Adherence to the WHO guidelines and associations with socio- demographic factors among Ethiopian preschool children: The SUNRISE study

Background The World Health Organisation (WHO) has called for more evidence on 24-hour movement behaviours from low- and middle-income countries. We examined the proportion of Ethiopian children aged 3.0-4.9 years who met the WHO guidelines on physical activity, sedentary behaviour and sleep for children under the age of five, and the associations between meeting the guidelines and socio-demographic factors. Methods A cross-sectional study was conducted in Adama and Lume Woreda, Ethiopia. Children were recruited through kindergartens in Adama and rural villages in Lume Woreda, Ethiopia. Physical activity and sleep were measured using ActiGraph accelerometer. Sedentary screen time and restrained sitting were parent-reported. Multivariable logistic regression models tested associations between meeting the individual and combined WHO guidelines and socio-demographic factors. Results A total of 430 children participated in the study (mean age 4.2 ± 0.6 years). More than half the children (58.0%) met all the WHO guidelines. A higher proportion met the physical activity (96.1%) and sleep guidelines (91.9%) compared to the sedentary screen time guideline (63.5%). Children who lived in rural areas were more likely to meet the sedentary behaviour (84.6% vs 38.2%, AOR = 7.31; 95%CI: 3.93, 14.02), sleep (98.6% vs 83.8%, AOR = 8.60; 95%CI: 3.55, 23.73) and combined (81.3% vs 30.1%, AOR = 7.41; 95%CI: 4.04, 13.97) guidelines than those who lived in urban areas. Conclusions Children from rural Ethiopia were more compliant with the WHO guidelines than their urban counterparts. Strategies to reduce screen time and promote healthy movement behaviours in urban areas are needed. Further studies with a larger representative sample might provide better insight across the regions of the country.