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Title of the paper:
Children vulnerability to under-nutrition among rural agro-ecological areas of Janamora
Woreda, Northwest Ethiopia.
Paper prepared by :
Souvenir Jean Jacques Bucyana1 ;Aweke Kebede (PhD.) ;Abebe Haile (PhD.)
Addis Ababa University,
Addis Ababa, October 2016
1
Addis Ababa Univeristy,College of Development Studies, Centre for food security studies;Correspondence:[email protected]
1. ABSTRACT
Regardless of encouraging progress in strengthening nutrition policies and improving nutritional
outcomes, under-nutrition remains a significant public health problem especially in the rural
areas of Ethiopia. The present investigation was aimed at assessing vulnerability of a total of 320
children of 6-24 months living from different rural agro-ecological situations (185 from highland
and 135 from lowlands areas) of Janamora district, Northwestern zone of Ethiopia.
Children of 6-12 months, (O.R: 0.530; CI: 0.378-0.742; p<0.05); from rural highland (OR:
0.279; CI: 0.157-0.499; p<0.05), born from illiterate mother (O.R: 0.786; CI: 0.626-0.987;
p<0.05), from household without improved sanitation facilities (O.R: 1.363; CI: 1.114-1.668;
p<0.05) were the most vulnerable to stunting. Besides, children from mother with IGA (O.R:
0.254; CI: 0.091-0.709; p<0.05) and children from households with bigger land size holding
(O.R: 0.254; CI: 0.091-0.709; p<0.05) were less likely to be stunted. Nevertheless, household
dietary diversity was associated with stunting at only p<0.2 (OR: 1.136: 0.964-1.340; p<0.2).
The root causes identified were the massive deforestation that occurred during the 1980s war,
environmental degradation, climate variability, dependency on rain-fed agriculture, soil erosion,
low agricultural productivity, lack of diversified livelihoods, population growth, gender
inequality, lack of basic facilities such as clean water and lack of health and education facilities,
and ineffective food market as the root causes of chronic malnutrition and poverty in rural areas
of Janamora Woreda.
The study revealed that the most vulnerable groups were small children from poor farmers'
households living in communities with limited capacity to resist, recover and to adapt to
unfavorable climate and environmental conditions. It recommends an agro-ecological
perspective in the understanding of food security and nutrition issues and advocates for
participatory and community based interventions.
Key words: Food security, vulnerability, stunting, agro-ecology, under-nutrition, food system.
2
2. INTRODUCTION
Hunger and nutritional failure signify both the cause as well as the consequence of a household’s
vulnerability to economic shocks, chronic and transient, and consist an important indicator of
food insecurity, poverty, and deprivation of well-being [1]. According to Mohammad [2]
undernutrition has many life threatening impacts which can include higher risk of severe
infections, chronic electrolyte imbalance and mortality. Already as IFAD [3] reported it,
undernutrition consists the largest contributor of child mortality worldwide.
For decades, the global political and development agenda has failed to put the spotlight on
hunger and undernutrition. While recent years have seen more ambition and action, which
culminated in the state of hunger in developing countries as a group improving since 1990, and
falling by 39 %, according to Global Hunger Index (GHI) of 2014 [4], which itself stands at
12.5%. However, “the level of hunger in the world is still ‘serious’ in fact, the number of hungry
people in the world remains ‘unacceptably high’. This can be seen through figures such as, about
805 million people being chronically undernourished, two billion people suffering from one or
more micronutrient deficiencies, and to be precise with a rate of 26 % of the world’s children
under 5 years being stunted or in other words chronically malnourished. Sadly, the three
quarters of the world’s hungry people live in rural areas, and, paradoxically, many of them are
smallholder farmers [5].
Furthermore, in South Asia and sub-Saharan Africa, home to three quarters of these children, the
figure was 40 per cent, making child undernutrition one of Africa's most fundamental challenges
for improved human development [5]. It is therefore, to be underlined that children whose
growth is stunted, people who don’t get enough vitamins and minerals for a healthy life, on the
other side adults who are overweight and obese—malnutrition takes many forms and affects
every country on Earth. A problem of staggering size, malnutrition is widespread enough to
threaten the world’s sustainable development ambitions [9]
In Ethiopia, regardless of encouraging progress in strengthening nutrition policies and improving
nutritional outcomes, undernutrition remains a significant public health problem especially in the
rural areas; with stunting, wasting and underweight of children under 5 estimated at 40%, 20%
and 9% respectively [6]. Moreover, currently climate change is no longer an issue of speculation
3
but a daily challenge to already food insecure rural Ethiopian farmers, who are living from rainfed agriculture as their main source of livelihoods. In fact, even though it is not correct, to argue
that undernourished children are primarily a rural phenomenon, to study the phenomenon of
undernutrition, taking into consideration the factor of environment and therefore of livelihood
differences is of paramount importance.
