs Institute. Quantitative papers were pooled for  statistical analysis and narrative synthesis. Odds ratios and  their 95% confidence intervals were calculated for analysis. Papers of optimal quality but without optimal data set for  meta-analysis were subjected for narrative synthesis
Results: Nonadherence towards Optimal feeding  recommendations was the most reported predictor of  stunting and wasting, while, maternal education and ‘Water,  Sanitation and Hygiene’ factors were the second. The findings  of the Meta-analysis showed no evidence of association  between household income/wealth and stunting of children  in Ethiopia (OR=1.14, 95% CI= 0.97, 1.34), heterogeneity test:  i 2 = 92%, df = 20, (P < 0.00001). On the other hand, children  in low income/wealth group were 1.73 times more likely to  have wasting compared to children of the higher  income/wealth households (OR=1.73, 95% C I= 1.51, 1.97)  heterogeneity test: i 2 = 71%, df = 20, (P < 0.00001).
Conclusion: An over-reliance on macroeconomic growth as a  solitary factor towards undernutrition should not be the way  forward. Supplementary and more focused nutrition specific  and sensitive interventions are needed in Ethiopia.