Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania
Identifieur interne : 002736 ( Pmc/Corpus ); précédent : 002735; suivant : 002737Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania
Auteurs : Chiara Altare ; Tefera Darge Delbiso ; George Mutembei Mutwiri ; Regine Kopplow ; Debarati Guha-SapirSource :
- Journal of Tropical Pediatrics [ 0142-6338 ] ; 2016.
Abstract
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DOI: 10.1093/tropej/fmw024
PubMed: 27122480
PubMed Central: 5040832
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania</title><author><name sortKey="Altare, Chiara" sort="Altare, Chiara" uniqKey="Altare C" first="Chiara" last="Altare">Chiara Altare</name><affiliation><nlm:aff id="fmw024-aff1">Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</nlm:aff></affiliation><affiliation><nlm:aff id="fmw024-aff2">Action Contre La Faim, Research and Analysis Unit, 14/16 Boulevard De Douaumont, Paris 75854, France</nlm:aff></affiliation></author><author><name sortKey="Delbiso, Tefera Darge" sort="Delbiso, Tefera Darge" uniqKey="Delbiso T" first="Tefera Darge" last="Delbiso">Tefera Darge Delbiso</name><affiliation><nlm:aff id="fmw024-aff1">Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</nlm:aff></affiliation></author><author><name sortKey="Mutwiri, George Mutembei" sort="Mutwiri, George Mutembei" uniqKey="Mutwiri G" first="George Mutembei" last="Mutwiri">George Mutembei Mutwiri</name><affiliation><nlm:aff id="fmw024-aff3">Concern Worldwide Tanzania, 169 Regent Estate, Mikocheni a, Dar Es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Kopplow, Regine" sort="Kopplow, Regine" uniqKey="Kopplow R" first="Regine" last="Kopplow">Regine Kopplow</name><affiliation><nlm:aff id="fmw024-aff4">Concern Worldwide, 52-55 Camden Street, Dublin 2, Ireland</nlm:aff></affiliation></author><author><name sortKey="Guha Sapir, Debarati" sort="Guha Sapir, Debarati" uniqKey="Guha Sapir D" first="Debarati" last="Guha-Sapir">Debarati Guha-Sapir</name><affiliation><nlm:aff id="fmw024-aff1">Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27122480</idno><idno type="pmc">5040832</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5040832</idno><idno type="RBID">PMC:5040832</idno><idno type="doi">10.1093/tropej/fmw024</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">002736</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002736</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania</title><author><name sortKey="Altare, Chiara" sort="Altare, Chiara" uniqKey="Altare C" first="Chiara" last="Altare">Chiara Altare</name><affiliation><nlm:aff id="fmw024-aff1">Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</nlm:aff></affiliation><affiliation><nlm:aff id="fmw024-aff2">Action Contre La Faim, Research and Analysis Unit, 14/16 Boulevard De Douaumont, Paris 75854, France</nlm:aff></affiliation></author><author><name sortKey="Delbiso, Tefera Darge" sort="Delbiso, Tefera Darge" uniqKey="Delbiso T" first="Tefera Darge" last="Delbiso">Tefera Darge Delbiso</name><affiliation><nlm:aff id="fmw024-aff1">Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</nlm:aff></affiliation></author><author><name sortKey="Mutwiri, George Mutembei" sort="Mutwiri, George Mutembei" uniqKey="Mutwiri G" first="George Mutembei" last="Mutwiri">George Mutembei Mutwiri</name><affiliation><nlm:aff id="fmw024-aff3">Concern Worldwide Tanzania, 169 Regent Estate, Mikocheni a, Dar Es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Kopplow, Regine" sort="Kopplow, Regine" uniqKey="Kopplow R" first="Regine" last="Kopplow">Regine Kopplow</name><affiliation><nlm:aff id="fmw024-aff4">Concern Worldwide, 52-55 Camden Street, Dublin 2, Ireland</nlm:aff></affiliation></author><author><name sortKey="Guha Sapir, Debarati" sort="Guha Sapir, Debarati" uniqKey="Guha Sapir D" first="Debarati" last="Guha-Sapir">Debarati Guha-Sapir</name><affiliation><nlm:aff id="fmw024-aff1">Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Tropical Pediatrics</title><idno type="ISSN">0142-6338</idno><idno type="eISSN">1465-3664</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold>Background:</bold> Stunting is a major public health problem in Africa and is associated with poor child survival and development. We investigate factors associated to child stunting in three Tanzanian regions.</p><p><bold>Methods:</bold> A cross-sectional two-stage cluster sampling survey was conducted among children aged 6-59 months. The sample included 1360 children aged 6-23 months and 1904 children aged 24-59 months. Descriptive statistics and binary and multivariate logistic regression analyses were used.</p><p><bold>Results:</bold> Our main results are: in the younger group, stunting was associated with male sex (adjusted odds ratio [AOR]: 2.17; confidence interval [CI]: 1.52-3.09), maternal absence (AOR: 1.93; CI: 1.21-3.07) and household diet diversity (AOR: 0.61; CI: 0.41-0.92). Among older children, stunting was associated with male sex (AOR: 1.28; CI: 1.00-1.64), age of 4 and 5 (AOR: 0.71; CI: 0.54-0.95; AOR: 0.60; CI: 0.44-0.83), access to improved water source (AOR: 0.70; CI: 0.52-0.93) and to a functioning water station (AOR: 0.63; CI: 0.40–0.98) and mother breastfeeding (AOR: 1.97; CI: 1.18-3.29).</p><p><bold>Conclusions:</bold> Interventions that increase household wealth and improve water and sanitation conditions should be implemented to reduce stunting. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Trop Pediatr</journal-id><journal-id journal-id-type="iso-abbrev">J. Trop. Pediatr</journal-id><journal-id journal-id-type="publisher-id">tropej</journal-id><journal-id journal-id-type="hwp">tropej</journal-id><journal-title-group><journal-title>Journal of Tropical Pediatrics</journal-title></journal-title-group><issn pub-type="ppub">0142-6338</issn><issn pub-type="epub">1465-3664</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27122480</article-id><article-id pub-id-type="pmc">5040832</article-id><article-id pub-id-type="doi">10.1093/tropej/fmw024</article-id><article-id pub-id-type="publisher-id">fmw024</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Papers</subject></subj-group></article-categories><title-group><article-title>Factors Associated with Stunting among Pre-school Children in Southern Highlands of Tanzania</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Altare</surname><given-names>Chiara</given-names></name><xref ref-type="aff" rid="fmw024-aff1"><sup>1</sup></xref><xref ref-type="aff" rid="fmw024-aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Delbiso</surname><given-names>Tefera Darge</given-names></name><xref ref-type="aff" rid="fmw024-aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Mutwiri</surname><given-names>George Mutembei</given-names></name><xref ref-type="aff" rid="fmw024-aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kopplow</surname><given-names>Regine</given-names></name><xref ref-type="aff" rid="fmw024-aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Guha-Sapir</surname><given-names>Debarati</given-names></name><xref ref-type="aff" rid="fmw024-aff1"><sup>1</sup></xref></contrib><aff id="fmw024-aff1"><sup>1</sup>Centre for Research on the Epidemiology of Disasters, Catholic University Louvain, Clos Chapelle-aux-Champs 30, Bte B1.30.15, Brussels 1200, Belgium</aff><aff id="fmw024-aff2"><sup>2</sup>Action Contre La Faim, Research and Analysis Unit, 14/16 Boulevard De Douaumont, Paris 75854, France</aff><aff id="fmw024-aff3"><sup>3</sup>Concern Worldwide Tanzania, 169 Regent Estate, Mikocheni a, Dar Es Salaam, Tanzania</aff><aff id="fmw024-aff4"><sup>4</sup>Concern Worldwide, 52-55 Camden Street, Dublin 2, Ireland</aff></contrib-group><author-notes><corresp id="fmw024-cor1">Correspondence: Chiara Altare, Clos Chapelle-aux-Champs 30, Bte B1.30.15 Brussels, 1200 Belgium. E-mail <<email>chiara.altare@uclouvain.be</email>></corresp></author-notes><pub-date pub-type="ppub"><month>10</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>27</day><month>4</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>27</day><month>4</month><year>2016</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<volume>62</volume><issue>5</issue><fpage>390</fpage><lpage>408</lpage><permissions><copyright-statement>© The Author [2016]. Published by Oxford University Press.</copyright-statement><copyright-year>2016</copyright-year><license xlink:href="http://creativecommons.org/licenses/by/4.0/" license-type="creative-commons"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><bold>Background:</bold> Stunting is a major public health problem in Africa and is associated with poor child survival and development. We investigate factors associated to child stunting in three Tanzanian regions.