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Open Access

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Master of Science (M.S.)

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Month Degree Awarded



Adolescent, Nutritional Status, Village-level Factors


Adolescent Nutritional Status and its Association with Village-level Factors in Tanzania

Undernutrition is associated with multiple risk factors operating at different levels, from the individual level to household and community levels. Empirical research has shown that contextual or environmental factors influence nutritional status, but very few studies have examined association between these factors and undernutrition among adolescents. This cross-sectional study used a two-level hierarchical nonlinear model to investigate the association between village-level factors and undernutrition (BMI for Age < 5th percentile of the WHO reference) among a sample of adolescents, (n=670) from 28 villages in Kilosa District, Tanzania. Our hypothesis that contextual factors are associated with undernutrition was supported. The odds of undernutrition were more than twice as high among adolescents from villages with low income expenditure values compared to villages with middle or high income expenditure values (OR: 2.28; CI: 1.429,3.645). Similarly, community food insecurity was a significant predictor of undernutrition (OR: 0.63; CI: 0.467, 0.847; p < 0.05). We also observed a positive association between improved nutritional status and dietary diversity. The multilevel analytic framework employed in this study has demonstrated that both individual-level and community-level characteristics are important predictors of undernutrition in adolescents. Our findings have important policy implications in relation to developing targeted intervention strategies that improve village SES and diversified diets, which in turn may contribute to improved nutritional health for adolescents and their household members.


First Advisor

Lorraine Cordeiro