ADDIS ABABA UNIVERSITY COLLEGE OF DEVELOPMENT STUDIES CENTER FOR FOOD SECURITY STUDIES NUTRITIONAL STATUS AND DETERMINANT FACTORS AMONG UNDER FIVE CHILDREN IN YEKA SUB CITY, ADDIS ABABA, ETHIOPIA BY: MARIYE KASSAYE RETA A THESIS SUBMITTED TO COLLEGE OF DEVELOPMENT STUDIES, CENTER FOR FOOD SECURITY STUDIES, ADDIS ABABA UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN FOOD SECURITY OCTOBER 2019, ADDIS ABABA ADDIS ABABA UNIVERSITY COLLEGE OF DEVELOPMENT STUDIES CENTER FOR FOOD SECURITY STUDIES NUTRITIONAL STATUS AND DETERMINANT FACTORS AMONG UNDER FIVE CHILDREN IN YEKA SUB CITY, ADDIS ABABA, ETHIOPIA BY: MARIYE KASSAYE RETA ADVISOR: ABEBE HAILE (Ph.D.) A THESIS SUBMITTED TO COLLEGE OF DEVELOPMENT STUDIES, CENTER FOR FOOD SECURITY STUDIES, ADDIS ABABA UNIVERSITY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN FOOD SECURITY OCTOBER 2019, ADDIS ABABA ADDIS ABABA UNIVERSITY DECLARATION I, Mariye Kassaye Reta, hereby declare that this thesis is original and has never been presented in any other institution. I also declare that primary and secondary information used has been duly acknowledged in this thesis. Student’s Name: _________________________ ________________ ______________ Candidate Signature Date This is to certify that the above declaration made by the candidate is correct to the best of my knowledge as an advisor. Approved by thesis advisor: Abebe Haile (Ph.D.) ________________ ______________ Signature Date i ADDIS ABABA UNIVERSITY, SCHOOL OF GRADUATE STUDIES This is to certify that the thesis prepared by Mariye Kassaye, entitled: “Nutritional Status and Determinant Factors among Under Five Children in four selected Woredas of Yeka Sub City, Addis Ababa, Ethiopia”, and submitted in partial fulfillment of the requirements for the degree of Masters (Food Security and Development Studies) complies with the regulation of the University and meet the accepted standards with respect to originality and quality. Examiner’ Approval: _________________________ ________________ ______________ Chairperson Signature Date Examiner: _________________________ ________________ ______________ Internal Examiner Signature Date Examiner: _________________________ ________________ ______________ External Examiner Signature Date ____________________________________________ Head, Center of Food Security and Development Studies ii Acknowledgements My first and foremost sincere gratitude goes to the Almighty God for the knowledge, strength, insight and health he bestowed on me throughout the period in which this thesis was done and the opportunity to contribute to knowledge. I would like to express my sincere and profound gratitude to my advisor Dr. Abebe Haile, Addis Ababa University, College of Development Studies, Center for Food Security Studies, for his effective supervision, guidance, motivation and encouragement throughout my thesis preparation. My employer, Bingham Academy also deserves many thanks for giving the chance to attend master program and support to accomplish this great academic achievement. I am indebted to my wife Tsion Wores and my children; Abenezer Mariye, Christian Mariye and Abegiyia Mariye who overwhelmingly supported me morally during my study period and continues to inspire my life. I wish to extend my appreciation to all mothers and caretakers who took part in the study for their co-operation and contribution without which the study would not have been successful. My appreciation goes to Sr. Elisabeth Tiliye and her team for her assistance during the data collection and to all Yeka Sub city and Woreda 01. 02, 03 and 04 administration office workers for their cooperation and unlimited help. My appreciation goes to my wonderful classmates for encouragement and guidance throughout this master program. It has been incredible to get to know so many unique personalities at once, and I have learned a lot from you all. Lastly, I wish to thank every person, especially, Mr. Eyakem Fikru, who has come into my life and inspired, touched, and illuminated me through their emotional support and words of encouragement throughout this whole process. iii List of acronyms AOR: Adjusted Odd Ratio ARIs: Acute Respiratory Infections CFs: Complementary Foods CHWs: Community Health Workers COR: Crud Odd Ratio CSA: Central Statistical Agency DALYs: Disability Adjusted Life Years EDHS: Ethiopian Demographic and Health Survey FAO: Food and Agricultural Organization FGD: Focus Group Discussion FMoH: Federal Ministry of Health HAZ: Height for Age z-score HFA: Height-for-Age IDDS: Individual Dietary Diversity Score IYCF: Infant and Young Child Feeding MDGs: Millennium Development Goals MUAC: Mid-Upper Arm Circumference NGO: Non- governmental Organization NNP: National Nutrition Program PEM: Protein Energy Malnutrition SAM: Severe Acute Malnutrition iv SD: Standard Deviation SDG: Sustainable Development Goals SPSS: Statistical Package for Social Science UN: United Nations UNDP: United Nation Development Program UNICEF: United Nations International Children’s Fund USAID: United States Agency for International Development WFH: Weight For Height WFP: World Food Program WHA: Weight For Age WHO: World Health Organization v Table of contents Contents Pages Acknowledgements .............................................................................................................................. iii List of acronyms .................................................................................................................................. iv List of Tables ....................................................................................................................................... ix List of Figures ....................................................................................................................................... x Abstract ................................................................................................................................................ xi CHAPTER ONE ................................................................................................................................... 1 INTRODUCTION ................................................................................................................................ 1 1.1 Background of the study ................................................................................................................. 1 1.2 Statement of the problem ............................................................................................................... 3 1.3. Objectives of the study ................................................................................................................... 5 1.3.1. General objective ...................................................................................................................... 5 1.3.2. Specific objectives .................................................................................................................... 5 1.4 Research questions .......................................................................................................................... 5 1.5. Significance of the study ................................................................................................................ 5 1.6. Scope of the study .......................................................................................................................... 6 1.7. Limitation of the study ................................................................................................................... 6 1.8. Organization of the paper ............................................................................................................... 6 CHAPTER TWO .................................................................................................................................. 7 REVIEW OF RELATED LITERATURE ............................................................................................ 7 2.1 The Basic Concept of Determinants ............................................................................................... 7 2.2 Theoretical framework .................................................................................................................... 8 2.3. Empirical literature ........................................................................................................................ 9 2.3.1. Measurement of child nutritional status ................................................................................... 9 2.3.2. Determinants of children’s nutritional status ......................................................................... 10 vi 2.3.3. Household economic welfare ................................................................................................. 11 2.3.3.1. Income of the household .................................................................................................. 11 2.3.3.2. Household or individual characteristics and education ................................................... 12 2.3.4. Environmental health condition ............................................................................................. 14 2.3.5. Maternal caring and characteristics ........................................................................................ 14 2.3.6. Child caring practices ............................................................................................................. 16 2.4. Conceptual framework