OVERNUTRITION AND ASSOCIATED FACTORS AMONG GOVERNMENT AND PRIVATE SECONDARY SCHOOL ADOLESCENT STUDENTS IN HARAR CITY, EASTERN ETHIOPIA

Abstract

Overnutrition is an emerging public health issue in developing countries including Ethiopia. Overnutrition in adolescents is associated with an increased risk of non-communicable diseases, poor health-related quality of life, poor academic performance, and social and emotional un-well beingness. However, there is a paucity of evidence regarding adolescent overnutrition in Eastern Ethiopia, particularly in Harar city. Objective: To assess overnutrition and associated factors among government and private secondary school adolescent students in Harar city, Ethiopia from February11–March10, 2022. Methods: A school-based comparative cross-sectional study was conducted. Multi-stage sampling was used to identify 781 study participants (586 in government and 195 in private schools). Data was collected using a self-administered questionnaire followed by anthropometric measurements. The collected data was entered onto Epi-Data version 4.6 and exported to STATA version 14 for analysis. WHO Anthroplus software was used to generate a Z score for the BMI-for-Age index. Both bivariable and multivariable logistic regression were fitted to identify factors associated with overnutrition. Crude and adjusted odds ratios with 95 confidence intervals were used to report associations and statistical significance was declared at a p < 0.05. Results: The overall magnitude of overnutrition was 9.3% (95% CI = 7.2–11.4) with 16.2% (95% CI = 10.8–21.3%) in private and 6.9% (95% CI = 4.8–9.0%) in government schools. Being female [AOR = 2.04, 95% CI: 1.17-3.55], late adolescent age [AOR = 0.53, 95% CI: 0.31-0.90], bigger family size [AOR=0.55, 95% CI: 0.31–0.97], high paternal education level [AOR = 2.03, 95% CI: 1.08-3.81], eating meat [AOR = 3.41, 95% CI: 1.27-9.17] and not consuming breakfast daily [AOR = 2.13, 95% CI: 1.24-3.67] were factors associated with overnutrition among all secondary school adolescents. Maternal educational level [AOR = 5.58, 95% CI: 1.17-26.57], not consuming breakfast and dinner daily [AOR = 2.87, 95% CI: 1.16-7.08] [AOR = 2.55, 95% CI: 1.06-6.08], respectively were factors associated with overnutrition in private school adolescents. Being female [AOR = 2.24, 95% CI: 1.05-4.75], egg consumption [AOR = 0.33, 95% CI: 0.14-0.78] and walk/use bicycle at least 10 minutes continuously [AOR = 0.37, 95% CI: 0.16-0.86] were factors associated with overnutrition in government school adolescents. Conclusion: The magnitude of overnutrition was relatively higher in the study area. Therefore, the city’s health and education bureau and schools should apply integrated interventions in collaborating with the community and other stakeholders to tackle this public health problem