Prevalence of stunting and associated factors among primary school children of Dagahbur city, Somali Region, Eastern Ethiopia

Prevalence of stunting and associated factors among primary school children of Dagahbur city, Somali Region, Eastern Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of stunting and associated factors among primary school children of Dagahbur city, Somali Region, Eastern Ethiopia Amin Ugas Mahad1*, Abdiwahab Hashi1, Mukhtar Omar1, Ahmed Mohammed Ibrahim1 This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8732568/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Globally, childhood stunting remains a major public health concern. It is estimated that approximately 165 million children under five years of age are affected worldwide. Stunting has been associated with a range of adverse outcomes, including increased susceptibility to infections, higher risk of mortality, delayed physical and cognitive development, reduced learning capacity, poor academic performance, and decreased productivity in adulthood. Therefore, this study was designed to assess the determinants of stunting among primary school children in Dagahbur City, Somali Region, Eastern Ethiopia. Methods An institution-based cross-sectional study was conducted from April to June 2019 among 354 primary school children aged 5–14 years. Anthropometric measurements were taken following standard procedures. Height-for-age Z-scores (HAZ) were generated using WHO AnthroPlus software, and stunting was defined as HAZ < -2 standard deviations. Data on socio-demographic, environmental, and child-related factors were collected using a structured questionnaire administered to parents or caregivers. Data were analyzed using SPSS version 23. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with stunting, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported. Results The prevalence of stunting among primary school children was 8.5% (95% CI: 5.6–11.3). In multivariable logistic regression analysis, stunting was significantly associated with sex of the child (AOR = 3.65; 95% CI: 1.35–9.85), birth order (AOR = 7.01; 95% CI: 1.98–24.84), husband’s occupation (AOR = 0.08; 95% CI: 0.01–0.44), water availability (AOR = 0.05; 95% CI: 0.01–0.21), source of drinking water (AOR = 0.24; 95% CI: 0.08–0.70), and liquid waste disposal practices (AOR = 5.47; 95% CI: 1.73–17.30). Conclusion The prevalence of stunting among primary school children in Dagahbur City was relatively low but remains a public health concern. Stunting was significantly associated with child sex, birth order, household occupation, water availability, drinking water source, and liquid waste disposal. These findings highlight the need for integrated nutrition-sensitive interventions focusing on water, sanitation, and household socio-economic conditions to address nutritional inequities among school-aged children. Nutrition & Dietetics Stunting associated factors primary school children Dagahbur City Somali Region Ethiopia Figures Figure 1 Figure 2 Figure 3 INTRODUCTION Stunting, commonly assessed using height-for-age indices, reflects chronic undernutrition and long-term growth failure in children. It is defined as a height-for-age Z-score below minus two standard deviations (-2 SD) from the median of the World Health Organization (WHO) reference population, while values below minus three standard deviations (-3 SD) indicate severe stunting. This condition represents the cumulative effects of prolonged nutritional deprivation and recurrent illness during critical periods of growth (1). Globally, childhood stunting remains a major public health concern. It is estimated that approximately 165 million children under five years of age are affected worldwide. Stunting has been associated with a range of adverse outcomes, including increased susceptibility to infections, higher risk of mortality, delayed physical and cognitive development, reduced learning capacity, poor academic performance, and decreased productivity in adulthood (2). Growth faltering typically begins early in life, with a marked increase in stunting observed between 6 and 23 months of age and a peak prevalence around 24–35 months. This pattern underscores the long-lasting consequences of undernutrition occurring during the first 1,000 days of life. However, the effects of early-life growth deficits often persist into later childhood and adolescence. According to reports from the United Nations Children’s Fund (UNICEF), more than 200 million school-aged children were estimated to be stunted by the year 2000. Projections suggested that, without effective interventions, the number of schoolchildren experiencing impaired physical and cognitive development due to stunting could reach one billion by 2020 (3), These findings highlight the importance of extending nutritional attention beyond early childhood. Evidence indicates that child nutritional status is closely linked to maternal factors and birth outcomes. Children born with low birth weight or small size are more likely to experience stunting, wasting, or underweight later in life. Similarly, maternal undernutrition, particularly among mothers with a body mass index (BMI) below 18.5 kg/m², has been associated with poorer growth outcomes in their children (1). In Ethiopia, childhood stunting remains highly prevalent and continues to pose a significant challenge to child development and educational achievement. National data indicate that more than two in five children are stunted, with considerable regional variation. Stunted children in Ethiopia tend to start school later, experience delayed grade progression, and account for a substantial proportion of grade repetition in primary education. Furthermore, stunting is associated with impaired brain development, which may have lasting effects on cognitive ability, school performance, and future economic productivity (4). Malnutrition among school-aged children is increasingly recognized as an important public health issue, particularly in low- and middle-income countries. Despite this, school-aged children are often excluded from national nutrition surveys, resulting in limited population-level data on their nutritional status. This lack of information constrains the development of targeted interventions for this age group (5). In Sub-Saharan Africa, the burden of stunting remains especially high, with estimates suggesting that up to 60% of children in some settings are affected (6). Education is one of the most important aspects of social and economic development. Education improves capabilities and is strongly associated with various socioeconomic variables such as lifestyle, income, and fertility for both individuals ‘and societies. Education plays a critical role in social and economic development and is closely linked to health and nutrition. Nutritional deficiencies during childhood can adversely affect school attendance, learning capacity, and educational attainment. Several studies conducted in developing countries have demonstrated a strong relationship between height-for-age and academic performance, indicating that chronic undernutrition may impair cognitive development and learning outcomes among school-aged children (7). Poor nutritional status is one of the major causes of low academic performance and productivity in primary education which may have an effect on the physical and cognitive development in children throughout their early years of life. Discovering the variables that influence the achievement of school children is of great importance because it would serve as an essential tool for regional and national Universal Basic Education Board and for other policymakers in the design of education policies. This would eventually lead to a rise in the quality of primary education and student’s nationally. To the best of our knowledge, there are limited local studies in the Somali Region that focus on the associated factors of stunting among primary school children. This population group has been largely neglected, as research attention has predominantly focused on preschool-aged children, who are assumed to be more vulnerable to undernutrition. However, interventions targeting school-aged children can complement efforts made during the preschool years and contribute to reducing undernutrition and its long-term adverse effects on child health and educational outcomes. Therefore, this study was designed to assess the determinants of stunting among primary school children in Dagahbur City, Somali Region, Eastern Ethiopia. MATERIALS AND METHODS Study area and period The study was conducted in Dagahbur City, located in the Jarar Zone of the Somali Regional State, Eastern Ethiopia. Dagahbur City lies approximately 650 km east of Jigjiga City and about 780 km from Addis Ababa. According to the 2011 Ethiopian Central Statistical Agency report, the district has an estimated population of 126,537. Dagahbur Woreda and the City Administration together have 25 public primary schools, of which 16 are located in Dagahbur Woreda and 9 within the city administration. The study was carried out from April to June 2019. Study design An institution-based cross-sectional study design was employed. Source of population and study population The source population consisted of all primary school children enrolled in public primary schools in Dagahbur City. The study population included primary school children attending the selected public primary schools during the 2019 academic year. Inclusion and exclusion criteria Inclusion criteria All primary school children who were present during the data collection period and whose parents or legal guardians provided informed consent were included in the study. Exclusion criteria ; Children with physical deformities that could affect height measurement, those who were seriously ill at the time of data collection, children with chronic illnesses, and children who had lived in the study area for less than one year were excluded. Sample size determination The required sample size for this study was determined by single population proportion formula with the following assumption: Specific objective 1; prevalence of stunting n= \(\:\frac{{\text{z}}^{2}\text{p}\text{q}}{{\text{d}}^{2}}\) where z = 1.96 P = the prevalence of stunting among primary school children a Fogera woreda, Northwest Ethiopia was 30.7%.(8) q = 1-p, 1-0.307 = 0.693 d = 0.05, degree of accuracy desired n= \(\:{\left(1.96\right)}^{2}\text{*}0.307\text{*}0.693/{0.05}^{2}\) , = 327 After adding a 10% non-response rate, the final sample size was 360 children . Table 1 :-Specific objective 2; associated factors of stunting among primary school children’s from different articles For the second objective (factors associated with stunting), the sample size was calculated using a double population proportion formula with Epi Info version 7, assuming 95% confidence level, 80% power, a 1:1 ratio, and 10% non-response rate. Since the sample size calculated for the first objective was larger, 360 participants were taken as the final sample size . (Table 1) Sampling technique A multistage sampling technique was used. From the nine urban public primary schools in Dagahbur City, two schools were selected using simple random sampling (lottery method). The total sample size was proportionally allocated to the selected schools based on student population size. Within each selected school, study participants were selected using systematic random sampling from the student registration lists. The sampling interval (k) was calculated for each class, and the first participant was selected randomly. The sample size for each school was calculated using the formula: ni=(n * Ni)/N) Where: ni=sample size of each selected school’s n=total sample size Ni=total number of students in each selected school N=total number of students in all selected schools (Figure 2) Data collection procedure Data were collected using a pre-tested, structured interviewer-administered questionnaire adapted from relevant literature. The questionnaire was initially prepared in English, translated into Somali, and then back-translated into English to ensure consistency. Parents or caregivers of the selected children were the respondents. After children were selected from schools, their household addresses were obtained from school records. Data collectors visited households to conduct interviews with parents or caregivers. Five diploma-level clinical nurses collected the data under the supervision of one health officer. A pretest was conducted on 5% of the sample in a nearby area with similar socio-economic characteristics prior to the actual data collection. Anthropometric measurements Anthropometric measurements were taken following standard procedures. Height was measured using a portable stadiometer with the child standing upright, barefoot, and with heels, buttocks, shoulders, and head touching the vertical surface. Measurements were recorded to the nearest 0.1 cm. The child’s age was verified using school records and confirmed with parents or caregivers. Measurement of nutritional status Height-for-age Z-scores (HAZ) were generated using WHO AnthroPlus software. Stunting was defined as a height-for-age Z-score below -2 standard deviations (< -2 SD) from the WHO reference median, while severe stunting was defined as HAZ < -3 SD. Study variables Dependent Stunting (Stunting, commonly assessed using height-for-age indices, reflects chronic undernutrition and long-term growth failure in children. It is defined as a height-for-age Z-score below minus two standard deviations (-2 SD) from the median of the World Health Organization (WHO) reference population, while values below minus three standard deviations (-3 SD) indicate severe stunting. This condition represents the cumulative effects of prolonged nutritional deprivation and recurrent illness during critical periods of growth.(1) Independent variables Socio demographic characteristics Sex of the child Age of the child Martial statues Type of marriage Parent’s education Parent’s occupations Monthly income House hold latrine condition No of family members Solid waste disposal Liquid waste disposal Child health and caring practice Birth order Dietary diversity Utilization of insecticide-treated bed nets Immunization Operational definition Stunting; is defined as low height-for-age at < -2 standard deviations (SD) of the median value of the National Center for Health Statistics/World Health Organization (NCHS/WHO) international growth reference. Severe stunting is defined as < -3 SD. (9) Primary school children: - children with age of 5 to 14 years old who are attending public schools. (10) Birth order: is a chronological order of sibling births in a family. (11) Anthropometry: Measurement of the variation of physical dimensions. .