INVESTIGATING THE CONTRIBUTION OF SOCIOECONOMIC AND ENVIRONMENTAL FACTORS TO UNDER-FIVE CHILD MALNUTRITION IN THE SISSALA WEST DISTRICT OF UPPER WEST REGION, GHANA

Abstract

Malnutrition is an important cause of infant and young child mortality and reduced life span. Child malnutrition in sub-Saharan Africa is said to be a function of a complex set of interrelated factors. This study sought to investigate the contribution of socioeconomic and environmental factors to under-five child malnutrition in Sissala West District. The study was descriptive cross-sectional in design, which employed multistage random sampling technique to select communities and households with a child under-five years of age. The data collection instruments included, structured interview guide, an observational checklist and anthropometric equipment (infantometer and weighing scale). Data was analysed using ENA for SMART 2011 software (November 10, 2014 version) and SPSS software (version 21.0). It was shown that 15%, 10.4% and 4.6% of the under- five children were stunted, underweight and wasted respectively. Most (95.4%) of the caregivers were females, 54.2% had no form of formal education, 77.7% were into farming and 13.5% were within the lower wealth index (poor). In addition, 65.0% practiced open defecation, 68.5% practiced handwashing habitually and 61.5% washed hands using soap under running water, 81.2% and 72.7% had clean immediate surroundings and kitchen environment respectively. With multinomial logistic regression analysis, low wealth index (aOR=3.7; 95%CI=1.6-8.4; p=0.002) was found to be a statistically significant predictor of stunting, while educational level of caregiver (aOR=1.9; 95%CI=1.2-5.1; p=0.048), low wealth index (aOR=5.5; 95%CI=2.2-13.3; p<O.OOI), no toilet in the house (aOR=4.6; 95%CI=1.1-20.0; p=0.042), cleanliness of bathroom/toilet (aOR=2.7; 95%CI=0.1-0.8; p=0.034) and drainage system (aOR=2.4; 95%CI=0.2-0.9; p=0.043) were found to be statistically significant in predicting underweight, and cleanliness of the bathroom/toilet (aOR=2.9; 95%CI=O.O-O.8; p=O.030) was the only significant predictor of wasting. The study therefore concluded that both socioeconomic and environmental factors have shown great importance in contributing to under-five child malnutrition. The Environmental Health and Sanitation Department of the District Assembly should be more vigorous in their household inspections and education campaigns to ensure that the rural folks put up household toilet facilities and adhere to best sanitary practices. Government and Non-Governmental Organisations should work towards getting the rural poor (lower wealth index households) to take up other income generating activities aside farming to alleviate poverty.