Factors Associated With Underweight and Stunting Among Children in Rural Terai of Eastern Nepal

Malnutrition continues to affect a large proportion of children in the developing world. The authors undertook this study to identify biologic, socioeconomic, and health care factors associated with underweight and stunting in young children in an the eastern Tarai (plains) district of Nepal. Data were collected via questionnaires from mothers of 443 children aged 6 to 36 months in Sunsari district. Multistage cluster sampling was used to select villages and children. Anthropometric measurements were made on both children and their mothers. Logistic regression was used to measure the independent (adjusted) effect of risk and protective factors on the odds of underweight or stunting. More than half (53.3%) of the children were found to be underweight (< 2 standard deviations weight for age below reference median) and more than one third (36.6%) had stunting (< 2 standard deviations height for age below reference median). Low maternal body mass index, child's age, higher birth order, and lower standard of living score were strong predictors of underweight, whereas mother's education > 5 years and participation in vitamin A and nutritional programs were protective. Infant age, low maternal body mass index, and low standard of living score were significant risk factors for stunting, whereas mother's education > 5 years was strongly protective. These results suggest that underweight and stunting are the result of a nexus of biological, socioeconomic, and health care factors.