</p><p><bold>Methods:</bold> A cross-sectional two-stage cluster sampling survey was conducted among children aged 6-59 months. The sample included 1360 children aged 6-23 months and 1904 children aged 24-59 months. Descriptive statistics and binary and multivariate logistic regression analyses were used.</p><p><bold>Results:</bold> Our main results are: in the younger group, stunting was associated with male sex (adjusted odds ratio [AOR]: 2.17; confidence interval [CI]: 1.52-3.09), maternal absence (AOR: 1.93; CI: 1.21-3.07) and household diet diversity (AOR: 0.61; CI: 0.41-0.92). Among older children, stunting was associated with male sex (AOR: 1.28; CI: 1.00-1.64), age of 4 and 5 (AOR: 0.71; CI: 0.54-0.95; AOR: 0.60; CI: 0.44-0.83), access to improved water source (AOR: 0.70; CI: 0.52-0.93) and to a functioning water station (AOR: 0.63; CI: 0.40–0.98) and mother breastfeeding (AOR: 1.97; CI: 1.18-3.29).</p><p><bold>Conclusions:</bold> Interventions that increase household wealth and improve water and sanitation conditions should be implemented to reduce stunting. Family planning activities and programmes supporting mothers during pregnancy and lactation can positively affect both newborns and older siblings.</p></abstract><kwd-group kwd-group-type="author"><kwd>stunting</kwd><kwd>growth</kwd><kwd>maternal support</kwd><kwd>child care</kwd><kwd>diet diversity</kwd><kwd>Tanzania.</kwd></kwd-group><counts><page-count count="19"></page-count></counts></article-meta></front><body><sec sec-type="intro"><title>INTRODUCTION</title><p>Linear growth failure is a major public health problem in Africa, where more than one-third of the children under 5 are too short for their age [<xref rid="fmw024-B1" ref-type="bibr">1</xref>, <xref rid="fmw024-B2" ref-type="bibr">2</xref>]. Extensive research has shown the health, economic and intergenerational consequences of stunting: higher risk of dying [<xref rid="fmw024-B3" ref-type="bibr">3</xref>]; poorer psychomotor and mental development and school achievement [<xref rid="fmw024-B4" ref-type="bibr">4</xref>, <xref rid="fmw024-B5" ref-type="bibr">5</xref>]; loss of human capital and economic productivity in adulthood [<xref rid="fmw024-B6" ref-type="bibr">6</xref>, <xref rid="fmw024-B7" ref-type="bibr">7</xref>]; in creased risk of chronic diseases [<xref rid="fmw024-B8" ref-type="bibr">8</xref>]; and reduced maternal reproductive outcomes [<xref rid="fmw024-B9" ref-type="bibr">9</xref>].</p><p>Stunting often begins <italic>in utero</italic>, as maternal nutrition is the first determinant of the child nutritional status [<xref rid="fmw024-B1" ref-type="bibr">1</xref>, <xref rid="fmw024-B10" ref-type="bibr">10</xref>], and continues generally during the first two years after birth [<xref rid="fmw024-B11" ref-type="bibr">11</xref>, <xref rid="fmw024-B12" ref-type="bibr">12</xref>]. Although the pathogenesis of stunting is not yet well-understood, studies have shown that inadequate nutrient intake, infections, unsafe water and poor child care are among its main determinants [<xref rid="fmw024-B13" ref-type="bibr">13</xref>, <xref rid="fmw024-B14" ref-type="bibr">14</xref>]. Other factors in developing countries include maternal education, socioeconomic status, residence and poor access to health services [<xref rid="fmw024-B15" ref-type="bibr">15–18</xref>].</p><p>There is increasing international recognition that efforts to prevent stunting can improve short- and long-term outcomes, at individual, community and country levels [<xref rid="fmw024-B7" ref-type="bibr">7</xref>, <xref rid="fmw024-B19" ref-type="bibr">19</xref>]. This is reflected in the number of governments joining the Scaling-Up Nutrition (SUN) movement (<ext-link ext-link-type="uri" xlink:href="http://scalingupnutrition.org">http://scalingupnutrition.org</ext-link>), and in the inclusion of nutrition-related goals in the World Health Assembly targets, Millennium Development Goals and Sustainable Development Goals.</p><p>In Tanzania, a SUN member, 35% of the children under 5 were stunted in 2014 [<xref rid="fmw024-B20" ref-type="bibr">20</xref>], down from 42% in 2010 [<xref rid="fmw024-B21" ref-type="bibr">21</xref>]. In central and southern highlands zones, however, the prevalence of chronic malnutrition reaches 50%. Here, the Government of Tanzania, UNICEF and Concern Worldwide, an international non-governmental organization, are implementing the ‘Bringing nutrition actions to scale in Iringa, Njombe and Mbeya regions of Tanzania’ project. It aims to reduce the prevalence of stunting by 10 percentage points over 5 years, through interventions targeting women and children, as well as strengthening capacities of local authorities. At the beginning of the project, baseline information was collected on infant and young child feeding (IYCF) practices, child and maternal nutritional and health status and household socioeconomic situation.</p><p>By analysing these baseline survey data, this paper investigates factors associated with stunting in regions with high stunting prevalence. Differently from the majority of studies from Tanzania, our analysis does not focus on HIV subjects, but on otherwise healthy children without confirmed co-morbidities.</p></sec><sec sec-type="methods"><title>METHODS</title><sec><title>Study area and population</title><p>The study was conducted in the regions of Iringa, Njombe and Mbeya, where 4.4 million people live, 72% of whom live in rural areas [<xref rid="fmw024-B22" ref-type="bibr">22</xref>]. Although these regions receive the highest rainfall and are Tanzania’s bread baskets, stunting prevalence was 51.3%, 51.5% and 36.0%, respectively, in 2014 [<xref rid="fmw024-B20" ref-type="bibr">20</xref>]. These are the second and the third highest values in Tanzania, well above the national prevalence (34.7%). The study population includes children under 5 in rural and urban households in the three regions.</p></sec><sec><title>Study and sampling design</title><p>One cross-sectional survey was conducted in each region in November 2013, using a two-stage cluster sampling design. Sixty-three clusters were selected in each region by probability proportional to the size using ENA delta software [<xref rid="fmw024-B23" ref-type="bibr">23</xref>]. Twenty households were chosen in each cluster by random sampling, using a random number table. A complete list of households with children under 5 in each cluster was prepared before the survey date. Households were visited for verification if necessary. Sample size was calculated to detect a 10 percentage point reduction in stunting among children 24–47 months by the end of the project in each region. Power was set at 80%, level of confidence at 95% (one-tailed test), design effect at 1.5 and non-response at 10%. A sample of 501 children in the age group 24–47 months per region was required. A total of 1253 households with children under 5 were targeted in each region to achieve the required sample size.</p></sec><sec><title>Measurements</title><p>Data were collected using a standardized questionnaire on a digital data gathering (DDG) device, via face-to-face interview with the main caregiver of the child. The following data were collected for anthropometric measurements of all children under 5: sex, age, weight, height and presence of bilateral pitting oedema. Length was taken for children under 24 months in horizontal position; height was taken standing for older children; both to the nearest 0.1 cm with a standard 130-cm height/length board. Weight was measured with an electronic scale to the nearest 0.1 kg. Stunting was defined as height-for-age <italic>z</italic>-score (HAZ) below −2 SD from the median height of the WHO reference population.</p><p>Additional data were collected to reflect selected immediate, underlying and basic causes of undernutrition as illustrated in the UNICEF Conceptual Framework [<xref rid="fmw024-B24" ref-type="bibr">24</xref>]. These were regrouped in child characteristics: IYCF practices, occurrence of diseases, supplementation and treatments received; maternal characteristic: nutritional status, pregnancy and breastfeeding status, workload, habits and supplementation during pregnancy and nutritional information received; and household characteristics: water source, sanitation facilities, use of iodized salt, household dietary diversity and farm diversity. When more than one child aged 6–23 months was present in a sampled household, only data from the youngest child were collected. Definition and measurements of variables used in the analysis are presented in <xref ref-type="table" rid="fmw024-T1">Table 1</xref>.
