THE BURDEN AND TRENDS OF CHILD AND MATERNAL MALNUTRITION ACROSS THE SUBNATIONAL STATES OF ETHIOPIA: THE GLOBAL BURDEN OF DISEASE STUDY 1990–2019

Introduction: The national prevalence of stunting, wasting and underweight in Ethiopia has been decreasing but still high. Maternal under nutrition in Ethiopia is high and has declined over the past 16 years, from 30% in 2000 to 22% in 2016. The aim of this paper was to assess the child and maternal disease burden due to malnutrition and its trends between 1990 and 2019 at the national and subnational levels of Ethiopia.

Method: The National Data Management Center for health’s research team at the Ethiopian Public Health Institute has analysed the Global Burden of Disease (GBD) 2019 secondary data for the year 1990 to 2019 for Ethiopia and its subnational states. The trends, prevalence and Disability Adjusted Life Years (DALY) rates of child malnutrition indicators in Ethiopia and subnational sates from 1990 to 2019 were calculated. Anaemia prevalence and percentage changes were reported with corresponding 95% confidence intervals.

Result: Ethiopia recorded slow progress in child and maternal malnutrition reduction from 1990 to 2019. The DALY rate attributable to child malnutrion was more than 250,000 per 100,000 in 1990 which was higher compared to the sub-Saharan Africa average and from the global average which has shown decrement from 1990 to 2019. The national prevalence of wasting was 7% with DALY rate of 135,161 (95% UI: 103,066- 178,131) in 2019.  The DALY rate of stunting in Ethiopia was 40143 (95% UI: 20776 – 70013) in 1990 and 3290 (95% UI: 1443 – 5856) in 2019 and has shown significant decrease between the 1990 and 2019 in Ethiopia and all the subnational states. Gambella region showed 89 % change rate for stunting, 71 % for wasting and 81 % for underweight significant reduction between 1990 and 2019. The prevalence of anaemia in children age < 5 years in Ethiopia was 62 % (95% UI, 59.1% - 65.1%) in 2019 and did not show significant decrease between 1990 and 2019. Somali was the highest prevalent subnational state compared to others which was 84.4% (95% UI: 79.8% -88.8%).

Conclusion: The prevalence of child malnutrition was still high in its all indicators after several interventions in the last 2 decades. The DALY rate of child malnutrition indicators is high with subnational variations and the prevalence of anaemia in children and women is high in all subnational states in Ethiopia.

Keywords: Ethiopia, subnational states, child malnutrition, maternal malnutrition, stunting prevalence, wasting prevalence, underweight prevalence, anaemia prevalence, DALY rate