Objective: This study examined the associations between the adequacy
of childcare provided by adult caretakers and childhood undernutrition
in rural Yemen, independent of household wealth and
food consumption.
Methods: We analyzed data of 3,549 children under the age of
5 years living in rural areas of Yemen based on the 2013 Yemen
Baseline Survey of Mother and Child Health. Nutritional status was
evaluated by the presence of underweight, stunting, and wasting
according to the World Health Organization child growth standards.
The impact of childcare including leaving children alone, putting
older children into labor force, and the use of antenatal care while
pregnant on child undernutrition was assessed and adjusted for food
consumption by children, household composition, demographic
and educational background of caretakers, and household wealth.
Results: The prevalence of underweight, stunting, and wasting was
46.2%, 62.6%, and 11.1%, respectively. Not leaving children alone,
keeping children out of the labor force, and use of antenatal care
were associated with a lower risk of underweight (odds ratio [OR]
= 0.84, P = 0.016; OR = 0.84, P = 0.036; and OR = 0.85, P = 0.042)
and stunting (OR = 0.80, P = 0.004; OR = 0.82, P = 0.024; and OR
= 0.78, P = 0.003). After further adjustment for food consumption,
the associations between adequate childcare indicators and lower
odds of stunting remained significant (OR = 0.73, P = 0.025; OR =
0.72, P = 0.046; and OR = 0.76, P = 0.038).
Conclusions: A marked prevalence of stunting among rural children
in Yemen was observed. Adequate childcare by adult caretakers
in families is associated with a lower incidence of underweight
and stunting among children under 5 years of age. Promoting adequate
childcare by adult household members is a feasible option
for reducing undernutrition among children in rural Yemen