Multilevel analysis of undernutrition and associated factors among adolescent girls and young women in Ethiopia

Wubshet Debebe Negash; Samrawit Mihret Fetene; Ever Siyoum Shewarega; Elsa Awoke Fentie; Desale Bihonegn Asmamaw; Rediet Eristu Teklu; Fantu Mamo Aragaw; Daniel Gashaneh Belay; Tewodros Getaneh Alemu; Habitu Birhan Eshetu

doi:10.1186/s40795-022-00603-x

Multilevel analysis of undernutrition and associated factors among adolescent girls and young women in Ethiopia

BMC Nutr. 2022 Sep 19;8(1):104. doi: 10.1186/s40795-022-00603-x.

Affiliations

¹ Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia. wubshetdn@gmail.com.
² Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia.
³ Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
⁴ Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
⁵ Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
⁶ Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
⁷ Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract

Background: The consequences of undernutrition have serious implication for the health and future reproductive periods of adolescent girls and young women aged 15-24 years. Inspite of this, they are neglected age groups and there is limited information about the nutritional status of this age group in Ethiopia. Therefore, estimating the extent and associated factors of undernutrition among adolescent girls and young women in a national context using multilevel analysis is essential.

Methods: Secondary data analysis was conducted from the Ethiopian Demographic and Health Survey 2016. A total sample weight of 5362 adolescent girls and young women was included in this study. A multilevel mixed-effect binary logistic regression model with cluster-level random effects was fitted to determine the associated factors of undernutrition among adolescent girls and young women in Ethiopia. Finally, the odds ratios along with the 95% confidence interval was generated to determine the individual and community level factors of undernutrition. A p-value less than 0.05 was declared as the level of statistical significance.

Results: Overall, 25.6% (95%CI: 24.5-26.9) of adolescent girls and young women were undernourished. Statistically significant individual level factors includes adolescent girls and young women aged 15-19 years (AOR: 1.53, 95%CI: 1.32-1.77), individual media exposure (AOR: 0.82, 95%CI: 0.69-0.97), and unprotected drinking water source (AOR: 1.24, 95%CI: 1.04-1.48). Whereas, Southern Nations, Nationalities, and Peoples' Region (AOR: 0.33, 95%CI: 0.13-0.83) and rural residence (AOR: 1.69, 95%CI: 1.24-2.32), were community level factors for adolescent girls and young women undernutrition.

Conclusion: One quarter of the Ethiopian adolescent girls and young women were undernourished. Therefore, the Ethiopian government should better engage this age group in different aspects of the food system. To improve nutritional status, public health interventions such as increased media exposure for rural residents and interventions that improve access to protected water sources will be critical.

Keywords: Adolescent girls and young women; Ethiopia; Factors; Multilevel; Undernutrition.