The Interrelationships of Child Under-Nutrition, Ecological and Maternal Factors: A Case Study of Pakistan by Using Composite Index of Anthropometric Failure

Under-nutrition is a serious health problem of developing countries, including Pakistan. Despite the implementation of a number of health strategies for the vulnerable population (especially children), the issue is still emerging and needs further investigation. The aim of this study was to investigate the role of various ecological and maternal factors responsible of children's nutritional health variations. By using Pakistan Demographic and Health Survey (PDHS) data, maternal factors were assessed as important factors of child under-nutrition. Multinomial nested logit regression and classification tree analysis were performed. A total of 1870 children of age < 5 years were included in the analysis and out of these 50.1% fall in the composite index of anthropometric failure (CIAF). Maternal education, mother's body mass index (BMI) and working status were among the significant factors while decision making autonomy remain insignificant. Maternal factors have significant impact on child health and use of CIAF as a measure of nutritional status is recommended for policy makers because of its capability to estimate the overall burden of under-nutrition.