Prevalence and determinants of stunting among children under 5 years in remote Nepal

Abstract

Abstract Introduction The growth and development of an individual is greatly influenced by their nutritional state during the first 5 years of life. Stunted growth and suboptimal weight gain remain major public health concerns during the most critical stages of growth and early childhood development. This study aims to assess the prevalence of stunting among children under 5 years of age and identify its associated factors in remote district of Nepal. Methods We conducted a survey with 487 mothers of children under 5 years of age in a remote area of Nepal. Smartphones were installed with KoBocollect software to collect the data. Trained health researchers collected the data including the anthropometric measurement (height, weight and mid‐upper arm circumference, MUAC) for assessment of the nutritional status. We followed World Health Organization guidelines for the anthropometric measurement and calculated the Z ‐score using Emergency Nutrition (ENA) software. Regarding the questions related to dietary diversity, we used a validated questionnaire: household dietary diversity score, child dietary diversity score and women dietary diversity score. We analysed all the data from the survey using SPSS version 24. We performed descriptive and multivariable analyses to find the nutritional status and factors associated with stunting. Result We found a high prevalence of stunting, that is, 56.7% among children under 5 years of age. Sociodemographic variables like age, sex of the child and ethnicity were significantly associated with the prevalence of stunting. Male children (60.7%) were more likely to be stunted compared to females (51.8%). We found that children from the Brahmin/Chhetri ethnic group were more likely to be stunted compared to children from Dalit and Janajati. Mothers who delivered their youngest child by skilled health personnel were less likely to have their children to be stunted. Similarly, children aged 24–59 months were 2.5 times more likely to be stunted than those aged 6–23 months. Conclusion Stunting among children under 5 years of age is very high in the remote district of Nepal. Sex, age of the child, ethnicity and delivery by a health professional were associated with the prevalence of stunting. There is a need for awareness and public health intervention to reduce the prevalence of stunting and improve the nutritional status of children under 5 years of age in remote districts of Nepal. Furthermore, assessment of the nutritional status of children in other remote districts of Nepal is important.