Introduction: Malnutrition is major public-health problem throughout the developing world and is an
underlying factor in over 50% of the 10–11 million children under 5 years of age who die each year. Although
the prevalence of malnutrition is generally high in Ethiopia, there were no enough documented predictors.
Therefore; this study was undertaken to identify predictors of acute malnutrition among 6 - 23 months in
HidhebuAbote Woreda, Oromiya Regional State, Ethiopia. Methods: Community based unmatched casecontrol
study design was utilized. Children of 6-23 months in the Woreda were screened by weight for height
and 288 children (144 cases and 144 controls) were selected by simple random sampling technique. Results: The
mean age of the cases and controls were 13.38 (+ 4.68) and 14.41 (+ 5.44) month respectively. There were more
males in the cases 68 (47.5%) than in the controls 58 (40.5%). Cases with malnutrition were more likely to: have
mothers who did not graduate as model by the health extension program (AOR= 7.246), have spring and /or river
as source of drinking water (AOR= 5.349), initiate breastfeeding late (AOR= 4.248), not exclusively
breastfed(AOR= 4.586), not given colostrums(AOR=2.706), be bottle fed (AOR=3.111) and have illness during
the last two weeks before the survey (AOR=4.136) compared to controls.Conclusion: Finally this study
identified that distal, intermediate and proximal factors associated with Acute Malnutrition among 6 - 23 months
Children in the study area. Therefore, those factors associated with Acute Malnutrition would be emphatically
considered during development of child health and Nutritional programs by police makers in collaboration with
others responsible bodies. Federal ministry of health would be better to give greater emphases to address under
two years child Nutritional status to improve through health education by using mass media and community
mobilization in more comprehensive manner by integrated to health extension program of model family
graduation package about child nutritional and optimal child feeding practices based on the final guideline and
improving water and sanitation including home based treatment of water using ‘Wuha’ Agar.