An analysis of trends and determinants of child undernutrition in Ethiopia

Abstract

In 2000 over half of Ethiopian preschool children were stunted and almost a third were severely stunted. However, since then, stunting prevalence has reduced by 1.4 percent points per year between 2001 and 2011, although progress slowed to 1.0 point per year between 2011 and 2014. This report uses two rounds of the Ethiopian Demographic Health Survey (EDHS) to statistically analyze patterns and trends in undernutrition (child growth) in Ethiopia over 2000 to 2011. The report finds that household assets, maternal and paternal education, antenatal care, and birth intervals are the most consistent predictors of undernutrition outcomes, with other factors only having importance in either rural or urban areas, but not both (piped water, toilet facilities). However, improvements in these factors only explain a small proportion of the observed improvements in nutrition over 2000-2011. The report hypothesizes that income growth and improved food security – latent factors rather imperfectly captured by the DHS asset index – are likely to have been the main forces driving nutritional change in recent decades. The report also analyzes the sources of the large rural-urban discrepancy in child nutrition outcomes in Ethiopia. Here the statistical models in question much more successfully explain the rural-urban gap, and suggest that differences in household assets explain at least two-thirds of the gap. Finally, the report analyses infant and young child feeding (IYCF) practices. IYCF practices in Ethiopia are very poor. While breastfeeding is widespread, exclusive breastfeeding is by no means universal, AND there is a striking lack of diversity in children’s diets, with most children regularly exposed only to basic staples (grains, roots, tubers), with cow milk constituting the only significant source of animal-based proteins and micronutrients. The most significant predictors of dietary diversity are household assets, parental education, cow ownership, antenatal care exposure, and maternal age, with older women giving their children less diverse diets. Going forward, improving the quality of Ethiopian diets will also be a major task for strategies to improve child growth. This research is supported by the Department for International Development’s Transform Nutrition Programme which is led by International Food Policy Research Institute (IFPRI)