(12) Type of marriage: is marriage either polygamies or monogamies. (13) Minimum dietary diversification: - consumption or feeding of different type of diet. (8) Immunization Status; child status to immunization either (fully, partially, up-to-date) immunized. (1) Data quality assurance To ensure data quality, several measures were implemented. Intensive two-day training was provided to data collectors prior to the start of data collection. Anthropometric measuring instruments were standardized and calibrated to zero before each measurement. The questionnaire was translated from English into Somali and back-translated into English to ensure consistency and clarity. The age of each child was obtained from school records and cross-checked using birth certificates and parental recall of key events. A pretest was conducted on 5% of the sample one week before the actual data collection in a nearby area with similar socio-economic characteristics to assess the validity and reliability of the questionnaire. The principal investigator closely supervised the data collection process and checked all completed questionnaires daily for completeness and logical consistency at the data collection sites. Data processing and analysis The collected data were checked for completeness and consistency. Each completed questionnaire was assigned a unique identification code. Data were entered into EpiData version 3.01 and cleaned by checking for missing values and logical inconsistencies. Double data entry was performed independently by two data clerks to minimize data entry errors. The cleaned dataset was then exported to SPSS version 23 for statistical analysis. Anthropometric data were analyzed using WHO AnthroPlus software to generate height-for-age Z-scores (HAZ) and determine stunting status. Descriptive statistics, including mean, median, frequency, and percentage, were computed and presented using tables and figures. Bivariate binary logistic regression analysis was performed, and all explanatory variables with a p-value < 0.25 (14). In the bivariate analysis were considered candidates for the multivariable logistic regression model (15). Multicollinearity among independent variables was assessed using the variance inflation factor (VIF) and tolerance tests. Model fit was evaluated using the Hosmer–Lemeshow goodness-of-fit test, which yielded a p-value of 0.365, indicating an adequate model fit. The discriminative ability of the model was assessed using the Receiver Operating Characteristic (ROC) curve, which produced an area under the curve (AUC) of 0.74, suggesting acceptable discrimination. The Nagelkerke pseudo R² value was 0.31, indicating a moderate explanatory power of the model . The strength of association was measured using adjusted odds ratios (AORs) with 95% confidence intervals, and statistical significance was declared at a p-value < 0.05. Ethics approval and consent to participate Ethical approval for this study was obtained from the Jigjiga University Institutional Health Research Ethics Review Committee (IHRERC/72/2019).Thestudy was conducted in accordance with the ethical principles of the Declaration of Helsinki . Official permission was obtained from the Jigjiga University Postgraduate Office and the Somali Regional Education Bureau before data collection. Written informed consent was obtained from parents or legal guardians of all participating children prior to data collection. Assent was also obtained from the children where appropriate. Participants were clearly informed about the purpose, benefits, and potential risks of the study. Confidentiality of the collected information was maintained by using unique codes instead of personal identifiers, and all data were used solely for research purposes. School privacy and local cultural norms were strictly respected throughout the study. RESULTS Socio- Demographic Characteristics of the Study Participants Out of the 360 participants initially sampled for the study, 354 participated, resulting in a response rate of 98.3%. Most participants were between 8 and 10 years of age. The mean age of the participants was 9.6 years (SD = 2.44). The sex ratio was nearly equal, with 182 males (51.4%) and 172 females (48.6%). The majority of the children were of birth order 2-5, accounting for 324 (91.5%), while only 30 (8.5%) were first-born. Among the participants, 253 (71.5%) lived with both parents, 71 (20.1%) lived with their mother only, 8 (2.3%) lived with their father only, 12 (3.4%) lived with their grandparents, and 10 (2.8%) lived with others. The majority of participants were of Somali ethnicity (342, 96.6%) and Muslim by religion (344, 97.2%). Regarding parental education, 156 (44.1%) of mothers had informal education, while 89 (25.1%) of fathers had informal education. Regarding marital status of the participants’ parents, 299 (84.5%) were married, 30 (8.5%) widowed, 24 (6.8%) divorced, and 1 (0.3%) other. (Table 2) Socio-economic characteristics of the respondent Of the 360 participants initially sampled, 354 participated. Regarding maternal occupation, 255 (72.0%) were housewives, 27 (7.6%) were government employees, 57 (16.1%) were merchants, and 15 (4.2%) had other occupations. Regarding paternal occupation, the majority were daily laborers (112, 31.6%), followed by government employees (108, 30.5%), merchants (75, 21.2%), and others (59, 16.7%). Most mothers (276, 78.0%) were older than 24 years. Concerning the number of living children in the household, 254 (71.8%) had more than 4 children, while 100 (28.2%) had fewer than 4 children. Based on average monthly family income, 271 (76.6%) earned 2900–5000 ETB. Most families (203, 57.3%) had more than ≥6 category. (Table 3) Environmental issue & sanitation, Child health and dietary conditions Of the 354 participants, 338 (95.5%) reported the availability of water, while 16 (4.5%) reported no water availability. Among them, 254 (71.8%) had access to safe water, whereas 100 (28.2%) did not. Additionally, 211 (59.6%) reported inadequate water supply. Regarding sanitation, 341 (96.3%) had latrines, while 13 (3.7%) did not. Among those with latrines, 219 (61.9%) had improved facilities, and 135 (38.1%) had unimproved facilities. Regarding waste disposal, 233 (65.8%) properly disposed of solid waste, while 121 (34.2%) did not. For liquid waste, 223 (63.0%) had proper disposal systems, whereas 131 (37.0%) had improper disposal. Most children (271, 76.6%) had a history of vaccination, while 83 (23.4%) had not been vaccinated. Regarding personal hygiene, 252 (71.2%) were rated as having good hygiene, and 102 (28.8%) had poor hygiene. In the last two weeks, 190 (53.7%) of participants experienced illness, while 164 (46.3%) did not. Regarding dietary frequency per day, 306 (86.4%) ate three times per day, 36 (10.2%) ate twice, 5 (1.4%) ate once, and 7 (2.0%) ate more than three times. Concerning drought, 318 (89.8%) reported drought in Dagahbur city in the previous year, while 36 (10.2%) reported no drought. Additionally, 203 (57.3%) reported extreme starvation in the surrounding area, while 151 (42.7%) reported no famine/starvation. (Table 4) Maternal obstetric, medical and nutritional status of the respondent Among the 354 participants, the nutritional status of their mothers was reported as thin (161, 45.5%), medium (179, 50.6%), and overweight (14, 4.0%). Regarding maternal past medical history, 263 (74.3%) were healthy, and 91 (25.7%) had a history of illness. The current medical status of mothers was healthy for 275 (77.7%) and unhealthy for 79 (22.3%). Out of the 354 mothers, 257 (72.6%) had good food intake, while 97 (27.4%) had poor intake. Current maternal status included 114 (32.2%) pregnant, 87 (24.6%) lactating, and 153 (43.2%) neither pregnant nor lactating. Place of delivery was hospital for 249 (70.3%) and home for 105 (29.7%). Mode of delivery was spontaneous vaginal delivery for 305 (86.2%), cesarean section for 48 (13.6%), and instrumental delivery for 1(0.3%)). Regarding supplementation, 228 (64.4%) used iron-folic acid during pregnancy, while 126 (35.6%) did not. ANC utilization was reported by 252 (71.2%), while 102 (28.8%) did not utilize ANC. Most households (269, 76.0%) utilized ITBN, while 85 (24.0%) did not. Maternal BMI was <18.5 for 2 (0.6%), 18.5-25 for 303 (85.6%), and ≥25 for 49 (13.8%). (Table 5) Prevalence of stunting among primary school children of Dagahbur city, Somali among primary school children of Dagahbur city, Somali region, Eastern Ethiopia 2019. The prevalence of stunting among primary school children was 8.5% (95% CI: 5.6-11.3). (Figure 3) Factors associated with stunting among primary school children of Dagahbur city In bivariate logistic regression, the following factors were examined: age of the child (COR = 1.62; 95% CI: 0.75-3.46), sex of the child (COR = 1.71; 95% CI: 0.79-3.70), birth order (COR = 3.98; 95% CI: 1.55-10.26), husband’s educational status (COR = 0.43; 95% CI: 0.15-1.28), husband’s occupation-government employee (COR = 0.40; 95% CI: 0.15-1.02), merchant (COR = 0.12; 95% CI: 0.03-0.56), daily laborer (COR = 0.34; 95% CI: 0.13-0.89), family size ≤3 (COR = 5.31; 95% CI: 0.97-29.14), 3-6 members (COR = 2.01; 95% CI: 0.92-4.38), water availability (COR = 0.09; 95% CI: 0.03-0.28), water source (COR = 0.31; 95% CI: 0.14-0.65), and liquid waste disposal (COR = 2.04; 95% CI: 0.85-4.89), which were significant at P-value <0.25. Nine variables (age, sex, birth order, husband’s education and occupation, family size, water availability, water source, and liquid waste disposal) were eligible for multivariate logistic regression. Variables with P < 0.05 in multivariate analysis were considered significant. In multivariate logistic regression, stunting was significantly associated with sex of the child (AOR = 3.65; 95% CI: 1.35-9.85), birth order (AOR = 7.01; 95% CI: 1.98-24.84), husband’s occupation (AOR = 0.08; 95% CI: 0.01-0.44), water availability (AOR = 0.05; 95% CI: 0.01-0.21), source of drinking water (AOR = 0.24; 95% CI: 0.08-0.70), and liquid waste disposal practices (AOR = 5.47; 95% CI: 1.73-17.30). (Table 6) DISCUSSION The present study was conducted to investigate the prevalence of stunting and its associated factors among primary school children in Dagahbur town. The prevalence of stunting was 8.5%, which is comparable to a cross-sectional study conducted among school-age children in Eastern Ethiopia (8.9%).(16) and study done in Colombian school children (9.9%).(17). However, the prevalence in this study is higher than that reported in a study on anthropometric indices and socio-demographic determinants among primary school children in an urban school in Pune, India, which found a stunting prevalence of 4.47% (95% CI: 3–5.94), and among Pakistani primary school children(8%).(19). The observed differences may be attributed to variations in study period, study area, age categories of the target populations, and the recently initiated nutrition-sensitive interventions in the study area. Conversely, the prevalence of stunting in this study is slightly lower than findings from other studies, including those conducted on nutrition, health, and academic achievement among primary school children in Uganda (8.7%) (20), Colombian school children(9.9%).(17), rural southeastern Kenya (23.3%)(21), Southwest Nigeria(17.4%).(22), and school-age children in Haiyk town, northeastern Ethiopia (11.3%) (23). Similar studies conducted on Durbete town, northwest Ethiopia(11.2).(24), Lideta sub-city, Addis Ababa, Ethiopia (19.6%).(11), North Sumatera, Indonesia 38.87%.(25), Dagoreti, Nairobi, Kenya.(24.3) (26), and Northwest Ethiopia.(37.9) (27), Arbminch Health And Demographic Surveillance Site, southern Ethiopia (41.9%) (28), Fogera and Libo Kemkem district, Ethiopia(42.7%) (29) reported highest prevalence rates. The lower prevalence in this study may be due to differences in study site, sample size, socioeconomic status, culture, feeding habits, and environmental conditions. In this study, the sex of the child was significantly associated with stunting (AOR = 3.65; 95% CI: 1.35-9.85), with male children being three times more likely to be stunted than female children. This finding aligns with a study on determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa (30). In contrast, studies conducted in rural areas of southern Pakistan reported that female children were more likely to be stunted than male (25), while other studies among Pakistani primary school children found no significant association between gender and stunting. The observed difference may be due to biological, behavioral, and socio-cultural mechanisms; for example, male children may be more active, leading to higher energy expenditure and increased vulnerability to stunting. Birth order was another significant factor associated with stunting (AOR = 7.01; 95% CI: 1.98-24.84). Children with a birth order greater than three were seven times more likely to be stunted compared to first-born or lower-order children. This is consistent with a study on undernutrition and associated risk factors among school-age children in Addis Ababa, Ethiopia.(11). The association may be due to older children receiving less attention, care, and resources from parents when new siblings are born. Fathers’ occupation was also significantly associated with stunting. Children of merchant fathers were less likely to be stunted (AOR = 0.08; 95% CI: 0.01-0.44) compared to their counterparts. This finding aligns with a study on predictors of stunting among school-age children in Northwestern Ethiopia (27) and research in rural southern Pakistan, which found that children of fathers working as government employees (PR = 1.71; CI: 1.05-2.79), shopkeepers (PR = 2.00; CI: 1.22-3.26), or farmers (PR = 1.43; CI: 0.93-2.22) were more likely to be stunted than those with landlord fathers(31) . Differences in living conditions, food availability, and intra-household food distribution may contribute to these disparities. Water-related factors were significantly associated with stunting. Children from households accessing safe water sources were 76% less likely to be stunted (AOR = 0.24; 95% CI: 0.08-0.70). This finding is consistent with a study on determinants of stunting in Indonesian children, which reported that drinking untreated water increased the odds of stunting more than threefold(32) the finding of this study is inverse to study conducted in rural India.