Demographic and socioeconomic characteristics

Atotal of 414 participated in the study with a response rate of 98.1%. The mean age (± 1SD) of participant children was 24.93 (± 15.57) months for both sexes. More than half, 212 (51.2%) of the children were male, and nearly one-third, 142 (34.3%) of the children were found in the age group 12–23 months. Among the total respondents, 389 (94.0%) were Amhara, and 362 (87.4%) were orthodox religion followers. From the total participant, the first birth order children were 118 (28.5%), and 137 (33.1%) of the children were born in less than 24 months spacing from the preceding siblings. From the total number of mothers, 362 (87.4%) were married, 363 (87.7%) were housewives and 258 (62.3%) of mothers had no formal education (Table 1).

Table 1 Sociodemographic characteristics of children among 6–59 months in Angolela Tera district, North Shoa, Amhara, Ethiopia, 2021 (N = 414)

Health care and environmental characteristics

As it is depicted in Table 2, 185 (44.7%) of children had a normal birth weight of 2.5–4.0 kg and 50 (12.1%) were < 2.5 kg. Of the total of 414children, 183 (46.3%) were fully vaccinated, whereas 166 (42%) of them are not fully vaccinated. Among the total children, 288 (69.6%) had got diarrhea during the 2 weeks of the period before data collection and 245 (59.2%) children were affected by recurrent diarrhea. Out of the total mothers, 251 (60.6%) mothers were delivered at health institutions, whereas 163 (39.4%) were delivered at home. The majority 336 (81.2%) of the mothers had no postnatal care (PNC), visits. Concerning the source of drinking water, 178 (43%) of the households used protected as well as the main source of drinking water (Table 2).

Table 2 Environmental and health care characteristics of children among 6–59 months in Angolalla Tera district, North Shoa, Amhara, Ethiopia, 2021 (N = 414)

Dietary characteristics

In terms of breastfeeding, the majority of 380 mothers (91.8%) were breastfeeding their babies. one hundred and seventy-six children (46.3%) started breastfeeding, within the first hour. Of the 380 infants’ total breastfeeding, 294 (77.3%) were colostrum. Of the 414 babies in total, 134 (32.4%) received prenatal diet.

Babies who were breastfed for less than 12 months were 167 (43.9%), 12–24 months were 157 (41.3%), and over 24 months were 56 (14.8%). The majority of the 281 respondents (67.9%) were initiated on parallel feeds at 6 months. In terms of nutrition, the mothers who used the cup to feed their babies were 140 (33.8%) and 138 (33.3%) used the hand to feed their babies (Table 3).

Table 3 Dietary characteristics of children among 6–59 months in Angolalla Tera district

Prevalence of pneumonia among children

Of 414 children’s participated in the study, 231 (55.8%) of them had a history of cough during the time of the study, 125 (30.2%) of children had difficulty of breathing and 102 (24.6%) had fast breathing at the time of the study. Among a total of 414 children, 259 (62.6%) had a fever, the overall prevalence of under-five children’s pneumonia during the study was 24 (5.8%) (Fig. 1).

Fig. 1
figure 1

Prevalence of pneumonia among 6–59 months children in Angolalla Tera district

Multivariate logistic regression

Data were analyzed using binary logistic regression analysis. Statistical associations were checked by 95% CI and odds ratio. Those variables which had a p value less than 0.2 in the binary logistical regression analysis were eligible for multivariable logistic regressions. Finally, the adjusted odds ratio was checked, and the significant variables p value < 0.05 were considered as associated factors for pneumonia.

Based on the multivariable logistic regression analysis of this study, child male sex, having a family toilet, children having fever in the last 2 weeks, maternal ANC follows up and children with stunted were associated with pneumonia. Male children were 4.1 times (AOR = 4.1, 95% CI 1.49–11.8) more likely to develop pneumonia.

This finding suggests that children who had stunting were 2.9 times (AOR = 2.9, 95% CI 1.16–7.60) more likely to develop pneumonia as compared to children who had no stunting. Also, this finding indicates that children who had a fever in the last 2 weeks were three times (AOR = 3.02, 95% CI 1.23–7.40) more likely to develop pneumonia as compared to children who had no fever in the last 2 weeks. Similarly mothers who had no ANC follow-up were two times (AOR = 2.07, 95% CI 1.16–7.6) more likely to develop pneumonia as compared to children who had no ANC follow-up. The family who has not to used latrine were three times (AOR = 3.12, 95% CI 1.09–8.94) more likely to develop pneumonia than those who have used latrine (Table 4).

Table 4 Multivariate logistic regression analysis factors associated with pneumonia among under-five children

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