Determinants of underweight among returnee lactating mothers in Gedeb District, Southern Ethiopia: a case-control study.

Objective: This study aimed to assess the determinants of underweight among returnees lactating mothers in governmental health facilities of Gedeo zone, Southern Ethiopia.

Design: Case-control study.

Setting: Gedeb District governmental health facilities.

Participants: A total of 264 returnees lactating mothers (88 cases and 176 controls) were randomly selected from four health institutions of Gedeb District.

Outcome measures: Underweight was measured by anthropometric measurement weight/height². An institutional-based unmatched case-control study was conducted from 11 July 2022 to 20 September 2022. The study involved 264 returnee lactating mothers, with 88 classified as cases (body mass index, BMI<18.5 kg/m²) and 176 as controls (BMI 18.5-24.9 kg/m²). Participants were selected through simple random sampling from public health institutions. Data were collected on sociodemographic, reproductive and nutritional factors using structured questionnaires and anthropometric measurements. Bivariate and multivariable logistic regression analyses were performed to identify significant determinants of maternal underweight.

Result: The study identified several key determinants of underweight. Returnee lactating mothers with a short birth interval (<24 months) were significantly more likely to be underweight (adjusted OR (AOR) 4.04, 95% CI 1.68 to 9.74). Unplanned pregnancies (AOR 7.60, 95% CI 3.14 to 18.41), home deliveries (AOR 5.81, 95% CI 2.09 to 16.14) and meals frequency <3 per day (AOR 2.51, 95% CI 1.12 to 5.63) were also strongly associated with increased risk of underweight. Inadequate dietary diversity (AOR 3.92, 95% CI 1.52 to 10.15) and food insecurity (AOR 4.72, 95% CI 1.77 to 12.61) further contributed to the risk. Poor socioeconomic status was associated with a higher likelihood of being underweight (AOR 4.38, 95% CI 1.49 to 12.82).

Conclusion: The study highlights significant factors contributing to maternal underweight among returnee lactating mothers. Addressing short birth intervals, unplanned pregnancies, dietary diversity and food insecurity is crucial. Policy-makers should focus on targeted interventions to improve maternal health, with special emphasis on returnee lactating mothers. Enhanced healthcare access, nutritional support and socioeconomic development are essential for mitigating underweight and improving overall health outcomes.