Use of Generalized Linear Mixed Effects Model in the Analysis of Wasting Among Under Five Years Children in Marsabit County, Kenya

Abstract

Malnutrition has continued to remain as one of the leading cause of mortality among under five year’s children in developing countries. The most affected region has been the sub-Saharan Africa where there is deficiency of adequate diet. The study targeted 451 respondents of children less than five years from both North-Horr and Laisamis Sub Counties in Marsabit County. The current study utilized retrospective data from the SMART Survey of July 2019 in Marsabit County, Kenya. The study employed use of generalized linear mixed effects model with childhood wasting being the outcome variable of interest. Results showed that 29.3 percent of the children were acutely malnourished while 70.7 percent were generally healthy. Factors such as the age of caregivers, the gender of the child, and the level of education of caregivers, if the child was weighed at birth, source of income, the occupation status, and the distance to the water source remained insignificant at a multivariate level. However, factors such as full-term maternal pregnancy, and persistent childhood illness for the past two weeks, were strong significant factors affecting the status of childhood wasting while controlling for site as a random factor. Moreover, mothers whose pregnancy was not term were 1.942 times more likely to have malnourished infants when compared to their counterparts who had full-term pregnancy [AOR=1.942, 95% CI=1.125-3.353]. Caregivers whose infants were not ill in the past two weeks were 52.4% less likely to be malnourished in comparison to infants with known past illnesses [AOR=0.476, 95% CI=0.303-0.748]. The estimated residual variance for measuring correlation between the study sites was 0.0297. Thus, the current study makes recommendations that maternal policymakers should improve both pre and postnatal care facilities for mothers in the reproductive age-groups so as to improve on the infants’ survival status within all the counties in Kenya.