<table-wrap id="fmw024-T1" orientation="portrait" position="float"><label>Table 1.</label><caption><p>Definitions and measurement of variables used in the analysis</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="1" colspan="1">Variable name</th><th rowspan="1" colspan="1">Definition and measurement</th><th rowspan="1" colspan="1">Values</th></tr></thead><tbody><tr><td rowspan="1" colspan="1"><italic>Child level</italic></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Minimum diet diversity (MDD) [<xref rid="fmw024-B43" ref-type="bibr">43</xref>]</td><td rowspan="2" colspan="1">Proportion of children aged 6 to 23 months eating from four or more food groups.</td><td rowspan="1" colspan="1">0 if < 4 groups</td></tr><tr><td rowspan="1" colspan="1">1 if ≥ 4 groups</td></tr><tr><td rowspan="2" colspan="1"> Minimum meal frequency (MMF) [<xref rid="fmw024-B25" ref-type="bibr">25</xref>]</td><td rowspan="2" colspan="1">Proportion of children receiving solid, semi-solid or soft food (but also including milk feed for non-breastfed children), the minimum number of times according to their age and breastfeeding status. Minimum is defined as:
<list list-type="bullet"><list-item><p>two times for breastfed infants aged 6 to 8 months;</p></list-item><list-item><p>three times for breastfed children aged 9 to 23 months;</p></list-item><list-item><p>four times for non-breastfed children aged 6 to 23 months.</p></list-item></list></td><td rowspan="1" colspan="1">0 if MMF not reached;</td></tr><tr><td rowspan="1" colspan="1">1 if MMF reached</td></tr><tr><td rowspan="2" colspan="1"> Minimum adequate diet (MAD) [<xref rid="fmw024-B25" ref-type="bibr">25</xref>]</td><td rowspan="2" colspan="1">Proportion of children aged 6 to 23 months who achieve both MMF and MDD. It is calculated separately for breastfed and non-breastfed children. For breastfed children, it corresponds to the children who reach both MDD and MMF. For non-breastfed children, MAD is based on a six-food-group MDD and requires also two separate milk feeds.</td><td rowspan="1" colspan="1">0 if MAD not reached;</td></tr><tr><td rowspan="1" colspan="1">1 if MAD reached</td></tr><tr><td rowspan="1" colspan="1"> Occurrence of disease</td><td rowspan="1" colspan="1">The occurrence of diarrhoea, fever or cough in the two weeks before the survey. Based on caregiver’s recall (children 6 to 23 months of age).</td><td rowspan="1" colspan="1">0 if no disease episode; 1 if at least one episode of any of the three conditions</td></tr><tr><td rowspan="2" colspan="1"> Child vitamin A supplementation</td><td rowspan="2" colspan="1">Proportion of children 6 to 23 months of age who received a Vitamin A dose (capsule) in the 6 months previous to the survey. Based on caregiver’s recall.</td><td rowspan="1" colspan="1">0 if vitamin A dose not received;</td></tr><tr><td rowspan="1" colspan="1">1 if vitamin A dose received</td></tr><tr><td rowspan="2" colspan="1"> Child deworming treatment</td><td rowspan="2" colspan="1">Proportion of children aged 6 to 23 months who received deworming treatment in the 6 months previous to the survey. Based on caregiver’s recall.</td><td rowspan="1" colspan="1">0 if deworming treatment not received;</td></tr><tr><td rowspan="1" colspan="1">1 if deworming treatment received</td></tr><tr><td rowspan="1" colspan="1">Maternal level</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Maternal malnutrition</td><td rowspan="2" colspan="1">Undernutrition defined as mid-upper arm circumference (MUAC) below 210 mm for non PLW; below 230 mm for PLW [<xref rid="fmw024-B26" ref-type="bibr">26</xref>].</td><td rowspan="1" colspan="1">0 not malnourished;</td></tr><tr><td rowspan="1" colspan="1">1 malnourished</td></tr><tr><td rowspan="3" colspan="1"> Hand-washing knowledge</td><td rowspan="3" colspan="1">Defined as good if three or more occasions when it is important to wash hands were given; satisfactory if two occasions were given; poor if one or none of the options were given.</td><td rowspan="1" colspan="1">2 good</td></tr><tr><td rowspan="1" colspan="1">1 satisfactory</td></tr><tr><td rowspan="1" colspan="1">0 poor</td></tr><tr><td rowspan="2" colspan="1"> Health-seeking behaviour</td><td rowspan="2" colspan="1">Proportion of caregivers who sought medical care in case of illness (diarrhoea, fever or cough) of the child.</td><td rowspan="1" colspan="1">0 medical care was not sought;</td></tr><tr><td rowspan="1" colspan="1">1 medical care was sought</td></tr><tr><td rowspan="3" colspan="1"> Workload during pregnancy</td><td rowspan="3" colspan="1">Perceived workload during pregnancy compared with the time before the pregnancy. Possible answers: ‘less’, ‘more’ or ‘the same.</td><td rowspan="1" colspan="1">Less</td></tr><tr><td rowspan="1" colspan="1">More</td></tr><tr><td rowspan="1" colspan="1">The same</td></tr><tr><td rowspan="3" colspan="1"> Food habits during pregnancy</td><td rowspan="3" colspan="1">Changes in the amount and types of food eaten during pregnancy compared with the time before pregnancy. Based on caregiver’s recall. Possible answers: ‘eaten less’/‘fewer types’; ‘eaten the same amount’/‘the same types’; ‘eaten more’/‘more food types’.</td><td rowspan="1" colspan="1">Less amount/fewer types;</td></tr><tr><td rowspan="1" colspan="1">Same amount/same number of types;</td></tr><tr><td rowspan="1" colspan="1">Bigger amount/more types.</td></tr><tr><td rowspan="2" colspan="1"> Vitamin A supplementation during pregnancy</td><td rowspan="2" colspan="1">Proportion of mothers who received vitamin A dose (capsule) in the first two months after delivery</td><td rowspan="1" colspan="1">0 not received;</td></tr><tr><td rowspan="1" colspan="1">1 received</td></tr><tr><td rowspan="2" colspan="1"> Iron supplementation during pregnancy</td><td rowspan="2" colspan="1">Proportion of mothers who received any iron table or iron syrup during their last pregnancy</td><td rowspan="1" colspan="1">0 not received;</td></tr><tr><td rowspan="1" colspan="1">1 received</td></tr><tr><td rowspan="2" colspan="1"> Advice on child and maternal nutrition</td><td rowspan="2" colspan="1">Proportion of caregivers who ever received information on maternal and child nutrition by health workers (hospital or health facility or feeding centre staff, midwives or village health workers), or traditional/religious leaders, or other relatives and friends. Based on the caregiver’s recall.</td><td rowspan="1" colspan="1">0 never received;</td></tr><tr><td rowspan="1" colspan="1">1 received</td></tr><tr><td rowspan="2" colspan="1"> Decision-making to feed</td><td rowspan="2" colspan="1">Who in the family makes the decision regarding what to feed the children.</td><td rowspan="1" colspan="1">1 mother;</td></tr><tr><td rowspan="1" colspan="1">2 others</td></tr><tr><td rowspan="1" colspan="1">Household level</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="3" colspan="1"> Household dietary diversity score [<xref rid="fmw024-B27" ref-type="bibr">27</xref>]</td><td rowspan="3" colspan="1">Number of food groups consumed by the household’s member in the 24 h before the survey. Categorization defined by the authors, as no standard thresholds exist.</td><td rowspan="1" colspan="1">0–4</td></tr><tr><td rowspan="1" colspan="1">5–8</td></tr><tr><td rowspan="1" colspan="1">9–12</td></tr><tr><td rowspan="4" colspan="1"> Farm production diversity score</td><td rowspan="4" colspan="1">Number of food groups produced by the household in the past 3 months. Categorization defined by the authors, as no standard thresholds exist.</td><td rowspan="1" colspan="1">0 (no production)</td></tr><tr><td rowspan="1" colspan="1">1–2</td></tr><tr><td rowspan="1" colspan="1">3–5</td></tr><tr><td rowspan="1" colspan="1">6–12</td></tr><tr><td rowspan="2" colspan="1"> Source of drinking water</td><td rowspan="2" colspan="1">Defined as improved if water coming from piped water, protected well, protected spring and bottled water. Otherwise = unimproved.</td><td rowspan="1" colspan="1">0 unimproved;</td></tr><tr><td rowspan="1" colspan="1">1 improved</td></tr><tr><td rowspan="2" colspan="1"> Hand-washing station</td><td rowspan="2" colspan="1">Defined as functional if a station was present, or water and soap or ash were available; non-functional if otherwise.</td><td rowspan="1" colspan="1">0 non-functional;</td></tr><tr><td rowspan="1" colspan="1">1 functional</td></tr><tr><td rowspan="2" colspan="1"> Use of iodized salt</td><td rowspan="2" colspan="1">Whether the household used iodized salt or not.</td><td rowspan="1" colspan="1">0 non-iodized salt;</td></tr><tr><td rowspan="1" colspan="1">1 iodized salt</td></tr></tbody></table></table-wrap></p></sec><sec><title>Quality control</title><p>The SMART methodology was used to ensure standardized procedures and tools [<xref rid="fmw024-B28" ref-type="bibr">28</xref>]. After a 6-day training, data collectors had to pass a standardization test to assess accuracy and precision of their anthropometric measurements. The questionnaire was piloted and finalized. Team leaders ensured data quality during data collection. Checks, skip functions and acceptable ranges were pre-established in the DDG devices to reduce mistakes. Implausible anthropometric measurements were defined as ±6 SD, as per WHO criteria [<xref rid="fmw024-B29" ref-type="bibr">29</xref>].</p></sec><sec><title>Statistical analysis</title><p>The analysis of factors associated with stunting was divided by age groups: 6–23 and 24–59 months, and conducted for the entire sample and broken down by region. Baseline sociodemographic and clinical characteristics of the sample were described with simple frequency distribution. Crude associations between stunting and sociodemographic and clinical variables were investigated using Pearson’s chi-square test. A multivariate logistic regression model was constructed to identify factors associated with stunting. Odds ratios (OR), 95% confidence intervals (CI) and <italic>p</italic>-values were obtained. <italic>P</italic>-values <0.05 were considered significant. Sampling weights were applied to ensure the representativeness of the sample at the regional level. The analysis was conducted in STATA IC/12.1 for Windows and SPSS 20.0. Anthropometric indicators were calculated with ENA software.</p></sec><sec><title>Ethical considerations</title><p>Concern Worldwide routinely conducts nutrition surveys within its programmes, which are not subject to research ethical scrutiny. The organization subscribes to the ethical principles outlined in the Humanitarian Charter [<xref rid="fmw024-B30" ref-type="bibr">30</xref>]. Furthermore, the project protocol and questionnaire were reviewed and approved by the Government of Tanzania and UNICEF. Oral informed consent was obtained by the interviewees. Consent to conduct anthropometric measurement was obtained from a parent or guardian in the local language.</p></sec></sec><sec sec-type="results"><title>RESULTS</title><p>Data were collected on a total of 3280 children aged 6–59 months. The region or district was missing in 16 records that were excluded, leading to a sample of 3264 children. Descriptive statistics are presented in <xref ref-type="table" rid="fmw024-T2">Table 2</xref>. We further excluded 17 records from the inferential analysis due to implausible anthropometric measurements. The final sample includes 3247 children aged 6–59 months, of which 1360 are in the age group of 6–23 months.