Therefore, from the climate and agro-ecological dimension Ethiopia's recognized diverse agroecologies can relatively help to characterize many of the potentials and constraints faced by other
African countries, although not of course every context[10]. Moreover, as Mazumdar [1]
recommended it, vulnerability studies considering indicators such as access to health services,
nutritional status, cultural practices, and gender inequality seem to be more comprehensive
especially in the current situations. Thus this study was conducted to assess the prevalence of
undernutriton with reference to stunting and to appraise the factors that contribute to children
vulnerability to it across different rural agro-ecological areas of Janamora Woreda.
3. METHODS
Study design, population and sampling techniques
The study followed a comparative cross-sectional design which consisted in measuring at a one
point, both dependent and independent variable simultaneously. To determine the prevalence for
multiple risk factors associated with stunting (HAZ<-2).The design adapted the analytical
formulation of vulnerability to child nutritional outcomes at community, household and
individual levels developed by Mazmudar [1]. Focus group discussions and Key informant
interviews were techniques used to collect information at community level whereas quantitative
data were collected from a survey conducted using structured questionnaires on a total of 320
households having children of 6-24 months. The sample comprised of two independent samples
of 135 households living in lowland areas (<2499 m.a.s.l) and 185 from highland areas (>2500
m.a.s.l) of rural areas of Janamora Woreda.
Janamora is one of the Woreda in the Amhara Regional state of Ethiopia, located in the Northern
Gondar zone. The estimate terrain elevation above sea level (a.s.l) is 2,900 m (9,500 ft) metres.
The Janamora region today covers the Semien Mountains and a portion of their southern slopes,
which makes access to this Woreda difficult. Amhara Regional State was purposively selected
4
because the prevalence rate of stunting was equal to that of rural areas in Ethiopia i.e. 42%
(which is a representative figure for all sub-groups of the community in the region) as per
reported in EMDHS [6] Janamora Woreda was also purposively selected due to its diversified
topography. The 6 Kebeles involved in the survey were selected because they were relatively
accessible and presented the desired agro-ecological conditions. The choices of Focus group
discussants from the three kebeles also followed the same approach. Key informant interviews
involved 2 NGO’s staffs, 2 government representatives and 2 long-time residents of Janamora.
Data were collected from March 15 to 10 April 2016. The quality of the data, was ensure by
training enumerators, and structured questionnaire prepared in English was translated in Amharic
language, FGD were held in Amharic and retranslated back to English. Using WHO Anthro v
3.2.2 software, raw anthropometric data (weight and height) were converted into nutritional
indicators (Weight-for-Age {WAZ}, Height-for-Age {HAZ}, and Weight-for-Height {WHZ})
and compare them with the latest reference population [11]. Content analysis technique was used
to analyze collected qualitative data. Prior to conducting the survey all the authorities concerned
and an informed verbal consent from participants to the survey was obtained before survey and
interviews. Privacy and confidentiality of collected information was ensured at all levels.
5
Figure 2. Analytical formulation of vulnerability to child nutritional outcomes at community,
household, and individual levels.
Source: Adapted from Mazumdar [1]
6
RESULTS AND DISCUSSIONS
1. Household’s demographic information
The survey was conducted on 320 households from rural lowland and highland areas2 of Janamora
representing a total population number of 1694.Almost all i.e 99.1% (N=320) were male headed
households (see Table 1). The lowland areas counted more young household heads 84% (n2=135)
compared to 73.5% (n2=185) from the highland. The results also revealed that the level of literacy
among all the household heads was at 40% (N=320). The greater number of illiterate household
heads was from the highland areas with a literacy rate of 37.8%. Among illiterate household heads
27.5 % (N=320) was, ironically the active members of the community within age group of 21-40. As
Action Aid Ethiopia reported (2016) the resource bases on which agricultural activities are based
upon, are progressively declining due to recurrent drought and environmental degradation, leaving
people in a situation of greater risk and the lack of diversified livelihoods also contributes to that.
