QUANTILE REGRESSION ANALYSIS OF DETERMINANTS OF STUNTING AMONG CHILDREN AGED 0-23 MONTHS IN TANZANIA: EVIDENCE FROM THE TANZANIA DEMOGRAPHIC AND HEALTH SURVEY REPORT, 2022

Abstract

Background: Stunting affects 30% of Tanzanian children under five, posing
significant health and developmental challenges, driven by complex factors including nutrition, maternal health, and socioeconomic conditions.
Objective: This study aims to identify determinants of stunting (Height-for-Age Z-score) HAZ) among children aged 0-23 months in Tanzania, examining heterogeneous effects across the HAZ distribution using quantile regression.
Methods: Using data from the 2022 Tanzania Demographic and Health Survey (TDHS), we applied quantile regression, guided by the UNICEF Conceptual Framework, to analyze child, maternal, household, and environmental factors at the 0.25, 0.5, and 0.75 HAZ quantiles.
Results: Breastfeeding significantly increased HAZ at the 0.25 quantile
(coefficient = 1.01, p < 0.001), protecting severely stunted children. Middle birth order (2-4) was protective at the 0.25 quantile (coefficient = 0.82, p = 0.002), while maternal age (25-29 years) reduced HAZ at the 0.25 and 0.5 quantiles (coefficients = -0.61, -0.62, p < 0.05). Unexpectedly, normal (2501-4000g) and large (>4000g) birth weights lowered HAZ at the 0.5 and 0.75 quantiles, possibly due to interventions for low-birth-weight infants and postnatal food insecurity. Household head age positively influenced HAZ at the 0.75 quantile (coefficient = 0.018, p = 0.049). Wealth, education, and sanitation were non-significant, likely due to contextual homogeneity.
Conclusion and Recommendation: Findings emphasise the need for enhanced breastfeeding promotion, targeted support for mothers aged 25-29, and postnatal nutrition for all infants. The Ministry of Health should prioritise exclusive breastfeeding through community and hospital programs. At the same time, the Tanzania Food and Nutrition Centre should support firstborns with maternal and nutritional interventions to address their stunting vulnerability.