营养状况是儿童身心发育不当的最重要原因之一。该研究试图根据年龄体重人体测量指数（z评分）评估影响6-59个月儿童营养不良严重程度的因素，并研究了kebeles水平之间儿童营养状况决定因素的差异。以社区为基础，横断面研究设计于2022年10月12日至11月12日进行.通过应用多阶段聚类抽样技术，考虑了397名6-59个月的儿童的异质性，使用了样本。数据通过SPSS输入，并使用R版本3.4.0和STATA14.2统计软件包使用多水平有序逻辑回归模型进行分析，并在5％的显着性水平下进行推断。结果表明,出生间隔≥24个月(OR=1.431253,95%CI1.2213371.6763421,P值=0.008),家庭经济状况中等(OR=16.21466，95%CI1.2214031.423929，P值=0.000)，富裕家庭的经济状况(OR=223.2856，95%CI1.342952.582325，P值=0.000)，失业母亲的就业状况(OR=0.2291348，95%CI0.05295110.9966281，P值=0.049)，无厕所设施（灌木丛场）（OR=0.3163329，95%CI0.18253560.5481975，P值=0.000），家庭成员数量(OR=0.9100682，95%CI0.83134810.9967315，P值=0.042)，母乳喂养<12个月(OR=0.53803,95%CI0.3223150.898135,P值=0.018),父亲的教育程度小学（OR=4.601687，95%CI1.7580092.22053，P值=0.000），父亲的文化程度中学以上（OR=99.65229，95％CI2.5335024.788896，P值=0.000）和地理区域（kebeles）被发现是影响6至59个月儿童营养状况的重要因素。总体变化的15%归因于Kebeles水平，根据两级多级序数逻辑回归，Kebeles水平引起的变异估计值等于0.569，组内相关系数为0.15。由于具有随机系数的响应变量随机截距模型的性质，该数据在预测6-59个月儿童营养不良的严重状况时充分拟合，用于多水平有序逻辑回归模型分析。所以,研究人员建议实施初级保健和营养计划，以适应ItangSpecialWoreda的每个kebeles特征，以保护儿童免受营养缺乏。
Nutritional status is one of the most important causes of improper physical and mental development in children. The study attempts to assess the factors affecting the severity status of children aged 6-59 months\' malnutrition based on the weight-for-age anthropometric index (z-score) and examine between-kebeles-level differences in determinants of the nutritional status of children. A community-based, cross-sectional study design was conducted from October 12 to November 12, 2022. A sample of 397 children aged 6-59 months primary data by applying multi-stage clustered sampling technique was used by considering their heterogeneity. The data were entered by SPSS and analyzed by using R version 3.4.0 and STATA 14.2 statistical software package using a multilevel ordinal logistic regression model and inferences were conducted at a 5% significance level. The results show that birth interval ≥ 24 months (OR = 1.431253, 95% CI 1.221337 1.6763421, P-value = 0.008), economic status of households medium (OR = 16.21466, 95% CI 1.221403 1.423929, P-value = 0.000), economic status of households rich (OR = 223.2856, 95% CI 1.34295 2.582325, P-value = 0.000), employment status of the mother unemployed (OR = 0.2291348, 95% CI 0.0529511 0.9966281, P-value = 0.049), No toilet facility (bush field) (OR = 0.3163329, 95% CI 0.1825356 0.5481975, P-value = 0.000), number of household members (OR = 0.9100682, 95% CI 0.8313481 0.9967315, P-value = 0.042), breastfeeding < 12 months (OR = 0.53803, 95% CI 0.322315 0.898135, P-value = 0.018), educational level of father Primary (OR = 4.601687, 95% CI 1.758009 2.22053, P-value = 0.000), educational level of father Secondary above (OR = 99.65229, 95% CI 2.533502 4.788896, P-value = 0.000) and geographical area (kebeles) were found to be important factors that affect a child\'s nutritional status between 6 and 59 months. 15% of the overall variation is attributable to the Kebeles level, according to two-level multilevel ordinal logistic regressions with estimates of the variation attributable to the Kebeles level equal to 0.569 and an intraclass correlation coefficient of 0.15. Due to the nature of the response variable random intercept model with random coefficients fitted the data adequately in predicting the severity status of children aged 6-59 months\' malnutrition for the multilevel ordinal logistic regression model analysis. So, the researcher recommended that implementing primary health care and nutrition programs that would fit each kebeles\' features in Itang Special Woreda to safeguard children from nutritional deficiency.
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