Change in stunting and its associated factors among children aged less than 5 years in Ethiopia using Ethiopia Demographic and Health Survey data from 2005 to 2019: a multivariate decomposition analysis

ObjectiveThe aim of this study is to assess change in stunting and its associated factors among children aged less than 5 years in Ethiopia using Ethiopia Demographic and Health Survey data from 2005 to 2019.DesignA community-based cross-sectional study was conducted.SettingThe study was conducted in Ethiopia.ParticipantsIn 2005, 4586 individuals were examined, followed by 10 282 in 2011, 9462 in 2016 and 4937 in 2019.Primary and secondary outcomesThe primary outcome of the study was stunting, and the secondary outcome was factors associated with stunting and its change. A multilevel logistic regression model was fitted to identify individual and community-level factors associated with stunting among children aged less than 5 years. Multivariate decomposition analysis was also carried out to assess the role of compositional characteristics and behavioural change for decline in stunting among children aged less than 5 years in Ethiopia.ResultsOver the study period, the prevalence rate of stunting in children aged less than 5 years decreased from 47% to 37% in 2019. Differences in behavioural change among children under the age of 5 years account for 76.69% of the overall decline in stunting prevalence rate in the years 2005-2011, 86.53% in the years 2005-2016, 98.9% in the years 2005-2019, 70.34% in the years 2011-2016 and 73.77% in the years 2011-2019. Behavioural adjustments among breastfed children, diet diversity, place of delivery, ANC follow-up and region have all had a major effect on stunting prevalence rate. The wealth index, parenteral education, child's age in months, length of breast feeding and area were among the compositional change factors.ConclusionA large percentage of children aged less than 5 years remains stunted in Ethiopia. Stunting was associated with alterations in the compositional and behavioural characteristics of children. Stimulating existing nutritional measures and improving the wealth index will make a significant difference in reducing stunting among Ethiopian children aged less than 5 years.