The magnitude of stunting in the study area is relatively lower than that of national and regional average. From the total stunted (21.82%) children, majority (62%) were male and a study finding by Forsido et al. [20] also found parallel result and identified that male children were 2.6 times [AOR = 2.601, 95% CI (1.681, 4.025)] more likely to become stunted than females [20]. It is attributed that male children are more vulnerable to environmental stress as compared to their counterparts [21, 22].
Household dietary diversity score of the study subjects was one of the variables that significantly (p < 0.041) attributed for child stunting. From the total households 84% scored low dietary diversity and majorities (72.15%) of the total stunted children were from those households. This finding of our study supported by community based cross-sectional survey in 42 countries among 6–23 months old children that found presence of positive association (Adjusted risk ratio = 1.15; 95% CI 1.01, 1.31) between dietary diversity and stunting [23]. Similarly, another cross-sectional survey conducted in Nigeria that intended to assess dietary diversity score and its association with nutritional status and socioeconomic characteristics of children below five years of age. The researchers identified that dietary diversity score has significant (p < 0.03) association with height-to-age of study participants [24].
Conversely, a study finding from Ghana on children 6–36 months of age come up with different conclusion. The study assessed the link between dietary diversity and the nutritional status of children depicted lack of association between high, medium and low household dietary diversity score categories and stunting (AOR = 1.18, 95% [CI] = 0.79, 1.76, p = 0.409) [25]. But present study area is primarily identified as drought vulnerable, food insecure and gets humanitarian emergency supports from the district and being food insecured might be the main reason behind low household dietary diversity score of majority of the households. Yang et al. [26] also reported the existence of strong association between food insecurity of household with lower dietary diversity score and increased prevalence of stunting. Food insecurity of households significantly (p < 0.0001) lowered dietary diversity as compared to food secured households. Moreover, food insecurity of the households associated with low dietary diversity and stunting [26]. Additionally, in our study area the community depends on limited dietary sources particularly maize, cassava and sorghum only.
The other independent predictor that significantly (p < 0.012) associated with child stunting is not feeding breast milk exclusively. Out of 362 study subjects, 80.4% not feed breast milk exclusively and attributed for 91% of stunted children. Children those feed breast milk exclusively are 3.5 times [AOR = 3.54, 95% CI, 1.33, 9.41] more likely to escape stunting as compared to the child that not feed breast milk exclusively for six months. In another way, early introduction of complementary feeding before 6 months of age is also found as a major factor that significantly (p < 0.000) related with child stunting [AOR = 0.08, 99% CI, 0.044, 0.174]. Majority (93.37%) of the study participants started complementary feeding before six months of age and 100% of stunted children are among those who started complementary feeding before 6 months of age. Only 6.63% children initiated complementary feeding timely at 6 month and none of them stunted.
A recent cross-sectional study from Indonesia also found similar result with this finding and portrays that untimely introduction of complementary food associated with stunting of children. Children those get their first food before six months of age are two times more likely become stunted as compared to their counterparts [27]. Likewise, more recent study from Ethiopia also strengthened the idea that early initiation of complementary feeding before six months of age significantly (AOR = 1.58; 95%, CI, 1.07, 2.34) attributed for stunting of children [28].
Eating animal source food during complementary feeding is significantly (p < 0.000) correlated with stunting of the children. Children those not feed animal source food like milk, egg are 0.06 times [AOR = 0.061, 95% CI, 0.016, 0.226] more prone to stunting as compared to those consumed animal source food. In the present study 61.6% of the children not get animal source food during complementary feeding and 96.2% of stunted children are among them. While, only 3.8% of stunted children are from children those get animal source food during their complementary feeding (38.4%). According to Headey et al. [29] intake of animal source food reduced stunting by 3.7–3.8 percentage points. The study conducted on 130,432 children between 6–23 months old from 49 countries on animal source food consumption and its association with stunting. The finding shows that not consuming animal source food significantly increased the magnitude of stunting. Moreover, consuming animal source food significantly (p < 0.047) improved height-for-age of 12–36 months old children [29].