Risk factors for stunting among under-fives in Libya

OBJECTIVE: Stunting is a chronic condition reflecting poor nutrition and health. Our aim was to ascertain major predictors of stunting in children <5 years old in Libya. POPULATION AND METHODS: A nationally representative, cross-sectional, two-stage stratified cluster sample survey enrolled 4549 under-fives from 6707 households. Logistic regression was used to determine individual risk factors in bivariate and multivariate analyses. RESULTS: Anthropometric measurements were available for 4498 children. Among the 929 stunted children (20.7 %), 495 were boys (53.3 %) and 434 were girls (46.5 %). In multivariate analysis, risk factors were young age (1-2 years: OR = 2.32, 95 % CI 1.67, 3.22; 2-3 years: OR = 1.64, 95 % CI 1.22, 2.21), resident of Al-Akhdar (OR = 1.67, 95 % CI 1.08, 2.58), being a boy (OR = 1.28, 95 % CI 1.05, 1.55), having a less educated father (illiterate: OR = 2.10, 95 % CI 1.17, 3.77; preparatory school: OR = 1.71, 95 % CI 1.11, 2.65), poor psychosocial stimulation (no family visits or trips: OR = 1.52, 95 % CI 1.07, 2.16; father rarely/never plays with child: OR = 2.24, 95 % CI 1.20, 4.16), filtered water (OR = 8.45, 95 % CI 2.31, 30.95), throwing garbage in the street (OR = 13.81, 95 % CI 2.33, 81.72), diarrhoea (OR = 1.58, 95 % CI 1.09, 2.29) and low birth weight (OR = 1.8, 95 % CI 1.17, 2.40). Protective factors were older age of father (OR = 0.53, 95 % CI 0.32, 0.90) and water storage (OR = 0.70, 95 % CI 0.54, 0.90). These variables only explained 20 % of cases of stunting. CONCLUSION: Various multilevel actions are needed to improve nutritional status of under-fives in Libya. At risk-groups include those with young age (1-3 years), resident of Al-Akhdar region, boys, father's low educational level, poor psychosocial stimulation, poor housing environment, diarrhoea and low birth weight.