The average family size in study area (5.3) was higher than national average of 4.9 for rural
households [7] and 40 % (N=320) of the households were made of more than 5 members in their
family (see Table 1). The minimum family size is 3 while the maximum was 10. The average of
dependency ratio of the two agro-ecological areas was 120.5 (± 64.6).The minimum was 40 while the
maximum value is 400. Dependency ratio relates the number of children (0-14 years old) and older
persons (65 years or over) to the working-age population (15-64).It indicates the potential effects of
changes in populations age structures for social and economic development, pointing out broad
trends in social support needs.
2. Access to maternal health services
The results indicated that there was a tendency of having mothers who were pregnant before the age
of 18 from both the highland and lowlands. The mean age was 26.3 (±6.3). This indicates that the
culture of early marriage is still alive amongst communities of Janamora Woreda. Results also
revealed higher rate of illiteracy which were at 79.4% and 77% for highland and lowland areas
respectively. Concerning involvement in Income generating activities only 30 respondents reported
2
Lowland kebeles involved in the study are Sarabar, Majje and Wayna: with 50, 25, and 60 households respectively
whereas highland kebeles were Awuchara with 85 and Deresgie with100 households.
7
to have a source of income,28 of them were making between 25-50US$ which was less than 50 US$
per month. The country estimated poverty line is 0.6US$ per day.
Access to Ante natal care was found at 55.4% in the highland and at 44.6% in the lowland among
the sampled mothers. However, a proportion of 12.5% (40) had delivered without receiving
antenatal care (ANC). This service is beneficial for both the wellbeing of the baby and of the
mother. It contributes to nutrition especially through provision of supplements for the pregnant
women to fulfill the micronutrients that cannot be provided through food. Those include Iron and
different multivitamins for example. The results revealed that 90.3% (289) of mothers (see Table 2)
experienced a safe delivery. It was found out that 25 out 31 cases of delivery with complication were
from the highland areas.
Stunting caused by early malnutrition cannot be reversed in adulthood and is associated with
complications during delivery. Although nutritional supplementation in childhood may enhance
future height, it remains uncertain what the small gains in average attained height mean in terms of
preventing difficult labor. Improved labor management is probably the most appropriate strategy for
preventing adverse health effects in stunted women. Furthermore, the association between short
stature and an increased risk of cephalo-pelvic disproportion is well established. In a review of 14
studies, the WHO found that women in the lowest quartile of height had a 60% higher risk of
assisted delivery than women in the top quartile, and the findings were consistent across study sites.
Although assisted delivery does not always equate cephalo-pelvic disproportion, it is probably a
good marker for dystocia in settings where caesarean sections are only done in extreme
circumstances. The nature of the effect appears to be relative rather than absolute in that, whatever
the average height of the population of women, the lowest tenth percentile is always at higher risk
[12]. As in the views of Gillespie and Haddad [13], malnutrition not only affects individual but also
its effects are passed from one generation to the next generation. The malnourished mothers give
birth to infants who struggle to survive and develop. If these children are girls then they often grow
up to become malnourished mothers themselves. This makes malnutrition a long term issue that
needs to be taken seriously if sustainable development goals need to be achieved.
8
3. Household Economic factors
Landlessness was found among households from Highland and lowland areas at 20% and 23%
respectively. Moreover considering the fact that in rural areas land is the basic and fundamental
productive resource on which people livelihoods depend heavily upon this consist a serious issues
that continues to rise especially due to population growth and causing agricultural productivity to
decrease. It was found out that migration was also a coping mechanism that was used by families
that could not recover from the stress caused to them by drought and by exhaustion of coping
strategies leaving people to leaving their own homes looking for a living.
4. Logistic regression analysis
Among many variables that were included in the bivariate correlation analysis only 10 variables were
significant with stunting. When introduced in the binary regression analysis, results that 8 out of 10
variables (Table 8) were significant predictors of stunting in children (6-24 months) at P<0.2.
These variables include:
a) Agro-ecological zone (as a demographic factor)
Children from households found in the highland zone (>2500 m.a.s.l) were significantly found to be
more likely stunted (OR:0.279; CI: 0.157-0.499; p<0.05)(See Table 8) compared to their counterparts
from the lowland areas. This might be caused by the effect of altitude on their growth, combined
with the other factors such as inadequate feeding practices, lack of information, diseases and others
factors. This zone was found to have been suffering from long period of drought that occurred in
2015 and damaged crop and caused death of animals. All the Kebeles of the Janamora Woreda were
covered by Product safety net program (PSNP) as an effort to improve the households food
security.
b) Sex of the child (Individual level factor)
The analysis showed that male children were significantly more vulnerable to stunting compared to
female children of the same age group (OR: 2.779; CI: 1.584-4.877; p<0.05) (See Table 8).The
possible explanation of this fact might be attributed to the biological nature of female body to have
more resistance capacity. However, more research should be initiated to investigate on any other
possible explanation of this finding which seems to be more social and contextual.
