{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:12:16Z","timestamp":1790806336846,"version":"4.1.0"},"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Stunting and wasting are key public health problems in Ghana that are significantly linked with mortality and morbidity risk among children. However, information on their associated factors using nationally representative data is scanty in Ghana. This study investigated the influence of Infant and Young Child Feeding (IYCF) indicators, socio-demographic and economic related factors, and water and sanitation on stunting and wasting, using nationally representative data in Ghana.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This is a secondary data analysis of the most recent (2017\/2018) Ghana Multi-Indicator Cluster Survey (MICS) datasets. The multi-indicator cluster survey is a national cross-sectional household survey with rich data on women of reproductive age and children under the age of five. The survey used a two-stage sampling method in the selection of respondents and a computer-assisted personal interviewing technique to administer structured questionnaires from October 2017 to January 2018. The present study involved 2529 mother-child pairs, with their children aged 6 to 23 months. We used the Complex Sample procedures in SPSS, adjusting for clustering and stratification effects. In a bivariate logistic regression, variables with P-values \u2264 0.05 were included in a backward multivariate logistic regression to identify the significant factors associated with stunting and wasting.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age of children was 14.32 \u00b1 0.14 months, with slightly more being males (50.4%). About 12% and 16% of the children were wasted and stunted, respectively. There were 39.4%, 25.9%, and 13.7% of children who, respectively, satisfied the minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). None of the IYCF indicators was significantly associated with stunting or wasting in the multivariate analysis but low socio-economic status, low birth weight, being a male child and unimproved toilet facilities were significantly associated with both wasting and stunting.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our findings suggest that aside from the pre-natal period, in certain contexts, household factors such as low socio-economic status and poor water and sanitation, may be stronger predictors of undernutrition. A combination of nutrition-specific and nutrition-sensitive interventions including the pre-natal period to simultaneously address the multiple determinants of undernutrition need strengthening.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0297698","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T17:29:41Z","timestamp":1711646981000},"page":"e0297698","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Low birth weight, household socio-economic status, water and sanitation are associated with stunting and wasting among children aged 6\u201323 months: Results from a national survey in Ghana"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0174-6862","authenticated-orcid":true,"given":"Hammond Yaw","family":"Addae","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Sulemana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6948-0706","authenticated-orcid":true,"given":"Taminu","family":"Yakubu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambrose","family":"Atosona","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1418-1693","authenticated-orcid":true,"given":"Rafatu","family":"Tahiru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fusta","family":"Azupogo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"pone.0297698.ref001","volume-title":"Nutrition in Universal health coverage","author":"WHO","year":"2019"},{"key":"pone.0297698.ref002","article-title":"Persistent Global Acute Malnutrition A discussion paper on the scope of the problem, its drivers, and strategies for moving forward for policy, practice, and research.","volume":"55","author":"H Young","year":"2017","journal-title":"a Feinstein Int Cent Publ."},{"key":"pone.0297698.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-021-84302-w","article-title":"Global, regional and national epidemiology and prevalence of child stunting, wasting and underweight in low- and middle-income countries, 2006\u20132018.","volume":"11","author":"P Ssentongo","year":"2021","journal-title":"Sci Rep"},{"key":"pone.0297698.ref004","first-page":"1","article-title":"Levels and trends in child malnutrition: Key findings of the 2020 Edition of the Joint Child Malnutrition Estimates.","volume":"24","author":"WHO","year":"2020","journal-title":"Geneva WHO."},{"key":"pone.0297698.ref005","first-page":"vi","article-title":"Food and nutrition security in transforming Ghana: a descriptive analysis of national trends and regional patterns.","author":"O Ecker","year":"2017","journal-title":"IFPRI\u2014Discuss Pap"},{"key":"pone.0297698.ref006","volume-title":"Global Nutrition Report | Country Nutrition Profiles\u2014Global Nutrition Report.","author":"Global Nutrition Report","year":"2020"},{"key":"pone.0297698.ref007","article-title":"Nutrition Landscape Information System (NLiS) country profile indicators: interpretation guide, second edition. 2nd ed.","author":"World Health Organization","year":"2019","journal-title":"Nutrition landscape information system (NLIS) Country Profile."},{"key":"pone.0297698.ref008","volume-title":"Child Behavioral Health in Sub-Saharan Africa.","author":"A Lois","year":"2022","edition":"1"},{"key":"pone.0297698.ref009","first-page":"1","article-title":"Ghana: Nutrition Profile (Updated December 2021).","volume":"1","author":"USAID","year":"2021","journal-title":"Nutr Profile."