This study revealed that magnitude of stunting among children aged 6–59 months at pastoral woredas of Bale zone was 43.7%. This is higher than finding from north-eastern Ethiopia (32.2%)[11], and the national prevalence (40%) [12] Uganda (33.3%)[13], Somalia(31%)[14]. However, the apparent prevalence of stunting in the current study area nearly comparable with finding in Tigray Region, Afar Region (46%) [12] and Sidama zone of South Ethiopia (45.8%) [15] and Bule Hora district, South Ethiopia (45.9%) [16], SNNPR’s (44%) and Amhara Region [12]. These considerable variations might be due difference in socio-economic and instantly access to comprehensive health services, topographical difference and cultural difference of the study areas.
Despite some considerable improvement in observed trends of malnutrition in last 15 successful years in Ethiopia, this descriptive study typically found that the proportion of stunting still remains a severe public health issue. According to the published report of the social and economic impacts of children under nutrition study in Ethiopia in 2009, Ethiopia undoubtedly lost 16.5% of GDP and 16% of all school repetition in primary school due to stunting [15]. Hence, this high magnitude of stunting implies that due attention has to be given to young children since stunting is associated with poor physical growth and prevent proper brain development which results in poor cognitive abilities, less schooling, high school dropout and country GDP loss [15].
Compared to girls, the likelihood of stunting was higher among boys. Similarly, different studies done in different parts of Ethiopia and studies done in Nairobi, Kenya and Democratic Republic of Congo have reported that under-five male children are more likely to become stunted than their female counterparts [17–20].
This could be because boys are more influenced by environmental stress than girls. Hence, boys are expected to display the impact of chronic under nutrition due to repeated infections and exposure to different pollutants [18, 20].
This study indicated that maternal educational status was inversely associated with stunting. This was consistent with reports in Nepal [21]India [22], Nigeria [23], Tanzania [24], Kenya [25], Somalia [14, 26], and Ethiopia [27]. The current study also found maternal education increase knowledge about their children’s health and nutrition, which can have impact on prevention of childhood malnutrition.
This study indicated that children living in households that have low monthly income were more likely to develop stunting than children living in high monthly income. This finding was consistent with the study done Nepal [21], India [22], Iran [28], Indonesia[29], and Ethiopia[15]. This could be due to the fact that, low income levels of households limits the kinds and the amounts of food available for consumption and will not have access to health care and get quality food.
This study found that stunting among children who were fed colostrum (First Breast milk) were less likely than among those who were not fed colostrum. This finding is congruent with findings of studies conducted in Gojjam, Ethiopia [18], in India[22],Nepal [21]and Somali regional state[2 6].This is due to that first milk/colostrum can protect children from different diseases such as diarrhea and pneumonia and it also indicates the importance of colostrum feeding to tackle childhood malnutrition.
Current study revealed that bottle-feeding as a risk factor of childhood stunting. This finding is congruent with findings from Gojjam [19], and Somali region of Ethiopia [30]Somali regional state (26), Gurage Zone [31]. This could be due to a high prevalence of bottle feeding in the current study area and t bottle feeding can increase repeated infection of children by diarrhea due to that bottle is easily contaminated and inappropriate for child feeding.
Growth monitoring is the process of following the growth rate of a child in in order to assess growth adequacy and identify faltering early through frequent anthropometric measurement. The current study found that children who had growth monitoring follow up were less likely stunted. This finding indicates the needs of growth monitoring follow up for under-five children to address the multiple causal factors impacting on a child’s growth and development.
In this study, using unimproved source of for drinking water showed significant association with stunting. This was consistent with findings from Nigeria[23], and Somali Regional State of Ethiopia [26]. This might be due to that under five children were children were risk group for a high rate of parasitic infection that simultaneously predisposes to malnutrition, hidden hunger, and other chronic and acute infectious diseases.