(33). This may be attributed due to lack of sewerage system in the town. The result shows that accessing water from safe source had greater odd ratio compared to counterpart so treating the source of water could be attributed for decline of under nutrition specially stunting. Similarly, water availability was a protective factor (AOR = 0.05; 95% CI: 0.01-0.21); households with larger water storage were 95% less likely to have stunted children. This aligns with previous research on water, sanitation, and hygiene (34),(35) Limited water supply may reduce household hygiene and food preparation quality, contributing to undernutrition. Improper liquid waste disposal was positively associated with stunting (AOR = 5.47; 95% CI: 1.73-17.30). Children in households with poor liquid waste management were five times more likely to be stunted. This finding is consistent with research in rural Mali.(36). and may be attributed to inadequate waste disposal areas, overcrowding, and substandard housing conditions. In summary, stunting in Dagahbur town is influenced by child sex, birth order, fathers’ occupation, water availability, safe water source, and liquid waste disposal practices. These findings highlight the need for integrated nutrition, water, and sanitation interventions targeting vulnerable children. CONCLUSION In this study, the prevalence of stunting, an indicator of chronic undernutrition, among primary school children in Degahbour City was 8.5% , which is lower than that reported in several other regions of Ethiopia. Stunting was found to be significantly associated with the child’s sex, birth order, husband’s occupation, household water availability, water source, and liquid waste disposal practices. Conversely, no statistically significant associations were observed between stunting and the person with whom the child lived, maternal educational status, recent child illness, personal hygiene practices, antenatal care utilization, or place of delivery. These findings highlight the importance of household socioeconomic and environmental factors in influencing the nutritional status of school-aged children. Strengthening water, sanitation, and hygiene conditions, along with targeted nutrition interventions for school-aged children, may contribute to reducing stunting in this population. Limitation of the study This study has some limitations that should be considered when interpreting the findings. First, the cross-sectional design does not allow for establishing causal relationships between stunting and the identified associated factors. Second, some variables were assessed based on parental or caregiver self-report, which may be subject to recall bias. Third, as the study was conducted among school-attending children, the findings may not be generalizable to all school-aged children in the community, particularly those who are not enrolled in school. Recommendation The findings of this study underscore the need to strengthen nutrition-related interventions for school-aged children in the Somali Region. Regional health authorities may enhance community-based nutrition education by increasing awareness of appropriate feeding practices and the consequences of chronic undernutrition. Interventions targeting parents and caregivers should emphasize timely feeding, balanced diets, and efficient use of locally available food resources. At the district level, strengthening school-based nutrition education and supporting school feeding initiatives may help address nutritional gaps among primary school children. In addition, further analytical and longitudinal studies are recommended to better understand the determinants of stunting among school-aged children and to inform context-specific interventions. Declarations Ethics approval and consent to participate Ethical approval for this study was obtained from the Jigjiga University Institutional Health Research Ethics Review Committee (IHRERC/72/2019). The study was conducted in accordance with the ethical principles of the Declaration of Helsinki . Official permission was obtained from the Jigjiga University Postgraduate Office and the Somali Regional Education Bureau before data collection. Written informed consent was obtained from parents or legal guardians of all participating children prior to data collection. Assent was also obtained from the children where appropriate. Participants were clearly informed about the purpose, benefits, and potential risks of the study. Confidentiality of the collected information was maintained by using unique codes instead of personal identifiers, and all data were used solely for research purposes. School privacy and local cultural norms were strictly respected throughout the study. Consent for publication: Not applicable. Clinical trial registration number: Not applicable. Competing interests: The authors declare that they have no competing interests. ORCID Amin Ugas Mahad https://orcid.org/0009-0003-8009-6654 Funding statement: The authors did not receive any specific funding for this work. Authors' contributions: AUM conceived and designed the study, coordinated data collection, performed data analysis, and drafted the manuscript. AH contributed to study design, data analysis, and manuscript revision. MO assisted with data collection, supervision, and interpretation of results. AMI assisted data analysis. All authors read and approved the final manuscript. Acknowledgment The authors express their gratitude to everybody who contributed to this original article at any step. Data Availability Statement The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. References EDHS. EDHS. 2016. lasleyoot. The Effect of Chronic Malnutrition (Stunting) on Learning Ability, a Measure of Human Capital: A Model in PROFILES for Country-Level Advocacy. 2016. MekdesWolde. determinant of stunting underweight,stunting and wasting among school children BMC. 2015. BirhanuA. stunting and associated factors among children age 6-59 months in lasta woreda north east ethiopia 2015. hedwigacham. nutrion,health and academic achievement of primary school schildren in uganda. 2014. abah. Nutritional status of schoolchildren in Jos East Local Government Area of Plateau State, North Central Nigeria. 2017. Sarma MSG. The Effects of Nutritional Status on Educational Performance of Primary School Children in the Plantation Sector in Nuwara Eliya Educational Zone cv. 2013. hunegnawmekonen. Institutional and community based cross sectional study used to determine the nutritional status of school children in terms of stunting, underweight and thinness and to identify its correlates at Fogera woreda, Northwest Ethiopia, . 2012 WHO Physical Status: The Use and Interpretation of Anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854 Geneva: WHO. 1995. firehiwotmesfin y. prevalence and associated factors of stunting among primary school children in eastern ethiopia. 2015. DawitDegarege. A community based cross-sectional study was conducted in 459 school age children and their parents or Caregivers living in Lideta sub-city, Addis Ababa, Ethiopia BMC public health problem. 2015. AkYadav a. anthropometric indices and its socio demographic determinants among primary school children of an urban school n pune india int J med public health. 2016. Amare T, Haile W, Abel F, Akilew A, Ayanaw T, Segenet Y. Nearly half of preschool children are stunted in Dembia district, Northwest Ethiopia: a community based cross-sectional study. Archives of Public Health 2015;74(13 ). Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression: John Wiley & Sons; 2013. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression-Source Code for Biology and Medicine. Source code for biology and medicine. 2008;3(1):1-8-0. firehiwotMesfin. Prevalence and associated factors of stunting among primary school children in eastern ethiopia 2015. louseeH.Dekker. stunting associated with poor socioeconomic and maternal nutrion status and respiratory morbidity in colombian school children 2010. AkYadav a. study done on anthropometric indices and its socio-demographic determinants among primary school children of an urban school in Pune, India 2016. MuhammedUmair. prevalence and socio demographic correlates of stunting and thinnes among pakistani primary school children. BMC public health problem. 2011. HedwigAcham. nutrion,health and academic achievment of primary school children in Uganda. 2016. chisashinsugi. factors asscociated with stunting among children according to the level of food insecurity in the household: a crossectional study in rural community of southern kenya. 2015. IdowuO.Senbanjo. prevalence and risk factors for stunting among school children and adolescents in abekokuta,southwest nigeria. 2011. yonatanmenber. A school based cross-sectional study was conducted on 414 school age children in Haiyk town Primary schools, North eastern Ethiopia. 2017. tilahunalelign. prevalence and factors associated with undernutrion and anemia among school children in durbete town,northwest ethiopia 2015. salmakhuwaja. prevalence and correlates of stunting among primary school children in rural areas of southern pakistan. 2005. MwankaEW. nutrional status and associated factors among children in public primary schools in Dagoretti,nairobikenya. 2013. amarelisanu. predictors of stunting among school age children in northwest ethiopia. 2018. EshetuZerihun. prevalence and factors associated with stunting and thinness among school age children in arbaminch health and demographic surveillance site southern ethiopia 2018. zaidaHerrador. cross sectional study of malnutrion and associated factors among school aged children in rural and urban setting of fogera and libo kemkem district ethiopia 2014. SusanKeino. determinants of stunting and overweight among young children and adolescents in sub saharan africa. 2014. khuwaja s. prevalence and correlates of stunting among primary school children in rural areas of southern pakistan. 2005. harriet. determinants of stunting in indonesian children:evidence from cross sectional survey indicate a prominent role for the water, sanitation an hygeine sector in stunting reduction. 2016. JeeHyunRah. household sanitation and personal hygiene practices are associated with child stunting in rural india: a cross sectional analysis of surveys. 2015. olivercumming. can water,sanitation and hygiene help eliminate stunting?current evidence and policy implications. 2016. WimVanderHoek. availability of irrigation water for domestic use in pakistan:its impact on prevalence of diarhea and nutrional status of children. 2002. michaelHarris. community level sanitation coverage more associated with child growth and household drinking water quality than access to a private tiolet in rural Mali. 2017. richardDsemba. effect of parental formal education on risk of child stunting in indonesia and bangladesh. 2008. Tables Table 1 :-Specific objective 2; associated factors of stunting among primary school children’s from different articles Factors %non exposed %of exposed Total sample size 10% none respondent rate Fathers occupation 66 9 28 31. (27) Sex of the child 63.6 36.6 119 131. (37) Child age 24.2 2.3 92 101.(23) Birth order 99 39 23 25. (11) Family size 15 40 114 125.(8) Table 2 :-Distribution of Socio-Demographic Characteristics of the Study Participants in Degahbur Town, Somali region, Eastern Ethiopia 2019. Variables Frequency(n=354) Percentage (%) Age of the child 5-9yrs 174 49.2 10-14yrs 180 50.8 Sex of the child Male 182 51.4 Female 172 48.6 Birth order First child 30 8.5 2-5 324 91.5 With whom the child lives with Mother 71 20.1 Father 8 2.3 Mother and Father 253 71.5 Grand families 12 3.4 Others 10 2.8 Ethnicity of the child Somali 342 96.6 Others 12 3.4 Religion of the child Muslim 344 97.2 Others 10 2.8 Educational level of the mother Informal 156 44.1 Formal 198 55.9 Marital status of the mother Married 299 84.5 Divorced 24 6.8 Widowed 30 8.5 Others 1 0.3 Husband educational level Informal 89 25.1 Formal 265 74.9 Table 3 :- Socio-economic characteristics of the respondent among primary school children of Dagahbur city, Somali region, Eastern Ethiopia 20 19. Variables Frequency(N=354) Percentage (%) Mothers Occupation House Wife 255 72.0 Government employee 27 7.6 Merchant 57 16.1 Others 15 4.2 Husband Occupation Government Employee 108 30.5 Merchant 75 21.2 Daily laborer 112 31.6 Other 59 16.7 Maternal Age 24 276 78.0 Number of Living Children 4 254 71.8 Average Family Monthly Income =5000 ETB 82 23.2 Family Size =6 203 57.3 Table 4 :-Environmental issue & sanitation, Child health and dietary conditions among primary school children of Dagahbur city, Somali region, Eastern Ethiopia 2019 . Variables Frequency(N=354) Percentage (%) Water availability Yes 338 95.5 No 16 4.5 Water Source Safe Water 254 71.8 Unsafe Water 100 28.2 Water Adequacy Yes 143 40.4 No 211 59.6 Latrine Situation Improved Facility 219 61.9 Unimproved Facility 135 38.1 Solid Waste Disposal Proper 233 65.8 Improper 121 34.2 Liquid Waste Disposal Proper 223 63.0 Improper 131 37.0 History of Vaccination Yes 271 76.6 No 83 23.4 Personal Hygiene of The Child Good 252 71.2 Poor 102 28.8 Child Illness In the Last two Weeks Yes 190 53.7 No 164 46.3 Minimum Dietary Diversification One Time 5 1.4 Two Time 36 10.2 Three Time 306 86.4 >Three Times 7 2.0 Drought Status Of Dagahbur City in the Past Year Yes 318 89.8 No 36 10.2 Table 5 :- Maternal obstetric, medical and nutritional status among mothers of primary school children of Dagahbur city, Somali region, Eastern Ethiopia 2019 . Variables Frequency(N=354) Percentage (%) History of Nutritional Status of The Mother Thin 161 45.5 Medium 179 50.6 Fat 14 4.0 Past History Disease Condition of The Mother Healthy 263 74.3 Unhealthy 91 25.7 Current Medical Status of The Mother Healthy 275 77.7 Unhealthy 79 22.3 Maternal Dietary Status Good 257 72.6 Poor 97 27.4 Place of Delivery Hospital 249 70.3 Home 105 29.7 Mode of Delivery Spontaneous Vaginal Delivery 305 86.2 Cesarean Section 48 13.6 Instrumental Delivery 1 0.3 Iron Folic Supplementation Yes 228 64.4 No 126 35.6 ANC Utilization Yes 252 71.2 No 102 28.8 ITBN Utilization Yes 269 76.0 No 85 24.0 BMI of the mother 25 49 13.8 Table 6 :-Bivariate and Multivariate logistic regression of stunting and associated factors among primary school children of degahbour city Somali region, Eastern Ethiopia 2019 . Variable Category Stunting COR AOR 95%CI P-value Stunted% Not stunted% Age of the child 5-9yrs 18(10.3) 156(89.7) 1.62 (0.75–3.46)* 1.66 (0.65–4.24) 0.29 10-14yrs 12(6.7) 168(93.3) 1.00 1.00 Sex of the child Male 19(10.4) 163(89.6) 1.71 (0.79–3.70)* 3.65 (1.35–9.85)* 0.01* Female 11(6.4) 161(93.6) 1.00 1.00 Birth order First child 7(23.0) 23(76.7) 3.98 (1.55–10.26)* 7.01 (1.98–24.84)* 0.003* 2-5 23(7.1) 301(92.9) 1.00 1.00 Husband education Informal 4(4.5) 85(95.5) 0.43 (0.15- 1.28)* 0.41(0.12-1.40) 0.15 Formal 26(9.8) 239(90.2) 1.00 1.00 Husband occupation Government employee 9(8.3) 99(91.7) 0.40 (0.15- 1.02) 0.57 (0.17-1.88) 0.29 Merchant 2(2.7) 73(97.3) 0.12,(0.023-0.56) * 0.08 (0.01- 0.44) * 0.004* Daily laborer 8(7.1) 104(92.9) 0.34 (0.13-0.89) 0.61 (0.19-2.00) 0.42 Others 11(18.6) 48(81.4) 1.00 1.00 Family size =6 12(5.9) 191(94.1) 1.00 1.00 Water availability Yes 23(6.8) 315(93.2) 0.09 (0.03- 0.28) * 0.05 ( 0.01- 0.21) * <0.001* No 7(43.8) 9(56.3) 1.00 1.00 Water source Safe water 14(5.5) 240(94.5) 0.31 (0.14- 0.65) * 0.24 (0.08-0.70) * 0.009* Unsafe water 16(16) 84(84.0) 1.00 1.00 Liquid waste Proper 23(10.3) 200(89.7) 2.04 (0.85- 4.89) * 5.47 (1.73-17.30) * 0.004* Improper 7(5.3) 124(94.7) 1.00 1.00 P- Value <0.25 for bivariate analysis and P-value <0.05 for multivariate analysis, a=farmer, agro-pastoralist, no job Additional Declarations The authors declare no competing interests. 