title: Impact of disasters on child stunting in Nepal.
abstract: BACKGROUND
  Stunting is a major public health problem that results from inadequate nutritional intake over a long period of time. Disasters have major implications in poor and vulnerable children. The aim of this study was, therefore, to assess the impact of disasters on child stunting in Nepal.
  
  
  METHODS
  A sample consisting of 2,111 children aged 6-59 months was obtained from the 2011 Nepal Demographic and Health Survey. We used bivariate and multivariate analyses to examine moderate and severe stunting against disaster, controlling for all possible confounders.
  
  
  RESULTS
  Out of the total study sample, 43% were stunted (17.1% severely and 25.9% moderately). The final model, after adjusting for confounders, showed that epidemics have no impact on child stunting (adjusted odds ratio [OR] =1.14, 95% confidence interval [CI]: 0.66, 1.97 and adjusted OR =1.04, 95% CI: 0.66, 1.65 for severe and moderate stunting, respectively). Floods have impact on child stunting (adjusted OR =0.57, 95% CI: 0.31, 0.96 and adjusted OR =0.66, 95% CI: 0.41, 0.94 for severe and moderate stunting, respectively). However, children aged 6-11 months, nonvaccinated children, children of working women, children who live in mountainous areas, and children from the poorest households were more likely to be moderately stunted. Similarly, children aged 36-47 months, Dalit and other ethnic groups, children from rural settings, and children from the poorest households were more likely to be severely stunted.
  
  
  CONCLUSIONS
  This article illustrates the need to rethink about child stunting in Nepal. This study suggests need for further research, integration of disaster data in the Nepal Demography Health Survey, educational interventions, public awareness, promotion of vaccination, and equity in health service delivery.
authors.affiliation: Centre for Research on the Epidemiology of Disaster (CRED), Institute of Health and Society (IRSS), Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Surya
authors.initials: S
authors.lastname: Gaire
authors.affiliation: Centre for Research on the Epidemiology of Disaster (CRED), Institute of Health and Society (IRSS), Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Tefera Darge
authors.initials: TD
authors.lastname: Delbiso
authors.affiliation: Department of Nursing, Tribhuvan University Teaching Hospital (TUTH), Institute of Medicine (IOM), Baluwatar, Kathmandu, Nepal.
authors.forename: Srijana
authors.initials: S
authors.lastname: Pandey
authors.affiliation: Centre for Research on the Epidemiology of Disaster (CRED), Institute of Health and Society (IRSS), Université Catholique de Louvain (UCL), Brussels, Belgium.
authors.forename: Debarati
authors.initials: D
authors.lastname: Guha-Sapir
keywords: Nepal; child nutrition; child stunting; disaster; epidemics; flood