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Neonatal and Pediatric Medicine
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  • Review Article   
  • Neonat Pediatr Med, Vol 7(6)
  • DOI: 10.4172/2572-4983.1000216

A Systematic Review and Meta-Analysis on Employment Status of Mothers and Acute Malnutrition among Under Five Children in Ethiopia

Kaleab Tesfaye Tegegne1*, Eleni Tesfaye Tegegne2 and Mekibib Kassa Tessema3
1Department of Public Health, Hawassa College of Health Science, Hawassa, Ethiopia
2Department of Medicine and Health Science, School of Nursing, University of Gondar, Gondar, Ethiopia
3Department Leishmania Research and Treatment Center, University of Gondar, Gondar, Ethiopia
*Corresponding Author: Kaleab Tesfaye Tegegne, Department of Public Health, Hawassa College of Health Science, Hawassa, Ethiopia, Email: kaleabtesfaye35@gmail.com

Received: 28-May-2021 / Accepted Date: 11-Jun-2021 / Published Date: 18-Jun-2021 DOI: 10.4172/2572-4983.1000216

Abstract

The objective of this meta-analysis was to determine the association between Employment status of mothers and acute malnutrition among under five children in Ethiopia.Using data from 11 studies in Ethiopia we performed a meta- analysis with a specific focus on acute malnutrition among under five children.

We applied a random effects analytic model and calculated a pooled odds ratio.Electronic databases were searched on reference manager software and quality assessment of the included studies was performed. using assessment of risk of bias tool. The funnel plot shows that there is no publication bias as Egger Regression p value is 0.882 and Begg and Mazumdar p-value is 0.815. The odds ratios for all studies revealed no statistically significant association of Acute Malnutrition among under five children with employed mothers compared to house wife mothers OR MH, Random, 95% CI, 0.93, (0.66, 1.32) Heterogeneity Tau²=0.26; Chi²=50.14, DF=10 (P<0.00001); I²=80% Test for overall effect: Z=0.39 (P=0.70) A total of 5301 under five children included in our systematic review and meta-analysis. The proportion of acute malnutrition among employed mothers is 26.1% (484) and among house wife mothers is 24% (825). Our findings suggest that employment status of mothers has not statistically significant association with acute malnutrition among under five children in Ethiopia.

Keywords: Acute malnutrition ; Employment ; Children ; Electronic databases

Introduction

Acute malnutrition is a recent and severe weight loss (wasting) as a result of acute food shortage and/or illness and is measured by weight for height or Mid Upper Arm Circumference (MUAC) [1].

Malnutrition is associated with more than half of all child mortality worldwide [2].

Malnutrition is a serious problem in the world; currently, 195 million under-five children are affected by malnutrition globally; 55 million of them suffer from acute malnutrition and around 26 million under-five children are severely acute malnourished. Among the total under-five children suffering from malnutrition, 90% lives in sub-Saharan Africa and South Asia. Every year, 3.5 million children die of malnutrition- related causes in the world [3,4]. Hence, it is at third level in the world of the disease burden in this age group [5].

In sub-Saharan Africa, the prevalence of stunting is declining but remains over 30% [6]. Among sub-Saharan countries, the prevalence of wasting in Ethiopia is 10%, and the prevalence of stunting is 38% [7].

Many studies in developing countries including Ethiopia showed that household characteristics like income [8-12], less access to health service, [9-11], household head [9-11], lack of toilet, [13,14] mothers’ education, [15,16], paternal education [17], hand washing, [18-20], household food insecurity [21,20], poor exclusive breast feeding [21,22] and number of under-five children or family size [23,24], has explained the occurrence of acute malnutrition.

The aim of this systematic review and meta-analysis is to determine the association between Employment status of mothers and acute malnutrition in children in Ethiopia.

Thus, this finding will be used as a source of information on the association between employment status of mothers and acute malnutrition among under five children in Ethiopia (Table 1).

S. No. Article Mother occupation / Employment status   Acute malnutrition   
      yes No
1 Tut Wie and Tsegaye  Housewife/Unemployed 85 115
    Employed /Others 23 113
2 Gebremeskel. F et al. Housewife/Unemployed 24 49
    Employed /Others 90 180
3 Gizaw, Z. et al. Housewife/Unemployed 63 496
    Employed /Others 7 25
4 Ahmed Tahir et al.  Housewife/Unemployed 37 75
    Employed /Others 45 89
5 Nebro  Damtew  et al. Housewife/Unemployed 24 55
    Employed /Others  80 152
6 Abuka T, et al. Housewife/Unemployed 102 235
    Employed /Others 49 65
7 Liben Legesse et al.  Housewife/Unemployed 37 187
    Employed /Others 14 132
8 Wondafrash M, et al. Housewife/Unemployed 38 246
    Employed /Others  15 263
9 Gebre A, et al. Housewife/Unemployed 103 575
    Employed /Others 33 129
10 Seid A, et al. Housewife/Unemployed 87 191
    Employed /Others 53 89
11 Agedew.E et al. Housewife/Unemployed 225 395
    Employed /Others 75 136

Table 1: Employment status of mothers and acute malnutrition among under five children in Ethiopia.

Methodology

Electronic databases were searched on reference manager software and quality assessment of the included studies was performed. Using assessment of risk of bias tool.