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2019.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-8732568/v1/d817f911ed91eaec22a910b6.png"},{"id":101633282,"identity":"7d67c7eb-691a-42f6-b131-cb20bfc841f2","added_by":"auto","created_at":"2026-02-02 05:59:40","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19872,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSchematic Presentation of sampling Procedure for identifying the prevalence of stunting and associated factors among primary school children in Dagahbour Woreda, Somali Region, Eastern Ethiopia 2019.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-8732568/v1/25508aa974099af29f5951c5.png"},{"id":101633281,"identity":"caf89ab2-993b-4a1d-b372-38ab000ba210","added_by":"auto","created_at":"2026-02-02 05:59:40","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":8515,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePrevalence of stunting among primary school children of degahbour city, Somali region, eastern Ethiopia 2019.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-8732568/v1/294ca7bf22d80c0511fa9315.png"},{"id":101755767,"identity":"b4da16d9-95b2-4896-8ec0-d0e5337eabf6","added_by":"auto","created_at":"2026-02-03 10:54:36","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2517030,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8732568/v1/efbd3d2e-927f-4235-babd-f515ca65f61b.pdf"},{"id":101753687,"identity":"cf7b9421-0fd3-4ece-8af3-e59418291e4b","added_by":"auto","created_at":"2026-02-03 10:40:33","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":27284,"visible":true,"origin":"","legend":"\u003cp\u003eENGLISH VERSION QUESTIONNAIRE\u003c/p\u003e","description":"","filename":"ANNEX1QuestionnairesForm.docx","url":"https://assets-eu.researchsquare.com/files/rs-8732568/v1/27835e2240e3e32a4326d9ae.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003ePrevalence of stunting and associated factors among primary school children of Dagahbur city, Somali Region, Eastern Ethiopia\u003c/p\u003e","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eStunting, commonly assessed using height-for-age indices, reflects chronic undernutrition and long-term growth failure in children. It is defined as a height-for-age Z-score below minus two standard deviations (-2 SD) from the median of the World Health Organization (WHO) reference population, while values below minus three standard deviations (-3 SD) indicate severe stunting. This condition represents the cumulative effects of prolonged nutritional deprivation and recurrent illness during critical periods of growth (1).\u003c/p\u003e \u003cp\u003eGlobally, childhood stunting remains a major public health concern. It is estimated that approximately 165\u0026nbsp;million children under five years of age are affected worldwide. Stunting has been associated with a range of adverse outcomes, including increased susceptibility to infections, higher risk of mortality, delayed physical and cognitive development, reduced learning capacity, poor academic performance, and decreased productivity in adulthood (2).\u003c/p\u003e \u003cp\u003eGrowth faltering typically begins early in life, with a marked increase in stunting observed between 6 and 23 months of age and a peak prevalence around 24\u0026ndash;35 months. This pattern underscores the long-lasting consequences of undernutrition occurring during the first 1,000 days of life. However, the effects of early-life growth deficits often persist into later childhood and adolescence. According to reports from the United Nations Children\u0026rsquo;s Fund (UNICEF), more than 200\u0026nbsp;million school-aged children were estimated to be stunted by the year 2000. Projections suggested that, without effective interventions, the number of schoolchildren experiencing impaired physical and cognitive development due to stunting could reach one billion by 2020 (3), These findings highlight the importance of extending nutritional attention beyond early childhood.\u003c/p\u003e \u003cp\u003eEvidence indicates that child nutritional status is closely linked to maternal factors and birth outcomes. Children born with low birth weight or small size are more likely to experience stunting, wasting, or underweight later in life. Similarly, maternal undernutrition, particularly among mothers with a body mass index (BMI) below 18.5 kg/m\u0026sup2;, has been associated with poorer growth outcomes in their children (1).\u003c/p\u003e \u003cp\u003eIn Ethiopia, childhood stunting remains highly prevalent and continues to pose a significant challenge to child development and educational achievement. National data indicate that more than two in five children are stunted, with considerable regional variation. Stunted children in Ethiopia tend to start school later, experience delayed grade progression, and account for a substantial proportion of grade repetition in primary education. Furthermore, stunting is associated with impaired brain development, which may have lasting effects on cognitive ability, school performance, and future economic productivity (4).\u003c/p\u003e \u003cp\u003eMalnutrition among school-aged children is increasingly recognized as an important public health issue, particularly in low- and middle-income countries. Despite this, school-aged children are often excluded from national nutrition surveys, resulting in limited population-level data on their nutritional status. This lack of information constrains the development of targeted interventions for this age group (5). In Sub-Saharan Africa, the burden of stunting remains especially high, with estimates suggesting that up to 60% of children in some settings are affected (6).\u003c/p\u003e \u003cp\u003eEducation is one of the most important aspects of social and economic development. Education improves capabilities and is strongly associated with various socioeconomic variables such as lifestyle, income, and fertility for both individuals \u0026lsquo;and societies.\u003c/p\u003e \u003cp\u003eEducation plays a critical role in social and economic development and is closely linked to health and nutrition. Nutritional deficiencies during childhood can adversely affect school attendance, learning capacity, and educational attainment. Several studies conducted in developing countries have demonstrated a strong relationship between height-for-age and academic performance, indicating that chronic undernutrition may impair cognitive development and learning outcomes among school-aged children (7).\u003c/p\u003e \u003cp\u003ePoor nutritional status is one of the major causes of low academic performance and productivity in primary education which may have an effect on the physical and cognitive development in children throughout their early years of life. Discovering the variables that influence the achievement of school children is of great importance because it would serve as an essential tool for regional and national Universal Basic Education Board and for other policymakers in the design of education policies. This would eventually lead to a rise in the quality of primary education and student\u0026rsquo;s nationally.\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, there are limited local studies in the Somali Region that focus on the associated factors of stunting among primary school children. This population group has been largely neglected, as research attention has predominantly focused on preschool-aged children, who are assumed to be more vulnerable to undernutrition. However, interventions targeting school-aged children can complement efforts made during the preschool years and contribute to reducing undernutrition and its long-term adverse effects on child health and educational outcomes. Therefore, this study was designed to assess the determinants of stunting among primary school children in Dagahbur City, Somali Region, Eastern Ethiopia.\u003c/p\u003e"},{"header":"MATERIALS AND METHODS","content":"\n \u003ch2\u003eStudy area and period\u003c/h2\u003e\n \u003cp\u003eThe study was conducted in Dagahbur City, located in the Jarar Zone of the Somali Regional State, Eastern Ethiopia. Dagahbur City lies approximately 650 km east of Jigjiga City and about 780 km from Addis Ababa. According to the 2011 Ethiopian Central Statistical Agency report, the district has an estimated population of 126,537. Dagahbur Woreda and the City Administration together have 25 public primary schools, of which 16 are located in Dagahbur Woreda and 9 within the city administration. The study was carried out from April to June 2019.\u003c/p\u003e\n\n\u003ch3\u003eStudy design\u003c/h3\u003e\n\u003cp\u003eAn institution-based cross-sectional study design was employed.\u003c/p\u003e\n\u003ch3\u003eSource of population and study population\u003c/h3\u003e\n\u003cp\u003eThe source population consisted of all primary school children enrolled in public primary schools in Dagahbur City. The study population included primary school children attending the selected public primary schools during the 2019 academic year.\u003c/p\u003e\n\u003ch3\u003eInclusion and exclusion criteria\u003c/h3\u003e\n\n \u003ch2\u003eInclusion criteria\u003c/h2\u003e\n \u003cp\u003eAll primary school children who were present during the data collection period and whose parents or legal guardians provided informed consent were included in the study.\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e;\u003c/p\u003e\n \u003cp\u003eChildren with physical deformities that could affect height measurement, those who were seriously ill at the time of data collection, children with chronic illnesses, and children who had lived in the study area for less than one year were excluded.\u003c/p\u003e\n\n\n \u003ch2\u003eSample size determination\u003c/h2\u003e\n \u003cp\u003eThe required sample size for this study was determined by single population proportion formula with the following assumption:\u003c/p\u003e\n\n\u003ch3\u003eSpecific objective 1; prevalence of stunting\u003c/h3\u003e\n\u003cp\u003en= \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\frac{{\\text{z}}^{2}\\text{p}\\text{q}}{{\\text{d}}^{2}}\\)\u003c/span\u003e\u003c/span\u003e where z\u0026thinsp;=\u0026thinsp;1.96\u003c/p\u003e\n\u003cp\u003eP\u0026thinsp;=\u0026thinsp;the prevalence of stunting among primary school children a Fogera woreda, Northwest Ethiopia was 30.7%.(8)\u003c/p\u003e\n\u003cp\u003eq\u0026thinsp;=\u0026thinsp;1-p, 1-0.307\u0026thinsp;=\u0026thinsp;0.693\u003c/p\u003e\n\u003cp\u003ed\u0026thinsp;=\u0026thinsp;0.05, degree of accuracy desired\u003c/p\u003e\n\u003cp\u003en=\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\left(1.96\\right)}^{2}\\text{*}0.307\\text{*}0.693/{0.05}^{2}\\)\u003c/span\u003e\u003c/span\u003e, =\u0026thinsp;327\u003c/p\u003e\n\u003cp\u003eAfter adding a 10% non-response rate, the final sample size was \u003cstrong\u003e360 children\u003c/strong\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable \u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e:-Specific objective 2; associated factors of stunting\u003c/strong\u003e\u003cstrong\u003e among primary school children\u0026rsquo;s from different articles\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFor the second objective (factors associated with stunting), the sample size was calculated using a double population proportion formula with Epi Info version 7, assuming 95% confidence level, 80% power, a 1:1 ratio, and 10% non-response rate. Since the sample size calculated for the first objective was larger, \u003cstrong\u003e360 participants were taken as the final sample size\u003c/strong\u003e. \u003cstrong\u003e(Table 1)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2 id=\"_Toc12520470\"\u003eSampling technique\u003c/h2\u003e\n\u003cp\u003eA multistage sampling technique was used. From the nine urban public primary schools in Dagahbur City, two schools were selected using simple random sampling (lottery method). The total sample size was proportionally allocated to the selected schools based on student population size.\u003c/p\u003e\n\u003cp\u003eWithin each selected school, study participants were selected using systematic random sampling from the student registration lists. The sampling interval (k) was calculated for each class, and the first participant was selected randomly.\u003c/p\u003e\n\u003cp\u003eThe sample size for each school was calculated using the formula:\u003c/p\u003e\n\u003cp\u003eni=(n * Ni)/N)\u003c/p\u003e\n\u003cp\u003eWhere: \u003c/p\u003e\n\u003cp\u003eni=sample size of each selected school\u0026rsquo;s\u003c/p\u003e\n\u003cp\u003en=total sample size\u003c/p\u003e\n\u003cp\u003eNi=total number of students in each selected school\u003c/p\u003e\n\u003cp\u003eN=total number of students in all selected schools\u003cstrong\u003e (Figure 2)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003eData collection procedure\u003c/h2\u003e\n\u003cp\u003eData were collected using a pre-tested, structured interviewer-administered questionnaire adapted from relevant literature. The questionnaire was initially prepared in English, translated into Somali, and then back-translated into English to ensure consistency.\u003c/p\u003e\n\u003cp\u003eParents or caregivers of the selected children were the respondents. After children were selected from schools, their household addresses were obtained from school records. Data collectors visited households to conduct interviews with parents or caregivers.\u003c/p\u003e\n\u003cp\u003eFive diploma-level clinical nurses collected the data under the supervision of one health officer. A pretest was conducted on 5% of the sample in a nearby area with similar socio-economic characteristics prior to the actual data collection.