Predictors of normal nutrition status among children aged 6-24 months in Gulu District, Northern Uganda. A case control study.

Abstract

Introduction: In the last two decades, most health indicators for Ugandan children have improved. However, the prevalence of undernutrition is still of public health concern. Most of the nutrition studies have focused on unfavorable factors that contribute to malnutrition rather than on the favorable factors that promote good nutrition status among children. This study aimed at identifying factors and practices of mothers/ caregivers associated with better nutritional outcomes for their children aged six to 24 months compared to mothers/ caretakers of children with poor nutritional outcomes living in the same neighborhood. Methodology: This was a case-control study conducted in Gulu district on 300 (i.e.,100 cases and 200 controls) purposively selected sample of children in the age group of 6- 24 months. Controls were children of normal nutrition status with WAZ, HAZ and WHZ ≥-2 Z-scores. Cases were undernourished children 6 to 24 months of age with at least one of the indices WAZ, HAZ or WHZ < −2 Z-scores. Quantitative data was collected using a semi-structured questionnaire. Logistic regression was used at bivariable and multivariable analysis to determine the predictors of good nutrition status using Odds ratios (ORs) as the measure of association. Both the crude (COR) and adjusted odds ratios (AOR) were reported. A p-value less than 0.05 was considered statistically significant at 95% confidence interval. Results: The mean age of the cases and controls was 15 months (SD ± 6) and 13 months (SD ± 5), respectively. At multivariable analysis, breastfeeding in the first hour of child’s life (AOR=3.31 95%CI. 1.52, 7.23), use of family planning (AOR=2.21 95% CI. 1.25, 3.90), less number of under-fives in the household (AOR=0.31 95%CI. 0.13, 0.73) and hand washing with soap (AOR=3.63 95%CI. 1.76, 7.49) were significantly independently associated with child’s optimal anthropometric nutrition status. Conclusion: Interventions that could improve children's nutrition status include; breastfeeding in the first hour of child’s life, use of family planning methods, child spacing and hand washing with soap. Key words: Nutrition status, community, caregivers, case and control.