Background: Stunting and anemia are a long-standing public health challenges which adversely affects the cognitive development and physical wellbeing of children in low income settings. The aim of this study was to assess the prevalence and associated factors of stunting and anemia among 6-23 months old children in Damot Sore District, Southern Ethiopia.

Methods: Cross-sectional survey was conducted among 477 children aged 6 – 23 months, which were living in Damot Sore District, in April 2017. A multistage sampling technique was used. Villages were randomly selected and systematic random sampling method was used to select study participants. Data on socio-demographic, anthropometric, dietary, blood samples for hemoglobin were collected. Data were entered into EPI Data V. 3.1 and exported into SPSS Version 21.0 for analysis. A principal component analysis (PCA) was done to generate wealth score of households.  Binary logistic regression model was used to identify factors associated with the outcome variables (stunting and anemia) separately, those variables having less than a p-value of 0.25 were chosen as candidate for multivariable analyses and finally multivariable logistic regression model was used to identify independent variables of each outcomes, with statistical significance set at p<0.05 (95% confidence interval (CI)).

Results: Out of 477 children studied, 31.7% were stunted and 52% were anemic. In the multivariable analyses, the number of under five children within a household (AOR=4.18, 95%CI: 2.65–6.57), drinking water from unsafe source (AOR=4.08, 95%CI: 1.33-12.54) and anemia (AOR=3.13, 95%CI 2.00-4.92) were factors significantly associated with stunting. On the other hand, independent variables of anemia were early initiation of complementary feeding (AOR=2.96, 95%CI: 1.23–4.85), poor dietary diversity (AOR=2.95, 95%CI: 1.78–4.91), poor breast feeding practice (AOR=2.94, 95% CI: 1.63–5.32) and stunting (AOR=3.65, 95%CI: 2.15–6.19).

Conclusion: This study revealed higher level of stunting and anemia among children aged 6 – 23 months than WHO (world health organization) criteria of public health importance. Sustainable promotion of diversified diet, optimal complementary feeding, optimal and complementary breast feeding practices, improving sanitation infrastructure are measures needed to tackle these severe public health challenges.

Keywords: Stunting, Anemia, Southern Ethiopia