\u003c/p\u003e\n\u003ch2\u003eAnthropometric measurements\u003c/h2\u003e\n\u003cp\u003eAnthropometric measurements were taken following standard procedures. Height was measured using a portable stadiometer with the child standing upright, barefoot, and with heels, buttocks, shoulders, and head touching the vertical surface. Measurements were recorded to the nearest 0.1 cm.\u003c/p\u003e\n\u003cp\u003eThe child\u0026rsquo;s age was verified using school records and confirmed with parents or caregivers.\u003c/p\u003e\n\u003ch2\u003eMeasurement of nutritional status\u003c/h2\u003e\n\u003cp\u003eHeight-for-age Z-scores (HAZ) were generated using WHO AnthroPlus software. Stunting was defined as a height-for-age Z-score below -2 standard deviations (\u0026lt; -2 SD) from the WHO reference median, while severe stunting was defined as HAZ \u0026lt; -3 SD. \u003c/p\u003e\n\u003ch2 id=\"_Toc12520472\"\u003eStudy variables\u003c/h2\u003e\n\u003cp id=\"_Toc12520473\"\u003eDependent \u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\u003cstrong\u003eStunting\u003c/strong\u003e\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e(Stunting, commonly assessed using height-for-age indices, reflects chronic undernutrition and long-term growth failure in children. It is defined as a height-for-age Z-score below minus two standard deviations (-2 SD) from the median of the World Health Organization (WHO) reference population, while values below minus three standard deviations (-3 SD) indicate severe stunting. This condition represents the cumulative effects of prolonged nutritional deprivation and recurrent illness during critical periods of growth.(1) \u003c/p\u003e\n\u003ch2 id=\"_Toc12520474\"\u003eIndependent variables\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eSocio demographic characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eSex of the child\u003c/li\u003e\n\u003cli\u003eAge of the child \u003c/li\u003e\n\u003cli\u003eMartial statues \u003c/li\u003e\n\u003cli\u003eType of marriage \u003c/li\u003e\n\u003cli\u003eParent\u0026rsquo;s education\u003c/li\u003e\n\u003cli\u003eParent\u0026rsquo;s occupations\u003c/li\u003e\n\u003cli\u003eMonthly income\u003c/li\u003e\n\u003cli\u003eHouse hold latrine condition \u003c/li\u003e\n\u003cli\u003eNo of family members \u003c/li\u003e\n\u003cli\u003eSolid waste disposal\u003c/li\u003e\n\u003cli\u003eLiquid waste disposal\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eChild health and caring practice\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003eBirth order\u003c/li\u003e\n\u003cli\u003eDietary diversity\u003c/li\u003e\n\u003cli\u003eUtilization of insecticide-treated bed nets\u003c/li\u003e\n\u003cli\u003eImmunization \u003c/li\u003e\n\u003c/ul\u003e\n\u003ch2 id=\"_Toc12520475\"\u003eOperational definition\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eStunting; \u003c/strong\u003eis defined as low height-for-age at \u0026lt; -2 standard deviations (SD) of the median value of the National Center for Health Statistics/World Health Organization (NCHS/WHO) international growth reference. Severe stunting is defined as \u0026lt; -3 SD. (9)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePrimary school children: -\u003c/strong\u003e children with age of 5 to 14 years old who are attending public schools. (10)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBirth order:\u003c/strong\u003e is a chronological order of sibling births in a family. (11)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnthropometry: \u003c/strong\u003eMeasurement of the variation of physical dimensions. .(12)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eType of marriage:\u003c/strong\u003e is marriage either polygamies or monogamies. (13)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMinimum dietary diversification: -\u003c/strong\u003econsumption or feeding of different type of diet. (8)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eImmunization Status; \u003c/strong\u003echild status to immunization either (fully, partially, up-to-date) immunized. (1)\u003c/p\u003e\n\u003ch2 id=\"_Toc12520476\"\u003eData quality assurance\u003c/h2\u003e\n\u003cp\u003eTo ensure data quality, several measures were implemented. Intensive two-day training was provided to data collectors prior to the start of data collection. Anthropometric measuring instruments were standardized and calibrated to zero before each measurement. The questionnaire was translated from English into Somali and back-translated into English to ensure consistency and clarity. The age of each child was obtained from school records and cross-checked using birth certificates and parental recall of key events.\u003c/p\u003e\n\u003cp\u003eA pretest was conducted on 5% of the sample one week before the actual data collection in a nearby area with similar socio-economic characteristics to assess the validity and reliability of the questionnaire. The principal investigator closely supervised the data collection process and checked all completed questionnaires daily for completeness and logical consistency at the data collection sites.\u003c/p\u003e\n\u003ch2 id=\"_Toc12520477\"\u003eData processing and analysis \u003c/h2\u003e\n\u003cp\u003eThe collected data were checked for completeness and consistency. Each completed questionnaire was assigned a unique identification code. Data were entered into EpiData version 3.01 and cleaned by checking for missing values and logical inconsistencies. Double data entry was performed independently by two data clerks to minimize data entry errors. The cleaned dataset was then exported to SPSS version 23 for statistical analysis. Anthropometric data were analyzed using WHO AnthroPlus software to generate height-for-age Z-scores (HAZ) and determine stunting status.\u003c/p\u003e\n\u003cp\u003eDescriptive statistics, including mean, median, frequency, and percentage, were computed and presented using tables and figures. Bivariate binary logistic regression analysis was performed, and all explanatory variables with a p-value \u0026lt; 0.25 (14). In the bivariate analysis were considered candidates for the multivariable logistic regression model (15). Multicollinearity among independent variables was assessed using the variance inflation factor (VIF) and tolerance tests.\u003c/p\u003e\n\u003cp\u003eModel fit was evaluated using the Hosmer\u0026ndash;Lemeshow goodness-of-fit test, which yielded a p-value of 0.365, indicating an adequate model fit. The discriminative ability of the model was assessed using the Receiver Operating Characteristic (ROC) curve, which produced an area under the curve (AUC) of 0.74, suggesting acceptable discrimination. The Nagelkerke pseudo R\u0026sup2; value was 0.31, indicating a \u003cstrong\u003emoderate explanatory power of the model\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e The strength of association was measured using adjusted odds ratios (AORs) with 95% confidence intervals, and statistical significance was declared at a p-value \u0026lt; 0.05.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eEthics approval and consent to participate \u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Jigjiga University Institutional Health Research Ethics Review Committee (IHRERC/72/2019).Thestudy was conducted\u003cstrong\u003ein accordance with the ethical principles of the Declaration of Helsinki\u003c/strong\u003e. Official permission was obtained from the Jigjiga University Postgraduate Office and the Somali Regional Education Bureau before data collection.\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from parents or legal guardians of all participating children prior to data collection. Assent was also obtained from the children where appropriate. Participants were clearly informed about the purpose, benefits, and potential risks of the study. Confidentiality of the collected information was maintained by using unique codes instead of personal identifiers, and all data were used solely for research purposes. School privacy and local cultural norms were strictly respected throughout the study.\u003c/p\u003e\n\u003cbr\u003e"},{"header":"RESULTS","content":"\u003ch2\u003eSocio- Demographic Characteristics of the Study Participants\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eOut of the 360 participants initially sampled for the study, 354 participated, resulting in a response rate of 98.3%. Most participants were between 8 and 10 years of age. The mean age of the participants was 9.6 years (SD = 2.44). The sex ratio was nearly equal, with 182 males (51.4%) and 172 females (48.6%).\u0026nbsp;\u003cstrong\u003eThe majority of the children were of birth order 2-5, accounting for 324 (91.5%), while only 30 (8.5%) were first-born.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the participants, 253 (71.5%) lived with both parents, 71 (20.1%) lived with their mother only, 8 (2.3%) lived with their father only, 12 (3.4%) lived with their grandparents, and 10 (2.8%) lived with others. The majority of participants were of Somali ethnicity (342, 96.6%) and Muslim by religion (344, 97.2%). Regarding parental education, 156 (44.1%) of mothers had informal education, while 89 (25.1%) of fathers had informal education.\u003c/p\u003e\n\u003cp\u003eRegarding marital status of the participants\u0026rsquo; parents, 299 (84.5%) were married, 30 (8.5%) widowed, 24 (6.8%) divorced, and 1 (0.3%) other. \u003cstrong\u003e(Table 2)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2 id=\"_Toc12520483\"\u003eSocio-economic characteristics of the respondent\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eOf the 360 participants initially sampled, 354 participated. Regarding maternal occupation, 255 (72.0%) were housewives, 27 (7.6%) were government employees, 57 (16.1%) were merchants, and 15 (4.2%) had other occupations. Regarding paternal occupation, the majority were daily laborers (112, 31.6%), followed by government employees (108, 30.5%), merchants (75, 21.2%), and others (59, 16.7%).\u003c/p\u003e\n\u003cp\u003eMost mothers (276, 78.0%) were older than 24 years. Concerning the number of living children in the household, 254 (71.8%) had more than 4 children, while 100 (28.2%) had fewer than 4 children. Based on average monthly family income, 271 (76.6%) earned 2900\u0026ndash;5000 ETB. Most families (203, 57.3%) had more than \u0026ge;6 category. \u003cstrong\u003e(Table 3)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2 id=\"_Toc12520484\"\u003eEnvironmental issue \u0026amp; sanitation, Child health and dietary conditions\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eOf the 354 participants, 338 (95.5%) reported the availability of water, while 16 (4.5%) reported no water availability. Among them, 254 (71.8%) had access to safe water, whereas 100 (28.2%) did not. Additionally, 211 (59.6%) reported inadequate water supply.\u003c/p\u003e\n\u003cp\u003eRegarding sanitation, 341 (96.3%) had latrines, while 13 (3.7%) did not. Among those with latrines, 219 (61.9%) had improved facilities, and 135 (38.1%) had unimproved facilities. Regarding waste disposal, 233 (65.8%) properly disposed of solid waste, while 121 (34.2%) did not. For liquid waste, 223 (63.0%) had proper disposal systems, whereas 131 (37.0%) had improper disposal.\u003c/p\u003e\n\u003cp\u003eMost children (271, 76.6%) had a history of vaccination, while 83 (23.4%) had not been vaccinated. Regarding personal hygiene, 252 (71.2%) were rated as having good hygiene, and 102 (28.8%) had poor hygiene. In the last two weeks, 190 (53.7%) of participants experienced illness, while 164 (46.3%) did not.\u003c/p\u003e\n\u003cp\u003eRegarding dietary frequency per day, 306 (86.4%) ate three times per day, 36 (10.2%) ate twice, 5 (1.4%) ate once, and 7 (2.0%) ate more than three times. Concerning drought, 318 (89.8%) reported drought in Dagahbur city in the previous year, while 36 (10.2%) reported no drought. Additionally, 203 (57.3%) reported extreme starvation in the surrounding area, while 151 (42.7%) reported no famine/starvation.\u003cstrong\u003e\u0026nbsp;(Table 4)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2 id=\"_Toc12520485\"\u003eMaternal obstetric, medical and nutritional status of the respondent\u003c/h2\u003e\n\u003cp\u003eAmong the 354 participants, the nutritional status of their mothers was reported as thin (161, 45.5%), medium (179, 50.6%), and overweight (14, 4.0%). Regarding maternal past medical history, 263 (74.3%) were healthy, and 91 (25.7%) had a history of illness. The current medical status of mothers was healthy for 275 (77.7%) and unhealthy for 79 (22.3%).\u003c/p\u003e\n\u003cp\u003eOut of the 354 mothers, 257 (72.6%) had good food intake, while 97 (27.4%) had poor intake. Current maternal status included 114 (32.2%) pregnant, 87 (24.6%) lactating, and 153 (43.2%) neither pregnant nor lactating. Place of delivery was hospital for 249 (70.3%) and home for 105 (29.7%). Mode of delivery was spontaneous vaginal delivery for 305 (86.2%), cesarean section for 48 (13.6%), and instrumental delivery for 1(0.3%)).\u003c/p\u003e\n\u003cp\u003eRegarding supplementation, 228 (64.4%) used iron-folic acid during pregnancy, while 126 (35.6%) did not. ANC utilization was reported by 252 (71.2%), while 102 (28.8%) did not utilize ANC. Most households (269, 76.0%) utilized ITBN, while 85 (24.0%) did not. Maternal BMI was \u0026lt;18.5 for 2 (0.6%), 18.5-25 for 303 (85.6%), and \u0026ge;25 for 49 (13.8%). \u003cstrong\u003e(Table 5)\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc12520486\"\u003ePrevalence of stunting among primary school children of Dagahbur city, Somali among primary school children of Dagahbur city, Somali region, Eastern Ethiopia 2019.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe prevalence of stunting among primary school children was \u003cstrong\u003e8.5% (95% CI: 5.6-11.3).\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e(Figure 3)\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003eFactors associated with stunting among primary school children of Dagahbur city\u003c/h2\u003e\n\u003cp\u003eIn bivariate logistic regression, the following factors were examined: age of the child (COR = 1.62; 95% CI: 0.75-3.46), sex of the child (COR = 1.71; 95% CI: 0.79-3.70), birth order (COR = 3.98; 95% CI: 1.55-10.26), husband\u0026rsquo;s educational status (COR = 0.43; 95% CI: 0.15-1.28), husband\u0026rsquo;s occupation-government employee (COR = 0.40; 95% CI: 0.15-1.02), merchant (COR = 0.12; 95% CI: 0.03-0.56), daily laborer (COR = 0.34; 95% CI: 0.13-0.89), family size \u0026le;3 (COR = 5.31; 95% CI: 0.97-29.14), 3-6 members (COR = 2.01; 95% CI: 0.92-4.38), water availability (COR = 0.09; 95% CI: 0.03-0.28), water source (COR = 0.31; 95% CI: 0.14-0.65), and liquid waste disposal (COR = 2.04; 95% CI: 0.85-4.89), which were significant at P-value \u0026lt;0.25.