UNDER-NUTRITION AND ITS DETERMINANTS AMONG DAILY

LABORERS WORKING IN COBBLESTONE PROJECT, ADDIS ABABA.

  BY: GETENEH MOGES (BSc, MPH)

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 Introduction 
Under-nutrition

 affecting more than 900 million individuals around the World (FAO, 2010).

 Low Body Mass Index (BMI) people are physically disadvantaged and they are
imposed a greater stress to carryout work requiring body mass. (Durnin JV, 1994)

 Under-nutrition of daily laborers in developing countries is poorly addressed.

 Higher alcohol consumer, miss breakfast and seek out convenience food.

 In Ethiopia, costs as high as 16.5% of its GDP, (Shenggen Fan, 2014.)

 Migration to Addis Ababa(37%), Substantial segment of migrants were involve in

daily laborers, they are disadvantaged, vulnerable, face reduce quality of life.
(World Bank: 2008).

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 significance of the study
 Information on daily laborers' under-nutrition level can provides some

insights on how policy actions can intervene

 However, there is paucity of data on level of under-nutrition of daily

laborers in Ethiopia, no research report on level of under-nutrition.

 It limited designing and initiating intervention strategies aims at

improving the nutritional status of daily laborers.

 Findings, to elicit support and promote cooperation among different

stakeholders towards the initiation of a sustainable nutrition program in

cobblestone project.

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Conceptual framework- shows relationship between level of under-
nutrition and its determinants with emphasis in cobblestone project.  
 
.Socio  demographic
age  of worker Behavioral factors
sex of worker alcohol drinking
educational status smoking
family size
monthly income Under-nutrition

Working conditions
daily working hours Physical environment INDIVIDUAL
hard physical labor Time & convenience Food preference
availability and (taste)
accessibility Dietary intake
food(healthy)

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 OBJECTIVES
General objective

 To assess the level of under-nutrition and its determinants among daily

laborers working in cobblestone project, Addis Ababa.

Specific objectives

 To determine the level of under-nutrition among daily laborer working in

cobblestone project,

 To identify factors associated with under-nutrition among daily laborers

working in cobblestone project.

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 Study Area and Period
METHODS
 Introduced by the mayor of Dire Dewa following a visit to France, More than 20 towns in Ethiopia,-
cobblestone-paving construction.

 This study was conducted in cobblestone project (Qatsila, Gewasa &Tafo sites (6,615 Daily laborers)

 The study was conducted from February 20 to April 1, 2015.

Study design

 Institution based cross sectional study was employed.

Inclusion criteria

 Age ≥18 years (both sex) and Work experience ≥ 6 months

Exclusion criteria

 Mental illness and acutely ill and diagnose for chronic illness before being daily laborer.

 Daily laborer who is lactating or pregna

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 Sample size calculation
For the 1st objective calculated using single population proportion

p= 0.5 expected estimates BMI< 18.5

Sample size= 423

For 2nd objective is calculated by epi info 7 using double population proportion

Percent of controls to exposed in daily laborers (smoker) assumed 50%.

Detecting OR = 2.00 (to have large sample size)

Sample size = 326

final sample size is 423.

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 Sampling procedure
Cobblestone project(6,615)
Stratified

Qatsila site Taffo site Gewasa site

N= 4500 N=450 N=1665

n=288 n=29 n=107

Systematic random sampling technique was used to

select the study subject

423 daily laborers

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 Data Quality control
Preparation phase
• questionnaire was adopted from standard material
• Training for data collectors and supervisors

• Pre-test conducted in similar set up

Data collection phase

• Designated field supervisors

• Regular supervision by the principal investigator

• Timely feedback for the data collectors and supervisors

Data analysis phase

• For all statistical significance tests, the cut -off value set [p<0.05,95%CI;]
was considered statistically significant for analysis of this study.

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 Study variables
Dependent variable

Under-nutrition (Yes, No)

Independent variables

socio demographic characteristics

Working conditions like daily working hours, hard physical labor

dietary intake.

Behavioral factors such as smoking, alcohol drinking, khat chewing.

Availability and accessibility of food.

