{"id":"https://openalex.org/W7203756442","doi":"https://doi.org/10.21203/rs.3.rs-10741256/v1","title":"Spatial Patterns and Determinants of Childhood Stunting in Ethiopia: A multilevel analysis of the 2024\u20132025 Ethiopia Demographic and Health Survey","display_name":"Spatial Patterns and Determinants of Childhood Stunting in Ethiopia: A multilevel analysis of the 2024\u20132025 Ethiopia Demographic and Health Survey","publication_year":2026,"publication_date":"2026-08-19","ids":{"openalex":"https://openalex.org/W7203756442","doi":"https://doi.org/10.21203/rs.3.rs-10741256/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-10741256/v1","doi":"https://doi.org/10.21203/rs.3.rs-10741256/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10741256/v1","pdf_url":"https://www.researchsquare.com/article/rs-10741256/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-10741256/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5067645488","display_name":"Solomon Gebretsadik","orcid":"https://orcid.org/0000-0002-6182-3620","observed_orcids":["https://orcid.org/0000-0002-6182-3620"]},"institutions":[{"id":"https://openalex.org/I4400600922","display_name":"Arsi University","ror":"https://ror.org/04s6kmw55","country_code":"ET","type":"education","lineage":["https://openalex.org/I4400600922"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Solomon Gebretsadik","raw_affiliation_strings":["Arsi University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Arsi University","institution_ids":["https://openalex.org/I4400600922"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063346215","display_name":"Maleda Tefera","orcid":"https://orcid.org/0000-0002-3014-0325","observed_orcids":["https://orcid.org/0000-0002-3014-0325"]},"institutions":[{"id":"https://openalex.org/I153487414","display_name":"Haramaya University","ror":"https://ror.org/059yk7s89","country_code":"ET","type":"education","lineage":["https://openalex.org/I153487414"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Maleda Tefera","raw_affiliation_strings":["School of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"School of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia","institution_ids":["https://openalex.org/I153487414"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5147595133","display_name":"Jibril Beshir Jemal","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4400600922","display_name":"Arsi University","ror":"https://ror.org/04s6kmw55","country_code":"ET","type":"education","lineage":["https://openalex.org/I4400600922"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Jibril Beshir Jemal","raw_affiliation_strings":["Arsi University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Arsi University","institution_ids":["https://openalex.org/I4400600922"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040516623","display_name":"Haji Aman Deybasso","orcid":"https://orcid.org/0000-0003-1441-3300","observed_orcids":["https://orcid.org/0000-0003-1441-3300"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Haji Aman Deybasso","raw_affiliation_strings":["FHI 360/ Alive and thrive"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"FHI 360/ Alive and thrive","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5040899284","display_name":"Roba Argaw Tessema","orcid":"https://orcid.org/0000-0001-8734-4030","observed_orcids":["https://orcid.org/0000-0001-8734-4030"]},"institutions":[{"id":"https://openalex.org/I153487414","display_name":"Haramaya University","ror":"https://ror.org/059yk7s89","country_code":"ET","type":"education","lineage":["https://openalex.org/I153487414"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Roba Argaw","raw_affiliation_strings":["Haramaya University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Haramaya University","institution_ids":["https://openalex.org/I153487414"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5127085363","display_name":"Marta A. Kisiel","orcid":"https://orcid.org/0000-0002-0410-1509","observed_orcids":["https://orcid.org/0000-0002-0410-1509"]},"institutions":[{"id":"https://openalex.org/I187531555","display_name":"Lund University","ror":"https://ror.org/012a77v79","country_code":"SE","type":"education","lineage":["https://openalex.org/I187531555"]}],"countries":["SE"],"is_corresponding":false,"raw_author_name":"Marta