<table-wrap id="fmw024-T2" orientation="portrait" position="float"><label>Table 2.</label><caption><p>Distribution of children aged 6–23 and 24–59 months by demographic, maternal and household characteristics, Iringa, Njombe and Mbeya regions, Tanzania, 2013</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="1">Variables</th><th colspan="2" rowspan="1">6–23 months<hr></hr></th><th colspan="2" rowspan="1">24–59 months<hr></hr></th></tr><tr><th rowspan="1" colspan="1"><italic>n</italic></th><th rowspan="1" colspan="1">% or * Mean (SD)</th><th rowspan="1" colspan="1"><italic>n</italic></th><th rowspan="1" colspan="1">% or * Mean (SD)</th></tr></thead><tbody><tr><td rowspan="1" colspan="1">Nutritional status</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Stunting</td><td rowspan="1" colspan="1">1352</td><td rowspan="1" colspan="1">42.2</td><td rowspan="1" colspan="1">1895</td><td rowspan="1" colspan="1">45.7</td></tr><tr><td rowspan="1" colspan="1"> Height for age</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">−1.79 (1.31)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">−1.99 (1.21)</td></tr><tr><td rowspan="1" colspan="1">Child’s age (in months)</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1">14.2 (5.2)*</td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1">38.4 (10.3)*</td></tr><tr><td rowspan="1" colspan="1"> 6–11</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">34.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 12–23</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">65.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 24–35</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">43.2</td></tr><tr><td rowspan="1" colspan="1"> 36–47</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">32.4</td></tr><tr><td rowspan="1" colspan="1"> 48–59</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">24.4</td></tr><tr><td rowspan="1" colspan="1">Child’s sex</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Female</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">47.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">50.3</td></tr><tr><td rowspan="1" colspan="1"> Male</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">52.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">49.7</td></tr><tr><td rowspan="1" colspan="1">Child living with</td><td rowspan="1" colspan="1">1338</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Both parents</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">83.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Mother only</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">14.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Other guardians</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Minimum diet diversity (MAD)</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">84.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">15.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Minimum meal frequency (MMF)</td><td rowspan="1" colspan="1">1336</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">73.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">26.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Minimum adequate diet (MAD)</td><td rowspan="1" colspan="1">1337</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">99.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Child’s consumption of animal source food</td><td rowspan="1" colspan="1">1338</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> At least one food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">32.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">67.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Child’s consumption of vitamin-A-rich food</td><td rowspan="1" colspan="1">1337</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">13.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">86.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Child’s consumption of pulse/legumes/nuts</td><td rowspan="1" colspan="1">1337</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">37.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">62.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Snack between the meals</td><td rowspan="1" colspan="1">1330</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No snack</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">80.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> One snack</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">12.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Two snacks</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">7.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Child morbidity</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No illness</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">55.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> One illness</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">23.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Two or three illnesses</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">20.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Health care-seeking behaviour in case of illness</td><td rowspan="1" colspan="1">550</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Care sought</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">71.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Care not sought</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">28.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Child received deworming treatment</td><td rowspan="1" colspan="1">1281</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">51.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">48.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Child received vitamin A supplementation</td><td rowspan="1" colspan="1">1285</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">80.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">19.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Maternal MUAC (in cm)</td><td rowspan="1" colspan="1">1309</td><td rowspan="1" colspan="1">27.8 (3.3)*</td><td rowspan="1" colspan="1">1694</td><td rowspan="1" colspan="1">28.1 (3.4)*</td></tr><tr><td rowspan="1" colspan="1"> Malnourished</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.9</td></tr><tr><td rowspan="1" colspan="1"> Non-malnourished</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">97.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">99.1</td></tr><tr><td rowspan="1" colspan="1">Mother currently pregnant</td><td rowspan="1" colspan="1">1348</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1856</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">10.2</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">97.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">89.8</td></tr><tr><td rowspan="1" colspan="1">Mother currently breastfeeding</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">74.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">92.3</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">24.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">7.7</td></tr><tr><td rowspan="1" colspan="1">Birth in the past 5 years</td><td rowspan="1" colspan="1">1357</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1902</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 1 child</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">77.3</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">85.2</td></tr><tr><td rowspan="1" colspan="1"> 2+ children</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">22.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">14.8</td></tr><tr><td rowspan="1" colspan="1">Maternal hand-washing knowledge</td><td rowspan="1" colspan="1">1357</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1902</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Poor</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">16.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">17.8</td></tr><tr><td rowspan="1" colspan="1"> Satisfactory</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">44.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">51.9</td></tr><tr><td rowspan="1" colspan="1"> Good</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">39.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">30.3</td></tr><tr><td rowspan="1" colspan="1">Hours the mother is away from home</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">46.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">42.6</td></tr><tr><td rowspan="1" colspan="1"> 1–3 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">21.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">20.5</td></tr><tr><td rowspan="1" colspan="1"> 4–7 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">21.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">22.4</td></tr><tr><td rowspan="1" colspan="1"> 8–24 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">10.