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 Socio-demographic Characteristics
Variables Number (n=423) Percent
AGE IN YEAR Median 24
18-24 years 247 58.4
SEX Male 300 70.9
Female 123 29.1
EDUCATION: No education 87 20.6
primary school 175 41.7
Secondary and above school 161 38
MARITAL STATUS None married 280 66.2
Married 143 33.8
Family size 1-2 319 75.4
≥3 104 24.6
Monthly income in ETB ≤ 1500 154 36.4
1500- 2499 124 29.3
≥2500 145 34.2
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dietary intake of daily laborers during the previous 24-hours
period(in percent)
Similar to studies in Gondar, UK, India coal mine worker
Yes No

.
96.9
93.6
87.2 87.2
85.6
r-
78.3 d iv e
75.4 74.5
t a ry
68.6 ie
d68.3
n
.8 6
64.8
5 m ea
55.8
o re is e l ow
sc b
44.2 i t y e re
i v e rs e rsw
d bo r
35.2
31.4 ary a 31.7
i e t l y l
d d ai
24.6 25.5
e an o f 21.7
e m .7%) 14.4
Th 48
12.8 12.8
6.4 (
206 core. 3.1
s ts
als be
rs les sity i try Eg
gs ds
nu
ts
uc
ts
fa
ts
ne
y us
re ab ru
f ul oo o eo
Ce tu
ge
t po ef d od nd rh an
nd se an pr sa ell
sa Ve nd d sl e ilk Oi
l ro si c
t ata an pu m ga
M
o e h , su
Ro M Fis ilk
m

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 BMI<18.5kg/m2 -Under-nutrition
Indian (33.3%95%CI: 28.8-38.0
versus 20.0%)
Male(37.3%) [95% CI; 31.8,43.1)
33.30% versus (23.6%) Female counterpart
Yes
66.70% No EDHS2011,A.A population (37.3%

versus 22.0% and 23.6%versus

14.4%)
 Gondar town population(33.3%
versus12.9%)
NNP – give priority to rural
population

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 Multiple binary logistic analyses were performed to identify
independent predictors of under-nutrition.

Characteristics under-nutrition Crude OR Adjusted OR

Yes No
Sex
Male 112(37.3%) 188(62.7) 1.93(1.19-3.11) * 1.16(0.62-2.17)
Female 29(23.6%) 94(76.4%) 1 1

Educational status
No education 50(57.5%) 37(42.5%) 6.41(3.56-11.56) * 7.83(3.78-16.22)*
Primary 63(36.0%) 112(64.0%) 2.67(1.60-4.45) * 2.26(1.25-4.08) *
1
≥ Secondary 28(17.4%) 133(82.6%) 1

Family size
≥3 50(48.1%) 54(51.9%) 2.31(1.47-3.65)* 2.88(1.54-5.40)*
1-2 91(28.5%) 228(71.8%) 1 1

Monthly income (ETB)

<1500 83(53.9%) 71(46.1%) 5.35(3.15-9.08)* 9.77(4.92-19.39)*
1500-2499 32(25.8%) 92(74.2%) 1.59(0.88-2.85) 2.16(1.08-4.34) *
≥2500 26 (17.9%) 119(82.1%) 1 1
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 Multiple binary logistic analyses . . .

Characteristics under-nutrition Crude OR Adjusted OR

Yes No

Dietary diversity
< Mean 89(43.2%) 117(56.8%) 2.41(1.59-3.65)* 1.82(1.07-3.08)*
≥ Mean score 52(24.0%) 165(76.0%) 1 1

Smoking
Yes 50 (59.5%) 34(40.5%) 4.00(2.43-6.59)* 2.02(1.06-3.87)*
No 91(26.8%) 248(73.2%) 1 1

Alcohol drinking
Yes 108(45.0%) 132(55.0%) 3.71(2.36-5.86)* 3.32(0.80-6.11)
No 33(18.0%) 150(82.0%) 1 1

Khat chewing
Yes 43(47.8%) 47(52.2%) 2.19(1.36-3.53)* 1.69(0.90-3.17)
No 98(29.4%) 235(70.6%) 1 1

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 Conclusion

From this study finding, substantial segments of daily laborers were undernourished.

Significant determinant of under-nutrition include; lower educational level, bigger

family size, lower monthly income, smoking and low dietary diversity.

Recommendations

Nutrition programs- an interim strategy until the majority are empowered through

better education and earn sufficient income to feed themselves.

Dietary diversity and eating habits in improving their nutritional status.

Empowered through behavior change education /smoking on under-nutrition.

It is recommended further research to be undertaken

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