},{"key":"pone.0297698.ref010","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/ajhb.22952","article-title":"Improved nutrition in the first 1000 days and adult human capital and health","volume":"29","author":"R. Martorell","year":"2017","journal-title":"Am J Hum Biol"},{"key":"pone.0297698.ref011","first-page":"1","article-title":"First 1000 days: The critical window to ensure that children survive and thrive","author":"UNICEF","year":"2017","journal-title":"Unicef"},{"key":"pone.0297698.ref012","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1017\/S1368980018000022","article-title":"Pragmatic implementation studies to improve nutrition practices and policies: Childcare during the first 1000 days as a contributor to long-term health.","volume":"21","author":"JL Walker","year":"2018","journal-title":"Public Health Nutr"},{"key":"pone.0297698.ref013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.heliyon.2017.e00298","article-title":"Dietary diversity and child malnutrition in Ghana.","volume":"3","author":"RB Frempong","year":"2017","journal-title":"Heliyon"},{"key":"pone.0297698.ref014","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pone.0219665","article-title":"The epidemiology of undernutrition and its determinants in children under five years in Ghana.","volume":"14","author":"M Boah","year":"2019","journal-title":"PLoS One"},{"key":"pone.0297698.ref015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1475-9276-6-21","article-title":"Malnutrition and the disproportional burden on the poor: The case of Ghana.","volume":"6","author":"E Van De Poel","year":"2007","journal-title":"Int J Equity Health."},{"key":"pone.0297698.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40795-017-0147-1","article-title":"The lancet series nutritional interventions in Ghana: A determinants analysis approach to inform nutrition strategic planning","volume":"3","author":"AE Yawson","year":"2017","journal-title":"BMC Nutr"},{"key":"pone.0297698.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/bmjopen-2021-059928","article-title":"Time trends in the prevalence and appropriate breast determinants of age- - 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Evaluating sex differences in growth, pathways and biocultural mechanisms","volume":"48","author":"AL Thompson","year":"2021","journal-title":"Ann Hum Biol"},{"key":"pone.0297698.ref052","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1093\/ajcn\/85.3.845","article-title":"Low birth weight is associated with altered immune function in rural Bangladeshi children: A birth cohort study","volume":"85","author":"R Raqib","year":"2007","journal-title":"Am J Clin Nutr"},{"key":"pone.0297698.ref053","first-page":"1","article-title":"Intrahousehold allocation, Household Headship and Nutrition of Under Fives: A study of Western Kenya.","volume":"15","author":"MS Mukhovi","year":"2015","journal-title":"African J Food Agric Nutr Dev."},{"key":"pone.0297698.ref054","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1758-5996-5-49","article-title":"Low birth weight: Causes and consequences.","volume":"5","author":"CA Negrato","year":"2013","journal-title":"Diabetol Metab Syndr"},{"key":"pone.0297698.ref055","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/mcn.12580","article-title":"Infant and young child feeding practices and nutritional status in Bhutan.","volume":"14","author":"RK Campbell","year":"2018","journal-title":"Matern Child Nutr"},{"key":"pone.0297698.ref056","article-title":"Dietary Risk Assessment in the WIC Program","author":"S Virginia","year":"2002"},{"key":"pone.0297698.ref057","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12937-020-00591-3","article-title":"Dietary habits associated with growth development of children aged < 5 years in the Nouna Health and Demographic Surveillance System, Burkina Faso.","volume":"19","author":"I Mank","year":"2020","journal-title":"Nutr J."},{"key":"pone.0297698.ref058","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1179\/2046905514Y.0000000155","article-title":"A child feeding index is superior to WHO IYCF indicators in explaining length-for-age Z-scores of young children in rural Cambodia.","volume":"35","author":"A Reinbott","year":"2015","journal-title":"Paediatr Int Child Health"},{"key":"pone.0297698.ref059","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12889-015-2494-7","article-title":"How well do WHO complementary feeding indicators relate to nutritional status of children aged 6\u201323 months in rural Northern Ghana?","volume":"15","author":"M Saaka","year":"2015","journal-title":"BMC Public Health."},{"key":"pone.0297698.ref060","first-page":"1","article-title":"Development of food-based dietary recommendations for children, 6\u201323 months old, in Karaga District and Gomoa East District, Ghana.","author":"ID Brouwer","year":"2017","journal-title":"Glob Alliance Improv Nutr."},{"key":"pone.0297698.ref061","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1016\/S2214-109X(19)30268-2","article-title":"The WASH Benefits and SHINE trials: interpretation of WASH intervention effects on linear growth and diarrhoea","volume":"7","author":"AJ Pickering","year":"2019","journal-title":"Lancet Glob Heal"},{"key":"pone.0297698.ref062","doi-asserted-by":"crossref","first-page":"902","DOI":"10.2166\/washdev.2021.005","article-title":"Linkages between environmental factors (Wash and energy) and infant and young child feeding practices in rural india: Implications for cross-sectoral interventions for child health.","volume":"11","author":"P Parikh","year":"2021","journal-title":"J Water Sanit Hyg Dev"},{"key":"pone.0297698.ref063","first-page":"29","volume-title":"The Burden of Malnutrition.","author":"The Global Nutrition Report","year":"2018"},{"key":"pone.0297698.ref064","volume-title":"ENUFF Proj Learn Br no 4","author":"SNV","year":"2020"},{"key":"pone.0297698.ref065","first-page":"1","volume-title":"Sanitation and Hygiene Applied Research for Equity (SHARE) and UNICEF.","author":"JE Mills","year":"2016"},{"key":"pone.0297698.ref066","first-page":"1","volume-title":"The Impact of Poor Sanitation on Nutrition","author":"UNICEF","year":"2014"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0297698","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T17:31:04Z","timestamp":1711647064000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0297698"}},"subtitle":[],"editor":[{"given":"Verda","family":"Salman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":66,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0297698","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,28]]}}}