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Table 3 Individual, neighborhood and country-level factors associated with the double burden of childhood malnutrition identified by multilevel logistic regression models

From: Individual and contextual factors associated with childhood malnutrition: a multilevel analysis of the double burden of childhood malnutrition in 27 countries

 

Model 1

Model 2

Model 3

Model 4

Model 5

  

OR (95% Crl)

OR (95% Crl)

OR (95% Crl)

OR (95% Crl)

Fixed effect model

Individual level factors

Age of child (months)

 

0.98*** [0.98, 0.98]

  

0.98*** [0.98,0.98]

Sex (male as ref)

Female

 

0.80*** [0.77, 0.83]

  

0.80*** [0.77, 0.83]

Child birth type (single birth as ref)

Multiple Births

 

1.28*** [1.15, 1.42]

  

1.28*** [1.15, 1.42]

Diarrhea in the last 2 weeks preceding the survey (No diarrhea as ref)

Had Diarrhea

 

1.06* [1.01, 1.12]

  

1.06* [1.01, 1.12]

Child Fever in the last 2 weeks preceding the survey (No fever as ref)

Had Fever

 

1.08** [1.03, 1.13]

  

1.08** [1.03, 1.13]

Currently breastfeeding (no as ref)

Yes

 

1.22*** [1.15, 1.29]

  

1.21*** [1.15, 1.29]

Maternal age (15–24 years as ref)

25–34 years

 

1.03 [0.98, 1.07]

  

1.02 [0.98, 1.07]

35–49 years

 

1.02 [0.96, 1.08]

  

1.02 [0.97, 1.08]

Maternal education (no education as ref)

Primary education

 

0.90*** [0.85, 0.95]

  

0.92** [0.87, 0.98]

Secondary education

 

0.88*** [0.82, 0.93]

  

0.89*** [0.84, 0.95]

Higher education

 

0.94 [0.85, 1.03]

  

0.95 [0.87, 1.05]

Maternal marital status (never married as ref)

Married or in a union

 

0.97 [0.88, 1.06]

  

0.96 [0.88, 1.06]

Divorced/widowed/separated

 

1.08 [0.95, 1.22]

  

1.08 [0.95, 1.22]

Maternal employment (not employed as reference)

Employed

 

0.90*** [0.86,0.94]

  

0.92*** [0.88, 0.96]

Number of under-5 children (no under 5 as ref)

1–3 children

 

1.31* [1.04,1.65]

  

1.29** [1.07,1.56]

4 or more children

 

1.34* [1.06,1.70]

  

1.32** [1.08,1.61]

Wealth index (poorest as ref)

Poorer

 

0.93* [0.88, 0.99]

  

0.91** [0.86, 0.97]

Middle

 

0.89*** [0.84, 0.94]

  

0.86*** [0.80, 0.91]

Richer

 

0.92* [0.87, 0.99]

  

0.88*** [0.82, 0.95]

Richest

 

0.97 [0.90, 1.05]

  

0.92 [0.85, 1.01]

Maternal health behavior (first quantile (least) as ref)

Second quantile

 

0.91*** [0.87, 0.96]

  

0.92** [0.87, 0.97]

Third quantile

 

0.87*** [0.82, 0.93]

  

0.88*** [0.83, 0.94]

Fourth quantile

 

0.97 [0.87, 1.09]

  

0.97 [0.87, 1.09]

Fifth quantile (highest)

 

0.93 [0.86, 1.02]

  

0.94 [0.86, 1.02]

Neighborhood-level factors

Community-level poverty

  

0.99 [0.94, 1.04]

 

0.92** [0.86, 0.97]

Community-level rurality

  

1 [0.86, 1.16]

 

0.96 [0.82, 1.12]

Community-level illiteracy

  

1.13*** [1.08, 1.19]

 

1.10*** [1.04, 1.16]

Community-level unemployment

  

1.11*** [1.06, 1.16]

 

1.06* [1.01, 1.11]

Community-level unsafe sanitation

  

1 [0.96, 1.05]

 

0.95* [0.91, 1.00]

Community-level unimproved water source

  

0.97 [0.92, 1.02]

 

0.96 [0.91, 1.01]

Community-level limited access to health facility

  

1.04 [0.99, 1.09]

 

1.04 [0.99, 1.09]

Country-level factors

Human development index (low HDI as ref)

Medium HDI

   

1.23 [0.82, 1.84]

1.34 [0.87, 2.06]

High HDI

   

2.32 [0.99, 5.47]

2.42* [1.04, 5.60]

Cereal yield (kg per hectare) (tertile 1 (low) as ref)

Tertile 2

   

1.21 [0.82, 1.77]

1.13 [0.68, 1.89]

Tertile 3 (high)

   

1.46 [0.99, 2.15]

1.47 [0.89, 2.43]

Total fertility rate (low fertility rate as ref)

Ideal fertility rate

   

1.14 [0.55, 2.37]

1.15 [0.53, 2.51]

High fertility rate

   

1.58 [0.82, 3.05]

1.43 [0.71, 2.90]

Random effect model

Country-level

Variance (95% CrI)

1.24 [1.09, 1.42]

1.29 [1.11, 1.51]

1.26 [1.10, 1.44]

1.18 [1.06, 1.31]

1.20 [1.05, 1.37]

VPC (%, 95% CrI)

21.0 [19.1, 23.1]

21.5 [19.3, 24.1]

21.2 [19.2, 23.4]

20.2 [18.6, 21.7]

20.3 [18.4, 22.3]

MOR (95% CrI)

2.89 [2.71, 3.12]

2.95 [2.73,3.23]

2.92 [2.72, 3.14]

2.82 [2.67, 2.98]

2.84 [2.66, 3.05]

Neighborhood-level

Variance (95% CrI)

1.38 [1.33, 1.43]

1.42 [1.36, 1.47]

1.38 [1.33, 1.43]

1.38 [1.34, 1.43]

1.41 [1.36, 1.47]

VPC (%, 95% CrI)

44.3 [42.4, 46.4]

45.1 [42.9, 47.5]

44.5 [42.5,46.6]

43.7 [42.2, 45.4]

44.2 [42.3, 46.3]

MOR (95% CrI)

3.07 [3.00, 3.13]

3.12 [3.04, 3.18]

3.07 [3.00, 3.13]

3.07 [3.02, 3.13]

3.10 [3.04, 3.18]

Model fit statistics

DIC

90,183

84,196

90,150

90,184

84,188

Sample size

Country-level

27

27

27

27

27

Neighborhood-level

13,788

13,485

13,788

13,788

13,485

Individual-level

138,782

132,787

138,782

138,782

132,787

  1. Exponentiated coefficients; 95% confidence intervals in brackets
  2. *p < 0.05, **p < 0.01, ***p < 0.001
  3. Model 1—empty null model, baseline model without any explanatory variables (unconditional model); Model 2—adjusted for only individual-level factors; Model 3—adjusted for only neighbourhood-level factors; Model 4—adjusted for only country-level factors; Model 5—adjusted for individual-, neighbourhood-, and country-level factors (full model); OR—odds ratio, CrI—credible interval, MOR—median odds ratio, VPC—variance partition coefficient, and DIC—Bayesian deviance information criteria
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Global Health Research and Policy

ISSN: 2397-0642

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