9
c) Age of the child (Individual level factor)
Results indicated that stunting was negatively associated with age, children within the smallest age
group (6-13 months) being the most vulnerable (OR: 0.530; CI: 0.378-0.742; p<0.05)(See Table 8).
According to ACF [14] a critical period in the outbreak of malnutrition is the transition from
exclusive breastfeeding until six months with complementary food. As exclusive breastfeeding does
not meet the baby’s nutritional needs anymore. For example, if a young child has to complete
breastfeeding by family meal, he/she may not satisfy his/her needs because of the following reasons:
 The offered texture of food is not in accordance with his sensorial-motor capacities
 Sharing the family meal does not correspond to his motor skills: There is a risk that he will
take much time to ingest a very small amount of food. The other children will be able to
satisfy their appetite while he/she will not be able to.
d) Maternal factors
 Mother level of education
Mother level of education was found negatively associated with stunting. Children that are born
from mother with low level of education were significantly found to be more vulnerable to stunting
(OR: 0.786; CI: 0.626-0.987; p<0.05).This is justified by the fact that they tend not to adopt easily
the indication provided to them by health extension agents. For example during household survey
most of the mothers who reported that they refuse to make their children vaccinated were afraid of
the side effects, and mostly preferred home treatment than taking they children to the health posts.
 Mother being involved in Income generating activity:
Income level of the mother was also found having a negative association with stunting. Children
born to mother who are involved in income generating activity were less vulnerable compared to
their counterparts, who are born from mothers who don’t have a way of making cash (O.R: 0.254;
CI: 0.091-0.709; p<0.05).The household with increased level of cash could afford medication and
variety of food including fruits and vegetable which consist a rich source of vitamins. Many
researches have revealed that mother’s income has been proven have a more impact on the
wellbeing of the whole family than that of the husband.
10
e) Household owning a latrine of any kind(Household environment factor)
A positive association was found between owning a latrine and stunting (OR: 1.363; CI: 1.114-1.668;
p<0.05).This means that children(6-24 months of age) who live in households that own latrines are
significantly more likely to be stunted than the children from households that do not own one. Most
of the household in the study area that had a latrine which do not fulfill the standards of an
improved latrine. For example the hole was not that much deep and therefore could instead expose
them to flies that contaminate their food and water. One the prominent issues in the rural areas in
general and in the study area in particular is the phenomenon of the fly insects which jeopardize the
sanitation and health of people in general and that of children in particular through a phenomenon
documented under environmental entheropathy[15]. A phenomenon through which children
exposition to defection affect their food assimilation and consequently lead to poor nutritional status
and to chronic malnutrition or stunting in other words.
f) Household land ownership (Household economic status)
Household land ownership was found in a negative association with children stunting. This makes
sense as in the rural area economic context; people’s lives depend heavily on their land resources.
Hence, for this study land size was considered as an indicator of economic status of the households
and according to the regression results, children from landless households were significantly more
likely to be stunted than the others from households with larger landholding(OR: 0.656; CI: 0.4470.965; p<0.05).
g) Household Dietary Diversity Score (Household food security-food consumption)
Household Dietary Diversity Score was not found statistically significant at 5% level of significance.
However, it was considered at 0.2 significance level, to show the association that exists between
food consumption at Household level and stunting among small children (6-24 months of age. A
positive but not significant at 0.05 confidence level association was found between HDDS and
stunting (OR: 1.136: .964-1.340; p<0.2).This means that even the households with high level of
dietary diversity can suffer from stunting as well as their counterparts. Food consumption at
household level alone cannot counteract stunting; in other words household dietary diversity does
not have much effect on children nutritional status.
11
CONCLUSION AND RECOMMENDATIONS
This study indicated that children (6-24 months) from households living in Janamora Woreda
highland areas located at 2500 m.a.s.l and higher, were more vulnerable to stunting than the ones
living in the remaining areas of the Woreda. The prevalence of stunting was found at 78.9% (for
HL) and at 57.8% (for LL) and the difference is 78.9-57.8 =21.1 %,( CI: 0.112-0.311; t-value
4.173, df 318, p<0.01).The significant predictors of stunting in children of 6-24 month of age
included the agro-ecological situation, age of the child and sex, mother’s level of education and
exposure to unhealthy household environment such as unimproved latrine were identified as risk
factors of stunting among children of less than two years.
