A cross-sectional study design to assess the determinants of the nutritional status of children aged 6 to 59 months who returned to Gedeo after being internally displaced in the Guji-Gedeo conflict, in Gedeb district, SNNPR, Ethiopia: Bayesian Binary Logistic Regression Approach
Authors: Legesse Alemayehu , Genoro Belayneh , Haile Arega , Tesfaye Adene 
Published: January 2023

Abstract
Background: The Guji-Gedeo conflict, which resulted in 306,572 internally displaced persons in Gedeb, gradually became the main reason for the forced evacuation of the Gedeo District (IDP). Malnutrition has worsened in conflict-affected areas. Children affected by conflict face an uneven burden of malnutrition and health problems. The purpose of the current study was to identify determinant factors associated with the nutritional status of the children (aged 6 to 59 months) who returned to the Gedeb District after being internally displaced in Guji-Gedeo.
Methodology: A cross-sectional study involving 6-59 months aged children who returned to the Gedeb district after being internally displaced in Guji-Gedeo was conducted from December 2019- to February 2020, and 418 participants were selected by employing a multistage sampling technique. A bayesian binary logistic regression model was used to model the effects of selected demographic, socioeconomic, health, and environmental factors. SPSS and Win BUGS software were used to analyze the data. The anthropometrics measure (WAZ, HAZ, WHZ) was generated using WHO Anthro Version 3.2.2.12. MCMC is used to estimate the parametric distribution for a given set of observations. This method's goal is to generate a sample of unknown parameter values from the posterior distribution by using Gibbs sampling. Convergence was assessed by time series (history) plot, density plot, Monte Carlo standard errors, and Gelman-Rubin statistic. The posterior summary estimates were assessed by the Gibbs sampler.
Results: Of all the 418 participants, 228 (54.5%) were males and 190 (45.45%) were females with one hundred-two from rural and 316 from urban area of residence. Malnutrition was found to be 45.9% prevalent in the Gedeb district. The covariates that were the most important determinants of children's nutritional status in this area were sex [AOR = 1.358, CI = 0.584 - 3.158], place of residence [AOR = 0.399, CI = 0.098 - 1.631], toilet status [AOR = 0.84, CI = 0.265 - 2.66 ], mother body mass index [AOR = 0.777, CI = 0.332 - 1.81], diarrhea before two weeks of the survey [AOR = 1.2, CI = 0.218 - 2.354] , birth order [4-5 birth order: AOR = 0.802; CI = 0.19 - 3.338, 6 and above birth order: AOR = 1.9, CI = 0.479 - 7.675], age of the child, birth interval, having family size 4 to 5, Occupational status and mother's education level since the credible intervals of posterior mean given by the MCMC method did not include 0 at a 95% significance level. Conclusion: The overall prevalence of malnutrition in the Gedeb district is about 46%. Malnutrition was statistically related to covariates such as sex, age, birth interval, birth order, mother's education level, place of residence, toilet status, mother's body mass index, having family size 4 to 5, occupational status and diarrhea before two weeks. There is a need to raise social awareness of the magnitude of conflict and the factors associated with child malnutrition. Furthermore, nutrition interventions should go beyond displaced children to incorporate returned children.