\u003c/p\u003e\n\u003cp\u003eNine variables (age, sex, birth order, husband\u0026rsquo;s education and occupation, family size, water availability, water source, and liquid waste disposal) were eligible for multivariate logistic regression. Variables with P \u0026lt; 0.05 in multivariate analysis were considered significant.\u003c/p\u003e\n\u003cp\u003eIn multivariate logistic regression, stunting was significantly associated with sex of the child (AOR = 3.65; 95% CI: 1.35-9.85), birth order (AOR = 7.01; 95% CI: 1.98-24.84), husband\u0026rsquo;s occupation (AOR = 0.08; 95% CI: 0.01-0.44), water availability (AOR = 0.05; 95% CI: 0.01-0.21), source of drinking water (AOR = 0.24; 95% CI: 0.08-0.70), and liquid waste disposal practices (AOR = 5.47; 95% CI: 1.73-17.30). \u003cstrong\u003e(Table 6) \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe present study was conducted to investigate the prevalence of stunting and its associated factors among primary school children in Dagahbur town. The prevalence of stunting was \u003cstrong\u003e8.5%,\u003c/strong\u003e which is comparable to a cross-sectional study conducted among school-age children in Eastern Ethiopia (8.9%).(16) and study done in Colombian school children (9.9%).(17). However, the prevalence in this study is higher than that reported in a study on anthropometric indices and socio-demographic determinants among primary school children in an urban school in Pune, India, which found a stunting prevalence of 4.47% (95% CI: 3\u0026ndash;5.94), and among Pakistani primary school children(8%).(19). The observed differences may be attributed to variations in study period, study area, age categories of the target populations, and the recently initiated nutrition-sensitive interventions in the study area.\u003c/p\u003e\n\u003cp\u003eConversely, the prevalence of stunting in this study is slightly lower than findings from other studies, including those conducted on nutrition, health, and academic achievement among primary school children in Uganda (8.7%) (20), Colombian school children(9.9%).(17), rural southeastern Kenya (23.3%)(21), Southwest Nigeria(17.4%).(22), and school-age children in Haiyk town, northeastern Ethiopia (11.3%) (23). Similar studies conducted on Durbete town, northwest Ethiopia(11.2).(24), Lideta sub-city, Addis Ababa, Ethiopia (19.6%).(11), North Sumatera, Indonesia 38.87%.(25), Dagoreti, Nairobi, Kenya.(24.3) (26), and Northwest Ethiopia.(37.9) (27), Arbminch Health And Demographic Surveillance Site, southern Ethiopia (41.9%) (28), Fogera and Libo Kemkem district, Ethiopia(42.7%) (29) reported highest prevalence rates. The lower prevalence in this study may be due to differences in study site, sample size, socioeconomic status, culture, feeding habits, and environmental conditions.\u003c/p\u003e\n\u003cp\u003eIn this study, the sex of the child was significantly associated with stunting (AOR = 3.65; 95% CI: 1.35-9.85), with male children being three times more likely to be stunted than female children. This finding aligns with a study on determinants of stunting and overweight among young children and adolescents in sub-Saharan Africa (30). In contrast, studies conducted in rural areas of southern Pakistan reported that female children were more likely to be stunted than male (25), while other studies among Pakistani primary school children found no significant association between gender and stunting. The observed difference may be due to biological, behavioral, and socio-cultural mechanisms; for example, male children may be more active, leading to higher energy expenditure and increased vulnerability to stunting. \u003c/p\u003e\n\u003cp\u003eBirth order was another significant factor associated with stunting (AOR = 7.01; 95% CI: 1.98-24.84). Children with a birth order greater than three were seven times more likely to be stunted compared to first-born or lower-order children. This is consistent with a study on undernutrition and associated risk factors among school-age children in Addis Ababa, Ethiopia.(11). The association may be due to older children receiving less attention, care, and resources from parents when new siblings are born.\u003c/p\u003e\n\u003cp\u003eFathers\u0026rsquo; occupation was also significantly associated with stunting. Children of merchant fathers were less likely to be stunted (AOR = 0.08; 95% CI: 0.01-0.44) compared to their counterparts. This finding aligns with a study on predictors of stunting among school-age children in Northwestern Ethiopia (27) and research in rural southern Pakistan, which found that children of fathers working as government employees (PR = 1.71; CI: 1.05-2.79), shopkeepers (PR = 2.00; CI: 1.22-3.26), or farmers (PR = 1.43; CI: 0.93-2.22) were more likely to be stunted than those with landlord fathers(31)\u003cstrong\u003e. \u003c/strong\u003eDifferences in living conditions, food availability, and intra-household food distribution may contribute to these disparities.\u003c/p\u003e\n\u003cp\u003eWater-related factors were significantly associated with stunting. Children from households accessing safe water sources were 76% less likely to be stunted (AOR = 0.24; 95% CI: 0.08-0.70). This finding is consistent with a study on determinants of stunting in Indonesian children, which reported that drinking untreated water increased the odds of stunting more than threefold(32) the finding of this study is inverse to study conducted in rural India.(33). This may be attributed due to lack of sewerage system in the town. The result shows that accessing water from safe source had greater odd ratio compared to counterpart so treating the source of water could be attributed for decline of under nutrition specially stunting.\u003c/p\u003e\n\u003cp\u003eSimilarly, water availability was a protective factor (AOR = 0.05; 95% CI: 0.01-0.21); households with larger water storage were 95% less likely to have stunted children. This aligns with previous research on water, sanitation, and hygiene (34),(35) Limited water supply may reduce household hygiene and food preparation quality, contributing to undernutrition.\u003c/p\u003e\n\u003cp\u003eImproper liquid waste disposal was positively associated with stunting (AOR = 5.47; 95% CI: 1.73-17.30). Children in households with poor liquid waste management were five times more likely to be stunted. This finding is consistent with research in rural Mali.(36). and may be attributed to inadequate waste disposal areas, overcrowding, and substandard housing conditions.\u003c/p\u003e\n\u003cp\u003eIn summary, stunting in Dagahbur town is influenced by child sex, birth order, fathers\u0026rsquo; occupation, water availability, safe water source, and liquid waste disposal practices. These findings highlight the need for integrated nutrition, water, and sanitation interventions targeting vulnerable children.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eIn this study, the prevalence of stunting, an indicator of chronic undernutrition, among primary school children in Degahbour City was \u003cstrong\u003e8.5%\u003c/strong\u003e, which is lower than that reported in several other regions of Ethiopia. Stunting was found to be significantly associated with the child\u0026rsquo;s sex, birth order, husband\u0026rsquo;s occupation, household water availability, water source, and liquid waste disposal practices.\u003c/p\u003e\n\u003cp\u003eConversely, no statistically significant associations were observed between stunting and the person with whom the child lived, maternal educational status, recent child illness, personal hygiene practices, antenatal care utilization, or place of delivery. These findings highlight the importance of household socioeconomic and environmental factors in influencing the nutritional status of school-aged children. Strengthening water, sanitation, and hygiene conditions, along with targeted nutrition interventions for school-aged children, may contribute to reducing stunting in this population.\u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003ch2 id=\"_Toc12520489\"\u003eLimitation of the study\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThis study has some limitations that should be considered when interpreting the findings. First, the cross-sectional design does not allow for establishing causal relationships between stunting and the identified associated factors. Second, some variables were assessed based on parental or caregiver self-report, which may be subject to recall bias. Third, as the study was conducted among school-attending children, the findings may not be generalizable to all school-aged children in the community, particularly those who are not enrolled in school.\u003c/p\u003e\n\u003ch2\u003e\u003cspan id=\"_Toc12520490\"\u003eRecommendation\u003c/span\u003e\u003c/h2\u003e\n\u003cp\u003eThe findings of this study underscore the need to strengthen nutrition-related interventions for school-aged children in the Somali Region. Regional health authorities may enhance community-based nutrition education by increasing awareness of appropriate feeding practices and the consequences of chronic undernutrition. Interventions targeting parents and caregivers should emphasize timely feeding, balanced diets, and efficient use of locally available food resources.\u003c/p\u003e\n\u003cp\u003eAt the district level, strengthening school-based nutrition education and supporting school feeding initiatives may help address nutritional gaps among primary school children. In addition, further analytical and longitudinal studies are recommended to better understand the determinants of stunting among school-aged children and to inform context-specific interventions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Jigjiga University Institutional Health Research Ethics Review Committee (IHRERC/72/2019).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003estudy was conducted\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ein accordance with the ethical principles of the Declaration of Helsinki\u003c/strong\u003e. Official permission was obtained from the Jigjiga University Postgraduate Office and the Somali Regional Education Bureau before data collection.\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from parents or legal guardians of all participating children prior to data collection. Assent was also obtained from the children where appropriate. Participants were clearly informed about the purpose, benefits, and potential risks of the study. Confidentiality of the collected information was maintained by using unique codes instead of personal identifiers, and all data were used solely for research purposes. School privacy and local cultural norms were strictly respected throughout the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication: \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial registration number:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eORCID\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmin Ugas Mahad https://orcid.org/0009-0003-8009-6654\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement:\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The authors did not receive any specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u003c/strong\u003e\u003cbr\u003e\u003cstrong\u003eAUM\u003c/strong\u003e conceived and designed the study, coordinated data collection, performed data analysis, and drafted the manuscript. \u003cstrong\u003eAH\u003c/strong\u003e contributed to study design, data analysis, and manuscript revision. \u003cstrong\u003eMO\u0026nbsp;\u003c/strong\u003eassisted with data collection, supervision, and interpretation of results. \u003cstrong\u003eAMI\u0026nbsp;\u003c/strong\u003eassisted data analysis. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors express their gratitude to everybody who contributed to this original article at any step.\u003c/p\u003e\n\u003ch3\u003eData Availability Statement\u003c/h3\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eEDHS. EDHS. 2016.\u003c/li\u003e\n\u003cli\u003elasleyoot. The Effect of Chronic Malnutrition (Stunting) on Learning Ability, a Measure of Human Capital: A Model in PROFILES for Country-Level Advocacy. 2016.\u003c/li\u003e\n\u003cli\u003eMekdesWolde. determinant of stunting underweight,stunting and wasting among school children BMC. 2015.\u003c/li\u003e\n\u003cli\u003eBirhanuA. stunting and associated factors among children age 6-59 months in lasta woreda north east ethiopia 2015.\u003c/li\u003e\n\u003cli\u003ehedwigacham. nutrion,health and academic achievement of primary school schildren in uganda. 2014.\u003c/li\u003e\n\u003cli\u003eabah. Nutritional status of schoolchildren in Jos East Local Government Area of Plateau State, North Central Nigeria. 2017.\u003c/li\u003e\n\u003cli\u003eSarma MSG. The Effects of Nutritional Status on Educational Performance of Primary School Children in the Plantation Sector in Nuwara Eliya Educational Zone cv. 2013.\u003c/li\u003e\n\u003cli\u003ehunegnawmekonen. Institutional and community based cross sectional study used to determine the nutritional status of school children in terms of stunting, underweight and thinness and to identify its correlates at Fogera woreda, Northwest Ethiopia, . 2012 \u003c/li\u003e\n\u003cli\u003eWHO \u003cem\u003ePhysical Status: The Use and Interpretation of Anthropometry.\u003c/em\u003e Report of a WHO Expert Committee. WHO Technical Report Series 854 Geneva: WHO. 1995.\u003c/li\u003e\n\u003cli\u003efirehiwotmesfin y. prevalence and associated factors of stunting among primary school children in eastern ethiopia. 2015.\u003c/li\u003e\n\u003cli\u003eDawitDegarege. A community based cross-sectional study was conducted in 459 school age children and their parents or Caregivers living in Lideta sub-city, Addis Ababa, Ethiopia BMC public health problem. 2015.\u003c/li\u003e\n\u003cli\u003eAkYadav a. anthropometric indices and its socio demographic determinants among primary school children of an urban school n pune india int J med public health. 2016.\u003c/li\u003e\n\u003cli\u003eAmare T, Haile W, Abel F, Akilew A, Ayanaw T, Segenet Y. Nearly half of preschool children are stunted in Dembia district, Northwest Ethiopia: a community based cross-sectional study. Archives of Public Health 2015;74(13 ).\u003c/li\u003e\n\u003cli\u003eHosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression: John Wiley \u0026amp; Sons; 2013.