Care and not wealth is a predictor of wasting and stunting of 'The Coffee Kids' of Jimma Zone, southwest Ethiopia

摘要

Background: The generation of cash from agricultural products is the mainstay of the livelihood of many households in developing countries. However, critics of cash cropping have highlighted its influence on dietary diversity and availability of foodat the household level, eroding the potential for optimal child caring practices. Methods: A community-based cross-sectional survey was carried out in three randomly selected coffee-producing districts of Jimma Zone in southwest Ethiopia. The underlyingcauses of malnutrition, food access, hygiene and care were assessed using the household food insecurity access scale, morbidity reports and infant and young child feeding practice core indicators of the World Health Organization. Anthropometric data wereconverted into weight for age, height for age, body mass index for age and weight for height Z-scores to determine child nutritional outcomes. Results: Prevalence of underweight, wasting, stunting and thinness were 14.2%, 9.1%, 24.1% and 9.9%, respectively. Multivariable logistic regression showed that children with suboptimal meal frequency were more than three times more likely to develop wasting (AOR = 3.3, p < 0.0001). Female children were twice as likely to develop wasting compared with males (AOR= 2.00, 4.1, p = 0.05). Children with suboptimal dietary diversity were almost four times as likely to develop stunting (AOR = 3.95, p < 0.0001 ). Those who were not exclusively breastfed during their first 6 months were almost five times as likely to develop stunting (AOR = 4.66, p < 0.0001). Conclusions: The findings imply that in coffee-producing areas, child caring practices are stronger independent predictors of nutritional status than wealth or economic indicators alone.