Urban–Rural Disparities and Determinants of Nutritional Status of Under-Five Children: An Example of Akinyele Local Government Area, Ibadan

Abstract

Background: Nutrition is an important element of a child’s survival and development. To achieve MDG 4 in Nigeria, nutritional status of under-five children needs to be improved as malnutrition remains an underlying factor in about one third of under-five deaths in Nigeria. Unfortunately, along with high prevalence of malnutrition, urban-rural disparities persist in child nutritional outcomes in Nigeria. Objective: To determine the differences in and predictors of the nutritional status of children in urban and rural areas of Akinyele LGA, Ibadan. Methods: A community based comparative cross sectional study was carried out in one urban and one rural ward of Akinyele LGA. Data was collected from mothers of 614 children. Anthropometric measurements were obtained from the children and Z scores generated using the WHO standard population. The children were classified as stunted, wasted or underweight using a cut off of -2 SD and severely stunted, severely wasted and severely underweight using a cut off of -3 SD.  Results: Of all the children, 56.2% were stunted, 17.4% were underweight and only 9% were wasted. Urban-rural location was significantly associated with stunting and underweight but not wasting. Rural dwellers were more likely to be underweight (OR 3.000, 95% CI 1.907- 4.718) and more likely to be stunted (OR 1.857, 95% CI 1.344- 2.565). The predictors of either or all of the nutritional indices were paternal education, having a sanitary toilet in the home, exclusive breastfeeding, socioeconomic status, birth order of the child, exclusive breastfeeding and complete immunization.  Conclusion: Disparities exist in the nutritional status of under-five children which is not due to location. Drivers of these disparities need to be identified in order for appropriate policies and actions to be taken.