Peer-reviewed article

Prevalence of Malnutrition and Associated Factors Among School Children in Hawella Tula Rural District, Hawassa, Sidama Regional State, Ethiopia: A Cross-Sectional Study.

Bonja F, Erko B, Ali MM, Ashenafi H · 7 Sept 2026

Abstract

Background Malnutrition, including stunting, wasting, and underweight, remains a major public health problem among school-age children in low-resource settings. In Hawella Tula, a sub-city of Hawassa, evidence on the magnitude and determinants of malnutrition is limited and not sufficiently context-specific. This gap constrains the development of targeted and effective interventions. Objective This study aimed to assess the prevalence of malnutrition and its associated factors among primary school children in Hawella Tula, Sidama, Ethiopia. Methods A school-based cross-sectional study was conducted involving 394 primary schoolchildren from June to December 2023. Data were collected using an interviewer-administered questionnaire and anthropometric measurements. Weight and height were measured using a calibrated digital scale and a Seca stadiometer. Nutritional status was assessed using height-for-age Z-scores (HAZ) and BMI-for-age Z-scores (BAZ). Bivariate and multivariable logistic regression analyzes were performed to identify factors associated with malnutrition. Results The prevalence of stunting and underweight was 29.4% (95% CI: 25.1-34.1) and 33.5% (95% CI: 29.0-38.3), respectively. Factors significantly associated with stunting included age > 12 years (AOR = 2.39, 95% CI: 1.43-3.98), family size > 5 (AOR = 2.94, 95% CI: 1.73-4.99), maternal lack of formal education (AOR = 2.88, 95% CI: 1.30-6.38), low household wealth (AOR = 2.28, 95% CI: 1.02-5.12), paternal polygamy (AOR = 2.24, 95% CI: 1.16-4.32), severe food insecurity (AOR = 3.02, 95% CI: 1.46-6.24), poor dietary diversity, and soil-transmitted helminth infection (AOR = 1.97, 95% CI: 1.19-3.25). Conclusion Malnutrition affects nearly one-third of schoolchildren in the study area, indicating a substantial public health concern. Targeted interventions focusing on improving dietary diversity, household food security, parental education, and parasitic infection control are urgently needed.