The investigation pointed to the fact that the prevalent unsafe conditions were rooted in the
massive deforestation that occurred during the 1980s war, environmental degradation, climate
variability, dependency on rain-fed agriculture, soil erosion, low agricultural productivity, lack
of diversified livelihoods, population growth, gender inequality, lack of basic facilities such as
clean water and lack of health and education facilities, and ineffective food market which do not
help people especially in time of hardship. Therefore an agro-ecological perspective in the
understanding of food security and nutrition issues is of a paramount importance. Moreover,
participatory and community based interventions seem to have a great potential in providing an
opportunity to restore and strengthen the capacity and the resilience of Janamora communities
and therefore should be looked into.
12
REFERENCES
[1] Mazumdar, S. (2012) Assessing vulnerability to undernutrition among under five in Egypt:
Contextual determinants of individual consequence. New Delhi, India.
[10] IFPRI & Joachim von Braun, Tesfaye T, and Webb P. (1998) Famine in Africa, Causes,
responses and prevention.IFPRI.Baltimore and London.UK.
[11] WHO (2006) World Health Organization report 2006:Working together for Health.
http://www.who.int/whr/2006/whr06_en.pdf?ua=1.
[12] Semba,D. and Bloem,M.W (2008) Nutrition and Health in Developing Countries, Second
Edition, Humana Press, 999 Riverview Drive, Suite 208, Totowa, NJ 07512.USA.
[13] Gillepsie S., Lawrence, Haddad (2003) The double burden of malnutrition in Asia: Causes,
consequences and solutions, Sage Publication, India.
[14] ACF (2012) Conceptual models of child malnutrition. The ACF Aprproach in mental health
and care practices.ACF.France.
[2] Muhammad, S.B, (2013) Explaining Malnutrition in Ethiopia: The Role of socioeconomic status
and maternal health on nutritional condition of children. Hague. The Netherland.
[4]vonGrebmer,K.,Headey,C.Bene,L.Haddad,T.Olfinbyi,D.Wiesmann,H.Fritschel,S.yin,Y.Yohannes
,C.Foley,C.von Oppeln,and B.Iseli.(2013) Global Hunger Index: The Challenge of Hunger: Building
resilience to achieve food and nutrition security. Bonn, Washington DC, and Dublin:
Welthungerhilfe, International Food Policy research Institute, and concern Worldwide.
[5] Dennis, D.M and Ross, M.W (2013) Food system strategies for preventing micronutrient
malnutrition. ESA working paper No.13-06.August 2013.FAO.Rome.Italy.
[6] Central Statistical Agency of Ethiopia (2014) Ethiopia Mini Demographic and Health Survey
2014.Addis Ababa, Ethiopia.
[7] Central Statistical Agency of Ethiopia (2011) Ethiopia Demographic and Health survey
2011.Addis Ababa, Ethiopia.
13
[8] Federal Ministry of Health (FMoH) (2011) National guideline for family planning services in
Ethiopia. Addis Ababa, Ethiopia.
[9] IFPRI (2015) Global Nutrition Report 2015: Actions and accountability to advance nutrition and
sustainable development 1-168. http.//www.ifpri.org/publication/global-nutrition-report-2015.
[15] www.wsp.org/scalingupsaniation, Accessed on 5 June 2016 at 11:00 pm.
14
HH’s head
(N=320)
AgroHH’s head sex
ecological
areas
(N=320)
Female Male
age Literacy (N=320)
Total
HH
Members (N=320)
21-40 years >41
Illiterate
Literate <=5
> 5years
Highland
(n1=185)
0.6%
(2)
57.2%
(183)
42.5%
(136)
15.3
(49)
37.8%
(121)
20%
(64)
55.2%
(102)
34%
(63)
Lowland
(n2=135)
0.3%
(1)
41.9%
(134)
35.3%
(113)
6.9%
(22)
22.5%
(72)
19.7
(63)
57.8
(78)
42.3%
(57)
Table 1. Households’ demographic information
Source: Field work, 2016
Table 2. Maternal factors
Agroecological
zone
Highland
(n1=185)
Lowland
(n2=135)
Education level (N=320)
Can read
&write
Secondary
& higher
Illiterat
e
Yes
<20 years
Yes
Safe
deliver
y
(N=320
)
Yes
15.1%
(28)
17%
(24)
5.4%(10)
79.4%
(147)
77%
(104)
53.3%
(16)
46.7%
(14)
12%
(22)
17%
(23)
55.4%
(155)
92.5%
(125)
55.4%
(160)
95.5%
(129)
5% (7)
Mother
IGA
Mother
age
ANC
(N=
320)
Place of delivery
(N=320)
Home
Health
facility
56.9%
(168)
43.1%
(127)
68.0%
(17)
32.0%
(8)
Source: Field work, 2016; ANC: Ante natal care; IGA: Income generating activity.
