The rate of stunting in Nepal is among the highest in the world, which is a major public health problem. The objective of this study was to present data on stunting prevalence according to socio-demographic and geographical circumstances and to determine the impact of those circumstances on the risk of stunting. Data from Nepal Demographic and Health Surveys were used with the study population of children under 5 years old. The prevalence of stunting was determined by descriptive analysis and logistic regression analysis was used to determine risk factors for stunting. The prevalence of stunting has declined in overall as well as in all groups and subgroups analysed. The percentage of stunted children from 2001 to 2016 decreased by 18 and 10.7% in the rural and urban areas respectively. The unadjusted analysis depicted association between stunting and children living in rural areas since children living in rural areas had higher odds of being stunted compared to their urban counterparts. However, the association was no longer observed when adjusted for other variables included in this study. Children born to mothers without any education had 2.27 (95% CI 1.70–3.05), 5.222 (95% CI 2.54–10.74), 1.81 (95% CI 0.92–3.55) and 1.92 (95% CI 1.28–2.89) odds of being stunted than those born to mothers with higher education for the year 2001, 2006, 2011 and 2016 respectively in the adjusted analysis. Similarly, children belonging to the poorest wealth quintile had 1.90 (95% CI 1.55–2.33), 1.87 (95% CI 1.36–2.58), 2.47 (95% CI 1.51–4.02) and 4.18 (95% CI 2.60–6.71) odds of being stunted than those belonging to the richest quintile in 2001, 2006, 2011 and 2016 respectively. The association between stunting and wealth quintile depicting children belonging to the poorest and poorer wealth quintile having higher odds of being stunted remain the same in both unadjusted and adjusted analysis. At national level, stunting is decreasing in Nepal; however, the prevalence of stunting is different between groups and subgroups analysed. The substantial inequalities in stunting have been preserved. Therefore, special emphasis should be given to vulnerable groups such as children belonging to the poorest and poorer wealth quintile instead of using blanket approach for delivering nutrition interventions. A balanced approach to nutritional inequalities prevalent across different regions and subgroups is required.

中文翻译：

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尼泊尔发育迟缓的趋势和不平等：2001 年至 2016 年四次尼泊尔人口健康调查的二次数据分析

尼泊尔的发育迟缓率是世界上最高的，这是一个重大的公共卫生问题。本研究的目的是根据社会人口和地理环境提供有关发育迟缓患病率的数据，并确定这些情况对发育迟缓风险的影响。尼泊尔人口和健康调查的数据用于 5 岁以下儿童的研究人群。通过描述性分析确定发育迟缓的患病率，并使用逻辑回归分析确定发育迟缓的危险因素。总体以及所分析的所有组和亚组的发育迟缓患病率均有所下降。2001年至2016年，农村和城市发育迟缓儿童比例分别下降18%和10.7%。未经调整的分析描述了发育迟缓与农村儿童之间的关联，因为与城市儿童相比，农村儿童发育迟缓的几率更高。然而，当调整本研究中包含的其他变量时，不再观察到这种关联。未受过任何教育的母亲所生的孩子有 2.27 (95% CI 1.70–3.05)、5.222 (95% CI 2.54–10.74)、1.81 (95% CI 0.92–3.55) 和 1.92 (95% CI 1.28–2.89) 的几率在调整后的分析中，分别比 2001 年、2006 年、2011 年和 2016 年受过高等教育的母亲所生的孩子发育迟缓。同样，属于最贫穷五分之一的儿童的几率为 1.90（95% CI 1.55–2.33）、1.87（95% CI 1.36–2.58）、2.47（95% CI 1.51–4.02）和 4.18（95% CI 2.60–6.71）比2001年最富有的五分之一的人发育迟缓，分别为 2006 年、2011 年和 2016 年。在未经调整和调整后的分析中，发育迟缓和财富五分位数之间的关联描绘了属于最贫穷和贫困五分之一的儿童发育迟缓的可能性更高。在国家层面，尼泊尔的发育迟缓正在减少；然而，所分析的组和亚组之间发育迟缓的发生率是不同的。发育迟缓方面的严重不平等得到了保留。因此，应特别重视弱势群体，例如属于最贫困和贫困五分之一的儿童，而不是使用一揽子方法提供营养干预。需要对不同地区和亚组普遍存在的营养不平等问题采取平衡的方法。在未经调整和调整后的分析中，发育迟缓和财富五分位数之间的关联描绘了属于最贫穷和贫困五分之一的儿童发育迟缓的可能性更高。在国家层面，尼泊尔的发育迟缓正在减少；然而，所分析的组和亚组之间发育迟缓的发生率是不同的。发育迟缓方面的严重不平等得到了保留。因此，应特别重视弱势群体，例如属于最贫困和贫困五分之一的儿童，而不是使用一揽子方法提供营养干预。需要对不同地区和亚组普遍存在的营养不平等问题采取平衡的方法。在未经调整和调整后的分析中，发育迟缓和财富五分位数之间的关联描绘了属于最贫穷和贫困五分之一的儿童发育迟缓的可能性更高。在国家层面，尼泊尔的发育迟缓正在减少；然而，所分析的组和亚组之间发育迟缓的发生率是不同的。发育迟缓方面的严重不平等得到了保留。因此，应特别重视弱势群体，例如属于最贫困和贫困五分之一的儿童，而不是使用一揽子方法提供营养干预。需要对不同地区和亚组普遍存在的营养不平等问题采取平衡的方法。