Levels, patterns and determinants of child malnutrition in Zimbabwe : evidence from the 1988, 1994 and 1999 Zimbabwe demographic and health surveys.

Abstract

Child nutrition has become a well accepted marker of a population's health. Consequently, in the past decades it has been common for health surveys to collect anthropometric measurements of children. Cross sectional data including that of demographic health surveys, therefore, provides a framework for analysis of progress in health of children in the developing world. Using data from the Zimbabwe Demographic Health Surveys (ZDHS) of 1988, 1994 and 1999, this dissertation describes the levels, patterns of distribution, and the changes in determinants of child malnutrition in Zimbabwe between 1988 and 1999. The study employed complimentary methodology by using both the quantitative as well as the qualitative data. Standardized anthropometric measures (weight and height/length of children 3-35 months) from ZDHS were converted into the three indices (weight-for-age, weight-for-height, and height-for-age) to measure patterns of child malnutrition using the Epi-Info software. In addition, the Statistical Package of Social Sciences (SPSS) was used for the descriptive statistics, bivariate analysis and regression models in the three cross-sectional data sets. Multiple linear regression models were used to analyze the effects of independent variables for child malnutrition in the year 1988, 1994 and 1999. The qualitative methodology was used to compliment and fill the gaps from the quantitative data. Focus group discussion indepth interviews were held with community stakeholders in two regions in Zimbabwe. It was observed that malnutrition patterns in Zimbabwe has slightly decreased between 1988 and 1994 before rising again in 1999 based on the current World Health Organization (WHO) standard. Stunting and underweight are more significant forms of malnutrition in Zimbabwe in all the survey years. The education of mothers, child age, had highly significant effects on the nutritional status of children, while other independent variable had varying significance over the years. Factors such as child's age, mother's education, and sources of water, and toilet facilities are important in explaining child malnutrition in Zimbabwe over the past years. The analysis of anthropometric data from demographic health surveys contributes a useful approach to evaluate and inform child health policy and interventions in the developing countries. The results also demonstrates how the second round and third round assessment of Demographic Health Survey anthropometry can add some advantages of longitudinal measurement to the cross sectional datasets.