A comparative analysis of determinants of low birth weight and stunting among under five children of adolescent and non-adolescent mothers using 2015/16 Tanzania Demographic and Health Survey (TDHS)

Ramadhani H Mtongwa; Charles Festo; Ester Elisaria

doi:10.1186/s40795-021-00468-6

A comparative analysis of determinants of low birth weight and stunting among under five children of adolescent and non-adolescent mothers using 2015/16 Tanzania Demographic and Health Survey (TDHS)

BMC Nutr. 2021 Nov 4;7(1):64. doi: 10.1186/s40795-021-00468-6.

Authors

Ramadhani H Mtongwa¹, Charles Festo², Ester Elisaria²

Affiliations

¹ The Nelson Mandela Institution of Science and Technology in Collaboration with Ifakara Health Institute, P.O. Box 447, Arusha, Tanzania. mtongwar@nm-aist.ac.tz.
² Department of Impact Evaluation, Health System and Policy Analysis, Ifakara Health Institute, Plot 463, Kiko Avenue Mikocheni, P.O. Box 78 373, Dar es Salaam, Tanzania.

Abstract

Background: Tanzania is one of the Sub-Saharan African country with nearly 12 out of 60 million people being adolescent. The prevalence of child marriage is higher with one out of every three girls being married before reaching their 18th birthday, 5 % being married by the age of 15, and 31% by the age of 18 years. Literature shows early pregnancy is associated with Low Birth Weight (LBW) and stunting among children under 5 years. This paper explores variation and factors associated with low birth weight and stunting among children born by adolescent and non-adolescent mothers.

Methods: Data from 13,266 women with children under 5 years collected as part of the 2015/2016 TDHS was re-analyzed using STATA version 14 software while accounting for survey design. A total of 6385 women (of which 7.2% were adolescent) and 8852 women (of which 6.7% were adolescent) were involved in the analysis of child birth weight and stunting respectively. Descriptive statistics stratified by maternal age was conducted with LBW and stunting as outcome variables followed by logistic regressions models controlling for confounding variables.

Results: The proportion of obese or overweight adolescent and non-adolescent mothers was 11.8 and 36.5% respectively. Antenatal care (ANC) attendance, areas of residence and social economic status were very similar in the two maternal age groups. Non- adolescent mothers had reduced odds of giving birth to LBW babies compared to adolescent mothers (Adjusted Odds Ratio (AOR) = 0.34; 95% CI: 0.22-0.50). Maternal undernutrition (AOR = 2.29; 95% CI: 1.43-3.67), being divorced, separated or widowed (AOR = 1.76; 95% CI: 1.24-2.50) and having at least four ANC visits (AOR = 0.64; 95% CI: 0.49-0.83) were significantly associated with reduced odds of having a LBW. Child stunting was not associated with maternal age. Maternal high socioeconomic status (AOR = 0.69; 95% CI: 0.57-0.84) and maternal obesity or overweight (AOR = 0.77; 95% CI: 0.64-0.92) were negatively associated with stunting. Child birth weight, sex, and age were significantly associated with stunting.

Conclusion: Maternal age was a predictor of LBW but not stunting. ANC attendance and not living with a spouse increase the risk of LBW babies. Stunting was associated with low maternal body mass index (BMI), low socioeconomic status, child birth weight, gender, and age. A multi-sectoral approach is needed to address child nutrition problems with teenagers 'specific intervention that offer emotional support, and health education during pregnancies for improving immediate and later life child birth outcomes.

Keywords: Adolescents; Low birth weight; Stunting; Tanzania; Under-five.