Determinants of Acute Malnutrition among Children 6-59 Months of Age Visiting Public Health Facilities in Dawe Kachen District, East Bale Zone, Oromia, Ethiopia: A Case Control Study

Abstract Background: Acute malnutrition in children is a life-threatening condition caused by a lack of nutrients and/or illness. Although a large number of acute malnutrition cases are reported in pastoral communities, only a few studies have been conducted on the determinants of acute malnutrition, especially during the drought season. Objectives The aim of this study was to identify determinants of acute malnutrition among children aged 6–59 months visiting public health facilities in the Dawe Kachen district, East Bale zone. Methods An institutional based, unmatched case‒control study was conducted from May to June 2022. A systematic random sampling technique was used to select 294 (98 cases and 196 controls) children aged 6–59 months. The data were collected using a structured questionnaire. Anthropometric data were analysed using the World Health Organization (WHO) Anthro version 3.2.2 tool. Bivariate and multivariate logistic regression models were used to identify factors independently associated with acute malnutrition. Finally, an adjusted odds ratio (OR) at a P value < 0.05 was considered to indicate an independent predictor of acute malnutrition. Results In this study, 294 children (98 patients and 196 controls) with mothers/caregivers were recruited, for a response rate of 100%. Family size ≥ 6(AOR = 3.117; 95% CI: 1.415–6.863), child age (6–11 months) (AOR = 4.945; 95% CI: 1.754–13.943), low dietary diversity score (AOR = 2.765; 95% CI: 1.479–5.168), children whose mother/caregivers have not received infant and young child feeding (IYCF) counselling (AOR = 7.911; 95% CI: 3.680–17.003), children who were initiated complementary feeding before or after six months of age (AOR = 1.966; 95% CI: 1.029–3.758), children who were late initiated breastfeeding after birth (AOR = 2.881; 95% CI: 1.510–5.499), children from household with poor wealth status and medium wealth status (AOR = 2.273; 95% CI: 1.064–4.857), (AOR = 4.057; 95% CI: 1.808–9.105), respectively, and children who had diarrhea two weeks prior to the survey (AOR = 2.519; 95% CI: 1.326–4.783) were found to be the independent predictors of acute malnutrition. Conclusion In the present study, family size ≥ 6, low dietary diversity score, child age (6–11 months), lack of IYCF counselling, late initiation of breastfeeding after birth, starting complementary feeding before and after 6 months, household wealth status, and diarrheal disease were identified as determinants of acute malnutrition in the study area. Nutritional education should be provided to the community continuously, based on nutritional activities that were previously incorporated into health extension packages. Creating awareness of family planning methods and the accessibility of methods at the HH level