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">14.6</td></tr><tr><td rowspan="1" colspan="1">Husband support during pregnancy</td><td rowspan="1" colspan="1">1019</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">73.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">26.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Amount of food during pregnancy</td><td rowspan="1" colspan="1">1009</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Less</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">45.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> The same</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">39.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> More</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">15.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Types of food during pregnancy</td><td rowspan="1" colspan="1">1011</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Fewer</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">37.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> The same</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">45.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> More</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">17.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Mother received iron during pregnancy</td><td rowspan="1" colspan="1">1004</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">62.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">38.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Mother received vitamin A dose after delivery</td><td rowspan="1" colspan="1">990</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">41.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">58.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Advice on child and maternal nutrition</td><td rowspan="1" colspan="1">1054</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">41.9</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">58.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Decision-making to feed</td><td rowspan="1" colspan="1">1063</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Mother</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">75.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Others</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">25.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Source of drinking water</td><td rowspan="1" colspan="1">1357</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1902</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Improved</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">68.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">70.7</td></tr><tr><td rowspan="1" colspan="1"> Not improved</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">31.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">29.3</td></tr><tr><td rowspan="1" colspan="1">Hand-washing station</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Functional</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">5.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">7.9</td></tr><tr><td rowspan="1" colspan="1"> No or not functional</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">94.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">92.1</td></tr><tr><td rowspan="1" colspan="1">Household dietary diversity score</td><td rowspan="1" colspan="1">1353</td><td rowspan="1" colspan="1">5 (4–6)*<sup>,2</sup></td><td rowspan="1" colspan="1">1894</td><td rowspan="1" colspan="1">5 (4–6)*<sup>,</sup><xref ref-type="table-fn" rid="fmw024-TF1"><sup>a</sup></xref></td></tr><tr><td rowspan="1" colspan="1"> 1–4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">40.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">36.7</td></tr><tr><td rowspan="1" colspan="1"> 5–8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">56.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">59.5</td></tr><tr><td rowspan="1" colspan="1"> 9–12</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">3.8</td></tr><tr><td rowspan="1" colspan="1">Household farm production diversity score</td><td rowspan="1" colspan="1">1349</td><td rowspan="1" colspan="1">3 (1–4)*<sup>,2</sup></td><td rowspan="1" colspan="1">1886</td><td rowspan="1" colspan="1">3 (2–5)*<sup>,</sup><xref ref-type="table-fn" rid="fmw024-TF1"><sup>a</sup></xref></td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">13.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">11.6</td></tr><tr><td rowspan="1" colspan="1"> 1–2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">30.3</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">24.1</td></tr><tr><td rowspan="1" colspan="1"> 3–5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">40.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">42.3</td></tr><tr><td rowspan="1" colspan="1"> 6–12</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">15.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">22</td></tr><tr><td rowspan="1" colspan="1">Home/kitchen garden</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">26.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">26.6</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">73.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">73.4</td></tr><tr><td rowspan="1" colspan="1">Frequency of buying fresh food</td><td rowspan="1" colspan="1">1357</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1902</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Daily</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">44.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">47.9</td></tr><tr><td rowspan="1" colspan="1"> 2–3 times/week</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">34.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">30.7</td></tr><tr><td rowspan="1" colspan="1"> Once a week</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">10.6</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">11.1</td></tr><tr><td rowspan="1" colspan="1"> Less often</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">10.1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">10.2</td></tr><tr><td rowspan="1" colspan="1">Production of animal source food</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> At least one food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">60.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">65.6</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">39.5</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">34.4</td></tr><tr><td rowspan="1" colspan="1">Consumption of animal source food</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> At least one food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">51.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">48.8</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">49.0</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">51.2</td></tr><tr><td rowspan="1" colspan="1">Production of vitamin A-rich food</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> At least one food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">38.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">47.2</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">61.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">52.8</td></tr><tr><td rowspan="1" colspan="1">Consumption of vitamin A-rich food</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> At least one food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">80.2</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">83.5</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">19.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">16.5</td></tr><tr><td rowspan="1" colspan="1">Use of iodized salt</td><td rowspan="1" colspan="1">1332</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1871</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Yes</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">79.3</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">79.2</td></tr><tr><td rowspan="1" colspan="1"> No</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">20.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">20.8</td></tr><tr><td rowspan="1" colspan="1">Place of residence</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Urban</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">18.7</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">20.5</td></tr><tr><td rowspan="1" colspan="1"> Rural</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">81.3</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">79.5</td></tr><tr><td rowspan="1" colspan="1">Region</td><td rowspan="1" colspan="1">1360</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1904</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Mbeya</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">63.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">67.4</td></tr><tr><td rowspan="1" colspan="1"> Njombe</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">14.8</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">13.4</td></tr><tr><td rowspan="1" colspan="1"> Iringa</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">21.4</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">19.2</td></tr></tbody></table><table-wrap-foot><fn id="fmw024-TF1"><p><sup>a</sup>Median and interquartile range.</p></fn></table-wrap-foot></table-wrap></p><p>Mean HAZ was −1.79 among 6–23-month-old children and −1.99 in the older group. Prevalence of stunting was 42.2%, and 45.7%, respectively.</p><p><xref ref-type="table" rid="fmw024-T3">Table 3</xref> presents results from the bivariate and multivariate logistic regression for 6–23-month-old children, and <xref ref-type="table" rid="fmw024-T4">Table 4</xref> for the age group 24–59 months. In both groups and after adjusting for confounding factors, children in Njombe and Iringa have higher odds of being stunted than children in Mbeya. Across regions, children in their second and third year of life have higher odds to be stunted than younger or older children. Male children have higher odds than female.