\u003c/li\u003e\n\u003cli\u003eBursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression-Source Code for Biology and Medicine. Source code for biology and medicine. 2008;3(1):1-8-0.\u003c/li\u003e\n\u003cli\u003efirehiwotMesfin. Prevalence and associated factors of stunting among primary school children in eastern ethiopia 2015.\u003c/li\u003e\n\u003cli\u003elouseeH.Dekker. stunting associated with poor socioeconomic and maternal nutrion status and respiratory morbidity in colombian school children 2010.\u003c/li\u003e\n\u003cli\u003eAkYadav a. study done on anthropometric indices and its socio-demographic determinants among primary school children of an urban school in Pune, India 2016.\u003c/li\u003e\n\u003cli\u003eMuhammedUmair. prevalence and socio demographic correlates of stunting and thinnes among pakistani primary school children. BMC public health problem. 2011.\u003c/li\u003e\n\u003cli\u003eHedwigAcham. nutrion,health and academic achievment of primary school children in Uganda. 2016.\u003c/li\u003e\n\u003cli\u003echisashinsugi. factors asscociated with stunting among children according to the level of food insecurity in the household: a crossectional study in rural community of southern kenya. 2015.\u003c/li\u003e\n\u003cli\u003eIdowuO.Senbanjo. prevalence and risk factors for stunting among school children and adolescents in abekokuta,southwest nigeria. 2011.\u003c/li\u003e\n\u003cli\u003eyonatanmenber. A school based cross-sectional study was conducted on 414 school age children in Haiyk town Primary schools, North eastern Ethiopia. 2017.\u003c/li\u003e\n\u003cli\u003etilahunalelign. prevalence and factors associated with undernutrion and anemia among school children in durbete town,northwest ethiopia 2015.\u003c/li\u003e\n\u003cli\u003esalmakhuwaja. prevalence and correlates of stunting among primary school children in rural areas of southern pakistan. 2005.\u003c/li\u003e\n\u003cli\u003eMwankaEW. nutrional status and associated factors among children in public primary schools in Dagoretti,nairobikenya. 2013.\u003c/li\u003e\n\u003cli\u003eamarelisanu. predictors of stunting among school age children in northwest ethiopia. 2018.\u003c/li\u003e\n\u003cli\u003eEshetuZerihun. prevalence and factors associated with stunting and thinness among school age children in arbaminch health and demographic surveillance site southern ethiopia 2018.\u003c/li\u003e\n\u003cli\u003ezaidaHerrador. cross sectional study of malnutrion and associated factors among school aged children in rural and urban setting of fogera and libo kemkem district ethiopia 2014.\u003c/li\u003e\n\u003cli\u003eSusanKeino. determinants of stunting and overweight among young children and adolescents in sub saharan africa. 2014.\u003c/li\u003e\n\u003cli\u003ekhuwaja s. prevalence and correlates of stunting among primary school children in rural areas of southern pakistan. 2005.\u003c/li\u003e\n\u003cli\u003eharriet. determinants of stunting in indonesian children:evidence from cross sectional survey indicate a prominent role for the water, sanitation an hygeine sector in stunting reduction. 2016.\u003c/li\u003e\n\u003cli\u003eJeeHyunRah. household sanitation and personal hygiene practices are associated with child stunting in rural india: a cross sectional analysis of surveys. 2015.\u003c/li\u003e\n\u003cli\u003eolivercumming. can water,sanitation and hygiene help eliminate stunting?current evidence and policy implications. 2016.\u003c/li\u003e\n\u003cli\u003eWimVanderHoek. availability of irrigation water for domestic use in pakistan:its impact on prevalence of diarhea and nutrional status of children. 2002.\u003c/li\u003e\n\u003cli\u003emichaelHarris. community level sanitation coverage more associated with child growth and household drinking water quality than access to a private tiolet in rural Mali. 2017.\u003c/li\u003e\n\u003cli\u003erichardDsemba. effect of parental formal education on risk of child stunting in indonesia and bangladesh. 2008.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e:-Specific objective 2; associated factors of stunting\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;among primary school children\u0026rsquo;s from different articles\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"687\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eFactors\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e%non exposed\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e%of exposed\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003eTotal sample size\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e10% none respondent rate\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eFathers occupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e31. (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eSex of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e63.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e36.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e131. (37)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eChild age\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e24.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e101.(23)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e25. (11)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 144px;\"\u003e\n \u003cp\u003eFamily size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 110px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 112px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e125.(8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp id=\"_Toc12337921\"\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003cstrong\u003e:-Distribution of Socio-Demographic Characteristics of the Study Participants in Degahbur Town,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSomali region, Eastern Ethiopia 2019.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"102%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Frequency(n=354)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Percentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eAge of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e5-9yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e49.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e10-14yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e50.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eSex of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e51.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e172\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eFirst child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e8.5\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003e2-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e91.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eWith whom the child lives with\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eMother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eFather\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eMother \u0026nbsp;and Father\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e71.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eGrand families\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eEthnicity of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eSomali\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e342\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e96.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eReligion of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eMuslim\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e344\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e97.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eEducational level of the mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eInformal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e156\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eFormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e198\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eMarital status of the mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e84.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eHusband educational level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eInformal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e25.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 43px;\"\u003e\n \u003cp\u003eFormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\"\u003e\n \u003cp\u003e74.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp id=\"_Toc12337922\"\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e:- Socio-economic characteristics of the respondent among primary school children of Dagahbur city, Somali region, Eastern Ethiopia 20\u003c/strong\u003e\u003cstrong\u003e19.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"661\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 222px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Frequency(N=354)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 210px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Percentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eMothers Occupation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eHouse Wife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e72.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eGovernment employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e7.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eMerchant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e16.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eHusband Occupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eGovernment \u0026nbsp;Employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e30.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eMerchant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eDaily laborer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e31.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eMaternal Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026lt;18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e19-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026gt;24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e276\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e78.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eNumber of Living Children\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026lt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026gt;4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e71.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eAverage Family Monthly Income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026lt;2900 ETB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e2900-5000 ETB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e76.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026gt;=5000 ETB\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e23.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003eFamily Size\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026lt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e3-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 229px;\"\u003e\n \u003cp\u003e\u0026gt;=6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 222px;\"\u003e\n \u003cp\u003e203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 210px;\"\u003e\n \u003cp\u003e57.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp id=\"_Toc12337923\"\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003cstrong\u003e:-Environmental issue \u0026amp; sanitation, Child health and dietary conditions among primary school children of Dagahbur city, Somali region, Eastern Ethiopia 2019\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"673\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; Frequency(N=354)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eWater availability\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e338\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e95.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 156px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e4.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eWater Source\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eSafe \u0026nbsp;Water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e71.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eUnsafe Water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e28.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eWater Adequacy\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e211\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e59.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eLatrine Situation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eImproved Facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e61.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eUnimproved Facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eSolid Waste Disposal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eProper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e65.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eImproper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e34.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eLiquid Waste Disposal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eProper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e63.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eImproper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e37.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eHistory of Vaccination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e76.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003ePersonal Hygiene of The Child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e71.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eChild Illness In the Last two Weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e190\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e53.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e46.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eMinimum Dietary Diversification\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eOne Time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eTwo Time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eThree Time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e306\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e86.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003e\u0026gt;Three Times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eDrought Status Of Dagahbur City in the Past Year\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e89.