TY - JOUR
T1 - Multilevel and spatial analyses of childhood malnutrition in Uganda
T2 - examining individual and contextual factors
AU - Amegbor, Prince M.
AU - Zhang, Zhaoxi
AU - Dalgaard, Rikke
AU - Sabel, Clive E.
N1 - Funding Information:
This study was supported by BERTHA—the Danish Big Data Centre for Environment and Health funded by the Novo Nordisk Foundation Challenge Programme (grant NNF17OC0027864).
Funding Information:
We are also grateful to the USAID DHS program, Uganda Bureau of Statistics (UBOS) and ICF for the data used in this study. BERTHA is an interdisciplinary research centre funded by the Novo Nordisk Foundation.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12
Y1 - 2020/12
N2 - In this study, we examine the concepts of spatial dependence and spatial heterogeneity in the effect of macro-level and micro-level factors on stunting among children aged under five in Uganda. We conducted a cross-sectional analysis of 3624 Ugandan children aged under five, using data from the 2016 Ugandan Demographic and Health Survey. Multilevel mixed-effect analysis, spatial regression methods and multi-scale geographically weight regression (MGWR) analysis were employed to examine the association between our predictors and stunting as well as to analyse spatial dependence and variability in the association. Approximately 28% of children were stunted. In the multilevel analysis, the effect of drought, diurnal temperature and livestock per km2 on stunting was modified by child, parent and household factors. Likewise, the contextual factors had a modifiable effect on the association between child’s sex, mother’s education and stunting. The results of the spatial regression models indicate a significant spatial error dependence in the residuals. The MGWR suggests rainfall and diurnal temperature had spatial varying associations with stunting. The spatial heterogeneity of rainfall and diurnal temperature as predictors of stunting suggest some areas in Uganda might be more sensitive to variability in these climatic conditions in relation to stunting than others.
AB - In this study, we examine the concepts of spatial dependence and spatial heterogeneity in the effect of macro-level and micro-level factors on stunting among children aged under five in Uganda. We conducted a cross-sectional analysis of 3624 Ugandan children aged under five, using data from the 2016 Ugandan Demographic and Health Survey. Multilevel mixed-effect analysis, spatial regression methods and multi-scale geographically weight regression (MGWR) analysis were employed to examine the association between our predictors and stunting as well as to analyse spatial dependence and variability in the association. Approximately 28% of children were stunted. In the multilevel analysis, the effect of drought, diurnal temperature and livestock per km2 on stunting was modified by child, parent and household factors. Likewise, the contextual factors had a modifiable effect on the association between child’s sex, mother’s education and stunting. The results of the spatial regression models indicate a significant spatial error dependence in the residuals. The MGWR suggests rainfall and diurnal temperature had spatial varying associations with stunting. The spatial heterogeneity of rainfall and diurnal temperature as predictors of stunting suggest some areas in Uganda might be more sensitive to variability in these climatic conditions in relation to stunting than others.
UR - http://www.scopus.com/inward/record.url?scp=85096183172&partnerID=8YFLogxK
U2 - 10.1038/s41598-020-76856-y
DO - 10.1038/s41598-020-76856-y
M3 - Article
C2 - 33208763
AN - SCOPUS:85096183172
SN - 2045-2322
VL - 10
SP - 1
EP - 15
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 20019
ER -
