{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:39:27Z","timestamp":1787017167324,"version":"build-2736575974"},"reference-count":21,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T00:00:00Z","timestamp":1702857600000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In developing countries, malnutrition is a noteworthy concern related to the well-being of people, and this study aimed to determine the factors that affect malnutrition among children below 5\u2009years in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The study used a secondary data source, specifically the Ghanaian Multiple Indicator Cluster Survey Six (MICS 6), which was conducted by the Ghana Statistical Service in 2017\u20132018. The MICS data are hierarchical, as children are categorised within households, and households are further grouped within a higher cluster, violating the independence assumption that must be addressed in the analyses. This study used a Bayesian multilevel ordinal logistic regression to model, identify and analyse the factors linked to child malnutrition in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The setting of the study was the household level across the previous 10 administrative regions in Ghana.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Data for 8875 children under 5\u2009years were used for the study. The data were gathered from households in all 10 administrative regions of Ghana using a sampling procedure consisting of stratification and random selection to ensure national representation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results showed that the Northern Region of Ghana had the highest occurrence rate of severe and moderate malnutrition, and factors such as the count of children\u2019s books or picture books, whether the child experienced fever in the last 2\u2009weeks, age and sex of the child, and the child\u2019s household wealth index quintile were strongly linked to malnutrition among Ghanaian children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings underscore the intricate interplay of factors contributing to child nutrition in Ghana and suggest that addressing malnutrition necessitates a comprehensive approach that considers factors such as access to healthcare and reading materials, household wealth, and other social and environmental factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075723","type":"journal-article","created":{"date-parts":[[2023,12,18]],"date-time":"2023-12-18T22:36:37Z","timestamp":1702938997000},"page":"e075723","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Identifying factors associated with child malnutrition in Ghana: a cross-sectional study using Bayesian multilevel ordinal logistic regression approach"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7543-1794","authenticated-orcid":false,"given":"Wahab Abdul","family":"Iddrisu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6363-6482","authenticated-orcid":false,"given":"Opoku","family":"Gyabaah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,12,18]]},"reference":[{"key":"2023121819351407000_13.12.e075723.1","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1108\/JHASS-02-2021-0030","article-title":"Gender differences in child nutrition status of Bangladesh: a multinomial modeling approach","volume":"4","author":"Haq","year":"2022","journal-title":"JHASS"},{"key":"2023121819351407000_13.12.e075723.2","unstructured":"Poda GG . n.d. Factors associated with malnutrition among children."},{"key":"2023121819351407000_13.12.e075723.3","doi-asserted-by":"crossref","unstructured":"Vassilakou T . Childhood malnutrition: time for action. Children 2021;8:103. doi:10.3390\/children8020103","DOI":"10.3390\/children8020103"},{"key":"2023121819351407000_13.12.e075723.4","doi-asserted-by":"crossref","first-page":"373","DOI":"10.5114\/fmpcr.2018.79350","article-title":"An assessment of the association between antenatal care and child malnutrition in Bangladesh","volume":"20","author":"Toma","year":"2018","journal-title":"Fmpcr"},{"key":"2023121819351407000_13.12.e075723.5","unstructured":"World health organization. malnutrition. 2021. Available: www.who.int\/news-room\/fact-sheets\/detail\/malnutrition"},{"key":"2023121819351407000_13.12.e075723.6","unstructured":"World Health Organization . Levels and trends in child malnutrition: UNICEF. 2021."},{"key":"2023121819351407000_13.12.e075723.7","unstructured":"Ghana Statistical Service . Ghana health service (GHS). ICF International Ghana Demographic and Health Survey 2014."},{"key":"2023121819351407000_13.12.e075723.8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4314\/gmj.v53i1.11","article-title":"Predictors of Underweight in children under-five years in Ghana","volume":"53","author":"Acquah","year":"2019","journal-title":"Ghana Med J"},{"key":"2023121819351407000_13.12.e075723.9","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1111\/ppe.12222","article-title":"Childhood malnutrition and its determinants among Under\u2010Five children in Ghana","volume":"29","author":"Aheto","year":"2015","journal-title":"Paediatr Perinat Epidemiol"},{"key":"2023121819351407000_13.12.e075723.10","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.cegh.2019.05.008","article-title":"Nutrition status and inequality among children in different geographical regions of Maharashtra, India","volume":"8","author":"Khadse","year":"2020","journal-title":"Clinical Epidemiology and Global Health"},{"key":"2023121819351407000_13.12.e075723.11","unstructured":"Ghana statistical service, multiple indicator cluster survey (Mics2017\/18), survey findings report. 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Malnutrition and the disproportional burden on the poor: the case of Ghana. Int J Equity Health 2007;6:21. doi:10.1186\/1475-9276-6-21","DOI":"10.1186\/1475-9276-6-21"},{"key":"2023121819351407000_13.12.e075723.17","doi-asserted-by":"crossref","unstructured":"Akparibo R , Harris J , Blank L , et al . Severe acute malnutrition in children aged under 5 years can be successfully managed in a Non\u2010Emergency routine community Healthcare setting in Ghana. 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