Determinants Of Overweight With Concurrent Stunting Among Ghanaian Children

ABSTRACT Background – Malnutrition is evident in the Ghanaian community. Stunting and overweight conditions occurring independently within individuals are of public health interest. Children under five are most susceptible to this condition. Studies concerning the dual burden of malnutrition in children have indicated the simultaneous occurrence of overweight and stunting within individuals (especially children). Objective - This analysis was performed to assess the prevalence of overweight with concurrent stunting among Ghanaian under-fives. The individual and contextual determinants of stunting; overweight; and overweight with concurrent stunting were also determined. Methodology – This study analyzed data sets of the fourth round of the Ghana Multiple Indicator Cluster Survey (MICS4). Eligible participants were under-fives whose mothers or caretakers provided complete interview responses. Univariate analyses were used to describe selected characteristics assessed from the Ghana MICS4 datasets. Chisquare and simple logistic regression analysis were used to compare the associations between the study outcomes (stunting, overweight and overweight with concurrent stunting) and several explanatory variables. Odds ratios with accompanying, 95% Confidence Intervals were used to assess the strength of association between the outcomes and each explanatory variable. The multiple logistic regression analysis was used to adjust for potential confounders. P < 0.05 was used to denote statistical significance. Results – Data was analyzed using 7550 children. The prevalence of stunting was 27.5%; underweight was 17.3%; wasting was 7.7%; overweight was 2.4% and double burden of malnutrition was 1.2%. Girls had a significantly higher odds than boys to be stunted (aOR = 1.312; 95% CI, 1.111 - 1.549). Children who lived in the northern zones were 13 times as likely as coastal children to be overweight (aOR = 12.888; 95% CI, 1.738 – 95.543). Under-fives who belonged to the fourth quintile, were 4 times as likely as children within the poorest quintile to be overweight and concurrently stunted (aOR = 4.311; 95% CI, 1.219 – 15.241) Conclusion - This analysis showed a 1.2% prevalence of the Double Burden of Malnutrition occurring among Ghanaian under-fives. Child’s age, sex, malaria parasitemia and anemia were individual determinants of stunting. Contextual determinants of stunting were mother’s age, religion of household head, wealth index quintile and mother registered with any health insurance. Individual determinant of overweight was the child’s age, while contextual determinants were the religion of household head, wealth index quintile, marital status and geographic zones. Contextual determinants of DBM were maternal age, wealth index quintile, religion of household head and marital status of women.