SOCIOECONOMIC, MATERNAL, AND CHILD-LEVEL DETERMINANTS OF UNDERNUTRITION AMONG CHILDREN UNDER FIVE YEARS IN SELECTED DISTRICTS OF PUNJAB, PAKISTAN: A CROSS-SECTIONAL STUDY

Abstract

Background: The problem of child under nutrition has been one of the most significant problems in the context of low and middle income countries such as Pakistan. Punjab, the largest Pakistani province has severe socioeconomic and regional inequalities, which affect nutritional outcomes of children. This paper was to investigate the socioeconomic, maternal, child-related, and environmental factors of stunting, underweight and wasting in children under the age of five years in sample districts in Punjab.

Methods: A cross-sectional study involving analysis was done on 3,200 children aged 059 months who were living in Lahore, Faisalabad, Multan, Bahawalpur and Rawalpindi. The data were gathered with the help of household-based survey based on the use of standardized questionnaires and anthropometric measurements. The definition of stunting, underweight and wasting was based on the World Health Organization growth standards. The independent determinants of each nutritional outcome were identified by multivariable logistic regression models and adjusted odds ratios with 95 per cent confidence intervals were presented.

Findings: Stunting, underweight and wasting were found to occur at 29.6, 23.1 and 8.9 percent, respectively. The best predictors of stunting and underweight were household poverty and low maternal education. The all kinds of undernutrition were significantly correlated with small birth size and short intervals of birth. In terms of age, exclusive breastfeeding deficiency analysis indicated that it was a major factor in underweight in infants, but scanty dietary diversity played a bigger role in older children. Wasting was mainly correlated with such acute factors as recent illness, unclean drinking water, incomplete immunization, and absence of skilled birth attendance.

Implications: The complex of socioeconomic deprivation, maternal features, early-life influences, and environment conditions contribute to child undernutrition in Punjab, which points to the necessity of interventions based on age and complexity of causes.