Ethnic Differentials in Stunting, Wasting and Underweight among Children Aged 6–59 Months in Karamoja, Uganda: A Comparative Cross-Sectional Study of the Pokot of Amudat and the Pian of Nakapiripirit Districts
Keywords:
child undernutrition; Karamoja; Pian; Pokot; stunting; Uganda; underweight; wastingAbstract
Background: Child undernutrition remains a leading cause of morbidity and mortality among children under five in Uganda, with Karamoja recording the country’s highest burden. Amudat and Nakapiripirit districts, home to the Pokot and Pian ethnic groups respectively, share similar agro-climatic conditions but have historically reported divergent malnutrition outcomes. Objective: To compare the prevalence and determinants of stunting, wasting and underweight among children aged 6–59 months between the Pokot of Amudat and the Pian of Nakapiripirit. Methods: A community-based comparative cross-sectional study was conducted among 270 households (135 per district) selected through two-stage cluster sampling. Anthropometric measurements were converted to WHO 2006 z-scores in ENA for SMART, and structured questionnaires captured socio-demographic, dietary and child-health data. Associations were tested using chi-square statistics at p<0.05. Results: Prevalence of stunting, wasting and underweight was 25.9%, 8.9% and 18.5% among the Pokot compared with 34.2%, 11.1% and 28.9% among the Pian, with underweight showing a significant ethnic differential (χ²=4.014, p=0.045). Boys were consistently more affected than girls in both groups. Household size, marital status, maternal knowledge of infant feeding and malnutrition causes, dietary diversity, meal frequency and recent illness were significantly associated with undernutrition in both districts. Conclusion: Despite sharing an agro-ecological zone, the Pian bear a significantly higher undernutrition burden, driven by household and maternal-knowledge factors rather than climate. Nutrition interventions in Karamoja should target ethnic-specific social determinants rather than a single sub-regional template.
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