Application of Adjacent Categories and Continuation Ratio Logit Models in Determining Factors Influencing Malnutrition in Children Living in the Eastern Part of Freetown, Sierra Leone

Malnutrition in children under five years of age remains a problem in many part of the world especially in Africa of which Sierra Leone is not an exception. In Sierra Leone, the magnitude of stunting, underweight and wasting in children less than five years increases tremendously in the rural areas, especially in the raining season. Child growth is nationally and internationally recognized as a principal indicator of the nutritional and health status of the populations of a country. Therefore, identifying the main factors associated with childhood malnutrition can help to inform and advice both Government and other national health agencies to implement policies that will help to alleviate or minimize the incidence in the country. No research have been conducted especially after the 5 years Sierra Leone rebel war, to particularly investigate the factors influencing malnutrition in under-five children living in this part of the country. This research work, therefore, aimed to identify the main factors influencing malnutrition in under-five children living in the eastern part of the capital city of Sierra Leone. A random sampling method was used to collect 500 observations from the study area. An ordinal logistic regression modelling techniques that involved the proportional odds; the non-proportional odds adjacent categories and the non-proportional odds forward continuation ratio logit models were used in the empirical analysis. Statistical tests showed that, the non-proportional odds adjacent category model outperformed both the proportional odds and the non-proportional odds continuation ratio models. Based on the empirical evidence, the mother’s age, the family income level and the number of post-natal hospital visits were the main factors influencing the malnutrition status of the under-five children living the study area. The child’s age and the child’s feeding status were also found to be significant determinants of under-five children malnutrition status. Malnutrition increases in under-five children from younger mothers, as compared to under-five children from older mothers. The more frequent, the number of post-natal hospital visit, the lower the malnutrition status of the under-five children. Similarly, increase in family income will reduce the incidence of malnutrition in under-five children. Also, malnutrition increases in older children as compared to younger children. Finally, the higher the quality and frequency of child’s feed, the lower the incidence of malnutrition in under-five children.