A. Kisiel","raw_affiliation_strings":["Lund University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Lund University","institution_ids":["https://openalex.org/I187531555"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015111963","display_name":"Kedir Teji Roba","orcid":"https://orcid.org/0000-0001-6227-9594","observed_orcids":["https://orcid.org/0000-0001-6227-9594","https://orcid.org/0000-0002-0805-3460"]},"institutions":[{"id":"https://openalex.org/I153487414","display_name":"Haramaya University","ror":"https://ror.org/059yk7s89","country_code":"ET","type":"education","lineage":["https://openalex.org/I153487414"]}],"countries":["ET"],"is_corresponding":false,"raw_author_name":"Kedir Teji Roba","raw_affiliation_strings":["Haramaya University"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Haramaya University","institution_ids":["https://openalex.org/I153487414"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5112354512","display_name":"Hassan Vatanparast","orcid":"https://orcid.org/0000-0003-2621-8385","observed_orcids":["https://orcid.org/0000-0003-2621-8385"]},"institutions":[{"id":"https://openalex.org/I32625721","display_name":"University of Saskatchewan","ror":"https://ror.org/010x8gc63","country_code":"CA","type":"education","lineage":["https://openalex.org/I32625721"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Hassan Vatanparast","raw_affiliation_strings":["University of Saskatchewan"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Saskatchewan","institution_ids":["https://openalex.org/I32625721"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":4,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10596","display_name":"Child Nutrition and Water Access","score":0.8726000189781189,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10596","display_name":"Child Nutrition and Water Access","score":0.8726000189781189,"subfield":{"id":"https://openalex.org/subfields/2916","display_name":"Nutrition and Dietetics"},"field":{"id":"https://openalex.org/fields/29","display_name":"Nursing"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T14495","display_name":"Public Health and Nutrition","score":0.11469999700784683,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10209","display_name":"Global Maternal and Child Health","score":0.010300000198185444,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/child-stunting","display_name":"child stunting","score":0.9929999709129333},{"id":"https://openalex.org/keywords/ethiopia","display_name":"Ethiopia","score":0.781000018119812},{"id":"https://openalex.org/keywords/spatial-clustering","display_name":"spatial clustering","score":0.8999999761581421},{"id":"https://openalex.org/keywords/regional-variation","display_name":"regional variation","score":0.796999990940094},{"id":"https://openalex.org/keywords/determinants-of-stunting","display_name":"determinants of stunting","score":0.8479999899864197},{"id":"https://openalex.org/keywords/maternal-education","display_name":"maternal education","score":0.8190000057220459},{"id":"https://openalex.org/keywords/household-wealth","display_name":"household wealth","score":0.7590000033378601},{"id":"https://openalex.org/keywords/birth-size","display_name":"birth size","score":0.7860000133514404},{"id":"https://openalex.org/keywords/water-and-sanitation-access","display_name":"water and sanitation access","score":0.8180000185966492},{"id":"https://openalex.org/keywords/child-nutrition","display_name":"child nutrition","score":0.4650000035762787}],"concepts":[{"id":"https://openalex.org/C53059260","wikidata":"https://www.wikidata.org/wiki/Q374758","display_name":"Multilevel model","level":2,"score":0.7458999752998352},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.6022999882698059},{"id":"https://openalex.org/C147077947","wikidata":"https://www.wikidata.org/wiki/Q1515895","display_name":"Socioeconomic status","level":3,"score":0.5530999898910522},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.5526999831199646},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.5376999974250793},{"id":"https://openalex.org/C158709400","wikidata":"https://www.wikidata.org/wiki/Q3578586","display_name":"Spatial