Objective: To investigate the differential effects of dietary diversity (DD) and
maternal characteristics on child linear growth at different points of the conditional
distribution of height-for-age Z-score (HAZ) in sub-Saharan Africa.
Design: Secondary analysis of data from nationally representative cross-sectional
samples of singleton children aged 0–59 months, born to mothers aged 15–49
years. The outcome variable was child HAZ. Quantile regression was used to
perform the multivariate analysis.
Setting: The most recent Demographic and Health Surveys from Ghana, Nigeria,
Kenya, Mozambique and Democratic Republic of Congo (DRC).
Subjects: The present analysis was restricted to children aged 6–59 months
(n 31 604).
Results: DD was associated positively with HAZ in the first four quantiles
(5th, 10th, 25th and 50th) and the highest quantile (90th) in Nigeria. The largest
effect occurred at the very bottom (5th quantile) and the very top (90th quantile)
of the conditional HAZ distribution. In DRC, DD was significantly and positively
associated with HAZ in the two lower quantiles (5th, 10th). The largest effects of
maternal education occurred at the lower end of the conditional HAZ distribution
in Ghana, Nigeria and DRC. Maternal BMI and height also had positive effects
on HAZ at different points of the conditional distribution of HAZ.
Conclusions: Our analysis shows that the association between DD and maternal
factors and HAZ differs along the conditional HAZ distribution. Intervention
measures need to take into account the heterogeneous effect of the determinants
of child nutritional status along the different percentiles of the HAZ distribution.