<table-wrap id="fmw024-T3" orientation="portrait" position="float"><label>Table 3.</label><caption><p>Crude and adjusted odds ratio (95% CI) for stunting among children aged 6 to 23 months, overall and disaggregated by region, according to child, maternal and household characteristics, southern highlands, Tanzania, 2013 (only significant results are shown)</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="1">Variables</th><th colspan="2" rowspan="1">Overall (<italic>N</italic> = 929)<hr></hr></th><th colspan="2" rowspan="1">Mbeya (<italic>N</italic> = 374)<hr></hr></th><th colspan="2" rowspan="1">Njombe (<italic>N</italic> = 348)<hr></hr></th><th colspan="2" rowspan="1">Iringa (<italic>N</italic> = 357)<hr></hr></th></tr><tr><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th></tr></thead><tbody><tr><td rowspan="2" colspan="1">Male sex</td><td rowspan="1" colspan="1">2.15<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.17<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.35<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.90<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">1.67<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.13<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.04<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.45<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td></tr><tr><td rowspan="1" colspan="1">(1.65–2.81)</td><td rowspan="1" colspan="1">(1.52–3.09)</td><td rowspan="1" colspan="1">(1.57–3.50)</td><td rowspan="1" colspan="1">(1.76–4.80)</td><td rowspan="1" colspan="1">(1.15–2.42)</td><td rowspan="1" colspan="1">(1.27–3.60)</td><td rowspan="1" colspan="1">(1.41–2.95)</td><td rowspan="1" colspan="1">(1.44–4.16)</td></tr><tr><td rowspan="1" colspan="1">Child age</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 6–11</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td></tr><tr><td rowspan="2" colspan="1"> 12–24</td><td rowspan="1" colspan="1">2.70<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">3.91<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.730<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">4.63<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.92<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">3.04<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">2.63<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">4.74<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td></tr><tr><td rowspan="1" colspan="1">(2.02–3.62)</td><td rowspan="1" colspan="1">(2.49–6.12)</td><td rowspan="1" colspan="1">(1.751–4.256)</td><td rowspan="1" colspan="1">(2.47–8.67)</td><td rowspan="1" colspan="1">(1.97–4.34)</td><td rowspan="1" colspan="1">(1.68–5.50)</td><td rowspan="1" colspan="1">(1.75–3.95)</td><td rowspan="1" colspan="1">(2.40–9.37)</td></tr><tr><td rowspan="2" colspan="1">Receiving deworming treatment</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.64<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.53<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.89<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.41–0.99)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.30–0.93)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.28–2.79)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Mother hours away from home</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 0 h</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 1–3 h</td><td rowspan="1" colspan="1">0.85</td><td rowspan="1" colspan="1">1.00</td><td rowspan="1" colspan="1">0.79</td><td rowspan="1" colspan="1">0.96</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.59–1.21)</td><td rowspan="1" colspan="1">(0.64–1.59)</td><td rowspan="1" colspan="1">(0.48–1.32)</td><td rowspan="1" colspan="1">(0.53–1.76)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 4–7 h</td><td rowspan="1" colspan="1">1.64<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">1.93<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">1.90<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">2.25<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.17–2.30)</td><td rowspan="1" colspan="1">(1.21–3.07)</td><td rowspan="1" colspan="1">(1.14–3.14)</td><td rowspan="1" colspan="1">(1.20–4.19)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 8–24 h</td><td rowspan="1" colspan="1">0.83</td><td rowspan="1" colspan="1">1.07</td><td rowspan="1" colspan="1">0.79</td><td rowspan="1" colspan="1">1.00</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.53–1.29)</td><td rowspan="1" colspan="1">(0.58–1.98)</td><td rowspan="1" colspan="1">(0.39–1.60)</td><td rowspan="1" colspan="1">(0.42–2.39)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Mother currently pregnant</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.98<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">4.26<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">6.64<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.05–8.51)</td><td rowspan="1" colspan="1">(1.08–16.87)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.23–35.66)</td></tr><tr><td rowspan="1" colspan="1">Food types during last pregnancy</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Fewer</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> The same</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.79<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.13–2.84)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> More</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.10</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.64–1.88)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Receiving husband support during pregnancy</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.61<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.38–0.99)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Births in the past 5 years</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> One</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td></tr><tr><td rowspan="2" colspan="1"> Two or more</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.02<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.11–3.66)</td></tr><tr><td rowspan="1" colspan="1">Household dietary diversity score</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 0–4</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 5–8</td><td rowspan="1" colspan="1">0.66<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">0.61<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">0.66<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">0.63</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.61<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.50–0.86)</td><td rowspan="1" colspan="1">(0.41–0.92)</td><td rowspan="1" colspan="1">(0.44–0.98)</td><td rowspan="1" colspan="1">(0.36–1.09)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.42–0.89)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 9–12</td><td rowspan="1" colspan="1">0.25<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">0.15<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">0.20<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">0.14<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.10<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.09–0.66)</td><td rowspan="1" colspan="1">(0.04–0.53)</td><td rowspan="1" colspan="1">(0.04–0.95)</td><td rowspan="1" colspan="1">(0.02–0.96)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.01–0.82)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Owning a home garden</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.58<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.38–0.89)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Production of animal-based food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.67<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">0.50<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.46–0.98)</td><td rowspan="1" colspan="1">(0.26–0.95)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Production of vitamin A-rich fruits and vegetables</td><td rowspan="1" colspan="1">1.43<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">1.71<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.59<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.09–1.87)</td><td rowspan="1" colspan="1">(1.06–2.76)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.09–2.32)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Frequency of buying fresh food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Daily</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td></tr><tr><td rowspan="2" colspan="1"> 2–3 times per week</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.20</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.19<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.78–1.85)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.14–4.23)</td></tr><tr><td rowspan="2" colspan="1"> Once a week</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.15</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.47</td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.66–2.00)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.53–4.05)</td></tr><tr><td rowspan="2" colspan="1"> Less often</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.28<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.11</td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.19–4.39)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.41–2.99)</td></tr><tr><td rowspan="2" colspan="1">Using iodized salt</td><td rowspan="1" colspan="1">0.72<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.54<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1">0.41<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td></tr><tr><td rowspan="1" colspan="1">(0.53–0.97)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.34–0.84)</td><td rowspan="1" colspan="1">(0.21–0.79)</td></tr><tr><td rowspan="1" colspan="1">Knowledge of hand-washing practices</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Poor</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td></tr><tr><td rowspan="2" colspan="1"> Satisfactory</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">3.10<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.33–7.24)</td></tr><tr><td rowspan="2" colspan="1"> Good</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.13</td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.47–2.71)</td></tr><tr><td rowspan="2" colspan="1">Improved water source</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.48<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.30–0.76)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Urban residence</td><td rowspan="1" colspan="1">0.68<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.50<xref ref-type="table-fn" rid="fmw024-TF2">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.49–0.95)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.30–0.81)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Region</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Mbeya</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Njombe</td><td rowspan="1" colspan="1">1.34<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1">1.77<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.03–1.76)</td><td rowspan="1" colspan="1">(1.11–2.80)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Iringa</td><td rowspan="1" colspan="1">1.19</td><td rowspan="1" colspan="1">1.59<xref ref-type="table-fn" rid="fmw024-TF2">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.91–1.55)</td><td rowspan="1" colspan="1">(1.06–2.40)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr></tbody></table><table-wrap-foot><fn id="fmw024-TF2"><p>Level of significance:. ***<italic>p</italic> < 0.01,**<italic>p</italic> < 0.05; OR = Odds ratio.