ecology","level":2,"score":0.525600016117096},{"id":"https://openalex.org/C2780151969","wikidata":"https://www.wikidata.org/wiki/Q949149","display_name":"Sanitation","level":2,"score":0.5253999829292297},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.5206999778747559},{"id":"https://openalex.org/C164866538","wikidata":"https://www.wikidata.org/wiki/Q367351","display_name":"Cluster (spacecraft)","level":2,"score":0.5085999965667725},{"id":"https://openalex.org/C159620131","wikidata":"https://www.wikidata.org/wiki/Q1938983","display_name":"Spatial analysis","level":2,"score":0.475600004196167},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.4715999960899353},{"id":"https://openalex.org/C2992879847","wikidata":"https://www.wikidata.org/wiki/Q374758","display_name":"Multilevel modelling","level":3,"score":0.4713999927043915},{"id":"https://openalex.org/C2777016058","wikidata":"https://www.wikidata.org/wiki/Q7574061","display_name":"Spatial distribution","level":2,"score":0.43540000915527344},{"id":"https://openalex.org/C94747663","wikidata":"https://www.wikidata.org/wiki/Q7574086","display_name":"Spatial variability","level":2,"score":0.40230000019073486},{"id":"https://openalex.org/C180478619","wikidata":"https://www.wikidata.org/wiki/Q7574066","display_name":"Spatial heterogeneity","level":2,"score":0.39419999718666077},{"id":"https://openalex.org/C92835128","wikidata":"https://www.wikidata.org/wiki/Q1277447","display_name":"Hierarchical clustering","level":3,"score":0.3880999982357025},{"id":"https://openalex.org/C149923435","wikidata":"https://www.wikidata.org/wiki/Q37732","display_name":"Demography","level":1,"score":0.36959999799728394},{"id":"https://openalex.org/C2910321205","wikidata":"https://www.wikidata.org/wiki/Q1938983","display_name":"Geographically Weighted Regression","level":2,"score":0.36169999837875366},{"id":"https://openalex.org/C45355965","wikidata":"https://www.wikidata.org/wiki/Q1643441","display_name":"Socioeconomics","level":1,"score":0.358599990606308},{"id":"https://openalex.org/C173727882","wikidata":"https://www.wikidata.org/wiki/Q5153620","display_name":"Common spatial pattern","level":2,"score":0.34220001101493835},{"id":"https://openalex.org/C110121322","wikidata":"https://www.wikidata.org/wiki/Q865811","display_name":"Distribution (mathematics)","level":2,"score":0.33480000495910645},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.3330000042915344},{"id":"https://openalex.org/C2777910687","wikidata":"https://www.wikidata.org/wiki/Q6007834","display_name":"Improved sanitation","level":3,"score":0.32019999623298645},{"id":"https://openalex.org/C41856607","wikidata":"https://www.wikidata.org/wiki/Q483130","display_name":"Geographic information system","level":2,"score":0.3041999936103821},{"id":"https://openalex.org/C61980418","wikidata":"https://www.wikidata.org/wiki/Q2221906","display_name":"Location","level":2,"score":0.2980000078678131},{"id":"https://openalex.org/C58640448","wikidata":"https://www.wikidata.org/wiki/Q42515","display_name":"Cartography","level":1,"score":0.27219998836517334},{"id":"https://openalex.org/C189326681","wikidata":"https://www.wikidata.org/wiki/Q10294","display_name":"Poverty","level":2,"score":0.2678999900817871},{"id":"https://openalex.org/C186744025","wikidata":"https://www.wikidata.org/wiki/Q7574064","display_name":"Spatial epidemiology","level":3,"score":0.26489999890327454},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.2565999925136566},{"id":"https://openalex.org/C142052008","wikidata":"https://www.wikidata.org/wiki/Q954027","display_name":"Cross-sectional study","level":2,"score":0.25429999828338623}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-10741256/v1","doi":"https://doi.org/10.21203/rs.3.rs-10741256/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10741256/v1","pdf_url":"https://www.researchsquare.com/article/rs-10741256/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10741256/v1","doi":"https://doi.org/10.21203/rs.3.rs-10741256/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10741256/v1","pdf_url":"https://www.researchsquare.com/article/rs-10741256/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"score":0.9763000011444092,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"},{"score":0.7578999996185303,"id":"https://metadata.un.org/sdg/10","display_name":"Reduced