Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study

Abstract Background Under-nutrition is a major public health concern among under-five children, especially in low- and middle-income countries like Ethiopia. Despite the Ethiopian government’s efforts, it remains a pressing issue among children. Prior studies often overlooked the exploration of unde...

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Main Authors: Amare Wubishet Ayele, Emmanuel Gabreyohannes, Yegnanew A. Shiferaw
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nutrition
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Online Access:https://doi.org/10.1186/s40795-025-01137-8
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author Amare Wubishet Ayele
Emmanuel Gabreyohannes
Yegnanew A. Shiferaw
author_facet Amare Wubishet Ayele
Emmanuel Gabreyohannes
Yegnanew A. Shiferaw
author_sort Amare Wubishet Ayele
collection DOAJ
description Abstract Background Under-nutrition is a major public health concern among under-five children, especially in low- and middle-income countries like Ethiopia. Despite the Ethiopian government’s efforts, it remains a pressing issue among children. Prior studies often overlooked the exploration of under-nutrition across different residential settings and failed to apply composite measures of under-nutrition. Therefore, this study aimed at assessing the prevalence of under-nutrition and its associated factors among under-five children in the urban and rural settings of Ethiopia, using a composite measure of under-nutrition. Methods Cross-sectional data from the most recent 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) was used in this study. After appropriate data processing, a total of 4,935 single-birth children aged 0 to 59 months were included. Descriptive statistics were used to summarize the data, while a multivariable binary logistic regression model was employed to identify factors associated with under-nutrition among under-five children. Statistical significance was determined at the p-value < 0.05 for each predictor, and the strength of association was assessed using odds ratios with 95% confidence intervals (CIs). Result In this study, the overall prevalence of under-nutrition among under-five children was 39.72% (95%CI: 38.35, 41.08), with 43.38% (95%CI: 41.80, 44.95) in rural areas and 27.56% (95%CI: 24.96, 30.15) in urban areas. Factors such as being female (AOR = 0.86, 95%CI: 0.75, 0.99), children having higher age, lower preceding birth interval, lower maternal age and education, low wealth status, region and lack of media exposure (AOR = 1.25, 95%CI: 1.05, 1.52) were significantly associated with increased likelihood of under-nutrition in rural areas. In urban areas, having lower maternal education (no education: AOR = 1.93, 95%CI: 1.11, 3.37; primary: AOR = 2.38, 95%CI: 1.45, 3.89), being in the higher age group, and larger family size (6+) (AOR = 2.25, 95%CI: 1.29, 3.93) were associated with increased likelihood of under-nutrition. Conclusion In this study, high prevalence of under-nutrition was observed, with notable disparities between rural and urban areas. Various factors associated with under-nutrition were identified through residential settings. Therefore, concerned stakeholders should address under-nutrition by promoting income-generating activities, initiating educational programs, and running media campaigns on nutrition. Future policies must consider regional and rural-urban disparities to create targeted interventions among children.
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spelling doaj-art-e55f381eadf64629b2fd9d6635e1fe702025-08-20T04:01:53ZengBMCBMC Nutrition2055-09282025-07-0111111810.1186/s40795-025-01137-8Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative studyAmare Wubishet Ayele0Emmanuel Gabreyohannes1Yegnanew A. Shiferaw2Department of Statistics, College of Natural and Computational Sciences, Debre Markos UniversityMathematics and Statistics Department, Ethiopian Civil Service UniversityDepartment of Statistics, Faculty of Science, University of JohannesburgAbstract Background Under-nutrition is a major public health concern among under-five children, especially in low- and middle-income countries like Ethiopia. Despite the Ethiopian government’s efforts, it remains a pressing issue among children. Prior studies often overlooked the exploration of under-nutrition across different residential settings and failed to apply composite measures of under-nutrition. Therefore, this study aimed at assessing the prevalence of under-nutrition and its associated factors among under-five children in the urban and rural settings of Ethiopia, using a composite measure of under-nutrition. Methods Cross-sectional data from the most recent 2019 Ethiopian Mini Demographic and Health Survey (EMDHS) was used in this study. After appropriate data processing, a total of 4,935 single-birth children aged 0 to 59 months were included. Descriptive statistics were used to summarize the data, while a multivariable binary logistic regression model was employed to identify factors associated with under-nutrition among under-five children. Statistical significance was determined at the p-value < 0.05 for each predictor, and the strength of association was assessed using odds ratios with 95% confidence intervals (CIs). Result In this study, the overall prevalence of under-nutrition among under-five children was 39.72% (95%CI: 38.35, 41.08), with 43.38% (95%CI: 41.80, 44.95) in rural areas and 27.56% (95%CI: 24.96, 30.15) in urban areas. Factors such as being female (AOR = 0.86, 95%CI: 0.75, 0.99), children having higher age, lower preceding birth interval, lower maternal age and education, low wealth status, region and lack of media exposure (AOR = 1.25, 95%CI: 1.05, 1.52) were significantly associated with increased likelihood of under-nutrition in rural areas. In urban areas, having lower maternal education (no education: AOR = 1.93, 95%CI: 1.11, 3.37; primary: AOR = 2.38, 95%CI: 1.45, 3.89), being in the higher age group, and larger family size (6+) (AOR = 2.25, 95%CI: 1.29, 3.93) were associated with increased likelihood of under-nutrition. Conclusion In this study, high prevalence of under-nutrition was observed, with notable disparities between rural and urban areas. Various factors associated with under-nutrition were identified through residential settings. Therefore, concerned stakeholders should address under-nutrition by promoting income-generating activities, initiating educational programs, and running media campaigns on nutrition. Future policies must consider regional and rural-urban disparities to create targeted interventions among children.https://doi.org/10.1186/s40795-025-01137-8Binary logistic regression modelComparative studyComposite measures of under-nutritionEthiopiaUnder-five childrenUnder-nutrition
spellingShingle Amare Wubishet Ayele
Emmanuel Gabreyohannes
Yegnanew A. Shiferaw
Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study
BMC Nutrition
Binary logistic regression model
Comparative study
Composite measures of under-nutrition
Ethiopia
Under-five children
Under-nutrition
title Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study
title_full Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study
title_fullStr Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study
title_full_unstemmed Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study
title_short Under-nutrition and its associated factors among under-five children across urban and rural settings of Ethiopia: a cross-sectional comparative study
title_sort under nutrition and its associated factors among under five children across urban and rural settings of ethiopia a cross sectional comparative study
topic Binary logistic regression model
Comparative study
Composite measures of under-nutrition
Ethiopia
Under-five children
Under-nutrition
url https://doi.org/10.1186/s40795-025-01137-8
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