Prevalence and factors associated with malnutrition among internally displaced children aged 6-59 months in Hawl Wadaag District, Mogadishu-Somalia

Abstract

Introduction: Worldwide, childhood malnutrition is a public health concern that contributes to impaired mental and physical growth. Malnutrition encompasses stunting, wasting underweight, micronutrient deficiency, and being overweight. Stunting and wasting in children under 5 years have declined worldwide from 32.6% in 2000 to 22.2% in 2017 and from 7.9% in 2012 to 7.5% in 2018 respectively, their prevalence is still high. The prevalence of stunting and wasting in Somalia is 25.3% and 15% respectively, there are major regional differences. For example, the prevalence of stunting is 25.3% in south and central Somalia, 15.1% in the northeast, and 8.6% in the northwest respectively. Internally displaced children are more likely to have malnutrition compared to the general population due to inadequate feeding, however the magnitude of stunting, wasting and underweight among children aged 6-59 months is not well documented, General objective: To determine the prevalence and factors associated with malnutrition among internally displaced children aged 6-59 months in Howl Wadag district Mogadishu-Somalia. Methods: This was a cross-sectional study. A total of 380 children aged 6 to 59 months and their caretakers were enrolled. Children and caretakers were enrolled using stratified systematic sampling techniques. Data was collected using a structured questionnaire, entered into Epidata 4.2, and analyzed using ENA Software for SMART and STATA version 16.0. Continuous variables were summarized using mean (SD) or median (IQR) and categorical variables as frequencies and percentages. The factors associated with stunting, wasting, and being underweight were analyzed using logistic regression analysis. Results: Most of the children were aged between 48 to 59 months [25.8% (98/380)] and the lowest number was aged 6 to 11 months [7.9% (30/380)]. The prevalence of wasting, stunting, and being underweight among children under 5 years were 17.9% (95%CI 14.4 - 22.1%), 23.7% (95%CI 19.7 - 28.2%), and 16.6% (95% CI 13.2 - 20.6%) respectively. Wasting was more likely among children whose caretakers were divorced (aOR = 8.1, 95%CI 1.46 – 44.75), working (aOR = 2.6, 95%CI 1.29 – 5.13) and children whose households had members equal to 5 or more (aOR = 2.3, 95%CI 1.15 – 4.60). Stunting was more likely among children whose caretakers were male (aOR = 2.5, 95%CI 1.15 – 5.48) and those whose households did not treat drinking water (aOR = 2.3, 95%CI 1.18 – 4.37). Underweight was more likely among children whose households had greater or equal to 5 members (aOR = 1.8, 95%CI 1.02 – 3.38) and less likely among children from households with high dietary diversity (aOR = 0.4, 95%CI 0.16 – 0.98). Conclusions: The prevalence of wasting, stunting, and being underweight among children under 5 years in households of IDPs in Howl Wadag district, Somalia was high 17.9%, 23.7%, and 16.6% respectively. The findings indicate that the prevalence of child malnutrition among IDPs is still a serious public health problem in relation to the WHO classification for public health significance. The household number of people was associated with waste and being underweight. While stunting was associated with male caretakers. Recommendations: There is a need to provide additional support to children whose parents have divorced, especially for those being taken care of by men. Local health authorities should also promote the use of family planning methods to regulate household sizes and sensitize households about drinking water treatment to prevent diseases such as diarrhea.