Spatial Distribution and Determinants of Stunting, Wasting and Underweight in Children Under Five in Ethiopia

Background: The burdens of malnutrition among under-five remain a significant obstacle to the achievement of better child health and wellbeing in Ethiopia where the prevalence of malnutrition is very high. The main aim of this study was to explore the spatial distribution of Stunting, wasting, and underweight in children under five in Ethiopia. Methods Secondary data from EDHS, 2016, was employed where a total of 10641 children under five were included in the survey. Based on some exclusion criteria, only 7960 of them were used in the final analysis. Spatial analysis was performed to explore the spatial distribution of malnutrition among under-five children in regions and zones of Ethiopia. Spatial Lag and Spatial Error models were used to examine the spatial dependence of stunting, wasting, and underweight. Geographically weighted regression analysis was performed to estimate the types and strength of relationships between malnutrition and determinant factors across the regions and within the Clusters or Zones of each region. Results: Among the under-five children included in the study, 36.6% were stunted, 12.2% were wasted and 25.2% were underweight. The Global Moran Index’s value indicates (Stunting, I = 0.3135, p-value < 0.00001, Wasting, I = 0.1948, p-value < 0.0001 and Underweight, I = 0.5291, p-value < 0.0001) there was the significant spatial variation of malnutrition across the regions and Zones of Ethiopia. Age of child, mother’s educational status, source of drinking water, toilet facility, number of children under-five in the household, wealth index of mother, breastfeeding duration, size of child at birth, and Body Mass Index of Mothers (BMI), region, and place of residence were a potential source of spatial variation for malnutrition in children under-five in the country. Conclusions There were the spatial dependencies and spatial patterns of malnutrition in children under five were clustered within and between the regions. Most of the hotspot areas of stunting, wasting and underweight were detected in the regions that had poor health facilities and less socioeconomic status.