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 355px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 156px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e10.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp id=\"_Toc12337924\"\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e5\u003c/strong\u003e\u003cstrong\u003e:- Maternal obstetric, medical and nutritional status among mothers of primary school children of Dagahbur city, Somali region, Eastern Ethiopia 2019\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"691\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency(N=354)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHistory of Nutritional Status of The Mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eThin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e45.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eMedium\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e179\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e50.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eFat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003ePast History Disease Condition of The Mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e74.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eUnhealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e25.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eCurrent Medical Status of The Mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e77.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eUnhealthy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e22.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eMaternal Dietary Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e257\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e27.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003ePlace of Delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e249\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e70.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eHome\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e29.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eMode of Delivery\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eSpontaneous Vaginal Delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e305\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e86.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eCesarean Section\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eInstrumental Delivery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eIron Folic Supplementation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e228\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e64.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eANC Utilization\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e71.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e28.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eITBN Utilization\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e269\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e76.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eBMI of the mother\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026lt;18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e18.5-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e303\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e85.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003e\u0026gt;25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 160px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 192px;\"\u003e\n \u003cp\u003e13.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp id=\"_Toc12337926\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e6\u003c/strong\u003e\u003cstrong\u003e:-Bivariate and Multivariate logistic regression of stunting and associated factors among primary school children of degahbour city Somali region, Eastern Ethiopia 2019\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"731\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStunting\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAOR 95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStunted%\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot stunted%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eAge of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e5-9yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e18(10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e156(89.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.62\u003c/strong\u003e \u003cstrong\u003e(0.75\u0026ndash;3.46)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.66\u003c/strong\u003e(0.65\u0026ndash;4.24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e10-14yrs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e12(6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e168(93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eSex of the child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e19(10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e163(89.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1.71\u003c/strong\u003e \u003cstrong\u003e(0.79\u0026ndash;3.70)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.65\u003c/strong\u003e \u003cstrong\u003e(1.35\u0026ndash;9.85)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.01*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eFemale\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e11(6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e161(93.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eBirth order\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eFirst child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e7(23.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e23(76.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3.98\u003c/strong\u003e \u003cstrong\u003e(1.55\u0026ndash;10.26)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7.01\u003c/strong\u003e \u003cstrong\u003e(1.98\u0026ndash;24.84)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.003*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e2-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e23(7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e301(92.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eHusband education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eInformal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e4(4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e85(95.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.43 (0.15- 1.28)*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.41(0.12-1.40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eFormal\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e26(9.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e239(90.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eHusband occupation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eGovernment employee\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e9(8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e99(91.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.40 (0.15- 1.02)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.57 (0.17-1.88)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eMerchant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2(2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e73(97.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.12,(0.023-0.56)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.08 (0.01- 0.44)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eDaily laborer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e8(7.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e104(92.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e0.34 (0.13-0.89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e0.61 (0.19-2.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eOthers\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e11(18.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e48(81.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eFamily size\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026lt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2(25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e6(75)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e5.31 (0.97- 29.14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e3.81(0.37-39.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e3-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e16(11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e127(88.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.01 (0.92-4.38)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u0026nbsp;1.79 (0.70-4.57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e\u0026gt;=6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e12(5.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e191(94.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eWater availability\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eYes \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e23(6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e315(93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.09 (0.03- 0.28)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.05 ( 0.01- 0.21)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e7(43.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e9(56.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eWater source\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eSafe water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e14(5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e240(94.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.31 (0.14- 0.65)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.24 (0.08-0.70)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.009*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eUnsafe water\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e16(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e84(84.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 122px;\"\u003e\n \u003cp\u003eLiquid waste\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eProper\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e23(10.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e200(89.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2.04 (0.85- 4.89)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e5.47 (1.73-17.30)\u003c/strong\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.004*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eImproper\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e7(5.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003e124(94.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 127px;\"\u003e\n \u003cp\u003e1.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 93px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eP- Value \u0026lt;0.25 for bivariate analysis and P-value \u0026lt;0.05 for multivariate analysis, a=farmer, agro-pastoralist, no job\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":true,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Stunting, associated factors, primary school children, Dagahbur City, Somali Region, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-8732568/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8732568/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGlobally, childhood stunting remains a major public health concern. It is estimated that approximately 165\u0026nbsp;million children under five years of age are affected worldwide. Stunting has been associated with a range of adverse outcomes, including increased susceptibility to infections, higher risk of mortality, delayed physical and cognitive development, reduced learning capacity, poor academic performance, and decreased productivity in adulthood. Therefore, this study was designed to assess the determinants of stunting among primary school children in Dagahbur City, Somali Region, Eastern Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eAn institution-based cross-sectional study was conducted from April to June 2019 among 354 primary school children aged 5\u0026ndash;14 years. Anthropometric measurements were taken following standard procedures. Height-for-age Z-scores (HAZ) were generated using WHO AnthroPlus software, and stunting was defined as HAZ \u0026lt; -2 standard deviations. Data on socio-demographic, environmental, and child-related factors were collected using a structured questionnaire administered to parents or caregivers. Data were analyzed using SPSS version 23. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with stunting, and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe prevalence of stunting among primary school children was 8.5% (95% CI: 5.6\u0026ndash;11.3). In multivariable logistic regression analysis, stunting was significantly associated with sex of the child (AOR\u0026thinsp;=\u0026thinsp;3.65; 95% CI: 1.35\u0026ndash;9.85), birth order (AOR\u0026thinsp;=\u0026thinsp;7.01; 95% CI: 1.98\u0026ndash;24.84), husband\u0026rsquo;s occupation (AOR\u0026thinsp;=\u0026thinsp;0.08; 95% CI: 0.01\u0026ndash;0.44), water availability (AOR\u0026thinsp;=\u0026thinsp;0.05; 95% CI: 0.01\u0026ndash;0.21), source of drinking water (AOR\u0026thinsp;=\u0026thinsp;0.24; 95% CI: 0.08\u0026ndash;0.70), and liquid waste disposal practices (AOR\u0026thinsp;=\u0026thinsp;5.47; 95% CI: 1.73\u0026ndash;17.30).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe prevalence of stunting among primary school children in Dagahbur City was relatively low but remains a public health concern. Stunting was significantly associated with child sex, birth order, household occupation, water availability, drinking water source, and liquid waste disposal. These findings highlight the need for integrated nutrition-sensitive interventions focusing on water, sanitation, and household socio-economic conditions to address nutritional inequities among school-aged children.\u003c/p\u003e","manuscriptTitle":"Prevalence of stunting and associated factors among primary school children of Dagahbur city, Somali Region, Eastern Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-02 05:59:35","doi":"10.21203/rs.3.rs-8732568/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d57cde0c-91fe-4512-8324-56cf849c3bd9","owner":[],"postedDate":"February 2nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":62111166,"name":"Nutrition \u0026 Dietetics"}],"tags":[],"updatedAt":"2026-02-02T05:59:35+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-02 05:59:35","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8732568","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8732568","identity":"rs-8732568","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}