Background: even if child undernutrition has come near zero in other WHO regions, the decline in sub-Sahara Africa (SSA) and South Asian countries is less encouraging. Moreover, child undernutrition is usually concentrated in the poorest segment of the population. In this study, we assessed the pattern of child undernutrition, the trend in socio-economic inequalities, and the possible predictors in Ethiopia, over the period between 2005 and 2016.

Method: in this study used the three consecutive survey data (2005, 2011, and 2016) from the Ethiopian Demographic and Health Survey. We first estimated trends of childhood stunting, underweight, and wasting from 2005 to 2016. We then calculated the rate differences to examine changes from 2005 to 2011 by household wealth status, education level and place of residence. We used concentration index and concentration curves to assess wealth related inequalities. Generalized Latent Linear Mixed Model (GLLMM) to identify predictor variables. We analysed the data using Stata 14.2 and SPSS version 25.0.

Result: a total of 23,934 mother-child pairs were obtained from the three consecutive survey. The prevalence of stunting decreased 12% from 50.8% in 2005 to 38.4% in 2016 and underweight 10% from 33.2% in 2005 to 23.7% in 2016. The prevalence of wasting was found to be steady with a marginal decline of 2%. The inequality in stunting, underweight, and wasting was statistically significant. The prevalence of stunting, underweight, and wasting showed higher declines among the richer and richest subgroups compared to the poorest and poorer subgroups. The wealth of the household and mother's level of education had a significant effect on the child's undernutrition in all the measures. Place of residence, on the other hand, has a significant effect on underweight only.

Conclusion: Despite the improvements in child undernutrition in terms of stunting and underweight, wasting is still a persistent problem in Ethiopia for the last two decades. Moreover, wealth-related inequality in child undernutrition is observed to be increasing for most of the indicators.