A meta-analysis was applied to determine the effect of mother’s employment status on acute malnutrition among fewer than five children in Ethiopia.

Words used to search related literatures on the topic were ‘Acute Malnutrition’, ‘Employment status of mothers in Ethiopia, Determinants of Acute Malnutrition in Ethiopia’ were used.

Study selection

The PRISMA statement [25] for the reporting of systematic reviews recommended by the Cochrane Collaboration was followed while conducting this meta-analysis (Figure 1).

diagram

Figure 1: Study flow diagram.

The first searching of databases results in 1008 articles.

After removing duplicates, we have got 184 studies on acute malnutrition among fewer than five children in Ethiopia.

Forty five [26] full-text articles assessed for eligibility and 11 studies met the inclusion criteria.

The rest were excluded due to studies not assess employment status of mothers and acute malnutrition among under five children in Ethiopia.

Results

Using data from 11 studies in Ethiopia we performed a meta- analysis with a specific focus on acute malnutrition among under five children.

We applied a random effects analytic model and calculated a pooled odds ratio.

The meta-analysis is done using RevMan software version 5.3 and meta essential software.

When we see the employment status of mothers, 35% (1857) employed mothers and 65% (3444) house wife mothers were included in this study.

The proportion of acute malnutrition among employed mothers is 26.1% (484) and among house wife mothers is 24% (825).

Meta-analysis

The odds ratios for all studies revealed no statistically significant association of Acute Malnutrition among under five children with employed mothers compared to house wife mothers.

OR MH, Random, 95% CI, 0.93, (0.66, 1.32)

Heterogeneity Tau²=0.26; Chi²=50.14, DF=10 (P<0.00001); I²=80%

Test for overall effect: Z=0.39 (P=0.70) (Figures 2-5).

employment

Figure 2: The association between employment status of mothers and acute malnutrition among under five children in Ethiopia.

children

Figure 3: Abbe plot for the association between employment status of mothers and acute malnutrition among under five children in Ethiopia.

Ethiopia

Figure 4: Galbraith plot for the association between employment status of mothers and acute malnutrition among under five children in Ethiopia.

employment

Figure 5: Funnel plot for the association between employment status of mothers and acute malnutrition among under five children in Ethiopia.

The Abbe plot shows that 3 studies are above zero effect and the rest below zero effect. Galbraith plot shows that 95% of the studies are within the range of two-color lines and there is no outlier of effect size.

The funnel plot shows that there is no publication bias as Egger Regression p value is 0.882 and Begg and Mazumdar p value is 0.815 (Table 2).

Egger regression
  Estimate SE CI LL CI UL
Intercept 0.81 5.28 -10.97 12.58
Slope -0.34 2.67 -6.28 5.6
t test 0.15      
p-value 0.882      
Begg and Mazumdar        
?x-y 3      
Kendall's Tau a 0.05      
Z 0.23      
P 0.815      

Table 2: The funnel plot shows that there is no publication bias as Egger regression p value is 0.882, Begg and Mazumdar p-value is 0.815.

Discussion

This systematic review and meta-analysis show that there is no statistical significant association between employment status of mothers and acute malnutrition among under five children in Ethiopia and this finding is similar with previous studies Wolayta Sodo Town [26], Konso, Southern Ethiopia, [27], Afar Region, Northeast Ethiopia [28], Karat Town Public Health Facilities, Southern Ethiopia [29], Hadaleala district, Afar region, northeast Ethiopia [30], analysis of the 2016 Ethiopia demographic and health survey [31] two Public Hospitals, North West Ethiopia [32].

The explanation for our finding may be majority of mothers have maternal leave and children get the same care by employed and house wife mothers.

This finding is not similar with previous studies Gedeo Zone, Ethiopia [33] Ethiopia [34].Ekpoma, Edo-Nigeria [35], Mazowe District of Zimbabwe [36], Adama Town, Central Ethiopia. [37], in Tanzania [38], in Addis Ababa [39], Chapel Hilly, Job Arket Paper [40], in Nghean Vietnam [41], in Aydyn, a western city of Turkey [42-44].

The explanation for the observed differences in the findings of our study and other previous studies may be difference in sample size and geographic variations.

Conclusion

Our findings suggest that employment status of mothers has not statistical significant association with acute malnutrition among under five children in Ethiopia.

Authors’ Contributions

Kaleab Tesfaye Tegegne, ElenI Tesfaye Tegegne and Mekibib Kassa Tessema was responsible for conceptualization, project administration, software, supervision, and development of the original drafting of the manuscript.

Kaleab Tesfaye Tegegne,, ElenI Tesfaye Tegegne and Mekibib Kassa Tessema were participated in quality assessment of articles, methodology, validation, and screening of research papers.

All authors contributed with data analysis, critically revised the paper, and agreed to be accountable for their contribution.

Acknowledgements

We would like to thank all the primary authors of the included articles.

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Citation: Tegegne KT, Tegegne ET, Tessema MK (2021) A Systematic Review and Meta-Analysis on Employment Status of Mothers and Acute Malnutrition among Under Five Children in Ethiopia. Neonat Pediatr Med 7:216. DOI: 10.4172/2572-4983.1000216

Copyright: © 2021 Tegegne KT, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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