Factors influencing undernutrition among children in Nepal: a comparative study of Composite Index of Anthropometric Failure (CIAF) using 2016 and 2022 demographic and health survey data

Abstract

INTRODUCTION: The Composite Index of Anthropometric Failure (CIAF), an innovative and comprehensive tool, assesses child undernutrition, surpassing traditional anthropometric indicators. However, as such, a vital nutrition indicator CIAF is the least used tool in Nepal. The objective of this study is to identify and compare the key factors influencing CIAF among children under three in Nepal by analysing the CIAF using data from the 2016 and 2022 Demographic and Health Surveys. METHODS: This study uses Nepal DHS data for 2016 and 2022 to examine factors associated with undernutrition among children under three years using the CIAF. Bivariate analysis and Multivariable logistic regression analysis were conducted to identify significant predictors of CIAF across the survey years. RESULTS: There has been a substantial reduction in childhood CIAF from 45 per cent in 2011 to 32.6 per cent in 2022. The logistic regression analysis reveals that adverse conditions such as the presence of anemia and low birth weight in children, along with low maternal BMI and maternal education and belonging to the poorest wealth quintile, are identified as significant contributors to the heightened risk of CIAF. The odds of undernutrition were found to be lower among children who received deworming medication and vitamin supplements. There is a statistically substantial provincial variation in the odds of CIAF in both 2016 and 2022, with notably higher risks observed in Lumbini Provinces in 2022. CONCLUSION: These findings underscore the need for targeted interventions to improve the nutritional status of disadvantaged children. Policymakers can use the identified determinants to formulate strategies to mitigate the risk of CIAF and promote children's overall well-being and development.

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