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SPATIAL VARIATIONS OF CHILD UNDERNUTRITION IN EAST GOJJAM ZONE, ETHIOPIA: IMPLICATIONS FOR AGROECOSYSTEM BASED GEOGRAPHICAL TARGETED INTERVENTION. [Abstract ID: 0609-01]
Child malnutrition in Ethiopia is a public health concern which has regional variations. To achieve sustainable solutions and meet the needs of the most vulnerable communities, recognition of the spatial distribution of child malnutrition in its specific context is crucial. Therefore, this study determined the spatial variations of child malnutrition across different agro-ecosystems in East Gojjam Zone, Amhara Regional State, Ethiopia. This community-based study was conducted with 3108 under-five-year-olds. Data were collected on socio-demographic variables using interviewer administered questionnaires, child anthropometric indices using weight and height scale and geographic location. SaTScan spatial analysis with the Bernoulli model was done to identify hotspot clusters. The percentage of children who are stunted, underweight, or wasting in the different locations was found. The highest percentage of child wasting was in the hilly and mountainous highlands and highest magnitude of children underweight and stunted were observed in Lowlands of Abay Valley. Spatial analysis indicated that sample clusters taken from the hilly and mountainous highlands were the most likely primary cluster for child wasting. Sample clusters taken from Lowlands of Abay Valley were identified as the most likely primary cluster for childhood stunting. In conclusion, the overall magnitude of stunting, underweight and wasting among the under-fives was found to be very high. Metrics of malnutrition differed significantly by agro-ecosystem, with agriculturally marginal agro-ecosystems showing systematically higher rates of underweight, wasted, and stunted children. The geographic variations found by this study have important policy implications which suggest that interventions in the agro-ecosystem should be targeted geographically.