Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Ling Shi

Second Advisor

Teri Aronowitz

Third Advisor

Patrice Nicholas


Childhood undernutrition continues to be one of the largest contributors to overall morbidity and mortality worldwide. Post conflict settings remain hardest hit due to a variety of factors. Maternal education has been linked to improved childhood health outcomes in developing countries, but there is a lack of studies as to the nature of its protective ability in post-conflict settings, with no studies examining whether healthcare service utilization can mediate the associations between maternal education on child undernutrition. The purpose of this study is to examine how maternal education, maternal knowledge of child treatment practices, and healthcare services utilization in Liberia (a post conflict country) affect childhood undernutrition. This research is a secondary data analysis using cross-sectional linked data from the Demographic Health Surveys Phase-V 2007 Liberia Household Survey and the Demographic Health Survey’s Child Survey. A total of 6,584 children under five years of age were included in this analysis. Data analysis guided by the Conceptual Model of Nursing and Population Health was used in this study. Descriptive analyses were performed to examine the characteristics of the sample. The relationship between maternal education and maternal knowledge of child treatment practices and childhood undernutrition was examined using multivariable logistic regression, after adjusting for sociodemographic variables such as mother’s characteristics (age at first parity, exposure to mass media), household characteristics (rural/urban residence, wealth index), and child’s characteristics (gender, age, disease status). Similar analyses were performed to examine the relationship between healthcare service utilization and childhood undernutrition. Mediation analysis was performed to investigate mediation effects of healthcare service utilization on the relation between maternal education and childhood nutrition outcomes.


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