Table 3. Households Economic factors
Agroecological
zone
Highland
(n1=185)
Land ownership (N=320)
No
livesto
ck
No
land
<0.5
ha
0.5-1 ha
1-1.5
ha
20%
(37)
55%
(102)
21.6%
(40)
3.2%
(6)
12.5%
(23)
Migrate
d
member
Source of food& income(N=320)
Yes
MF
SW
WL
SWP
83.9%
(26)
83.5%
(154)
7%
(13)
8.7%
(16)
0.6%
(1)
15
Lowland
(n2=135)
23%
(31)
41.4%
(56)
34.9%
(47)
0.7%
(1)
22.3%
(30)
16.1%
(5)
85.2%
(115)
0.7%
(1)
0.7%
(1)
13.4%
(18)
Source: Field work, 2016; MF: Mixed farming, SW: Salaried work; WL: Wage labor; SWP:
Sale of wild products.
Table 4.Water and sanitation among households
Agro-ecological
zone
Latrine
(N=320)
Water accessibility (N= 320)
No toilet
Less accessible
Accessible (<30 minutes to
(>30 minutes to water
water source)
source)
Highland
48.7%(90)
(n1=185)
Lowland
39.3% (53)
(n2=135)
Source: Field survey, 2016
70.9%(175)
13.7%(10)
29.1%(72)
86.3%(63)
Table 5. Children characteristics
AGE (mo)
Boys
Girls
6-12
46.4% (45)
53.6% (52)
13-18
53.6%(45)
46.4% (29)
19-24
54.4%(81)
45.6% (68)
Total (N=320)
53.5%(171)
46.5%(149)
Source: Field work, 2016
Table 6. Dietary diversity score among sampled houdseholds
HDDS
Agro-ecological zone
N=320
Mean
Std. Deviation
Highland
185
6.12
1.696
Lowland
135
6.59
1.894
16
Table 7. Prevalence of stunting by agro-ecological zone
Agro-ecological zone
HAZ group (N=320)
Normal
Moderate stunting
Severe stunting
Highland(n1=185)
21% (39)
21,6% (40)
57.3% (106)
Lowland(n2=135
42.3%(57)
20.7% (28)
37 % (50)
Source: Field survey, 2016
Table 8. Statistical tests of individual predictors
Variables in the Logistic regregression Equation
B
S.E.
Wald
df
Sig.
Exp(B)
95%
C.I.for
EXP(B)
Lower
Upper
Step
AEZ (LL:(1);HL:(0)
-1.27
0.29
18.63
1
0.00
0.28
0.15
0.499
1a
Sex of child:F:(0);M: (1)
1.02
0.28
12.68
1
0.00
2.78
1.58
4.877
Age of child
-.635
0.17
13.6
1
0.00
0.53
0.38
0.742
Mother’s EDUCATION
-.241
0.11
4.28
1
0.04
0.78
0.62
0.987
Mother’s IGA
-1.37
0.52
6.85
1
0.00
0.25
0.09
0.709
Number of rooms
0.360
0.298
1.456
1
0.23
1.43
0.8
2.572
Latrine
0.310
0.103
9.080
1
0.00
1.36
1.11
1.668
Land ownership
-.421
.197
4.581
1
0.03
0.656
0.45
0.965
Aidin2015(1)
0.12
0.34
0.12
1
0.72
1.129
0.58
2.205
HDDS
0.13
0.08
2.30
1
0.13
1.13
0.96
1.340
Constant
2.647
1.098
5.811
1
0.016
14.11
a. Variable(s) entered on step 1: Cluster, Sex_of_child, Age_of_child, Mother_EDUCATION_level, Mother_IGA,
Number_of_rooms, Latrine, Land_ownership, Aidin2015, and HDDS.
17
18
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