</p></fn></table-wrap-foot></table-wrap><table-wrap id="fmw024-T4" orientation="portrait" position="float"><label>Table 4.</label><caption><p>Crude and adjusted odds ratio (95% CI) for stunting among children aged 24 to 59 months, overall and disaggregated by region, according to child, maternal and household characteristics, southern highlands, Tanzania, 2013 (only significant results are shown)</p></caption><table frame="hsides" rules="groups"><thead><tr><th rowspan="2" colspan="1">Variables</th><th colspan="2" rowspan="1">Overall (<italic>N</italic> = 1618)<hr></hr></th><th colspan="2" rowspan="1">Mbeya (<italic>N</italic> = 561)<hr></hr></th><th colspan="2" rowspan="1">Njombe (<italic>N</italic> = 517)<hr></hr></th><th colspan="2" rowspan="1">Iringa (<italic>N</italic> = 535)<hr></hr></th></tr><tr><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th><th rowspan="1" colspan="1">Crude OR</th><th rowspan="1" colspan="1">AOR</th></tr></thead><tbody><tr><td rowspan="1" colspan="1">Child age</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 24–35</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 36-47</td><td rowspan="1" colspan="1">0.73<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.71<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.70<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.69*</td><td rowspan="1" colspan="1">0.68<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.68*</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.57–0.94)</td><td rowspan="1" colspan="1">(0.54–0.95)</td><td rowspan="1" colspan="1">(0.49–1.00)</td><td rowspan="1" colspan="1">(0.45–1.05)</td><td rowspan="1" colspan="1">(0.47–0.99)</td><td rowspan="1" colspan="1">(0.44–1.06)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 48-59</td><td rowspan="1" colspan="1">0.59<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">0.60<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">0.52<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">0.53<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">0.64<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.61<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.44–0.78)</td><td rowspan="1" colspan="1">(0.44–0.83)</td><td rowspan="1" colspan="1">(0.35–0.77)</td><td rowspan="1" colspan="1">(0.33–0.85)</td><td rowspan="1" colspan="1">(0.43–0.97)</td><td rowspan="1" colspan="1">(0.37–0.98)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Male sex</td><td rowspan="1" colspan="1">1.30<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">1.28<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.04–1.61)</td><td rowspan="1" colspan="1">(1.00–1.64)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Mother currently breastfeeding</td><td rowspan="1" colspan="1">1.79<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">1.97<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.82<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.20–2.68)</td><td rowspan="1" colspan="1">(1.18–3.29)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.23–6.47)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Mother currently pregnant</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.28<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">2.81<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.05–4.93)</td><td rowspan="1" colspan="1">(1.20–6.60)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Mother hours away from home</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 0 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 1–3 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.58<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.98</td><td rowspan="1" colspan="1">1.20</td><td rowspan="1" colspan="1">1.32</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.36–0.94)</td><td rowspan="1" colspan="1">(0.63–1.53)</td><td rowspan="1" colspan="1">(0.72–2.00)</td><td rowspan="1" colspan="1">(0.86–2.01)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 4–7 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.81</td><td rowspan="1" colspan="1">1.64<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">1.66<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">1.63<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.50–1.30)</td><td rowspan="1" colspan="1">(1.07–2.52)</td><td rowspan="1" colspan="1">(1.01–2.73)</td><td rowspan="1" colspan="1">(1.09–2.44)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 8–24 h</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.97</td><td rowspan="1" colspan="1">1.53*</td><td rowspan="1" colspan="1">1.95<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">1.31</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.55–1.71)</td><td rowspan="1" colspan="1">(0.97–2.39)</td><td rowspan="1" colspan="1">(1.15–3.31)</td><td rowspan="1" colspan="1">(0.76–2.27)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Improved water source</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.70<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.58<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">1.56<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.63<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.52–0.93)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.39–0.87)</td><td rowspan="1" colspan="1">(1.06–2.29)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.40–0.99)</td></tr><tr><td rowspan="2" colspan="1">Functional hand-washing station</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.63<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.43<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.40–0.98)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.18–0.99)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Knowledge of hand-washing practices</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Poor</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1">1</td></tr><tr><td rowspan="2" colspan="1"> Satisfactory</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.81</td><td rowspan="1" colspan="1">0.80</td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.51–1.28)</td><td rowspan="1" colspan="1">(0.47–1.36)</td></tr><tr><td rowspan="2" colspan="1"> Good</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.55<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.47<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.34–0.90)</td><td rowspan="1" colspan="1">(0.26–0.85)</td></tr><tr><td rowspan="1" colspan="1">Household dietary diversity score</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> 0–4</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 5–8</td><td rowspan="1" colspan="1">0.66<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.65<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.53–0.83)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.47–0.91)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 9–12</td><td rowspan="1" colspan="1">0.96</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.25</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.52–1.80)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.59–2.66)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Household consuming animal-based food</td><td rowspan="1" colspan="1">0.67<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.63<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">0.63<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.54–0.84)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.46–0.86)</td><td rowspan="1" colspan="1">(0.42–0.94)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Farm production diversity score</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> No production</td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 1–2 food groups</td><td rowspan="1" colspan="1">0.90</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.79<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.67–1.20)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.01–3.14)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 3-5 food groups</td><td rowspan="1" colspan="1">1.56<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.33<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.04–2.33)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.38–3.93)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 6–12 food groups</td><td rowspan="1" colspan="1">1.34</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">3.16<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(0.92–1.94)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.72–5.78)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Household production of animal-based food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.72<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.45<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.52–0.99)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.04–2.02)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Production of vitamin A-rich fruits and vegetables</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">2.25<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.63–3.10)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Owning a home garden</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.99<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.44–2.75)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Frequency of buying fresh food</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Daily</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> 2–3 times per week</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.46<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.00–2.11)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Once a week</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.64*</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.99–2.72)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Less often</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.30</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.80–2.13)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1">Urban residence</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">1.74<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">2.02<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">0.61<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">0.47<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(1.18 – 2.57)</td><td rowspan="1" colspan="1">(1.21 – 3.39)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1">(0.39 – 0.95)</td><td rowspan="1" colspan="1">(0.31 – 0.72)</td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">Region</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1"> Mbeya</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Njombe</td><td rowspan="1" colspan="1">1.83<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1">1.77<xref ref-type="table-fn" rid="fmw024-TF7">***</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.47–2.29)</td><td rowspan="1" colspan="1">(1.33–2.35)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="2" colspan="1"> Iringa</td><td rowspan="1" colspan="1">1.27<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1">1.37<xref ref-type="table-fn" rid="fmw024-TF8">**</xref></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td rowspan="1" colspan="1">(1.02–1.59)</td><td rowspan="1" colspan="1">(1.04–1.79)</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr></tbody></table><table-wrap-foot><fn id="fmw024-TF5"><p><italic>Note</italic>. OR = Odds ratio.