Abstract
This study examined the positive and negative determinants of normal linear growth among pre-school children living in better-off households, using survey data from Ghana, Kenya, Nigeria, Mozambique and Democratic Republic of Congo (DRC). The main outcome variable was child height-for-age z-scores (HAZ), categorized into HAZ≥-2SD (normal growth/not stunted) and HAZ<–2 (stunted). Logistic regression was utilized in the analysis. We estimated adjusted odd ratios (aORs) of the determinants of normal growth. Higher maternal weight (measured by body mass index) was associated with increased odds of normal growth in Mozambique, DRC, Kenya and Nigeria. A unit increase in maternal years of education was associated with increased odds in normal growth in DRC (aOR=1.06, 95% CI=1.03, 1.09), Ghana (aOR=1.08, 95% CI=1.04, 1.12), Mozambique (aOR=1.08, 95% CI=1.05, 1.11) and Nigeria (aOR=1.07, 95% CI=1.06, 1.08). A year increase in maternal age was associated positively with normal growth in all the five countries. Breastfeeding was associated with increased odds of normal growth in Nigeria (aOR= 1.30, 95% CI=1.16, 1.46) and Kenya (aOR=1.37, 95% CI=1.05, 1.79). Children of mothers who were working had 25% (aOR=0.75, 95% CI=0.60, 0.93) reduced odds of normal growth in DRC. A unit change in maternal parity was associated with 10% (aOR=0.90, 95% CI=0.84, 0.97), 23% (aOR=0.77, 95% CI=0.63, 0.93), 25% (aOR=0.75, 95% CI=0.69, 0.82), 6% (aOR=0.94, 95% CI=0.89, 0.99) and 5% (aOR=0.95, 95% CI=0.92, 0.99) reduced odds of normal growth in DRC, Ghana, Kenya, Mozambique and Nigeria respectively. A child being a male was associated with 16% (aOR=0.82, 95% CI=0.68, 0.98), 40% (aOR=0.60, 95% CI=0.40, 0.89), 37% (aOR=0.63, 95% CI=0.51, 0.77) and 21% (aOR=0.79, 95% CI=0.71, 0.87) reduced odds of normal child growth in DRC, Ghana, Kenya and Nigeria respectively. In conclusion, maternal education, weight, age, breastfeeding and antenatal care are positive determinants of normal child growth, while maternal parity, employment, and child sex and age are negative determinants. Interventions to promote child growth should take into account these differential effects.
