Dataset Information

Good governance, public health expenditures, urbanization and child undernutrition Nexus in Ethiopia: an ecological analysis.

ABSTRACT:

Background

Child undernutrition remains the major public health problem in low and middle-income countries including Ethiopia. The effects of good governance, urbanization and public health expenditure on childhood undernutrition are not well studied in developing countries. The objective of the study is to examine the relationship between quality of governance, public health expenditures, urbanization and child undernutrition in Ethiopia.

Methods

This is pooled data analysis with ecological design. We obtained data on childhood undernutrition from the Ethiopian Demographic and Health Surveys (EDHS) that were conducted in 2000, 2005, 2011 and 2016. Additionally, data on quality of governance for Ethiopia were extracted from the World Governance Indicators (WGI) and public health spending and urbanization were obtained from the World Development Indicators and United Nations' World Population Prospects (WPP) respectively. Univariate and multivariate analysis were done to assess the relationship between governance, public health expenditure and urbanization with childhood undernutrition.

Result

Government effectiveness (adjusted odd ratio (AOR)?=?20.7; p?=?0.046), regulatory quality (AOR?=?0.0077; p?=?0.026) and control of corruption (AOR?=?0.0019; p?=?0.000) were associated with stunting. Similarly, government effectiveness (AOR?=?72.2; p?=?0.007), regulatory quality (AOR?=?0.0015; p?=?0.004) and control of corruption (AOR?=?0.0005; p?=?0.000) were associated with underweight. None of the governance indicators were associated with wasting. On the other hand, there is no statistically significant association observed between public health spending and urbanization with childhood undernutrition. However, other socio-demographic variables play a significant effect on reducing of child undernutrition.

Conclusion

This study indicates that good governance in the country plays a significant role for reducing childhood undernutrition along with other socio-demographic factors. Concerned bodies should focus on improving governance and producing a quality policy and at the same time monitor its implementation and adherence.

SUBMITTER: Biadgilign S

PROVIDER: S-EPMC6334413 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Good governance, public health expenditures, urbanization and child undernutrition Nexus in Ethiopia: an ecological analysis.

Biadgilign Sibhatu S Ayenew Habtamu Yesigat HY Shumetie Arega A Chitekwe Stanley S Tolla Assaye A Haile Demewoz D Gebreyesus Seifu Hagos SH Deribew Amare A Gebre Betemariam B

BMC health services research 20190115 1

<h4>Background</h4>Child undernutrition remains the major public health problem in low and middle-income countries including Ethiopia. The effects of good governance, urbanization and public health expenditure on childhood undernutrition are not well studied in developing countries. The objective of the study is to examine the relationship between quality of governance, public health expenditures, urbanization and child undernutrition in Ethiopia.<h4>Methods</h4>This is pooled data analysis with ...[more]

PMID: 30646917

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Project description:BackgroundUndernutrition is a significant public health challenge and one of the leading causes of child mortality in a wide range of developing countries, including Ethiopia. Poor access to water, sanitation, and hygiene (WASH) facilities commonly contributes to child growth failure. There is a paucity of information on the interrelationship between WASH and child undernutrition (stunting and wasting). This study aimed to assess the association between WASH and undernutrition among under-five-year-old children in Ethiopia.MethodsA secondary data analysis was undertaken based on the Ethiopian Demographic and Health Surveys (EDHS) conducted from 2000 to 2016. A total of 33,763 recent live births extracted from the EDHS reports were included in the current analysis. Multilevel logistic regression models were used to investigate the association between WASH and child undernutrition. Relevant factors from EDHS data were identified after extensive literature review.ResultsThe overall prevalences of stunting and wasting were 47.29% [95% CI: (46.75, 47.82%)] and 10.98% [95% CI: (10.65, 11.32%)], respectively. Children from households having unimproved toilet facilities [AOR: 1.20, 95% CI: (1.05,1.39)], practicing open defecation [AOR: 1.29, 95% CI: (1.11,1.51)], and living in households with dirt floors [AOR: 1.32, 95% CI: (1.12,1.57)] were associated with higher odds of being stunted. Children from households having unimproved drinking water sources were significantly less likely to be wasted [AOR: 0.85, 95% CI: (0.76,0.95)] and stunted [AOR: 0.91, 95% CI: (0.83, 0.99)]. We found no statistical differences between improved sanitation, safe disposal of a child's stool, or improved household flooring and child wasting.ConclusionThe present study confirms that the quality of access to sanitation and housing conditions affects child linear growth indicators. Besides, household sources of drinking water did not predict the occurrence of either wasting or stunting. Further longitudinal and interventional studies are needed to determine whether individual and joint access to WASH facilities was strongly associated with child stunting and wasting.

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Project description:Household water food and energy (WFE) expenditures, reflect respective survival needs for which their resources and social welfare are inter-related. We developed a policy driven quantitative decision-making strategy (DMS) to address the domain geospatial entities' (nodes or administrative districts) of the WFE nexus, assumed to be information linked across the domain nodal-network. As investment in one of the inter-dependent nexus components may cause unexpected shock to the others, we refer to the WFE normalized expenditures product (Volume) as representing the nexus holistic measure. Volume rate conforms to Boltzman entropy suggesting directed information from high to low Volume nodes. Our hypothesis of causality-driven directional information is exemplified by a sharp price increase in wheat and rice, for U.S. and Thailand respectively, that manifests its impact on the temporal trend of Israel's administrative districts of the WFE expenditures. Welfare mass (WM) represents the node's Volume combined with its income and population density. Formulation is suggested for the nodal-network WM temporal balance where each node is scaled by a human-factor (HF) for subjective attitude and a superimposed nodal source/sink term manifesting policy decision. Our management tool is based on two sequential governance processes: one starting with historical data mapping the mean temporal nodal Volumes to single out extremes, and the second is followed by WM balance simulation predicting nodal-network outcome of policy driven targeting. In view of the proof of concept by model simulations in in our previous research, here HF extends the model and attention is devoted to emphasize how the current developed decision-making approach categorically differs from existing nexus related methods. The first governance process is exemplified demonstrating illustrations for Israel's districts. Findings show higher expenditures for water and lower for energy, and maps pointing to extremes in districts' mean temporal Volume. Illustrations of domain surfaces for that period enable assessment of relative inclination trends of the normalized Water, Food and Energy directions continuum assembled from time stations, and evolution trends for each of the WFE components.

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Dataset Information

Good governance, public health expenditures, urbanization and child undernutrition Nexus in Ethiopia: an ecological analysis.

Background

Methods

Result

Conclusion

Publications

Good governance, public health expenditures, urbanization and child undernutrition Nexus in Ethiopia: an ecological analysis.

Similar Datasets

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