A multilevel analysis of individual, household and community level factors on stunting among children aged 6-59 months in Eswatini: A secondary analysis of the Eswatini 2010 and 2014 Multiple Indicator Cluster Surveys

Introduction Child stunting is a significant public health problem in Eswatini. It is associated with a range of child health outcomes, including morbidity, physical and cognitive growth. Objective To determine the individual, household, and community-level factors associated with child stunting in Eswatini in 2010 and 2014. Methods Using the Eswatini Multiple Indicator Cluster Surveys conducted in 2010 and 2014, a secondary analysis was done of the children surveyed, aged 6-59 months. A total of 1,891 were surveyed in 2010, and 1,963 children in 2014. Univariate, bivariable analysis and multivariable multilevel logistic regression were used to establish the factors associated with stunting. Results The study found that stunting decreased significantly between 2010 and 2014, from 31.4% to 25.5% (p<0.001). In both 2010 and 2014, lower odds of stunting were observed among female children, in children born to women with tertiary education compared to those born to women with no formal education. Lower odds of stunting were observed among children from rich households compared to poorest households. In both 2010 and 2014, increased odds of stunting were observed among children aged 12-23, 24-35 and 36-47 months compared to children aged 6-11 months. At the household level, higher odds of stunting were observed among children from households with two and more children under five years of age compared to those with only one child and in 2010, among children from households with a pit latrine and no toilet facility compared to households with a flush toilet. At the community level, in 2010, higher odds of stunting were observed among children from the Shiselweni compared to those from the Lubombo region. Conclusion The findings highlight the individual, household, and community-level factors significantly associated with stunting and the changes between the two surveys.