</p></fn><fn id="fmw024-TF6"><p>Level of significance:</p></fn><fn id="fmw024-TF7"><p>***<italic>p</italic> < 0.01,</p></fn><fn id="fmw024-TF8"><p>**<italic>p</italic> < 0.05.</p></fn></table-wrap-foot></table-wrap></p><p>In the entire sample, children aged 6–23 months had lower odds of stunting if they received deworming treatment or came from a household consuming five or more food groups or that has a home garden. In Njombe, children from households producing animal-based food have lower odds of stunting. In Iringa, using iodized salt was also found to be protective. Risk factors in the same age group are maternal absence for 4–7 h and production of vitamin-A-rich food. In Njombe and Iringa, children whose mother is currently pregnant have higher odds of stunting. In Iringa, two or more births in the past 5 years, reduced frequency of buying fresh vegetables and improved knowledge of hand-washing practices were other risk factors.</p><p>Overall, children aged 24–59 months from households with access to improved water source or with a functioning water station had lower odds of stunting. Knowledge of hand-washing practices protects against stunting in Iringa, while in Mbeya, children from households consuming animal-based food have lower odds. In the entire sample, children whose mother was currently breastfeeding have higher odds of stunting. Short maternal absence (1–3 h) was a protective factor in Mbeya, while longer absence (4–7 h) was a risk factor in Njombe. Urban residence was a protective factor in Njombe and a risk factor in Mbeya.</p></sec><sec sec-type="discussion"><title>DISCUSSION</title><p>This study investigates factors associated to the nutritional status of pre-school children in Tanzanian southern highlands. The likelihood of stunting is higher among children in the regions of Njombe and Iringa, compared with Mbeya. As the regions have similar socioeconomic profiles, further effort is needed to investigate possible explanatory factors to better define interventions. For example, diet habits, cultural practices and HIV prevalence could play a role. Children under 2 years of age consume more dairy products in Mbeya than in the other regions (results not shown), which is associated with improved linear growth [<xref rid="fmw024-B31" ref-type="bibr">31</xref>]. The higher HIV/AIDS prevalence in Njombe (15%) compared with Iringa and Mbeya (9%) [<xref rid="fmw024-B32" ref-type="bibr">32</xref>] can also have implications on the households’ economic status and indirectly on the child nutritional status [<xref rid="fmw024-B33" ref-type="bibr">33</xref>]: reduced labour productivity, increased expenditure in illness and funerals and reduced food security. Njombe registers, for example, the lowest mean household dietary diversity score (HDDS), followed by Iringa and Mbeya (difference among regions is significant). Within Mbeya though, urban children seem to be more disadvantaged than their rural counterparts, possibly due to the fast urbanization that was not followed by an equitable development of and access to health, sanitation and educational services [<xref rid="fmw024-B34" ref-type="bibr">34</xref>].</p><p>With regard to child characteristics, our analysis confirms that children in their second and third year of life are more likely to be stunted than both younger and older children. This is well-recognized in the literature. Studies have shown that children accumulate growth delay during the first 2 years of life, with stunting peaking around 2 and 3 years, after which they stabilize [<xref rid="fmw024-B12" ref-type="bibr">12</xref>, <xref rid="fmw024-B35" ref-type="bibr">35</xref>]. Furthermore, boys are at higher risk than girls, which also confirms results from sub-Saharan African and Asian countries [<xref rid="fmw024-B36" ref-type="bibr">36</xref>].</p><p>The nutritional status of a child is directly related to maternal presence and her reproductive status. Maternal time allocation affects both the child nutritional status (through the time spent caring for the child) and income generation (through labour force) [<xref rid="fmw024-B37" ref-type="bibr">37</xref>]. The net effect may vary by household and by child age. Our study shows that small children are particularly affected by maternal absence, while the results are mixed among older children. Furthermore, in Njombe and Iringa, children of pregnant women and of women with recent short birth intervals are more likely to be stunted. Among the older children, those whose mother is breastfeeding have higher odds. These results point in the same direction: older children may suffer from the presence of younger siblings. Programmes supporting mothers during pregnancy and lactation can have positive effects not only on the newborn, but also on older siblings. Cost–benefit studies of such interventions should also take this into account. Various activities could contribute towards reducing the workload on women: conservation agriculture, shortening distance to drinking water sources and engaging with other family members. Reproductive health programmes involving men and boys represent an important channel to emphasize men’s shared responsibility in pregnancy and childcare [<xref rid="fmw024-B38" ref-type="bibr">38</xref>]. A better understanding of cultural norms defining women’s and men’s reproductive role in the Tanzanian southern highlands is necessary to design successful programmes. Finally, our study supports the evidence on promoting child spacing and family planning, which can reduce maternal burden and has been shown to contribute to a reduction of stunting [<xref rid="fmw024-B39" ref-type="bibr">39</xref>].</p><p>It is widely accepted that economic welfare boosts nutritional status. Studies from resource-limited settings show that children from families with greater income and resources tend to have better diets, improved nutritional status and an overall growth-conducive environment [<xref rid="fmw024-B16" ref-type="bibr">16</xref>, <xref rid="fmw024-B40" ref-type="bibr">40</xref>]. Our study contributes to this evidence by showing that higher HDDS is associated with lower odds for stunting among 6–23-month-old children. The number of food groups consumed in a household is commonly used as a proxy for the socioeconomic level, as it reflects the economic access to a variety of foods [<xref rid="fmw024-B27" ref-type="bibr">27</xref>]. The interpretation of the relation between HDDS and stunting is complicated by the fact that richer families usually have better access to health care and improved environmental health, therefore pointing to a broader relation between poverty and stunting. Cultural food practices may have a strong mediating influence on a child nutrition status regardless of the family economic conditions. Further operational research to unravel the pathways should be undertaken.</p><p>Access to improved water source and to a functioning hand-washing station protects against stunting, particularly among older children. These two public health interventions are likely to reduce the transmission of diarrhoeal diseases and the risk of tropical enteropathy [<xref rid="fmw024-B41" ref-type="bibr">41</xref>], which are both associated with reduced linear growth. As 43% of the Tanzania households still do not have access to improved water source [<xref rid="fmw024-B21" ref-type="bibr">21</xref>], strengthening strategies to increase the provision of water and sanitation interventions is crucial for the health of preschool children.</p><p>Surprisingly, the production of vitamin-A-rich food was found to increase the odds of stunting, instead of reducing it. It should be investigated further whether producing vitamin-A-rich food substitutes the production (and consumption) of animal-based food, which may have a greater impact on child growth.</p><p>None of the IYCF indicators was associated with linear growth, despite evidence from multi-country studies that indicate that diverse [<xref rid="fmw024-B42" ref-type="bibr">42</xref>, <xref rid="fmw024-B43" ref-type="bibr">43</xref>] and adequate diet, as well as solid food consumption [<xref rid="fmw024-B44" ref-type="bibr">44</xref>], reduce the risk of stunting. In the same studies, no association is found between meal frequency and linear growth, as in our analysis. Very few children (<1%) in our study met the definition of adequate diet, unlike the National Nutrition Survey, where 7.3%, 5.3% and 23.9% of the children in Iringa, Mbeya and Njombe, respectively, received minimum adequate diet (MAD). The results are not comparable unfortunately, as the calculation of MAD in the National Nutrition Survey did not consider milk feeds for non-breastfed children as recommended by the WHO.</p><p>The present study has some limitations. First, the cross-sectional design does not allow to investigate causation, but only association. Second, information on maternal education was not collected, despite the importance recognized to it in the literature. The SMART questionnaire should include it in the future. Third, it was not possible to investigate the extent to which HIV/AIDS influences stunting in this population. Given the complexity and sensitivity around HIV status, data on HIV prevalence were not collected.</p><p>In conclusion, our analysis confirms that stunting remains a public health problem in the southern highlands region in Tanzania. Interventions aiming to improve household wealth and sanitation conditions to reduce the high level of stunting should be put in place. Furthermore, family planning activities as well as supporting programmes for mothers during pregnancy and lactation can have positive effects not only on the newborn, but also on older siblings.</p></sec></body><back><ack><title>ACKNOWLEDGEMENTS</title><p>The authors would like to thank the data collection teams and the participants to the survey; Irish Aid, UNICEF and Concern Worldwide for the financial support in the implementation of the project; the Fond National de Recherche Scientifique (FNRS) and the Université catholique de Louvain for the financial support to the CRED team.</p></ack><sec><title>FUNDING</title><p>This work was supported by Irish Aid, UNICEF, Concern Worldwide, <funding-source>Fond National de Recherche Scientifique</funding-source> (PDR <award-id>14692731</award-id>), Université catholique de Louvain and Association pour l'epidémiologie des désastres.</p></sec><ref-list><title>REFERENCES</title><ref id="fmw024-B1"><label>1</label><mixed-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Black</surname><given-names>R</given-names></name><name><surname>Victora</surname><given-names>CG</given-names></name><name><surname>Walker</surname><given-names>SP</given-names></name></person-group>, <etal></etal><article-title>Maternal and child undernutrition and overweight in low-income and middle-income countries</article-title> [Internet]. <source>Lancet</source><year>2013</year>;<volume> 382</volume>:<fpage> 427</fpage>–<lpage>51</lpage>. <ext-link ext-link-type="uri" xlink:href="http://www.thelancet.com/journals/a/article/PIIS0140-6736(13)60937-X/fulltext">http://www.thelancet.com/journals/a/article/PIIS0140-6736(13)60937-X/fulltext</ext-link> (25 May 2014, date last accessed).</mixed-citation></ref><ref id="fmw024-B2"><label>2</label><mixed-citation publication-type="other"><collab>United Nations Children’s Fund, World Health Organization, World Bank</collab>. 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