inequalities"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7203756442.pdf","grobid_xml":"https://content.openalex.org/works/W7203756442.grobid-xml"},"referenced_works_count":26,"referenced_works":["https://openalex.org/W1492916972","https://openalex.org/W2071937436","https://openalex.org/W2118898434","https://openalex.org/W2127625194","https://openalex.org/W2161643046","https://openalex.org/W2340601058","https://openalex.org/W2396904246","https://openalex.org/W2528342610","https://openalex.org/W2547553770","https://openalex.org/W2739955018","https://openalex.org/W2788364872","https://openalex.org/W2883227601","https://openalex.org/W2889051089","https://openalex.org/W2996290198","https://openalex.org/W3020897668","https://openalex.org/W3089584927","https://openalex.org/W3135710094","https://openalex.org/W3172634088","https://openalex.org/W4283769571","https://openalex.org/W4283814649","https://openalex.org/W4320493214","https://openalex.org/W4321748113","https://openalex.org/W4396886482","https://openalex.org/W4405542695","https://openalex.org/W4411131317","https://openalex.org/W7133326647"],"related_works":["https://openalex.org/W4283769571","https://openalex.org/W2340601058","https://openalex.org/W3187766998","https://openalex.org/W3208703036","https://openalex.org/W4396886482","https://openalex.org/W7202029361","https://openalex.org/W3175779633","https://openalex.org/W7203500361","https://openalex.org/W3089584927","https://openalex.org/W3195482464"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Childhood":[2],"stunting":[3,26,108],"remains":[4,178],"a":[5],"major":[6],"public":[7],"health":[8,209],"concern":[9],"in":[10,62,66,130,158,176],"Ethiopia,":[11],"with":[12,41,145,172],"substantial":[13],"socioeconomic":[14],"and":[15,22,46,51,77,86,94,125,148,165,168,180,187,192,197,208],"geographic":[16,47,156],"variation.":[17],"Understanding":[18],"both":[19,185],"the":[20,152,159],"determinants":[21,129],"spatial":[23,44,52,79,188,193],"distribution":[24],"of":[25,89,161],"is":[27],"essential":[28],"for":[29,198],"designing":[30],"targeted":[31],"interventions.":[32],"Therefore,":[33],"this":[34],"study":[35],"aimed":[36],"to":[37],"identify":[38],"factors":[39],"associated":[40],"childhood":[42],"stunting,":[43],"clustering,":[45],"variation":[48],"using":[49,71,83],"multilevel":[50,72,131,191],"analyses.":[53],"Methods":[54],"Data":[55],"from":[56],"5,820":[57],"children":[58],"aged":[59],"0\u201359":[60],"months":[61],"787":[63],"DHS":[64],"clusters":[65],"Ethiopia":[67,177],"(2024\u20132025)":[68],"were":[69,81,127],"analyzed":[70],"mixed-effects":[73],"logistic":[74],"regression.":[75],"Global":[76],"local":[78],"patterns":[80],"assessed":[82],"Moran\u2019s":[84],"I":[85,139],"Local":[87],"Indicators":[88],"Spatial":[90,133],"Association":[91],"(LISA),":[92],"respectively,":[93],"geographically":[95,205],"weighted":[96,106],"regression":[97],"(GWR)":[98],"examined":[99],"spatially":[100],"varying":[101],"contextual":[102],"determinants.":[103],"Results":[104],"The":[105],"national":[107],"prevalence":[109],"was":[110],"39.8%":[111],"(95%":[112],"CI:":[113],"37.4\u201342.1).":[114],"Child":[115],"age,":[116],"birth":[117],"size,":[118],"maternal":[119,121,162],"education,":[120,163],"BMI,":[122],"household":[123,169],"wealth,":[124],"region":[126],"significant":[128,136],"models.":[132],"analysis":[134],"revealed":[135],"clustering":[137],"(Moran\u2019s":[138],"=":[140],"0.153,":[141],"p":[142],"<":[143],"0.001),":[144],"distinct":[146],"high-":[147],"low-burden":[149],"areas":[150],"across":[151],"country.":[153],"GWR":[154],"demonstrated":[155],"heterogeneity":[157],"influence":[160],"water":[164],"sanitation":[166],"access,":[167],"environmental":[170],"conditions":[171],"stunting.":[173],"Conclusion":[174],"Stunting":[175],"high":[179],"unevenly":[181],"distributed,":[182],"shaped":[183],"by":[184],"hierarchical":[186],"factors.":[189],"Integrating":[190],"evidence":[194],"highlights":[195],"where":[196],"whom":[199],"interventions":[200],"should":[201],"be":[202],"prioritized,":[203],"supporting":[204],"tailored":[206],"nutrition":[207],"strategies.":[210]},"counts_by_year":[],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2026-08-20T00:00:00"}
