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Spatiotemporal clustering and correlates of childhood stunting in Ghana: Analysis of the fixed and nonlinear associative effects of socio-demographic and socio-ecological factors

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  • Fiifi Amoako Johnson

Abstract

Childhood stunting remains a major public health issue in many low- and middle-income countries. In Ghana, the progress made is insufficient to reach the targets set by the 2025 World Health Assembly and the 2030 United Nations Sustainable Development Goals. Although studies have examined the socio-demographic determinants of childhood stunting, there has not been any systematic study to examine the spatial associative effects of the socio-demographic and socio-ecological factors at the district level, where health programmes are implemented and monitored. Bayesian geo-additive semiparametric regression technique was used to analyse five conservative rounds of Demographic and Health Surveys in Ghana, with socio-ecological covariates derived from the Demographic and Health Survey Program Geospatial Covariate datasets to examine the temporal trends in childhood stunting, the extent of geospatial clustering at the district level and their associative relationships with socio-demographic and socio-ecological factors. The findings show that childhood stunting in Ghana is not spatially randomly distributed but clustered. Clustering of high childhood stunting was observed amongst districts in the Upper West, Upper East, Northern, North East, Savannah, and Western North regions, whilst clustering of low childhood stunting was observed in districts in the Greater Accra, Volta, Bono and the Eastern regions. Whist socio-demographic factors were predominantly associated with clustering of districts with high childhood stunting, the socio-ecological factors were mainly associated with clustering of districts with low childhood stunting. The socio-ecological factors identified to have a nonlinear associative effect with childhood stunting were Insecticide Treated Net (ITN) coverage, nightlight composite, travel time to a main settlement and population density. The findings suggest that targeted interventions at the district level are essential to reducing childhood stunting in Ghana.

Suggested Citation

  • Fiifi Amoako Johnson, 2022. "Spatiotemporal clustering and correlates of childhood stunting in Ghana: Analysis of the fixed and nonlinear associative effects of socio-demographic and socio-ecological factors," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-22, February.
  • Handle: RePEc:plo:pone00:0263726
    DOI: 10.1371/journal.pone.0263726
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    References listed on IDEAS

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    1. Fiifi Amoako Johnson & Mumuni Abu & Chigozie Edson Utazi, 2019. "Geospatial correlates of early marriage and union formation in Ghana," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-17, October.
    2. Raymond Boadi Frempong & Samuel Kobina Annim, 2017. "Dietary diversity and child malnutrition in Ghana," Post-Print hal-04162948, HAL.
    3. Jenny Doorn & Peter Verhoef & Tammo Bijmolt, 2007. "The importance of non-linear relationships between attitude and behaviour in policy research," Journal of Consumer Policy, Springer, vol. 30(2), pages 75-90, June.
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