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Geostatistical analysis, web-based mapping and environmental determinants of under-five chronic malnutrition (stunting): evidence from the 2014 Ghana Demographic and Health Survey

Justice Moses Kwaku Aheto (UNIVERSITY OF GHANA)

Background: Under-five child stunting rates are among the health indicators of utmost importance globally. At the national level, malnutrition accounts for about 40% of under-five mortality in Ghana. Disease risk mapping provides opportunities for disease surveillance and targeted interventions. We aimed to estimate and map under-five stunting prevalence, with the ultimate goal of identifying communities at higher risk where interventions and further research can be targeted.

Method: The 2014 Ghana Demographic and Health Survey data was used in this study. Analyses were conducted on 2734 children residing in 415 geographical clusters. The outcome variable is child stunting. We employed a geostatistical model to investigate both measured and unmeasured spatial risk factors for child stunting. We then visualised the stunting prevalence by mapping the predicted prevalence and exceedance probabilities.

Results: Out of 2734 children, 535 (19.6%) were stunted. Elevation, precipitation and aridity were environmental and climatic factors associated with stunting in the non-spatial model. Substantial geographical variations in prevalence of childhood stunting were found. The predicted mean stunting prevalence was 28% with a range of 13 % to 38%. Children residing in parts of northern region were at highest risk of stunting.

Conclusion: The prevalence maps indicate substantial geographical variations in childhood stunting. This can be used as an effective tool in the identification of communities that require targeted interventions by program managers and implementers; this is critical as part of an overall strategy in reducing the stunting burden given the very limited public health resources in the country.