In the present study, the prevalence of stunting, underweight and wasting were 27.4%, 28.7% and 22.7%, respectively. In this study, stunting is lower than the studies conducted in in Ethiopia (38.3%) [25], in Shabelle zone, Somali region (30.4%) [31], in Shinille District (33.4%) [32], in Tigray region 39.1% [5] and Takusa district 36.5% [33]. The prevalence of underweight in this finding is higher the studies conducted in Ethiopia (23.3%) [25], in Tigray (23.9%) [5], Dale district19% [34] and Takusa district 19.5% [33]. This figure is lower than the previously reported stunting (46.9%) and underweight (33%), but higher than wasting (11.6%), and in Tigray region [17]. A similar study conducted in Nairobi Peri-Urban Slum reported a higher prevalence of stunting (30.2%) but lower underweight (14.9%) [35]. Similar studies conducted in Ethiopia reported a higher prevalence of stunting (46.3%), the comparable prevalence of underweight (28.4%), but lower prevalence of wasting (9.8%) [36]. This might be due to the fact that there is a difference in barriers to under-nutrition such as cultural difference and other socio-demographic characteristics.
The prevalence of wasting in this study is higher compared to the study conducted in Ethiopia 10.1% [25], in Haramaya district 10.7% [37], in Dale district 14% (32), in Tigray region [5] in Pakistan 10.7% [38] and Nairobi Peri-Urban slum 4.5% [35]. This divergence might be due to the difference in socioeconomic background, variation in sample size, dietary habits and type of meals among the study population. Similar studies conducted in Hidabu Abote District in the Oromia region reported a higher prevalence of stunting (47.6%) and underweight (30.9%), but a lower prevalence of wasting (16.7%) [39]. A study conducted in rural Ethiopia also reported a higher finding 41.2% of stunting, but a lower finding 27% of underweight [40], whereas a study conducted in Nigeria reported a higher prevalence of stunting 47.6% but a lower prevalence of underweight 25.6% [41]. While a study in the Bure Town of West Gojjam Zone (Amhara region) [42] reported a lower prevalence of stunting, underweight and wasting (24.9%, 14.30% and 11.1%, respectively). A similar study in east Gojjam Zone [43] reported lower prevalence of underweight (15.3%) and wasting (10%), but higher stunting (44.7%). This could be due to there is a difference in obstacles to under-nutrition such as cultural differences and other socio-demographic characteristics.
Almost 16.1% of children were both stunted and underweight; the proportion of underweight and wasting was 11.7%, the proportion of stunted and wasted was 5.5%, and all three malnutrition conditions were only 4.7% children. The prevalence of both underweight and wasting at this finding is higher than the study finding in Amhara region (7.3%) [44]. The prevalence of both stunted and underweight at this study is lower than compared to the study conducted in Ethiopia 19.47% [25] and Amhara region (23.1%) [44], but much higher than the study conducted in Kilimanjaro Region, Tanzania 33% [45]. The prevalence of all the three conditions at this finding is lower than the study conducted in Amhara region (4.5%) [44], in Kilimanjaro Region, Tanzania 12% [45], but higher than in Ethiopia 3.87% [25]. The variation might be due to socioeconomic background, geographical characteristics of the study area, access to health care, cultural difference in dietary habits and care practices.
According to the multivariable logistic regression analysis, the age of a child, type of birth, toilet facility and anemia level was significantly associated with being stunted. The risk of being stunted was 1.94 and 1.66 times more likely among children that were aged 25–47 and 48–59 as compared to those aged 0–24 months, respectively. This finding is in line with the studies conducted in Ethiopia [25], in Haramaya district [37], in Pakistan [38], in Amhara region [44] and in Kilimanjaro Region, Tanzania [45], but against the study conducted in Tigray region [5]. This might be because as children’s’ growth older, they may have fewer access attentions and not provide sufficient food from their families. Male children were 0.23 times less likely to be stunted as compared to female children. This result is in agreement with the study conducted in Bule Hora district, South Ethiopia [46], but in contradiction the studies conducted in Tigray region [5] and Pakistan [38]. The odds of stunting among children who were born in multi birth types were 2.86 times higher as compared to those born in single birth type. This finding is consistent with the study carried out in Tigray region [5]. The reason behind might be in multi birth type, there could be food competition between children and it leads to malnutrition; and the mothers’ breasts may not produce enough milk for both children.
Children from the household who had not toilet facility were 1.45 times more likely to be stunted as compared to the children household who had a toilet facility. This result is in contradiction with the studies conducted in Tigray region [5] and in Bule Hora district, South Ethiopia [46]. This might be since lack of toilet facility is the main cause for intestinal parasites and microorganisms which leads to loss of appetite leading to poor nutritional status; this might repeated infection causes depressed immunity and making the severity and duration of disease more sever contributing to the poor nutritional status of the children. Children born from the medium and rich households were 0.44 and 0.22 times less likely to develop stunting as compared to those born from poor households. This fining supported with the literature reported that the poor wealth index is strongly correlated with under-five stunting [5, 42, 47–49]. The possible explanation for this might be mothers from households having the rich or middle wealth status were more likely to provide micronutrients in reached foods and seek medical treatment for their children. Being stunted of anemic children was 2.36 times more likely to be stunted as compared to non-anemic children. This finding has supported the study conducted in Ethiopia [25]. This is because the anemia causes the children to reduce feed intake and leads to malnutrition.
The children who were 25–47 and 48–59 aged groups were 1.67 and 1.70 times more likely to develop underweight as compared to those who were 0–24 aged groups. This finding is supported by the study conducted in Ethiopia [25], but in contradiction the study conducted in Tigray region [5] and Pakistan [38]. This might be due to the fact that as children’s’ growth older, they may have less access to attentions and not provide sufficient food from their families. Compared to children large size at birth, the odds of underweight among children in the medium and small size at birth were 1.17 and 1.55 times higher. This study is in line with the study conducted in Tigray region [5] and in Pakistan [38]. The odds of being wasting were 0.11 times lower among female children than male children. Our results showed that male children were more likely to be stunted as compared to female children. The finding is consistent with the previous research reported that male children are more vulnerable to develop malnutrition because they require comparatively more calories for growth and development [50]. One of the reasons for low caloric intake in children is their low socioeconomic status as observed in our study. The anemic children were 1.65 times more likely to be underweight as compared to non-anemic children.
The results of the adjusted showed that male children were 0.35 times less likely to be wasting compared to female children. This finding is consistent with finding in Tigray region [5], but against in previous studies indicated that boys had a significantly worse nutritional status than girls [5]. The risk of being wasting among children who were from underweight and normal-weight mothers were 1.64 and 1.38 times higher compared to those born from overweight mothers. This study is in line with findings in Pakistan [38], in Ethiopia [25], in India [51] and Vietnam [52]. This finding is also similar to other previously conducted studies [37, 53]. The children who had small size at birth were 1.58 times more likely to be wasting compared to those who had large size at birth. This result is supported by the study conducted in Tigray region [5]. Children whose household used unimproved water were 1.66 times more likely to be wasting as compared to the children household used improved water. This finding is supported with finding in Haramaya district, Eastern Ethiopia [37]. This might be because impure water is a vehicle for intestinal parasites which leads to loss of appetite leading to poor nutritional status; this might repeated infection causes depressed immunity and making the severity and duration of disease more sever contributing to the poor nutritional status of the children.