An analysis of under-five nutritional status in Lesotho: the role of parity order and other socio-demographic characteristics

Abstract

Abstract Introduction: Africa is plagued by severe malnutrition, which most avidly affects children under the age of five both in the short-term and long term, and has consequences for the individual child, the household and the community. This study wishes to inform those who are in the field of child development and health as well as to contribute to a general understanding of the nutritional effects of under-five children in Lesotho. Methodology: With the use of the 2004 Lesotho Demographic and Health Survey (LDHS) data univariate, bivariate and multivariate analysis was used to assess child malnutrition. Logistic regression was used to assess the relationship between parity order and weight-for-height (wasting) and weight-for-age (underweight). Multinomial logistic regression was performed for the height-for-age (stunting). Results: Only in height-for-age (stunting) and for the malnourished category in the multinomial logistic regression are statistically significant results encountered for the three anthropometric measures. Parity order becomes more significant once all the independent variables are taken into account in the second model. Conclusion and Recommendations: The study found that 50% of children in Lesotho are of parity order 1 and 2, and that only a quarter of all children lived in urban areas. According to the computed wealth index only 27 of the children lived in households where the wealth index score was above 5, and the educational level of the mother showed a large disparity. The anthropometric measures showed great disparity in terms of total number and percentage of children in each nutritional level. Just over a quarter of all children are classified as stunted, and a further one in five children as severely stunted. Also, 12.3% of children under the age of five are underweight, and 3.65% are severely underweight. In the second model for the stunting measure it was found that malnourishment and severe malnourishment had a higher probability of occurring amongst those children at whose mother’s had a higher educational level. This may be due to the fact that either mother’s with a lower educational level have more time to care and support their children and that the public health system may have been effective in disseminating key child health messages to the point that educational attainment may no longer be a determinant of child’s nutritional status. The mother’s age at birth of the index child found that children born to older mothers have a higher likelihood of being stunted. The wealth index showed a surprising result in that those children, in general, in households that have a low wealth index (0 and 1) score were less likely to suffer from stunting than children in households with a higher wealth index score. It was found that children of lower birth orders were at more likely to be stunted or severely stunted than those children born at higher birth orders. Further research is required, especially for wasting where cases of malnourishment were too small to be statistically significant for mother’s age at birth of the index child.