Determinants of child malnutrition in rural and urban Ecuadorian highlands

Abstract

Objective: To identify and compare the sociodemographic determinants of stunting, wasting and overweight among infants of urban and rural areas in the Ecuadorian highlands. Design: Cross-sectional study. Setting: Nabon (rural) and Cuenca (urban) cantons, Azuay Province, Ecuador. Subjects: A total of 703 children aged 0–24 months and their caregivers (227 rural and 476 urban) recruited during the period from June to September 2008. Results: Stunting prevalence was significantly higher in the rural area (37?4 % v. 17?7 %; P , 0?001) while wasting (7?1 %) and overweight (17?1 %) prevalence were more similar between areas. Determinants of stunting for the pooled sample were male gender (OR 5 1?43; 95 % CI 1?06, 1?92; P 5 0?02), preterm delivery (OR 5 1?65; 95 % CI 1?14, 2?38; P 5 0?008), child’s age (OR 5 1?04; 95 % CI 1?01, 1?07; P 5 0?011), maternal education (OR 5 0?95; 95 % CI 0?92, 0?99; P 5 0?025) and facility-based delivery (OR 5 0?57; 95 % CI 0?45, 0?74; P , 0?001). The latter was also a determinant of overweight (OR 5 0?39; 95 % CI 0?25, 0?62; P , 0?001). Rural determinants of stunting were maternal height (OR 5 0?004; 95 % CI 0?00004, 0?39; P 5 0?018), diarrhoea prevalence (OR 5 2?18; 95 % CI 1?13, 4?21; P 5 0?02), socio-economic status (OR 5 0?79; 95 % CI 0?64, 0?98; P 5 0?030) and child’s age (OR 5 1?07; 95 % CI 1?02, 1?11; P 5 0?005). Urban determinants were: maternal BMI for stunting (OR 5 0?91; 95 % CI 0?84, 0?99; P 5 0?027), cough prevalence (OR 5 0?57; 95 % CI 0?34, 0?96; P 5 0?036) and facility-based delivery (OR 5 0?25; 95 % CI 0?09, 0?73; P 5 0?011) for overweight, and hygiene for wasting (OR 5 0?57; 95 % CI 0?36, 0?89; P 5 0?013). Conclusions: Infant malnutrition was associated with different sociodemographic determinants between urban and rural areas in the Ecuadorian highlands, a finding which contributes to prioritize the determinants to be assessed in nutritional interventions.