Chronic Malnutrition among Under Five Children of Ethiopia May Not Be Economic. A Systematic Review and Meta-Analysis
ABSTRACT Background: Ethiopia is one of the four low income countries in achieving MDG4, however, minimizing child under-nutrition became critical undertaking thus far. This review aimed at identifying the predictors of under-5 children nutrition in Ethiopia. Methods: Databases searched were Med Line, HINARY, MedNar and Embase. Furthermore, gray literatures were also sought. All papers selected for inclusion in the review were subjected to a rigorous critical appraisal using standardized critical appraisal instruments from the Joanna Briggs Institute. Quantitative papers were pooled for statistical analysis andnarrative synthesis. Odds ratios and their 95% confidence intervals were calculated for analysis. Papers of optimal quality but without optimal data set for meta-analysis were subjected for narrative synthesisResults: Nonadherence towards Optimal feeding recommendations was the most reported predictor of stunting and wasting, while, maternal education and ‘Water, Sanitation and Hygiene’ factors were the second.The findings of the Meta-analysis showed no evidence of association between household income/wealth and stunting of children in Ethiopia (OR=1.14, 95% CI= 0.97, 1.34), heterogeneity test: i2 = 92%, df = 20, (P < 0.00001). On the other hand, children in low income/wealth group were 1.73 times more likely to have wasting compared to children of the higher income/wealth households (OR=1.73, 95% C I= 1.51, 1.97) heterogeneity test: i2 = 71%, df = 20, (P < 0.00001).Conclusion: An over-reliance on macroeconomic growth as a solitary factor towards undernutrition should not be the way forward. Supplementary and more focused nutrition specific and sensitive interventions are needed in Ethiopia. Key words: child undernutrition, systematic review, meta-analysis, Ethiopia